Report text available as:

  • TXT
  • PDF   (PDF provides a complete and accurate display of this text.) Tip ?
                                                       Calendar No. 128
113th Congress                                                   Report
                                 SENATE
 1st Session                                                     113-71

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



 
  DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND 
               RELATED AGENCIES APPROPRIATION BILL, 2014
                                _______
                                

                 July 11, 2013.--Ordered to be printed

                                _______
                                

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

                                 REPORT

                         [To accompany S. 1284]

    The Committee on Appropriations reports the bill (S. 1284) 
making appropriations for Departments of Labor, Health and 
Human Services, and Education, and related agencies for the 
fiscal year ending September 30, 2014, and for other purposes, 
reports favorably thereon and recommends that the bill do pass.

                     Amounts in new budget authority
Total of bill as reported to the Senate.............    $783,365,379,000
Amount of 2013 appropriations\1\\2\.................     757,440,498,000
Amount of 2014 budget estimate......................     787,803,163,000
Bill as recommended to Senate compared to--
    2013 appropriations.............................     +25,924,881,000
    2014 budget estimate............................      -4,437,784,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public
  Law 112-25.
\2\Includes emergency funding of $825,000,000 in the Disaster Relief
  Appropriations Act, 2013 (division A of Public Law 113-2).



                                CONTENTS

                              ----------                              
                                                                   Page

List of Abbreviations............................................     4
Summary of Budget Estimates and Committee Recommendations........     8
    Overview.....................................................     8
    Reducing Healthcare Costs....................................     8
    Early Childhood Care and Education...........................     9
    Improving Fiscal Accountability..............................    10
    Promoting Policy Reform......................................    11
    Prevention...................................................    11
    Reducing Violence--Now is the Time...........................    12
    Assisting People With Disabilities...........................    13
    Helping America's Workers....................................    13
    Other Highlights of the Bill.................................    14
Title I: Department of Labor:
    Employment and Training Administration.......................    16
    Employee Benefits Security Administration....................    27
    Pension Benefit Guaranty Corporation.........................    27
    Wage and Hour Division.......................................    28
    Office of Labor-Management Standards.........................    29
    Office of Federal Contract Compliance Programs...............    29
    Office of Workers' Compensation Programs.....................    30
    Occupational Safety and Health Administration................    32
    Mine Safety and Health Administration........................    33
    Bureau of Labor Statistics...................................    34
    Office of Disability Employment Policy.......................    35
    Departmental Management......................................    36
    General Provisions...........................................    39
Title II: Department of Health and Human Services:
    Health Resources and Services Administration.................    41
    Centers for Disease Control and Prevention...................    58
    National Institutes of Health................................    83
    Substance Abuse and Mental Health Services Administration....   111
    Agency for Healthcare Research and Quality...................   119
    Centers for Medicare and Medicaid Services...................   122
    Administration for Children and Families.....................   128
    Administration for Community Living..........................   140
    Office of the Secretary......................................   145
    General Provisions...........................................   155
Title III: Department of Education:
    Education for the Disadvantaged..............................   158
    School Readiness.............................................   161
    Impact Aid...................................................   162
    School Improvement Programs..................................   163
    Indian Education.............................................   168
    Innovation and Improvement...................................   169
    Safe Schools and Citizenship Education.......................   176
    English Language Acquisition.................................   177
    Special Education............................................   178
    Rehabilitation Services and Disability Research..............   181
    Special Institutions for Persons With Disabilities:
        American Printing House for the Blind....................   185
        National Technical Institute for the Deaf................   185
        Gallaudet University.....................................   186
    Career, Technical, and Adult Education.......................   186
    Student Financial Assistance.................................   188
    Student Aid Administration...................................   191
    Higher Education.............................................   192
    Howard University............................................   199
    College Housing and Academic Facilities Loans Program........   200
    Historically Black College and University Capital Financing 
      Program Account............................................   200
    Institute of Education Sciences..............................   201
    Departmental Management:
        Program Administration...................................   203
        Office for Civil Rights..................................   204
        Office of the Inspector General..........................   205
    General Provisions...........................................   205
Title IV: Related Agencies:
    Committee for Purchase From People Who Are Blind or Severely 
      Disabled...................................................   207
    Corporation for National and Community Service...............   207
    Corporation for Public Broadcasting..........................   212
    Federal Mediation and Conciliation Service...................   212
    Federal Mine Safety and Health Review Commission.............   212
    Institute of Museum and Library Services.....................   213
    Medicaid and CHIP Payment and Access Commission..............   214
    Medicare Payment Advisory Commission.........................   214
    National Council on Disability...............................   214
    National Health Care Workforce Commission....................   215
    National Labor Relations Board...............................   215
    National Mediation Board.....................................   215
    Occupational Safety and Health Review Commission.............   216
    Railroad Retirement Board....................................   216
    Social Security Administration...............................   217
Title V: General Provisions......................................   222
Compliance With Paragraph 7, Rule XVI of the Standing Rules of 
  the 
  Senate.........................................................   224
Compliance With Paragraph 7(c), Rule XXVI of the Standing Rules 
  of the Senate..................................................   225
Compliance With Paragraph 12, Rule XXVI of the Standing Rules of 
  the Senate.....................................................   225
Budgetary Impact of Bill.........................................   232
Comparative Statement of New Budget Authority....................   233

                         LIST OF ABBREVIATIONS

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

       SUMMARY OF BUDGET ESTIMATES AND COMMITTEE RECOMMENDATIONS

    For fiscal year 2014, the Committee recommends total budget 
authority of $783,365,379,000 for the Departments of Labor, 
Health and Human Services, and Education, and Related Agencies. 
This amount includes $164,330,000,000 in current year 
discretionary funding and $1,253,000,000 in cap adjustments for 
healthcare fraud and abuse and for program integrity at the 
Social Security Administration, in accordance with the 
allocation for this bill.
    Fiscal year 2013 levels cited in this report reflect the 
enacted amounts in Public Law 113-6, the Consolidated and 
Further Continuing Appropriations Act, 2013. They do not 
reflect the March 1, 2013, sequester of funds required under 
Public Law 112-25 (the Budget Control Act of 2011) or agency 
transfers and reprogrammings that are allowed in Public Law 
113-6 and that have occurred since that law's enactment. Where 
applicable, the fiscal year 2013 levels include emergency 
funding in the Disaster Relief Appropriations Act, 2013.

                                OVERVIEW

    The Labor, Health and Human Services, and Education, and 
Related Agencies appropriations bill constitutes the largest of 
the nondefense Federal appropriations bills. But even more 
noteworthy than the size of the bill is the breadth of the 
critical services that are funded by this legislation, which 
range from medical research to job training, from home energy 
assistance to mental health, from early childhood care and 
education to the operations of the Social Security 
Administration.
    Balancing the competing priorities in this bill is always 
difficult, but especially so at a time when discretionary 
spending as a share of the overall economy has dropped to 
historically low levels. The Committee has examined all of the 
programs in this bill and recommended what it believes is an 
appropriate level for each of them, within the limits of the 
bill's allocation. Details are included in the report.
    Several themes permeate the Committee's recommendation, 
described below. All funding comparisons are to fiscal year 
2013 levels.

                       REDUCING HEALTHCARE COSTS

    The Nation's fiscal health is inextricably linked to our 
ability to curb the cost of healthcare. The Affordable Care 
Act, enacted in 2010, is vital to that effort. But this 
appropriations bill also plays a critical role--by supporting 
the ACA's implementation, promoting efforts to prevent chronic 
diseases, and increasing funding for medical research.
    Implementing the Affordable Care Act.--The ACA has already 
resulted in historic savings for the Federal Government and for 
American families. More than 6.3 million Medicare beneficiaries 
have saved more than $6,100,000,000 on prescription drugs. In 
2012 alone, consumers also saved $2,000,000,000 because of 
provisions to review premium rates and to require insurers to 
provide rebates if they do not spend at least 80 percent of 
premiums on care, rather than overhead. In 2013, some 8.5 
million Americans with health coverage will receive rebates, 
averaging $100 per family. And the law's provisions have 
extended the life of the Medicare Trust Fund by 8 years.
    Fiscal year 2014 begins on the same day the ACA will open 
enrollment for new health coverage in the Health Insurance 
Marketplace, which will for the first time offer people a 
single place where they can compare the costs and benefits of 
different health insurance plans and choose the one that fits 
their needs.
    The Committee includes $5,217,357,000 for Program 
Management at the Centers for Medicare and Medicaid Services, 
the lead agency with responsibility for overseeing the ACA. CMS 
will use this funding to run the Marketplace, ensure compliance 
with the Patient's Bill of Rights and other insurance market 
rules, and implement additional quality measures to improve 
healthcare services for all Americans.
    Alzheimer's Disease.--The total payments for healthcare, 
long-term care, and hospice for people with Alzheimer's and 
other dementias are projected to increase from $203,000,000,000 
in 2013 to a staggering $1,200,000,000,000 in 2050.
    Without a medical breakthrough to prevent, slow, or stop 
the disease, Medicare and Medicaid costs related to Alzheimer's 
could rise an estimated 500 percent. Research is desperately 
needed to bring those costs under control. Therefore, the bill 
includes a significant increase for the National Institute on 
Aging, the NIH Institute with the primary responsibility for 
preventing, treating, and curing Alzheimer's disease.
    The Committee recommendation also includes $20,000,000 for 
a new Alzheimer's Disease Initiative consisting of $10,500,000 
to strengthen dementia-capable long-term services and supports, 
$4,200,000 for an outreach campaign to assist caregivers of 
individuals with Alzheimer's disease, and $5,300,000 to train 
healthcare providers on how to recognize the signs and symptoms 
of Alzheimer's and manage the disease.

                   EARLY CHILDHOOD CARE AND EDUCATION

    High-quality early childhood care and education has been 
proven to have positive, lasting effects for children and 
families. It also supports the Nation's long-term economic 
security by preparing our next generation of workers, 
entrepreneurs, and business leaders. The Committee provides a 
combined increase of $2,561,394,000 for the key early childhood 
care and education programs in this bill: Head Start, the Child 
Care and Development Block Grant, and Preschool Development 
Grants. Together, they address the entire age range of birth 
through 5.
    Head Start.--The Committee recommendation includes 
$9,621,070,000, a $1,635,030,000 increase, for Head Start. This 
includes a $1,430,376,000 increase to expand Early Head Start, 
including the creation of new Early Head Start-Child Care 
Partnerships, to serve children and families from before birth 
through age 3.
    Child Care and Development Block Grant.--The Committee 
recommendation includes $2,500,000,000, a $176,344,000 
increase, for CCDBG. This includes a $110,000,000 increase to 
improve the quality of the child care workforce and health and 
safety standards.
    Preschool Development Grants.--The Committee bill includes 
$750,000,000 for a new program to support States' efforts to 
expand or create high-quality preschool systems for 4-year-olds 
from low- and moderate-income families.

                    IMPROVING FISCAL ACCOUNTABILITY

    The Committee has an obligation to promote the fiscal 
accountability and effective use of taxpayer dollars. This bill 
provides funding for several efforts to combat fraud, waste, 
and abuse within Federal programs.
    Healthcare Program Integrity.--Fraud committed against 
Federal healthcare programs diverts critical resources from 
services that are intended for some of the Nation's most 
vulnerable populations. The Committee includes $640,000,000 for 
HCFAC activities at CMS, more than double the fiscal year 2013 
level of $309,170,000. Every $1 spent on these activities 
returns approximately $7.90 to the Treasury. At that rate, the 
level in this bill would return more than $5,000,000,000.
    Social Security Program Integrity.--The Committee includes 
$1,197,000,000, a $440,948,000 increase, for Social Security 
program integrity activities, including continuing disability 
reviews [CDRs] and SSI redeterminations. CDRs and 
redeterminations save $9 and $5, respectively, for each $1 
spent by reducing waste, fraud, abuse, and improper payments in 
the Social Security, Medicare, and Medicaid programs. Combined, 
the Committee recommendation for Social Security program 
integrity activities is estimated to save $9,600,000,000 over 
10 years.
    Unemployment Insurance Program Integrity.--The Committee 
recommendation includes $80,000,000, an increase of 
approximately $20,000,000, to conduct reemployment and 
eligibility assessments [REAs] and UI improper payment reviews. 
This level is projected to save State UI trust funds an 
estimated $315,000,000 through REAs by helping claimants exit 
the UI program faster and avoid exhausting their benefits.
    Protecting Students and Taxpayers.--The Committee bill 
includes a new provision prohibiting colleges and universities 
from spending Federal educational funding on marketing, 
recruitment, and advertising. This reform will ensure that 
Federal resources are targeted at educating students as opposed 
to online advertisements and aggressive recruiting activities, 
so that both students and taxpayers receive a good return on 
their investment.
    Spending on Conferences.--The Committee helps prevent 
excessive spending on conferences and other administrative 
expenses by requiring departments, agencies, boards, and 
commissions funded in this bill to report to Inspectors General 
or senior ethics officials on the costs and contracting 
procedures involved in any conference that costs more than 
$100,000.

                        PROMOTING POLICY REFORM

    This bill launches or continues several initiatives that 
will leverage policy reform and transform key Federal services.
    Race to the Top--College Affordability and Completion.--The 
Committee includes $250,000,000 to support a new Race to the 
Top program focused on college affordability and completion. 
Funding will incentivize States to reduce costs for students 
and families and improve academic outcomes.
    Public Access to Federally Funded Research.--In fiscal year 
2009, Congress required NIH to improve the public's ability to 
access taxpayer-funded research by means of an online NIH 
repository. This effort has been highly successful. The 
Committee includes a new general provision that extends the 
requirement to other agencies funded in this bill.
    Investing in Innovation.--The Committee bill provides 
$170,000,000 for the Investing in Innovation education program, 
which allows grantees to develop and test promising new ideas 
and replicate programs that are successful.
    Accelerating Cures.--The Committee bill includes 
$50,000,000, five times the fiscal year 2013 level, for the 
Cures Acceleration Network, an NIH initiative intended to help 
speed the translation and application of discoveries that have 
shown signs of success at the laboratory level but have not 
advanced far enough to attract significant investments from the 
private sector.
    Performance Partnerships for Disconnected Youth.--The 
Committee bill includes a new authority called Performance 
Partnerships that will provide States and local communities 
with unprecedented flexibility to improve services for 
disconnected youth. Up to 13 States and/or local communities 
will be allowed to combine funding that they receive through 
various programs within this bill for these pilot projects.

                               PREVENTION

    Nearly three-quarters of all healthcare costs are 
attributable to chronic diseases, the majority of which are 
preventable. This bill promotes prevention efforts by 
supporting implementation of the ACA, which will enable 
millions of newly insured Americans to receive preventive 
screenings; providing discretionary funding for programs such 
as childhood immunizations and cancer screenings; and 
allocating the Prevention and Public Health Fund, which will 
total $1,000,000,000 in fiscal year 2014.
    Key prevention programs listed below are either funded in 
this bill or through transfers from the PPH Fund.
    Community Transformation Grants.--The Committee includes 
$290,000,000, an increase of $143,660,000, for evidence-based 
public health interventions to reduce obesity and smoking and 
make preventive services more accessible.
    Childhood Immunizations.--The Committee includes 
$579,457,000 for immunization programs. Immunization saves 
$10.20 in direct medical costs for every $1 invested.
    Smoking Prevention.--The Committee includes $202,892,000 
for the Office of Smoking and Health at CDC. This funding, an 
increase of $34,698,000, will continue the successful media 
campaign, ``Tips From a Former Smoker,'' and expand State quit-
lines.
    Diabetes Prevention Program [DPP].--The Committee includes 
$10,000,000 for the DPP, a set of lifestyle interventions that 
has been proven to reduce the risk of developing diabetes by 58 
percent in individuals at high risk.
    Elder Falls.--In 2010, 2.3 million older adults were 
treated in emergency departments after a fall, with more than 
662,000 of these patients being hospitalized. Many of these 
falls are preventable with lifestyle interventions and 
appropriate physical supports. In a new initiative, the 
Committee includes $10,000,000 to research and implement 
evidence-based approaches to preventing elderly falls.

                   REDUCING VIOLENCE--NOW IS THE TIME

    The mass shootings last year at an Aurora, Colorado, movie 
theater and at Sandy Hook Elementary School in Newtown, 
Connecticut, raised public awareness about the problems of 
violence and mental illness in our communities as perhaps never 
before.
    There are approximately 30,000 firearm-related homicides 
and suicides in the United States each year, and almost one-
quarter of 14- to 17-year-olds have witnessed a shooting in 
their lifetime. Research shows that exposure to community 
violence can impact children's mental health and development 
and can substantially increase the likelihood that these 
children will later commit violent acts themselves. 
Unfortunately, less than half of children and adults with 
diagnosable mental health problems receive the treatment they 
need.
    Addressing these challenges will require complex, 
comprehensive solutions that are beyond the scope of any single 
school, community, State, or set of laws. But funding provided 
in this bill to prevent violence, increase access to mental 
health treatment, and improve school safety can play an 
important role.
    Mental Health Services.--The Committee bill includes 
$119,000,000 in new funding to increase access to mental health 
services. This includes: $95,000,000 for the administration's 
Now Is the Time initiative; $15,000,000 for Mental Health First 
Aid programs that help identify and respond to individuals 
showing signs of mental illness; $40,000,000 for grants to 
States to reduce violence in schools and increase the number of 
students receiving mental health services; and $40,000,000 to 
address shortages in the behavioral health workforce. The 
Committee also includes $24,187,000 for a new Mental Health 
Block Grant set-aside for evidence-based programs that serve 
individuals with early serious mental illness.
    Safe and Healthy Schools.--Research shows that safe, 
positive school environments can help reduce unhealthy student 
behavior, increase academic achievement, and counter the 
effects that violence can have on students. The Committee bill 
includes $195,191,000 for specific activities to improve 
learning conditions in the Nation's schools. This amount 
includes $50,000,000 for a new School Climate Transformation 
Grants program, which will train school staff to implement 
evidence-based strategies to improve school climate; 
$25,000,000 to help school districts develop, implement, and 
improve their emergency management plans; $25,000,000 for 
Project Prevent, which will help schools in troubled 
communities break the cycle of violence; and up to $8,000,000 
for Project SERV, which offers education-related services 
following a violent or traumatic event.
    Tracking Violent Deaths.--The National Violent Death 
Reporting System [NVDRS] is an 18-State surveillance system 
that pulls together information on violent deaths with the aim 
of developing effective interventions and preventive measures. 
The Committee bill includes $18,465,000, an increase of 
$15,000,000, to expand NVDRS to additional States and 
communities.
    Public Health Research.--Behind motor vehicle injuries, 
firearm injuries are the second leading cause of injury and 
mortality in the United States. The Committee bill includes 
$10,000,000 to build the public health research base on how to 
reduce the threat of firearm-related violence.

                   ASSISTING PEOPLE WITH DISABILITIES

    Special Education.--The Committee bill provides 
$11,722,946,000, an increase of $168,246,000, under section 611 
of part B Grants to States for educating students with 
disabilities between the ages of 3 and 21. The bill also 
includes $462,710,000, an increase of $20,886,000, to support 
statewide systems of coordinated and early intervention 
services for children with disabilities 2 years old and 
younger, as well as their families.
    Promoting Readiness of Minors in SSI.--The Committee bill 
continues the PROMISE program, an interagency effort to improve 
outcomes for children, and the families of children, receiving 
SSI benefits. This program, which will award its first grants 
in late fiscal year 2013, will improve services for these 
transition-aged youth by encouraging State-level innovation and 
facilitating better coordination that can help young people 
with disabilities enter and succeed in competitive, integrated 
employment.
    Special Education Research.--The bill includes $69,905,000, 
an increase of $20,099,000, to support research on how children 
and adults with disabilities learn and how best to meet their 
educational needs.
    Assistive Technology.--The Committee bill provides 
$37,500,000, an increase of $4,730,000, for activities to 
improve occupational and educational opportunities and the 
quality of life for people with disabilities through assistive 
technology.

                       HELPING AMERICA'S WORKERS

    Job Training.--The Committee recommendation includes 
$2,683,766,000, an increase of $85,658,000, for Workforce 
Investment Act Grants to States to provide job training skills 
and assistance to low-skilled adults, dislocated workers, and 
low-income youth with barriers to employment.
    Paid Leave for Workers.--The Committee bill includes 
$5,000,000 to support a new State Paid Leave Fund. The Fund 
will provide planning and implementation grants to States that 
wish to establish paid leave programs and provide benefits to 
workers who need to take time off for reasons covered under the 
Family and Medical Leave Act.
    Veterans Employment and Training.--The Committee 
recommendation includes $300,518,000, an increase of 
$36,611,000, to expand employment services to transitioning 
servicemembers, veterans with disabilities, and their spouses 
and caregivers.
    Protecting Whistleblowers.--The Committee recommendation 
includes $567,012,000 for OSHA and targets a $6,042,000 
increase for its enforcement of whistleblower laws. These laws 
provide important protections for workers who raise issues in 
their workplace about practices that could impact fellow 
employees or the public.
    Preventing Misclassifications.--The Committee 
recommendation includes an increase of $14,000,000 to address 
the misclassification of workers as independent contractors. 
Misclassifications deny workers their rights to unemployment 
benefits, overtime pay, and other benefits, and also reduce 
revenue to the Unemployment, Social Security, and Medicare 
trust funds, as well as to the Treasury.

                      OTHER HIGHLIGHTS OF THE BILL

    Pell Grants.--The Committee bill maintains the 
discretionary portion of the maximum Pell grant award level at 
$4,860 for the 2014-2015 school year. Combined with mandatory 
funding, the total maximum award will rise by $140 to $5,785.
    National Institutes of Health.--The Committee bill provides 
$30,946,776,000, an increase of $307,127,000, to fund 
biomedical research at the 27 Institutes and Centers that 
comprise NIH.
    This level will allow NIH to allocate $40,000,000 for the 
proposed new Brain Research through Application of Innovative 
Neurotechnologies [BRAIN] Initiative.
    Community Health Centers.--The Committee bill includes 
$1,574,606,000 for CHCs. Combined with mandatory funding 
provided in the ACA, the fiscal year 2014 program level for 
CHCs is $3,774,606,000, an increase of $700,000,000.
    Title I (Education for the Disadvantaged).--The Committee 
includes $14,612,425,000, an increase of $125,000,000, for 
title I grants to LEAs for improving education for low-income 
students. These funds support 90 percent of the 14,000 school 
districts across the Nation.
    Children's Hospitals Graduate Medical Education.--The 
Committee recommendation includes $267,313,000 for CHGME, the 
same level as in fiscal year 2013. The Committee rejects the 67 
percent cut to this program proposed by the administration.
    Low Income Home Energy Assistance.--The Committee 
recommendation includes $3,614,729,000 for LIHEAP and rejects 
the administration's proposed cut to the program.
    Community Services Block Grant.--The Committee 
recommendation rejects the administration's proposed cut to the 
CSBG and includes $676,003,000 for this program, the same as 
the fiscal year 2013 funding level.
    AIDS Drug Assistance Program.--The Committee recommends 
$943,299,000 for ADAP, an increase of $46,797,000.
    Promise Neighborhoods.--Inspired by the Harlem Children's 
Zone program, Promise Neighborhoods supports cradle-to-career 
services designed to improve educational outcomes for students 
in distressed neighborhoods. The Committee includes $56,754,000 
for this program.
    Unaccompanied Alien Children.--The Committee includes 
$494,597,000, a $119,509,000 increase, to provide care and 
services for unaccompanied alien children while they await 
placement with a sponsor and adjudication of their immigration 
status. Such children are often fleeing abuse, trafficking, or 
other dangerous situations in their home country,
    Social Security Administration.--The Committee 
recommendation includes $11,965,473,000, a $533,578,000 
increase, for SSA's administrative expenses. This includes a 
$440,948,000 increase for program integrity activities and a 
$92,630,000 increase in core administrative expenses for SSA to 
keep pace with an aging population and persistently record-high 
workloads.
    TRIO.--The bill includes $849,932,000, an increase of 
$11,680,000, to help low-income and first generation college 
students plan, prepare for, and succeed in college through the 
TRIO programs.

                                TITLE I

                          DEPARTMENT OF LABOR

                 Employment and Training Administration

                    TRAINING AND EMPLOYMENT SERVICES

Appropriations, 2013\1\\2\..............................  $3,211,756,000
Budget estimate, 2014...................................   3,387,405,000
Committee recommendation................................   3,264,213,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.
\2\Includes emergency funding of $25,000,000 in the Disaster Relief 
Appropriations Act, 2013 (division A of Public Law 113-2).

    The Training and Employment Services account provides 
funding primarily for activities under WIA, and 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 2014 will support the 
program from July 1, 2014, through June 30, 2015. A portion of 
this account's funding, $1,772,000,000, is available on October 
1, 2014, for the 2014 program year.
    Any reference in this title of the report to the 
``Secretary'' or the ``Department'' shall be interpreted to 
mean the Secretary of Labor or the Department of Labor, 
respectively, unless otherwise noted.
    The Committee encourages the Department to continue to work 
with other Federal agencies to align and streamline employment 
and training services.
    The Committee encourages the Department to use grant funds 
and training programs to facilitate solutions to address the 
shortage in the STEM workforce, such as laboratory 
professionals. STEM fields are central to U.S. economic 
competitiveness and growth, and the Committee urges the 
Department to continue to address gaps in the Nation's approach 
to strengthening the STEM pipeline.

Grants to States

    The Committee recommends $2,683,766,000 for Training and 
Employment Services Grants to States.
    As proposed in the budget request, the Committee retains 
bill language that allows a local workforce board to transfer 
up to 30 percent between the adult and dislocated worker 
assistance State grant programs, if such transfer is approved 
by the Governor. In addition, a local board may award a 
contract to an institution of higher education or other 
eligible training provider if the board determines that it 
would facilitate the training of multiple individuals in high-
demand occupations, if such contract does not limit customer 
choice.
    The Committee recommendation modifies current law regarding 
the amount of WIA State grant funding that may be set aside by 
Governors. As proposed in the budget request, the Committee 
includes bill language authorizing the Governor of a State to 
reserve not more than 7.5 percent of the funds allotted to a 
State through the WIA State grant programs for statewide 
workforce investment activities. The current maximum set-aside 
in each State is 5 percent. The funding increase provided for 
the WIA State grant programs in this bill will allow the set-
aside to grow without reducing funds provided to local areas.
    The Committee notes that GAO Report 12-97, dated January 
19, 2012, found that one of the six identified characteristics 
of effective local public and private workforce partnerships 
was leadership. The Committee encourages the Department to 
support States, in cooperation with local elected officials and 
local workforce board chairs, in the development of high-
quality standards for workforce development leaders and to 
support professional development of such leaders based on the 
standards.
    Adult Employment and Training.--For adult employment and 
training activities, the Committee recommends $791,644,000.
    This program is funded by formula to States and further 
distributed to local workforce investment areas through one-
stop centers. 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.
    The Committee commends the Department for employment 
outcomes among adult exiters who receive on-the-job training 
and encourages the Department to continue supporting these 
efforts and increase participation.
    Funds made available in this bill for adult employment and 
training support activities in program year 2014, which occurs 
from July 1, 2014, through June 30, 2015. The bill provides 
that $79,644,000 is available for obligation on July 1, 2014, 
and that $712,000,000 is available on October 1, 2014. Both 
categories of funding are available for obligation through June 
30, 2015.
    Youth Training.--For youth training activities, the 
Committee recommends $846,632,000.
    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 activities in program year 
2014, which occurs from April 1, 2014, through June 30, 2015.
    Dislocated Worker Assistance.--For dislocated worker 
assistance, the Committee recommends $1,045,490,000.
    This program is a State-operated effort that provides core 
and intensive services, training, and support to help 
permanently separated workers return to productive unsubsidized 
employment. In addition, States must use statewide reserve 
funds for rapid response assistance to help workers affected by 
mass layoffs and plant closures. States must also use these 
funds to carry out additional statewide employment and training 
activities such as providing technical assistance to certain 
low-performing local areas, evaluating State programs, and 
assisting with the operation of one-stop delivery systems. 
States may also use funds for implementing innovative incumbent 
and dislocated worker training programs.
    Funds made available in this bill support activities in 
program year 2014, which occurs from July 1, 2014, through June 
30, 2015. The bill provides that $185,490,000 is available for 
obligation on July 1, 2014, and that $860,000,000 is available 
on October 1, 2014. Both categories of funding are available 
for obligation through June 30, 2015.

Federally Administered Programs

    Dislocated Worker Assistance National Reserve.--The 
Committee recommends $220,859,000 for the Dislocated Worker 
Assistance National Reserve, which is available to the 
Secretary for activities such as responding to mass layoffs, 
plant and/or military base closings, and natural disasters that 
cannot be otherwise anticipated as well as for technical 
assistance, training, and demonstration projects.
    Funds made available in this bill support activities in 
program year 2014, which occurs from July 1, 2014, through June 
30, 2015. The bill provides that $20,859,000 is available for 
obligation on July 1, 2014, and that $200,000,000 is available 
on October 1, 2014. Both categories of funding are available 
for obligation through June 30, 2015.
    As proposed in the budget request, the Committee continues 
bill language from previous years authorizing the use of funds 
under the dislocated workers program for projects that provide 
assistance to new entrants in the workforce or incumbent 
workers and assistance where there have been dislocations 
across multiple sectors or local areas of a State.
    Native American Programs.--The Committee recommends 
$47,467,000 for Native American programs. These programs are 
designed to improve the economic well-being of Native Americans 
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 $84,123,000 for migrant and seasonal farmworkers 
programs, which serve members of economically disadvantaged 
families whose principal livelihood is derived from migratory 
and other forms of seasonal farmwork, fishing, or logging 
activities. Enrollees and their families are provided with 
employment, training, and related services intended to prepare 
them for stable, year-round employment within and outside of 
the agriculture industry.
    The Committee recommendation provides that $77,949,000 be 
used for State service area grants. The Committee 
recommendation also includes bill language directing that 
$5,667,000 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 
$507,000 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 $994,000 
for activities authorized under the WANTO Act of 1992. 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 $84,530,000 for the 
YouthBuild program. YouthBuild targets at-risk, high school 
dropouts and prepares them with the skills and knowledge they 
need to succeed in a knowledge-based economy.
    Workforce Innovation Fund.--The Committee recommends 
$49,806,000 for WIF, a program that provides competitive grants 
to test innovative strategies; replicate and expand effective, 
evidence-based strategies and activities, including sector 
strategies, career pathways, incumbent worker training, and on-
the-job training; and align programs and strengthen the 
workforce system in a State or region in order to substantially 
improve the education and employment outcomes for job seekers 
and workers, youth, including individuals up to age 24, and 
employers. WIF awards are 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.
    The Committee recommendation includes a set-aside of 
$5,000,000 to support a new, interagency initiative to improve 
services for disconnected youth and the development of 
performance partnership pilots; the budget request includes 
$10,000,000 for this purpose.
    The budget request also includes a $50,000,000 set-aside 
for projects that address the employment needs of veterans. The 
Committee does not recommend a set-aside for this purpose 
within WIF, but provides a significant increase for the 
Veterans' Employment and Training Service account.
    The Committee notes that although the program was created 
in fiscal year 2011, with additional funding appropriated in 
fiscal years 2012 and 2013, the Department did not award the 
first WIF grants until June 2012. The Committee is awaiting the 
results of the initial grants.
    The Committee recommendation includes new bill language, as 
requested by the administration, that allows a portion of the 
funds for WIF to be used for Pay for Success pilots, which will 
provide performance-based awards to States or local governments 
and not-for-profit organizations providing or arranging 
services that improve employment and education outcomes for 
individuals, including those with barriers to employment. The 
Committee understands that these pilots will be funded only if 
the Department determines that they could improve outcomes and 
eligible entities show interest. The Committee directs the 
Department to provide at least 15 days' notice to the Committee 
before issuing any announcements related to Pay for Success 
activity.
    The Committee recommendation includes new bill language, as 
requested by the administration, that allows the Secretary to 
authorize WIF awardees to use a portion of grant funds for 
evaluation purposes if the Department's chief evaluation 
officer approves the evaluation plan. This is in addition to 
the 5 percent set-aside made available to the Secretary for 
technical assistance and evaluations.
    The Committee commends ETA for its collaborative work with 
IMLS to integrate the education, employment, and training 
services provided by public libraries into the workforce 
development system. The Committee encourages ETA to continue to 
invest in building and strengthening partnerships between the 
one-stop system and public libraries and recommends that ETA 
encourage applicants for grants under WIF to collaborate with 
public libraries.
    The budget request includes a general provision that 
provides the Secretary with the authority to waive statutes and 
regulations relating to WIA, the Wagner-Peyser Act, and title I 
of the Rehabilitation Act when the Secretary believes waivers 
would substantially improve employment and education outcomes. 
The Committee does not include this general provision.

National Activities

    The Committee remains greatly concerned about the low level 
of literacy and numeracy skills among adult workers. The 
Committee continues to encourage the Department to work with 
the Department of Education to examine and share best practices 
to help adults with the lowest literacy levels improve their 
overall skills and employment opportunities. The Committee 
requests a report on the Department's progress in educating the 
workforce system on the effectiveness of adult literacy and 
basic skills programs that have successfully implemented 
strategies for delivering basic literacy instruction together 
with occupational training; the report should be provided to 
the Committee no later than March 1, 2014. Further, the 
Committee recommends that these best practices be widely 
disseminated to maximize outreach to programs that would be 
able to implement improved approaches.
    Pilots, Demonstrations, and Research.--The Committee 
recommends $6,590,000 for pilots, demonstrations, and research 
authorized by section 171 of WIA to support grants or contracts 
to conduct research, pilots, or demonstrations that foster 
promising practices for national policy application.
    Reintegration of Ex-Offenders.--The Committee recommends 
$80,078,000 for the Reintegration of Ex-Offenders program. The 
budget request includes a $10,000,000 set-aside for Pay for 
Success projects. The Committee recommendation does not include 
the set-aside. The Reintegration of Ex-Offenders program helps 
prepare and assist adult ex-offenders return to their 
communities through pre-release services, mentoring, and case 
management. The program also provides support, opportunities, 
education, and training to youth who are involved in court and 
on probation, in aftercare, or on parole, or who would benefit 
from alternatives to incarceration or diversion from formal 
judicial proceedings. Programs are carried out directly through 
State and local governmental entities and community-based 
organizations, as well as indirectly through intermediary 
organizations.
    Within the funds provided, the Committee recommendation 
includes $20,000,000 for competitive grants to national or 
regional intermediaries for activities that prepare young ex-
offenders and school dropouts for employment. Priority should 
be given to projects that serve high-crime, high-poverty areas.
    Evaluation.--As proposed in the budget request, the 
Committee recommends using a set-aside funding mechanism to 
support the evaluation of employment and training programs. 
Instead of directly providing funds for evaluation, the 
Committee recommendation will support these activities through 
a 0.5 percent tap on all training and employment programs, 
including the Training and Employment Services, Office of Job 
Corps, Community Service Employment for Older Americans, and 
State Unemployment Insurance and Employment Service Operations. 
The new set-aside approach will ensure that sufficient funding 
is available to carry out comprehensive evaluation and applied 
research activities, including continued support of the WIA 
Adult and Dislocated Worker Programs Gold Standard Evaluation.
    The ETA will conduct evaluation and applied research 
activities in consultation with the Department's chief 
evaluation officer, who oversees the evaluation program. 
Results will inform policy, advance the Department's mission, 
and improve its performance-based management initiatives.
    Workforce Data Quality Initiative.--The Committee 
recommends $6,000,000 for the Workforce Data Quality 
Initiative. 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. Thirty-
one States have been awarded grants through this program. This 
funding will expand the initiative to approximately six 
additional States.

                          OFFICE OF JOB CORPS

Appropriations, 2013\1\.................................  $1,699,541,000
Budget estimate, 2014...................................   1,691,923,000
Committee recommendation................................   1,706,923,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The recommendation for operations of Job Corps centers is 
$1,586,776,000. The Committee understands that construction on 
the new Job Corps center in Manchester, New Hampshire, will be 
substantially completed in December 2014. The Committee's 
recommended level for operations includes funds to ensure that 
competitively awarded contracts will be in place to keep the 
process of opening the Manchester center on course.
    The Committee remains concerned about the Department's 
mismanagement of Job Corps, which resulted in projected costs 
exceeding the funding provided for the operations account and, 
most recently, a 12-week freeze on new student enrollment. An 
OIG audit dated May 31, 2013, found that programmatic, 
budgetary, and managerial problems as well as a lack of proper 
program integrity controls contributed to the shortfalls in 
program years 2011 and 2012. The Committee directs the 
Secretary to provide a report no later than December 1, 2013, 
on the progress of the Department's implementation of the OIG 
recommendations, in addition to the new on-board strength 
model's impact on projecting program costs.
    The Committee understands that the Department is 
undertaking a full review of the Job Corps Policy and 
Requirements Handbook to improve and update program management 
and identify potential areas for additional cost savings. The 
Committee supports the Department's effort in this area and 
encourages the Department to seek input from all stakeholders 
in Job Corps. The Committee directs the Department to provide a 
report no later than March 1, 2014, on the Department's 
progress in reviewing and updating the handbook.
    The Committee recommendation for administrative costs is 
$30,147,000. This funding will support additional staff to 
conduct financial oversight and monitoring of the Job Corps 
program.
    The Committee also recommends a total of $90,000,000 in 
construction, renovation, and acquisition funds. This amount is 
available from July 1, 2014, to June 30, 2017. The budget 
request is $75,000,000. The Committee notes that an OIG audit 
report dated December 7, 2012, found Job Corps did not address 
maintenance deficiencies in a timely manner and did not 
sufficiently track and monitor obligated funds. The Committee 
directs the Secretary to provide a report no later than June 
30, 2014, on the Department's progress in implementing the OIG 
recommendations to ensure the health and safety of students, 
staff, and visitors as well as making improvements to the 
Funded-not-Corrected system, which center contractors use to 
track and monitor repair deficiencies.
    As requested by the administration, the Committee again 
includes bill language allowing the Secretary to transfer up to 
15 percent of construction, renovation, and acquisition funds, 
if necessary, to meet the operational needs of Job Corps 
centers or to achieve administrative efficiencies. The 
Committee includes new bill language requiring the Secretary to 
notify the House and Senate Committees on Appropriations at 
least 15 days in advance of any transfer and expects the 
notification to include a justification.

            COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS

Appropriations, 2013\1\.................................    $447,355,000
Budget estimate, 2014...................................     380,000,000
Committee recommendation................................     447,355,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    As in fiscal years 2012 and 2013, the budget request 
includes a proposal to transfer the CSEOA program to ACL in 
HHS. The Committee again recommends keeping the program in DOL.
    CSEOA provides part-time employment in community service 
activities for unemployed, low-income persons aged 55 and 
older.

              FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES

Appropriations, 2013\1\.................................    $797,000,000
Budget estimate, 2014...................................     656,000,000
Committee recommendation................................     656,000,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes mandatory funds for 
the Federal unemployment benefits and allowances program that 
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, 2013\1\.................................  $4,018,879,000
Budget estimate, 2014...................................   3,825,699,000
Committee recommendation................................   3,848,094,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $3,762,198,000 
authorized to be drawn from the Employment Security 
Administration account of the Unemployment Trust Fund and 
$85,896,000 to be provided from the general fund of the 
Treasury.
    The funds in this account are used to provide 
administrative grants and assistance to State agencies that 
administer Federal and State unemployment compensation laws and 
operate the public employment service.
    The Committee bill retains language from previous years 
that enables States to use funds appropriated under this 
account to assist other States if they are impacted by a major 
disaster declared by the President and that permits the 
Secretary to use funds to make payments on behalf of States for 
the use of the National Directory of New Hires. At the request 
of one or more States, the Secretary may reallot funds for 
States to carry out activities that benefit the administration 
of unemployment compensation laws of a requesting State.
    The Committee recommends a total of $2,967,818,000 for UI 
activities. The budget request is $2,917,872,000. For UI State 
operations, the Committee recommends $2,931,575,000. These 
funds are available for obligation by States through December 
31, 2014. The Committee includes new bill language, as proposed 
by the administration, that allows the Department to make funds 
used for automation acquisitions and for competitive grants 
awarded to States for system improvements, reemployment and 
eligibility assessments, improper payments and activities to 
address misclassification of workers available for obligation 
through December 31, 2014. The Committee includes bill language 
allowing States to obligate funds for these activities through 
September 30, 2016, as requested by the administration.
    The Committee recommendation supports investments in UI 
program integrity activities, including technology-based 
programs that identify and reclaim overpayments. The Committee 
requests a report no later than March 1, 2014, on the 
Department's plan to address the detection and recovery of 
improper payments, including desired outcomes and steps it will 
take to help States improve their performance. The Committee 
also expects the Secretary to submit a report by June 30, 2015, 
providing the status of the outcomes identified in the March 1, 
2014, plan.
    As proposed in the budget request, the Committee includes 
new bill language allowing States awarded grants for improved 
operations or to carry out national activities of the Federal-
State UI system to award subgrants to other States. This 
authority provides States more flexibility in improving 
operations and national activities of the UI system.
    The Committee recommendation includes $80,000,000 to 
conduct in-person reemployment and eligibility assessments and 
UI improper payment reviews and continues bill language 
allowing the Secretary to provide additional funding to support 
these activities if funds become available as the result of a 
decrease in UI workload activity. This important program 
integrity initiative has been shown to help claimants exit the 
UI program faster and avoid exhausting UI benefits. The 
Committee recommendation will fund an estimated 1,352,000 
reemployment and eligibility assessments, saving State UI Trust 
Funds an estimated $315,000,000 and expanding the initiative 
from 42 to 45-50 States. The Committee intends for a portion of 
these or other administrative funds to be used for additional 
technology-based overpayment prevention, detection, and 
collection activities.
    The budget request includes an amendment to the Balanced 
Budget and Emergency Deficit Control Act of 1985 that would 
provide a discretionary cap adjustment for $20,000,000 of the 
proposed $80,000,000. The Committee recommendation does not use 
the cap adjustment, which has yet to be enacted.
    The Committee recommendation includes new bill language 
that provides $10,000,000 for an award program designed to 
incentivize States to improve misclassification efforts, as 
requested by the administration. States that are most 
successful in addressing worker misclassification, which denies 
the Federal and State UI Trust Funds hundreds of millions of 
dollars a year, will be able to use these incentive funds to 
upgrade their misclassification detection and enforcement 
programs.
    The Committee recommendation includes $3,000,000 for 
continued support of the UI Integrity Center of Excellence. The 
Center's mission is to develop, implement, and promote 
innovative integrity strategies in the UI program, focusing on 
the prevention and detection of fraud.
    The Committee includes new bill language, as requested by 
the administration, providing $25,000,000 to assist States in 
carrying out UI demonstration projects as authorized by the 
Middle Class Tax Relief and Job Creation Act of 2012. The 
authorizing statute allows the Secretary to enter into 
agreements with up to 10 States to conduct demonstration 
projects that test and evaluate measures designed to expedite 
reemployment of individuals receiving UI benefits.
    The Committee recommendation provides for a contingency 
reserve amount should the unemployment workload exceed an 
average weekly insured claims volume of 3,357,000, as proposed 
in the budget request.
    For UI national activities, the Committee recommends 
$11,243,000. These funds are directed to activities that 
benefit the Federal-State UI system, including helping States 
adopt common technology-based solutions to improve efficiency 
and performance and supporting training and contracting for 
actuarial support for State trust fund management.
    For the Employment Service allotments to States, the 
Committee recommends $730,797,000. This amount includes 
$22,550,000 in general funds together with an authorization to 
spend $708,247,000 from the Employment Security Administration 
account of the Unemployment Trust Fund. The Committee includes 
new bill language requiring that no less than $30,000,000 be 
used to provide targeted reemployment services to UI 
beneficiaries, as requested by the administration. Congress 
last appropriated funding for reemployment services in ARRA. A 
recent DOL report to Congress found that reemployment services 
coupled with reemployment and eligibility assessments not only 
shorten UI duration, but also boost employment and earnings for 
UI claimants. The Committee recommendation continues to support 
States' efforts in providing these critical workforce services 
to UI claimants.
    The Committee also recommends $20,871,000 for Employment 
Service national activities. The administration of the work 
opportunity tax credit accounts for $18,485,000 of the 
recommended amount; 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 $65,262,000. 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 $63,346,000. The Committee does not 
include any funding for the administration's proposal to co-
brand and increase public awareness of the one-stop career 
center system.
    The Committee recommendation includes $8,976,000 for ETA, 
in collaboration with ODEP, to continue to implement their 
joint plan for improving effective and meaningful participation 
of persons with disabilities in the workforce. The Committee 
expects that these funds, in combination with funding available 
to ODEP, will continue to improve the accessibility and 
accountability of the public workforce development system for 
individuals with disabilities.
    The Committee recommendation includes new bill language, as 
proposed in the budget request, authorizing the Secretary to 
collect fees for costs associated with additional data 
collection requested by States and local governments, 
institutions of higher education, or nonprofit organizations 
under the National Agricultural Workers Survey, and to retain 
the proceeds to cover such costs.

                         STATE PAID LEAVE FUND

Appropriations, 2013....................................................
Budget estimate, 2014...................................      $5,000,000
Committee recommendation................................       5,000,000

    The Committee recommendation includes $5,000,000 to create 
a new State Paid Leave Fund. Paid leave programs are financed 
by employer and/or employee contributions and offer benefits to 
workers who must take time off to care for an ill child, 
spouse, or parent, or to bond with a newborn or recently 
adopted child. Competitive grants will be awarded to States to 
support pre-implementation planning, such as research and 
analysis and financial modeling, as well as to support 
implementation costs, including information technology, 
outreach to eligible workers and employers, project management, 
and the development of reporting and performance accountability 
processes.
    In determining eligibility for funding, the Committee 
strongly urges the Secretary to include States that have passed 
State paid leave laws but have yet to implement programs due to 
funding constraints, as well as States that have yet to pass 
paid leave laws but are in the planning phase.

        ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS

Appropriations, 2013....................................................
Budget estimate, 2014...................................    $600,000,000
Committee recommendation................................     600,000,000

    The Committee recommends and the budget requests such sums 
as are necessary in mandatory funds for this account. The 
appropriation is available to provide advances to several 
accounts for purposes authorized under various Federal and 
State unemployment compensation laws and the Black Lung 
Disability Trust Fund, whenever balances in such accounts prove 
insufficient.
    The Committee bill includes new language proposed in the 
budget request to provide advances from this account to the 
Employment Security Administration account of the Unemployment 
Trust Fund. The language will ensure the Unemployment Trust 
Fund has enough funding to provide loans to States to 
administer the UI and Employment Service programs and Veterans 
Employment and Training programs.

                         PROGRAM ADMINISTRATION

Appropriations, 2013\1\.................................    $146,787,000
Budget estimate, 2014...................................     149,617,000
Committee recommendation................................     151,602,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation of $151,602,000 for program 
administration includes $100,994,000 in general funds and 
$50,608,000 from the Employment Security Administration account 
of the Unemployment Trust Fund.
    General funds in this account pay for the Federal staff 
needed to administer employment and training programs under 
WIA, OAA, the Trade Act of 1974, WANTO, and the National 
Apprenticeship Act. Trust funds provide for the Federal 
administration of employment security functions under title III 
of the Social Security Act.

               Employee Benefits Security Administration


                         SALARIES AND EXPENSES

Appropriations, 2013\1\.................................    $182,787,000
Budget estimate, 2014...................................     179,104,000
Committee recommendation................................     176,472,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $176,472,000 for EBSA.
    EBSA plays a critical role in improving health benefits and 
retirement security for American workers and their families. 
EBSA is responsible for the enforcement of title I of ERISA in 
both civil and criminal areas and for enforcement of sections 
8477 and 8478 of the Federal Employees' Retirement Security Act 
of 1986. EBSA administers an integrated program of regulation, 
compliance assistance and education, civil and criminal 
enforcement, and research and analysis.
    Benefits under EBSA's jurisdiction consist of approximately 
$7,000,000,000,000 in assets covering approximately 140 million 
participants and beneficiaries. EBSA oversees benefit security 
for an estimated 700,000 private retirement plans, 2.3 million 
health plans, and similar numbers of other welfare benefit 
plans, such as those providing life or disability insurance.
    The Committee directs the Department to work with HHS and 
the Department of the Treasury to revise their joint FAQ 
regarding section 2706 of the ACA, as explained in the HHS 
title of this report.

                  Pension Benefit Guaranty Corporation

    PBGC's estimated obligations for fiscal year 2014 include 
single-employer benefit payments of $6,358,000,000, multi-
employer financial assistance of $115,000,000, and 
administrative expenses of $505,441,000. Administrative 
expenses are comprised of three activities: (1) pension 
insurance activities, $80,000,000; (2) pension plan termination 
expenses, $268,230,000; and (3) operational support, 
$157,211,000. These expenditures are financed by permanent 
authority.
    The PBGC is a wholly owned Government corporation 
established by ERISA. The law places it within DOL and makes 
the Secretary the chair of its board of directors. The 
corporation receives its income primarily from insurance 
premiums collected from covered pension plans, assets of 
terminated pension plans, collection of employer liabilities 
imposed by the act, and investment earnings. The primary 
purpose of the corporation is to guarantee the payment of 
pension plan benefits to participants if covered defined 
benefit plans fail or go out of existence.
    The President's budget proposes to continue authority for a 
contingency fund for the PBGC that provides additional 
administrative resources when the number of participants in 
terminated plans exceeds 100,000. When the trigger is reached, 
an additional $9,200,000 becomes available through September 
30, 2015, for every 20,000 participants in terminated plans. A 
trigger also is included for additional investment management 
fees for plan terminations or asset growth. The bill does not 
revise this trigger to allow additional resources for 
investment management fees incurred in carrying out the PBGC's 
Board-approved investment policy, as proposed in the budget. 
The Committee bill includes current law provisions to ensure 
that the PBGC can take immediate, uninterrupted action to 
protect participants' pension benefits. The Committee expects 
to be notified immediately of the availability of any funds 
provided by these provisions.
    The Committee bill also continues authority allowing the 
PBGC additional obligation authority for unforeseen and 
extraordinary pre-termination expenses, after approval by OMB 
and notification of the Committees on Appropriations of the 
House of Representatives and the Senate.
    The Committee is very concerned by the lack of progress in 
selecting a participant and plan sponsor advocate, a position 
required by Public Law 112-141, which was signed by President 
Obama on July 6, 2012. Among other things, the advocate is 
expected to act as a liaison between PBGC and participants in 
terminated pension plans, ensure that participants receive 
everything they are entitled to under law, and provide plan 
sponsors with assistance in resolving disputes with PBGC. The 
Committee expects the PBGC Board to move expeditiously in 
selecting a candidate for this position, which should occur as 
soon as possible but no later than 90 days after enactment of 
this act. The Committee also believes that the advocate must be 
a full-time position reporting directly to the PBGC Board given 
the significant duties required.
    PBGC's single-employer program protects about 33 million 
workers and retirees in approximately 24,000 defined benefit 
pension plans. The multi-employer insurance program protects 
about 10 million participants in roughly 1,500 plans.

                         Wage and Hour Division


                         SALARIES AND EXPENSES

Appropriations, 2013\1\.................................    $226,607,000
Budget estimate, 2014...................................     243,254,000
Committee recommendation................................     243,254,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $243,254,000 for WHD.
    WHD is responsible for administering and enforcing laws 
that provide minimum standards for wages and working conditions 
in the United States. The Fair Labor Standards Act [FLSA], 
employment rights under the Family and Medical Leave Act 
[FMLA], and the Migrant and Seasonal Agricultural Worker 
Protection Act are several of the important laws that WHD is 
charged with administering and/or enforcing.
    The Committee recommendation includes additional funds over 
the fiscal year 2013 level to address the misclassification of 
employees as independent contractors and to enforce the FMLA 
and FLSA.
    The Committee also supports the President's request to 
provide additional resources for WHD to increase its oversight 
of organizations participating in the special minimum wage 
program for individuals with disabilities authorized under 
section 14(c) of the FLSA, in order to protect the rights of 
workers with disabilities. The Committee also urges WHD to 
continue exploring and implementing strategies with ODEP and 
other Federal agencies to provide additional opportunities for 
such workers to participate in competitive integrated 
employment.

                  Office of Labor-Management Standards


                         SALARIES AND EXPENSES

Appropriations, 2013\1\.................................     $41,206,000
Budget estimate, 2014...................................      46,891,000
Committee recommendation................................      41,206,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $41,206,000 for OLMS.
    OLMS administers the Labor-Management Reporting and 
Disclosure Act of 1959 and related laws. These laws establish 
safeguards for union democracy and financial integrity. They 
also require public disclosure by unions, union officers, 
employers, and others. In addition, the Office administers 
employee protections under federally sponsored transportation 
programs.

             Office of Federal Contract Compliance Programs


                         SALARIES AND EXPENSES

Appropriations, 2013\1\.................................    $104,976,000
Budget estimate, 2014...................................     108,467,000
Committee recommendation................................     106,000,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $106,000,000 for OFCCP.
    This Office protects workers and potential employees of 
Federal contractors from employment discrimination prohibited 
under Executive Order 11246, section 503 of the Rehabilitation 
Act of 1973, and the Vietnam Era Veterans' Readjustment 
Assistance Act of 1974.
    Almost 3 years ago, the Department issued an advance notice 
of proposed rulemaking regarding regulations for implementing 
section 503 of the Rehabilitation Act. The proposal would 
strengthen affirmative action provisions for workers with 
disabilities under section 503, and details specific actions 
that a contractor must take to satisfy its obligations. The 
Committee strongly supports the administration's plan to issue 
a final rule during fiscal year 2013. The Committee encourages 
the Department to make technical assistance regarding the rule 
available to Federal contractors.

                Office of Workers' Compensation Programs


                         SALARIES AND EXPENSES

Appropriations, 2013\1\.................................    $117,604,000
Budget estimate, 2014...................................     120,600,000
Committee recommendation................................     117,604,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $117,604,000 for OWCP. The bill 
provides authority to expend $2,116,000 from the special fund 
established by the Longshore and Harbor Workers' Compensation 
Act.
    OWCP administers four distinct compensation programs: the 
Federal Employees' Compensation Act [FECA], the Longshore and 
Harbor Workers' Compensation Act, the Black Lung Benefits 
programs, and the Energy Employees Occupational Illness 
Compensation Program. In addition, OWCP houses the Division of 
Information Technology Management and Services.

                            SPECIAL BENEFITS

Appropriations, 2013....................................    $350,000,000
Budget estimate, 2014...................................     396,000,000
Committee recommendation................................     396,000,000

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

               SPECIAL BENEFITS FOR DISABLED COAL MINERS

Appropriations, 2013\1\.................................    $182,227,000
Budget estimate, 2014...................................     133,235,000
Committee recommendation................................     133,235,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends a mandatory appropriation of 
$98,235,000 in fiscal year 2014 for special benefits for 
disabled coal miners. This is in addition to the $35,000,000 
appropriated last year as an advance for the first quarter of 
fiscal year 2014, for a total program level of $133,235,000 in 
fiscal year 2014. The decrease in this account below the fiscal 
year 2013 level reflects a declining beneficiary population.
    These mandatory funds are used to provide monthly benefits 
to coal miners disabled by black lung disease and their widows 
and certain other dependents, as well as to pay related 
administrative costs.
    The Committee also recommends an advance appropriation of 
$24,000,000 for the first quarter of fiscal year 2015. This 
amount is the same as the budget request. These funds will 
ensure uninterrupted benefit payments to coal miners, their 
widows, and dependents.

     DIVISION OF ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION

                         SALARIES AND EXPENSES

Appropriations, 2013\1\.................................     $52,147,000
Budget estimate, 2014...................................      55,176,000
Committee recommendation................................      55,176,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $55,176,000 for the Division of 
Energy Employees Occupational Illness Compensation. This is a 
mandatory appropriation.
    The Division administers EEIOCPA, which provides benefits 
to eligible employees and former employees of DOE, its 
contractors and subcontractors, or to certain survivors of such 
individuals. The mission also includes delivering benefits to 
certain beneficiaries of the Radiation Exposure Compensation 
Act. The division is part of OWCP.
    In fiscal year 2014, the volume of incoming claims under 
part B of EEOICPA is estimated at about 6,500 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 5,900 new claims will be 
received during fiscal year 2014. Under this authority, the 
Department provides benefits to eligible DOE contractor 
employees who were found to have work-related occupational 
illnesses due to exposure to a toxic substance at a DOE 
facility, or to the employees' survivors.

                    BLACK LUNG DISABILITY TRUST FUND

Appropriations, 2013\1\.................................    $301,006,000
Budget estimate, 2014...................................     316,559,000
Committee recommendation................................     316,559,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee bill provides an estimated $316,559,000 for 
this mandatory appropriations account. This estimate is 
comprised of $59,081,000 for administrative expenses and an 
estimated $257,478,000 for benefit payment and interest costs.
    The Committee bill continues to provide indefinite 
authority for the Black Lung Disability Trust Fund to provide 
for benefit payments. In addition, the bill provides for 
transfers from the trust fund for administrative expenses for 
the following Department agencies: up to $33,033,000 for the 
part C costs of the Division of Coal Mine Workers' Compensation 
Programs; up to $25,365,000 for Departmental Management, 
Salaries and Expenses; and up to $327,000 for Departmental 
Management, Inspector General. The bill also allows a transfer 
of up to $356,000 for the Department of the Treasury.
    The trust fund pays all black lung compensation/medical and 
survivor benefit expenses when no responsible mine operation 
can be assigned liability for such benefits or when coal mine 
employment ceased prior to 1970, as well as all administrative 
costs that are incurred in administering the benefits program 
and operating the trust fund.

             Occupational Safety and Health Administration


                          SALARIES AND EXPENSES

Appropriations, 2013\1\.................................    $563,658,000
Budget estimate, 2014...................................     570,519,000
Committee recommendation................................     567,012,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $567,012,000 for OSHA, which is 
responsible for enforcing the Occupational Safety and Health 
Act of 1970 in the Nation's workplaces.
    The Committee continues bill language to allow OSHA to 
retain up to $200,000 per fiscal year of tuition fees for 
training institute courses to be used for occupational safety 
and health training and education grants in the private sector.
    The Committee bill retains language that continues to 
effectively exempt farms employing 10 or fewer people from the 
provisions of the act with the exception of those farms having 
a temporary labor camp. The bill also retains language 
exempting small firms in industry classifications having a lost 
workday injury rate less than the national average from general 
schedule safety inspections.
    The Committee is extremely disappointed by the Department's 
continued delays in issuing a rule for occupational exposure to 
silica. The silica rulemaking process is almost a decade old. 
The administration's most recent regulatory agenda stated that 
a notice of proposed rulemaking would be issued in May 2013--
another in a series of deadlines that the Department has failed 
to meet. The Committee directs the Department to issue a notice 
of proposed rulemaking on silica not later than 30 days after 
enactment of this act. The Committee also supports rulemaking 
for the Injury and Prevention Program and the timetable for 
actions outlined in the Department's January 8, 2013, 
regulatory agenda.
    The Committee recommends $103,987,000 for grants to States 
under section 203(g) of the Occupational Safety and Health Act. 
These funds primarily are provided to States that have taken 
responsibility for administering their own occupational safety 
and health programs for the private sector and/or the public 
sector. State plans must be at least as effective as the 
Federal program and are monitored by OSHA. The Committee bill 
continues language that allows OSHA to provide grants of up to 
50 percent for the costs of State plans approved by the agency. 
The Committee believes that, given the continuing fiscal 
pressures facing State budgets, OSHA should continue its 
practice of allowing States an extra year to match the 
appropriation provided by this bill for support of their State 
plans, and also should extend the period of expenditure for 
these funds for an additional quarter.
    The Committee also believes that OSHA's worker safety and 
health training and education programs, including the grant 
program that supports such training, are a critical part of a 
comprehensive approach to worker protection. Under the program, 
grants are made to various types of organizations representing 
employers and labor organizations for direct training of 
workers on occupational safety and health. The Committee 
recommendation includes $10,709,000 for the OSHA Susan Harwood 
Training Grant Program.

                 Mine Safety and Health Administration


                          SALARIES AND EXPENSES

Appropriations, 2013\1\.................................    $372,547,000
Budget estimate, 2014...................................     380,721,000
Committee recommendation................................     380,721,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $380,721,000 for 
MSHA.
    MSHA insures the safety and health of the Nation's miners 
by conducting inspections and special investigations of mine 
operations, promulgating mandatory safety and health standards, 
cooperating with the States in developing effective State 
programs, and improving training in conjunction with States and 
the mining industry.
    The Committee bill continues language authorizing MSHA to 
use up to $2,000,000 for mine rescue and recovery activities. 
It also retains the provision allowing the Secretary to use any 
funds available to the Department to provide for the costs of 
mine rescue and survival operations in the event of a major 
disaster. In order to prepare properly for an actual emergency, 
the Committee also directs MSHA to continue to devote resources 
toward a competitive grant activity for effective emergency 
response and recovery training in various types of mine 
conditions.
    In addition, bill language is included to allow the 
National Mine Health and Safety Academy to collect not more 
than $750,000 for room, board, tuition, and the sale of 
training materials to be available for mine safety and health 
education and training activities. Bill language also allows 
MSHA to retain up to $2,499,000 from fees collected for the 
approval and certification of equipment, materials, and 
explosives for use in mines, and to utilize such sums for these 
activities. Bill language also allows MSHA to establish, 
collect, and retain fees for services related to the analysis 
of rock dust samples.
    As requested by the administration, the Committee includes 
new bill language allowing the Secretary to reallocate up to 
$3,000,000 within MSHA's program lines to support inspections 
or investigations. The Committee expects to be notified prior 
to any such reallocation. The Committee also expects that any 
reallocations will not prevent MSHA from addressing important 
issues that are proposed in the budget request or identified in 
this report. In addition to items identified previously, the 
priorities include: effective implementation of corrective 
actions related to the Upper Big Branch internal review; 
adequate support for MSHA's instructional capacity for training 
of mine safety and health inspectors and other mine safety 
professionals; and sufficient support for MSHA's Accountability 
Program.
    Finally, the bill includes new language intended to support 
the relocation of MSHA's headquarters by authorizing the 
transfer of necessary funds to the Office of the Solicitor.

                       Bureau of Labor Statistics


                         SALARIES AND EXPENSES

Appropriations, 2013\1\.................................    $607,852,000
Budget estimate, 2014...................................     613,794,000
Committee recommendation................................     609,852,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $609,852,000 for BLS. This amount 
includes $67,041,000 from the Employment Security 
Administration account of the Unemployment Trust Fund and 
$542,811,000 in Federal funds.
    BLS is the principal fact-finding agency in the Federal 
Government in the broad field of labor economics.
    The Committee recognizes that the Nation requires current, 
accurate, detailed labor statistics for Federal and non-Federal 
data users. The Nation also requires Government programs to be 
administered as cost-effectively as possible. However, the 
current ability of the cooperative statistics system to meet 
those needs is in question. Any weaknesses of this system could 
reduce the ability of State and local regions to effectively 
plan for recovery, anticipate industry demand for workforce 
needs, and meet other labor market information challenges.
    Therefore, the Committee directs the Secretary to 
commission a study of and report on a comprehensive assessment 
of the proper purpose, structure, methods, and operations of 
the Federal-State cooperative statistics system, particularly 
regarding the appropriate roles and responsibilities of BLS, 
ETA, the State labor market information agencies, and the 
system's relationship with the Census Bureau, NCES, State 
workforce agencies, State education agencies, and private 
vendors.
    The Committee believes the National Academies of Science 
(Committee on National Statistics) and the National Academy of 
Public Administration are well-qualified to produce such a 
report. The Committee requests the release of an interim report 
within 12 months of the enactment of this act and a final 
report within 24 months of the enactment of this act. The 
interim report shall contain, at minimum, a rigorous assessment 
of the Current Employment Statistics Program [CES], including 
an evaluation of the accuracies of past and present methods for 
producing initial State and metro area CES estimates, 
identification of the methods most likely to produce accurate 
initial estimates, and recommendations for appropriate BLS and 
State roles and responsibilities in preparing such accurate 
estimates. The report also should consider recommendations for 
how to improve the collection of this large volume of 
information, including through the use of technology; 
coordinate the Federal and State data systems to provide 
timely, accurate, and geographically detailed information on 
employment, education and training, occupations, and worker 
skills, as well as ease of access and technical assistance; and 
improve responsiveness to the data needs of labor market 
participants and policymakers at the Federal, State, and local 
levels.
    The Committee directs the Secretary to use such sums as may 
be necessary for this study, allocated equally from funds 
available to the Secretary, BLS, ETA, and the States. The State 
contribution should be made through a set-aside from BLS 
cooperative system grants to States.
    Within available resources, the Committee encourages BLS to 
prioritize work on the Contingent Work Supplement to the 
Current Population Survey.

                 Office of Disability Employment Policy

Appropriations, 2013\1\.................................     $38,802,000
Budget estimate, 2014...................................      42,432,000
Committee recommendation................................      42,432,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $42,432,000 for ODEP. The 
Committee intends that at least 80 percent of these funds shall 
be used to design and implement research and technical 
assistance grants and contracts to develop policy that reduces 
barriers to competitive, integrated employment for youth and 
adults with disabilities.
    The mission of ODEP is to provide leadership, develop 
policy and initiatives, and award grants furthering the 
objective of eliminating physical and programmatic barriers to 
the training and employment of people with disabilities. The 
Committee strongly supports each component of ODEP's mission 
and, in particular, urges the Secretary to ensure that ODEP 
carries out its leadership role with respect to governmentwide 
policies related to the training and employment of individuals 
with disabilities. The Committee believes that ODEP should put 
a high priority on providing support and technical assistance 
to Federal agencies for the implementation of Executive Order 
13548 regarding the hiring of persons with disabilities.
    The Committee recommendation includes $9,000,000 for ODEP, 
in collaboration with 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 continue to improve the accessibility and 
accountability of the public workforce development system for 
individuals with disabilities.

                        Departmental Management


                         SALARIES AND EXPENSES

Appropriations, 2013\1\.................................    $345,661,000
Budget estimate, 2014...................................     347,956,000
Committee recommendation................................     346,685,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $346,685,000 for the 
Departmental Management account. Of this amount, $346,359,000 
is available from general funds and $326,000 is available by 
transfer from the Employment Security account of the 
Unemployment Trust Fund. In addition, $25,365,000 is available 
by transfer from the Black Lung Disability Trust Fund.
    The primary goal of the Department is to protect and 
promote the interests of American workers. The departmental 
management appropriation pays the salaries and related expenses 
of staff responsible for formulating and overseeing the 
implementation of departmental policy and management activities 
in support of that goal. In addition, this appropriation 
includes a variety of operating programs and activities that 
are not involved in departmental management functions, but for 
which other appropriations for salaries and expenses are not 
suitable.
    The Committee continues its support of the Department's 
efforts to reduce the backlog of mine safety cases before the 
Federal Mine Safety and Health Review Commission [FMSHRC] and 
to assure that the timely processing of cases occurs in the 
future.
    The Committee directs the Secretary, in conjunction with 
FMSHRC, to provide a joint report to the Committees on 
Appropriations of the House of Representatives and Senate for 
reducing the number of pending cases and average case 
processing time to appropriate levels by the end of fiscal year 
2015. The report should fully explain how such levels were 
determined. It also should establish goals and metrics for 
determining when the levels will be achieved and how they will 
be maintained in the future.
    The Committee recommendation includes $95,425,000 for the 
Bureau of International Labor Affairs [ILAB], of which 
$66,375,000 is available for obligation through December 31, 
2014. ILAB's appropriation is available to help improve working 
conditions and labor standards for workers around the world and 
carry out ILAB's statutory mandates and international 
responsibilities. Funding for international programming to 
eliminate the worst forms of child labor should prioritize 
comprehensive and sustainable initiatives that address the root 
causes of the problem, including lack of education and 
vocational training opportunities; household poverty; lack of 
data and awareness of the scope and impact of the worst forms 
of child labor; gaps in social protection services; and weak 
enforcement of labor laws, which increase the vulnerability of 
households to the worst forms of child labor.
    The Committee expects ILAB to maintain its current effort 
on programs to combat exploitative child labor. The Committee 
also expects that the integrated child labor and worker rights 
projects proposed in the budget request will have a significant 
and direct child labor component. The bill requires ILAB to 
spend not more than $59,887,000 for programs to combat 
exploitative child labor internationally and not less than 
$6,488,000 to implement model worker rights programs in 
countries with which the United States has trade preference 
programs or free trade agreements. The bill also continues 
language from last year's act regarding the authority to fund 
microfinance activities.
    Additionally, the Committee commends the Department for 
annually completing the country assessments on commitments to 
eliminate the worst forms of child labor, consistent with the 
requirements of 19 U.S.C. 2464.
    The Committee recommendation provides $8,467,000 for 
program evaluation and allows these funds to be available for 
obligation through September 30, 2015. The Committee bill also 
continues the authority of the Secretary to transfer these 
funds to any other account in the Department for evaluation 
purposes. The Committee bill includes requested authority to 
use up to 0.5 percent of certain Department appropriations for 
evaluation activities identified by the chief evaluation 
officer. The bill language differs slightly from last year's 
bill by including the Training and Employment Services in the 
list of accounts covered by this authority, as proposed in the 
budget request. The Committee expects to be notified of the 
planned uses of funds derived from this authority.
    The Committee recommendation provides $11,536,000 for the 
Women's Bureau. These funds will enable the Bureau to undertake 
critical work in addressing the pay gap. The Committee 
continues bill language allowing the Bureau to award grants.
    The Committee is very supportive of Executive Order 13548 
and the Department's goal to raise the representation of 
individuals with disabilities in its workforce from 7.24 
percent in fiscal year 2010 to 11.3 percent by fiscal year 
2016. However, fiscal year 2011 results suggest the Department 
is not on pace to meet its goals. The Committee encourages the 
Department to accelerate its efforts in this area.

                    VETERANS EMPLOYMENT AND TRAINING

Appropriations, 2013\1\.................................    $263,907,000
Budget estimate, 2014...................................     300,518,000
Committee recommendation................................     300,518,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation of $300,518,000 for VETS 
includes $38,185,000 in general revenue funding and 
$262,333,000 to be expended from the Employment Security 
Administration account of the Unemployment Trust Fund. The 
Committee recommendation supports a significant expansion of 
services to veterans, transitioning servicemembers, and family 
members.
    This account provides resources for VETS to maximize 
employment opportunities for veterans and transitioning 
servicemembers, including protecting their employment rights. 
VETS carries out its mission through a combination of grants to 
States, competitive grants, and Federal enforcement and 
oversight.
    The Committee recommendation includes new bill language, as 
proposed in the budget request, specifying funding levels for 
particular activities, as opposed to providing a lump sum 
appropriation. The new bill language also allows the Secretary 
to reallocate funds among activities in an amount not to exceed 
3 percent of the funding from which any reallocation is made.
    The Committee provides $203,081,000 for the Jobs for 
Veterans State Grants [JSVG] program. This funding level will 
enable the Department to increase the level of intensive 
services provided to veterans by Disabled Veterans' Outreach 
Program [DVOP] specialists as well as to reach new populations 
of servicemembers and their families in need of employment 
services. As proposed by the administration, the Committee 
includes new bill language specifying that JSVG funds may be 
used to provide DVOP and Local Veterans' Employment 
Representatives [LVER] services to transitioning servicemembers 
early in their separation from military service; wounded 
warriors recuperating in military treatment facilities or 
transition units; and, spouses and family caregivers to help 
ensure the family has income to provide sufficient support.
    The Committee provides $14,000,000 for the Transition 
Assistance Program [TAP]. This funding will support an 
estimated 5,444 employment workshops at military installations 
and in virtual classrooms worldwide for exiting servicemembers 
and spouses. The VOW to Hire Heroes Act of 2011 requires TAP 
services for most transitioning servicemembers.
    The Committee recommendation includes $41,838,000 for 
Federal administration costs. This funding level will support 
outreach to major private-sector companies to generate interest 
in hiring veterans and improve oversight and strengthen 
protection of veterans' employment rights, among other 
activities.
    The Committee recommends $38,185,000 for the Homeless 
Veterans' Reintegration Program [HVRP] to help homeless 
veterans attain the skills they need to gain meaningful 
employment. HVRP is the only Federal program that focuses 
exclusively on the employment of veterans who are homeless.
    The Committee recommendation includes $3,414,000 for the 
National Veterans' Training Service Institute [NTVI], which 
provides training to Federal staff and veteran service 
providers. At this recommended level, NTVI will be able to 
train an estimated 2,210 veteran service providers and meet the 
new training requirements of the Veterans' Benefits Act of 
2010.

                  INFORMATION TECHNOLOGY MODERNIZATION

Appropriations, 2013\1\.................................     $19,775,000
Budget estimate, 2014...................................      20,587,000
Committee recommendation................................      19,775,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $19,775,000 for the IT 
Modernization account. Funds available in this account are used 
for two primary activities. The first is departmental support 
systems, for which $4,898,000 is provided. These funds help 
align IT investments with the Department's strategic 
objectives. The second budget activity, for which $14,877,000 
is provided, assists the Department in consolidating and 
optimizing common IT infrastructure services, protecting 
privacy, and improving timely and efficient services to the 
public.

                    OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2013\1\.................................     $83,520,000
Budget estimate, 2014...................................      85,714,000
Committee recommendation................................      83,520,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $83,520,000 for the DOL OIG. The 
bill includes $77,634,000 in general funds and authority to 
transfer $5,886,000 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.
    Through a comprehensive program of audits, investigations, 
inspections, and program evaluations, OIG attempts to reduce 
the incidence of fraud, waste abuse, and mismanagement, and to 
promote economy, efficiency, and effectiveness.

                           General Provisions

    Section 101. The bill continues a provision limiting the 
use of Job Corps funding for compensation of an individual that 
is not a Federal employee at a rate not to exceed Executive 
Level II.
    Section 102. The bill continues a provision providing for 
general transfer authority.
    Section 103. The bill continues a provision prohibiting 
funding for the procurement of goods and services utilizing 
forced or indentured child labor in industries and host 
countries already identified by the Department in accordance 
with Executive Order 13126.
    Section 104. The bill continues a provision requiring that 
funds available under section 414(c) of the American 
Competitiveness and Workforce Improvement Act of 1998 may only 
be used for competitive grants for training in occupations and 
industries for which employers are using H-1B visas to hire 
foreign workers.
    Section 105. The bill continues a provision limiting the 
use of ETA funds by a recipient or subrecipient for 
compensation of an individual at a rate not to exceed Executive 
Level II.
    Section 106. The bill continues a provision prohibiting the 
Secretary from taking any action to alter the procedure for 
redesignating local areas under subtitle B of title I of WIA.
    Section 107. The bill modifies a provision providing the 
ETA with authority to transfer funds provided for technical 
assistance services to grantees to program administration when 
it is determined that those services will be more efficiently 
performed by Federal employees. The provision does not apply to 
section 173A(f)(2) of the WIA.
    Section 108. The bill modifies a provision allowing up to 
0.5 percent of discretionary appropriations provided in this 
act for all Department agencies to be used by the Office of the 
Chief Evaluation Officer for evaluation purposes consistent 
with the terms and conditions in this act applicable to such 
office.
    Section 109. The bill includes a new provision allowing the 
Secretary to reserve up to 3 percent of funds available under 
section 272(b) of the Trade Act of 1974 to conduct evaluations 
and provide technical assistance relating to the activities 
carried out under the Community College and Career Training 
Grant program and to allow grantees to award subgrants.
    Section 110. The bill includes a new provision transferring 
the claims function under several Federal statutes currently 
performed by GAO to DOL.
    Section 111. The bill includes a new provision adjusting 
the salary cap for the Administrator of the Wage and Hour 
Division from Executive Level V to Executive Level IV.
    Section 112. The bill includes a new provision that 
provides flexibility with respect to the crossing of H-2B 
nonimmigrants working in the seafood industry and clarifies the 
Department's regulatory authority with respect to the H-2B visa 
program.
    Section 113. The bill includes a new provision related to 
the H-2A program.

                                TITLE II

                DEPARTMENT OF HEALTH AND HUMAN SERVICES

    The administration request for HHS reflects a proposal to 
increase program evaluation transfers under section 241 of the 
PHS Act from 2.5 percent to 3 percent. Through these transfers, 
PHS agencies contribute a percentage of their budget authority 
to fund program evaluation activities throughout the 
Department. The percentage is specified in section 205 of the 
title II general provisions.
    The Committee rejects the proposed increase to 3 percent 
because of the effect on PHS Act agencies that are used as a 
source of evaluation transfers, most notably NIH. The Committee 
also believes that raising the tap would reduce the 
transparency of its recommended funding levels.
    For programs that are the source of the transfers, an 
increase in the evaluation tap would effectively cut their 
funding. With regard to NIH, the administration presents its 
request as an increase of approximately $471,000,000 over the 
fiscal year 2012 level; the effective increase for NIH, after 
factoring in the proposed tap increase, would actually be 
approximately $147,000,000 less. There are many other examples 
where the budget request touts significant increases for 
particular programs without noting that its tap proposal would 
undercut a portion of those increases. For these reasons, the 
Committee maintains the evaluation transfer amount at 2.5 
percent, the same level as in fiscal year 2013.
    This is the fourth year that the administration has 
proposed an increase in the section 241 tap percentage. The 
Committee strongly discourages a similar increase in the fiscal 
year 2015 request.
    Any references in this title of the report to the 
``Secretary'' or the ``Department'' shall be interpreted to 
mean the Secretary of HHS or the Department of HHS, 
respectively, unless otherwise noted.

              Health Resources and Services Administration

    HRSA activities support programs to provide healthcare 
services for mothers and infants; the underserved, elderly, and 
homeless; rural residents; and disadvantaged minorities. This 
agency supports cooperative programs in maternal and child 
health, AIDS care, healthcare provider training, and healthcare 
delivery systems and facilities.

                     BUREAU OF PRIMARY HEALTH CARE

Appropriations, 2013\1\.................................  $1,574,646,000
Budget estimate, 2014...................................   1,566,932,000
Committee recommendation................................   1,574,646,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation for the activities of the 
Bureau of Primary Health Care is $1,574,646,000.

Community Health Centers

    The Committee provides $1,574,606,000 in this bill for the 
Community Health Centers program. Combined with the 
$2,200,000,000 in mandatory funding appropriated for fiscal 
year 2014 in the ACA, the Committee's recommended program level 
totals $3,774,606,000.
    Programs supported by this funding include community health 
centers, migrant health centers, healthcare for the homeless, 
and public housing health service grants. The Committee 
continues to support the ongoing effort to increase the number 
of people who have access to medical services at health 
centers.
    The Committee includes bill language, modified from last 
year, requiring the administration to award all fiscal year 
2014 funds by September 30, 2014. Such awards shall include 
$142,000,000 in base grant adjustments and not less than 
$700,000,000 in new access point awards and expanded service 
awards. These levels assume that funds made available for 
outreach and enrollment in health exchanges in fiscal year 2013 
will be awarded as base grant adjustments in fiscal year 2014.
    In addition, within the amount provided, the Committee 
provides up to $94,893,000 under the Federal Tort Claims Act 
[FTCA], available until expended. These funds are used to pay 
judgments and settlements, occasional witness fees and 
expenses, and related administrative costs. The Committee 
intends FTCA coverage funded through this bill to be inclusive 
of all providers, activities, and services included within the 
health centers' federally approved scope of project.
    Native Hawaiian Health Care.--The Committee includes 
sufficient funding in the Community Health Centers program to 
support healthcare activities funded under the Native Hawaiian 
Health Care Program, which is specifically cited in the bill. 
The Committee expects that not less than the fiscal year 2013 
level be provided for these activities in fiscal year 2014.

Free Clinics Medical Malpractice Coverage

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

                      BUREAU OF HEALTH PROFESSIONS

Appropriations, 2013\1\.................................    $731,548,000
Budget estimate, 2014...................................     540,804,000
Committee recommendation................................     773,190,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation for the activities of the 
Bureau of Health Professions is $773,190,000. In addition, the 
Committee recommends transferring $30,300,000 to the Bureau 
from the PPH Fund.
    The total program level assumed in this bill for the Bureau 
is $803,490,000.
    The Bureau of Health Professions provides policy leadership 
and grant support for health professions workforce development. 
The mission of the Bureau is to identify shortage areas while 
working to make them obsolete. Its programs are intended to 
ensure that the Nation has the right clinicians, with the right 
skills, working where they are needed.
    The Committee notes that section 223 of this act modifies 
the rules governing National Health Service Corps contracts, 
which are administered in the Bureau of Health Professions. The 
authorization for this program allows contract cancellations up 
to 45 days prior to the end of the current fiscal year, which 
was intended to give HHS time to redirect those funds to new 
contracts before the available funding expired. NHSC now makes 
contracts on a rolling basis throughout the year with funds 
that do not expire. Under the rolling award system, Corps 
members who sign contracts in January have 7 months to cancel, 
while Corps members who sign up in September are not given the 
opportunity to cancel. Section 223 will allow every Corps 
member 60 days to cancel their contract.

Training for Diversity

            Centers of Excellence
    The Committee provides $22,863,000 for the Centers of 
Excellence program. Institutions that are designated as centers 
of excellence are private institutions whose mission is to 
train disadvantaged minority health professionals for service 
in underserved areas. Funds are used for the recruitment and 
retention of students, faculty training, and institutional 
improvements.
    The Committee continues to support the Centers of 
Excellence program and the financial stability it has provided 
for the schools that participate. However, the Committee is 
concerned by reports that recent award amounts were based in 
large part on the amount of funding requested by each school, 
resulting in large, unexpected cuts for some of the schools and 
large increases for others. The Committee directs HRSA to 
institute an award review process that focuses more fully on 
the merits of the requested activities. The Committee expects 
HRSA to report back to the Committees on Appropriations of the 
House of Representatives and the Senate on the implementation 
of this process in the fiscal year 2015 budget justification.
            Health Careers Opportunity Program
    The Committee provides $14,942,000 for the Health Careers 
Opportunity Program [HCOP]. The purpose of this program is to 
create an educational pipeline to increase the number of 
individuals from educationally or economically disadvantaged 
backgrounds who enter the health and allied health professions. 
HCOP supports activities for disadvantaged students through 
formal academic and research training and student enhancement 
services.
    The Committee encourages HRSA to refocus the program on 
reaching undergraduate and post-baccalaureate students.
            Faculty Loan Repayment
    The Committee provides $1,253,000 for the Faculty Loan 
Repayment program. This program provides for the repayment of 
education loans for individuals from disadvantaged backgrounds 
who are health professions students or graduates and who have 
agreed to serve for at least 2 years as a faculty member of a 
health professions school.
            Scholarships for Disadvantaged Students
    The Committee provides $47,357,000 for the Scholarships for 
Disadvantaged Students program. 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 $50,962,000 for Primary Care 
Training and Enhancement programs, which support the expansion 
of training in internal medicine, family medicine, pediatrics, 
and physician assistance. Funds may be used for developing 
training programs or providing direct financial assistance to 
students and residents.
    The Committee once again urges HRSA to prioritize the 
training of physician assistants and includes bill language 
allowing HRSA to increase funding for this activity.

Pediatric Loan Repayment

    The Committee recommends $5,000,000 to create a new loan 
repayment program for pediatric specialties, as authorized in 
section 775 of the PHS Act.
    The Committee is concerned that shortages of child mental 
health providers and pediatric subspecialists are more severe 
than the shortages that exist for general pediatricians. 
Available fellowship positions are left unfilled because of the 
burden of student loans for specialty training. The Committee 
recommendation in this bill will fund 64 initial 2-year loan 
repayment awards for eligible providers working in underserved 
areas. The Committee urges HRSA to prioritize pediatric 
specialties aimed at mental and behavioral health services in 
implementing this program.

Training in Oral Health Care

    The Committee recommends $32,654,000 for Training in Oral 
Health Care programs. Funds may be used to expand training in 
general dentistry, pediatric dentistry, public health 
dentistry, dental hygiene, and other oral health access 
programs. Funds may also be used to plan and operate training 
programs, as well as to provide financial assistance to 
students and residents.
    The Committee recommendation includes not less than 
$8,000,000 each for general and pediatric dentistry. The 
Committee encourages HRSA to focus on training programs that 
target vulnerable populations in risk-based clinical disease 
management of all populations.
    The Committee urges HRSA to work with CMS on the evaluation 
of additional models for expanding access to oral healthcare. 
Such models should include emergency room diversion programs 
and efforts under State law to deploy and evaluate new provider 
types.

Interdisciplinary, Community-Based Linkages

            Area Health Education Centers
    The Committee provides $30,025,000 for AHECs, which link 
university health science centers with community health service 
delivery systems to provide training sites for students, 
faculty, and practitioners. The program supports three types of 
projects: core grants to plan and implement programs; special 
initiative funding for schools that have previously received 
AHEC grants; and model programs to extend AHEC programs with 50 
percent Federal funding.
    The Committee is pleased by HRSA's collaboration with 
SAMHSA to develop and replicate community health worker 
programs that integrate primary care and behavioral health. 
HRSA should include in the fiscal year 2015 budget 
justification a report on progress made in this initiative.
            Geriatric Education
    The Committee provides $30,629,000 for Geriatric Education 
programs. Geriatric programs include: Geriatric Education 
Centers, the Geriatric Academic Career Awards program, and the 
Geriatric Training for Physicians, Dentists, and Behavioral and 
Mental Health Professionals program.
    The Committee reiterates its support for geriatric 
education and the effort to ensure that the wider primary care 
provider community has the skills and training to provide high-
quality and coordinated care to older adults. The Committee 
looks forward to receiving the report HRSA is compiling to 
detail the ways in which geriatric training content is being 
integrated into primary care training in HRSA-supported 
institutions.
    In addition, the Committee recommendation transfers 
$5,300,000 from the PPH Fund to train health professionals on 
issues related to Alzheimer's disease. These funds are awarded 
to Geriatric Education Centers for outreach and education 
efforts to enhance healthcare providers' knowledge of the 
disease, improve detection and early intervention, and improve 
care for people with Alzheimer's disease and their caregivers.
            Mental and Behavioral Health
    The Committee provides $3,916,000 for Mental and Behavioral 
Health programs. 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.--The Committee supports the 
Secretary's initiative to increase the number of psychologists 
pursuing clinical work with high-need and high-demand 
populations. These populations are defined as rural, 
vulnerable, and/or underserved populations, as well as 
veterans, military personnel, and their families. While the 
Committee commends the emphasis on programs targeting veteran 
and military personnel population centers, the Committee is 
concerned that many servicemembers reintegrate into civilian 
life in communities that are rural and far from military and 
veteran facilities. As such, the Committee encourages HRSA to 
maintain a strong commitment to underserved areas generally.
    Social Work Training Program.--The Committee recognizes the 
importance of social workers and their contribution to family 
planning and maternal and child health outcomes, particularly 
in low-income communities. The Committee intends the increase 
in this program to be used to continue and expand the 
Leadership Training in Social Work program, formerly funded in 
the Maternal Child Health Bureau of HRSA. This program annually 
funds three centers of excellence at schools of social work to 
help develop the next generation of social workers and provide 
critical leadership, resources, and training. The Leadership 
Training in Social Work program has successfully recruited many 
qualified minority candidates for long-term training, and 
graduates have taken faculty positions in schools of social 
work, pursued careers in policy and research, and become local 
leaders in direct service. The Committee directs the Bureau of 
Health Professions to work with the Maternal Child Health 
Bureau to ensure a smooth transition for grantees.
            Health Professions Workforce Information and Analysis
    The Committee recommends $5,000,000 for health professions 
workforce information and analysis. The program provides for 
the collection and analysis of targeted information on the 
Nation's healthcare workforce, research on high-priority 
workforce questions, the development of analytic and research 
infrastructure, and program evaluation and assessment.

Public Health Workforce Development

    The Committee provides $35,177,000 for Public Health 
Workforce Development, including $10,177,000 in budget 
authority and $25,000,000 in transfers from the PPH Fund.
    This program line, also called Public Health and Preventive 
Medicine, funds programs that are authorized in titles III and 
VII of the PHS Act and support awards to schools of medicine, 
osteopathic medicine, public health, and integrative medicine 
programs. Funds are used to expand and improve residency 
training programs, and provide financial assistance to trainees 
enrolled in such programs.
    The Committee recommendation includes $3,813,000 for 
preventive medicine residencies.
    Integrative Medicine.--The Committee includes $3,502,000 
for existing programs related to integrative medicine and 
$2,000,000 for a new competitive opportunity to improve 
residency programs in integrative medicine. The Committee 
intends the new funding to be used to award a national center 
of excellence on integrative primary care for the purpose of 
developing and disseminating best practices for integrative 
medicine training for physicians and nurses. HRSA should select 
a nonprofit entity with a strong record of leadership in the 
field of integrative medicine curriculum development, with 
experience in both publishing and working with residency 
programs.

Nursing Workforce Development Programs

    The Committee provides $251,099,000 for Nursing Workforce 
Development programs. The Committee recommendation is 
sufficient to fund all nursing programs at the level requested 
in the budget, which provides an increase of $19,672,000 for 
Advanced Education Nursing.
    Within funds available for the Nursing Education and 
Retention program, the Committee intends that no less than 
$5,000,000 be awarded to nurse-managed health centers.
    The Committee remains concerned that waiting lists for 
admission to nursing school are limiting our Nation's ability 
to address the nursing shortage. For that reason, the Committee 
continues to place a strong priority on filling vacant nursing 
faculty positions, the majority of which require either a Ph.D. 
or a doctorate of nursing practice. The Committee encourages 
the Division of Nursing to prioritize this level of training 
and create incentives for students to pursue teaching as a 
career.

Children's Hospitals Graduate Medical Education

    The Committee provides $267,313,000 for the CHGME program. 
The program provides support for graduate medical education 
training programs in both ambulatory and in-patient settings 
within freestanding children's teaching hospitals. CHGME 
payments are determined by a per-resident formula that includes 
an amount for direct training costs added to a payment for 
indirect costs. Payments support training of resident 
physicians as defined by Medicare in both ambulatory and 
inpatient settings.

National Practitioner Data Bank

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

                    MATERNAL AND CHILD HEALTH BUREAU

Appropriations, 2013\1\.................................    $860,252,000
Budget estimate, 2014...................................     824,861,000
Committee recommendation................................     858,600,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation for the MCH Bureau is 
$858,600,000. The President's request includes an additional 
$28,494,000 in transfers from the PPH Fund; the Committee 
recommendation for this account does not include any such 
transfers.
    The mission of the Bureau is to improve the physical and 
mental health, safety, and well-being of the Nation's women, 
infants, children, adolescents, and their families. This 
population includes fathers and children with special 
healthcare needs.

Maternal and Child Health Block Grant

    The Committee provides $643,807,000 for the MCH Block 
Grant, which provides a flexible source of funding that allows 
States to target their most urgent maternal and child health 
needs. The program supports a broad range of activities 
including: providing prenatal care, well child services, and 
immunizations; reducing infant mortality; preventing injury and 
violence; expanding access to oral healthcare; addressing 
racial and ethnic disparities; and providing comprehensive care 
through clinics, home visits, and school-based health programs.
    The Committee includes bill language requiring that the 
State grant portion of the block grant be funded at no less 
than $554,890,000. The fiscal year 2013 level is $554,171,000. 
The budget request is $549,729,000.
    The Committee also includes bill language identifying 
$78,641,000 for the Title V SPRANS set-aside. Within that 
total, the Committee recommendation includes sufficient funding 
to fully fund the set-asides for oral health, epilepsy, sickle 
cell anemia, and fetal alcohol syndrome at the level requested 
in the budget.
    Hemophilia.--The Committee commends HRSA on its work to 
establish models of hemophilia care in a culturally sensitive, 
family-centered coordinated manner. The National Hemophilia 
Program is a model system for caring for high-cost, chronic 
conditions. The Committee encourages HRSA to share best 
practices with CMS, particularly those regarding transitioning 
care from adolescence to adulthood.
    Oral Health.--The Committee recognizes the key role that 
Maternal and Child Health Centers in Pediatric Dentistry 
provide in preparing dentists with dual training in pediatric 
dentistry and dental public health, fostering academic 
leadership, and developing expertise in the treatment of 
children with special healthcare needs. The Committee 
encourages HRSA to provide incentives for these centers to 
leverage resources to strengthen and expand their activities.
    Perinatal Hepatitis B.--The Committee is pleased at the 
progress that has been made in reducing perinatal hepatitis B 
transmission and commends HRSA for the ongoing review of best 
practices. The Committee notes that the 2010 rate of 
transmission was the lowest on record and well below the 
Healthy People 2010 goal. However, given the availability of an 
effective post-exposure prophylaxis protocol, the Committee 
believes that the elimination of all perinatal transmission is 
a goal worth pursuing. In view of the large number of at-risk 
women being seen in HRSA-funded settings, the Committee urges 
HRSA to move expeditiously to integrate the best practices 
identified in the review into routine practice. In addition, 
HRSA is encouraged to validate further best practices to 
prevent perinatal hepatitis B transmission, particularly in 
high-risk ethnic communities disproportionately impacted by 
chronic hepatitis B.
    Social Work Training Program.--The Committee recognizes the 
importance of social workers and their contribution to family 
planning and maternal and child health outcomes, particularly 
in low-income communities. The Committee has included funding 
in the Bureau of Health Professions to continue and expand the 
Leadership Training Program in Social Work, which annually 
funds three centers of excellence at schools of social work to 
help develop the next generation of social workers and to 
provide critical leadership, resources, and training. The 
Committee directs the MCH Bureau to work with the Bureau of 
Health Professions to ensure a smooth transition for the 
program's grantees.

Sickle Cell Anemia

    The Committee provides $4,770,000 for grants and contracts 
to help coordinate service delivery for individuals with sickle 
cell disease, including genetic counseling and testing; 
training of health professionals; and coordination of 
education, treatment, and continuity of care programs.

Traumatic Brain Injury

    The Committee provides $9,760,000 for the Traumatic Brain 
Injury program. The program supports implementation and 
planning grants to States for coordination and improvement of 
services to individuals and families with traumatic brain 
injuries. Such services can include: pre-hospital care, 
emergency department care, hospital care, rehabilitation, 
transitional services, education, employment, long-term 
support, and protection and advocacy services.
    The Committee includes no less than the fiscal year 2013 
funding level for protection and advocacy services, as 
authorized under section 1305 of Public Law 106-310.

Autism and Other Developmental Disorders

    The Committee provides $47,142,000 for the Autism and Other 
Developmental Disorders initiative. The program supports 
surveillance, early detection, education, and intervention 
activities on autism and other developmental disorders, as 
authorized in the Combating Autism Act of 2006.
    The Committee directs HRSA to fund research on evidence-
based practices for interventions for individuals with autism 
and other developmental disabilities, for development of 
guidelines for those interventions, and for information 
dissemination at no less than fiscal year 2013 levels.
    Leadership Education in Neurodevelopmental and Related 
Disabilities [LEND].--The Committee directs that HRSA provide 
no less than the fiscal year 2013 level for LEND programs to 
maintain their capacity to train professionals to diagnose, 
treat, and provide interventions to individuals with autism 
spectrum disorders.

Newborn Screening for Heritable Disorders

    The Committee provides $9,913,000 in budget authority for 
the Newborn Heritable Disorders Screening program, as described 
in section 1109 of the Newborn Screening Saves Lives Act of 
2008. The budget request is funded entirely through transfers 
from the PPH Fund.
    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.

Healthy Start

    The Committee provides $103,532,000 for the Healthy Start 
infant mortality initiative. The primary purpose of Healthy 
Start is to reduce infant mortality and generally improve 
maternal and infant health in at-risk communities. Grants are 
awarded to State and local health departments and nonprofit 
organizations to conduct an infant mortality review, develop a 
package of innovative health and social services for pregnant 
women and infants, and evaluate these efforts.
    Public-Private Partnerships.--The Committee commends 
Healthy Start for engaging in public-private partnerships that 
identify best practices and lead to continuous quality 
improvement within the program. The Committee encourages HRSA 
to continue to evaluate rigorously the Healthy Start program 
and these partnerships.
    Stillbirth and Sudden Unexpected Infant Deaths [SUIDs].--
The Committee notes that racial disparities in stillbirth and 
SUIDs persist and significantly contribute to the more than 
25,000 stillbirths and over 4,000 SUIDs each year. HRSA is 
encouraged 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 continues to support 
HRSA's efforts to review cases of stillbirth and SUIDs at a 
local level, especially to identify better ways to address 
racial disparities.

Universal Newborn Hearing Screening and Early Intervention

    The Committee provides $18,660,000 for universal newborn 
hearing screening and early intervention activities. This 
program awards grants to 53 States and territories that support 
statewide systems of newborn hearing screening, audiologic 
diagnostic testing before 3 months of age, and enrollment in 
early intervention programs before the age of 6 months.

Emergency Medical Services for Children

    The Committee provides $21,116,000 for the Emergency 
Medical Services for Children [EMSC] program which focuses on 
improving the pediatric components of the emergency medical 
services system and improving the quality of care provided to 
children in the pre-hospital setting. Funding is available to 
every State emergency medical services office to improve the 
quality of emergency care for children and to pay for research 
and dissemination of best practices.
    The Committee commends HRSA for initiating a demonstration 
project in fiscal year 2012 to support innovative models to 
increase pediatric care in rural and tribal communities. The 
Committee also applauds the EMSC program for its collaboration 
with other Federal agencies in order to achieve EMS systemwide 
improvements. Finally, the Committee remains strongly 
supportive of the Pediatric Emergency Care Applied Research 
Network.

                            HIV/AIDS BUREAU

Appropriations, 2013\1\.................................  $2,342,623,000
Budget estimate, 2014...................................   2,412,178,000
Committee recommendation................................   2,393,951,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $2,393,951,000 for 
the HIV/AIDS Bureau, including $25,000,000 in transfers under 
section 241 of the PHS Act.
    The mission of the Bureau is to address the unmet care and 
treatment needs of persons living with HIV/AIDS. The Bureau 
administers the Ryan White Care Act, which provides a wide 
range of community-based services, including primary and home 
healthcare, case management, substance abuse treatment, mental 
health, and nutritional services.
    HIV Testing, Linkage, and Adherence.--The Committee is 
aware that, despite the demonstrated success of treatment-as-
prevention programs, less than half of all Americans with HIV 
are on antiretroviral treatment. The Committee believes that 
the key steps to ending the HIV/AIDS epidemic include finding 
those people who are unaware of their HIV-positive status, 
linking all Americans with HIV/AIDS to care and treatment, and 
retaining them in that care and treatment. The Committee urges 
HRSA within its Ryan White SPRANS portfolio to focus on the 
development of systemic approaches aimed at ensuring viral load 
suppression.

Emergency Assistance

    The Committee provides $669,915,000 for emergency 
assistance grants to eligible metropolitan areas 
disproportionately affected by the HIV/AIDS epidemic.
    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 notes that the provision requiring HRSA to 
transfer funds from part A to part B of the Ryan White Care Act 
as a result of the four transitional grant areas that changed 
status in fiscal year 2011 has expired. Therefore, the 
Committee expects HRSA to transfer no funds in fiscal year 2014 
related to transitional grant areas.

Comprehensive Care Programs

    The Committee provides $1,369,327,000 for HIV healthcare 
and support services.
    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 $943,299,000 
for AIDS medications in ADAP. This funding level is sufficient 
to continue the activities funded through HHS transfers in the 
previous 2 fiscal years and provide an increase of $11,797,000. 
The Committee intends that the increase provided for ADAP be 
awarded according to the statutory formula.

Early Intervention Services

    The Committee provides $204,765,000 for early intervention 
grants. These 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 $77,013,000 for grants for 
coordinated services to women, infants, children, and youth.
    Funds are awarded to community health centers, family 
planning agencies, comprehensive hemophilia centers, county and 
municipal health departments, and other nonprofit community-
based programs that provide comprehensive primary healthcare 
services to populations with or at risk for HIV.

AIDS Dental Services

    The Committee provides $13,458,000 for the AIDS Dental 
Services program. This program provides grants to dental 
schools, dental hygiene schools, and postdoctoral dental 
education programs to assist with the cost of providing 
unreimbursed oral healthcare to patients with HIV.

AIDS Education and Training Centers

    The Committee provides $34,473,000 for AIDS Education and 
Training Centers [AETCs]. AETCs train healthcare practitioners, 
faculty, and students who care for AIDS patients outside of the 
traditional health professions education venues and support 
curriculum development on the diagnosis and treatment of HIV 
infection for health professions schools and training 
organizations.

                       HEALTH CARE SYSTEMS BUREAU

Appropriations, 2013\1\.................................    $101,299,000
Budget estimate, 2014...................................      83,836,000
Committee recommendation................................     103,515,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation for the Health Care Systems 
Bureau is $103,515,000.
    The Health Care Systems Bureau protects the public health 
and improves the health of individuals through efforts to 
support and enhance the systems by which healthcare is 
delivered in America.

Organ Donation and Transplantation

    The Committee provides $26,015,000 for organ donation and 
transplantation activities. 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.

National Cord Blood Inventory

    The Committee provides $11,864,000 for the National Cord 
Blood Inventory. 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 $23,283,000 for the C.W. Bill Young 
Cell Transplantation Program.
    The Committee continues to strongly support cell 
transplantation through the use of cord blood, bone marrow, 
peripheral blood stem cells, and other sources of stem cells 
that may be available in the future. The Committee appreciates 
HRSA's efforts to increase the diversity of the registry and 
the program's research efforts to improve the availability, 
efficiency, safety, and cost of transplants and the 
effectiveness of program operations.

Office of Pharmacy Affairs

    The Committee provides $4,463,000 for the Office of 
Pharmacy Affairs [OPA]. OPA administers the 340B drug pricing 
program, which requires drug manufacturers to provide discounts 
or rebates to a set of programs and hospitals that serve a 
disproportionate share of low-income patients.
    The Committee remains strongly committed to OPA's plans to 
develop a transparent system to verify the accuracy of the 340B 
ceiling price. Therefore, the Committee again includes a 
statutory provision, requested by the administration, to allow 
a nominal cost recovery fee to fund the implementation of 
program integrity provisions recommended by the inspector 
general and included in the ACA. The fee will be set at 0.1 
percent for covered entities and is expected to generate 
$6,000,000 in fiscal year 2014. The Committee expects HRSA to 
report the expected and actual amounts generated by the fee in 
HRSA's annual budget justification.
    More than simply an individual discount program, the 340B 
program was designed to help safety net providers maintain, 
improve, and expand patient access to healthcare services 
generally. In establishing the program in 1992, Congress 
explicitly stated that the 340B program was intended to 
``enable entities to stretch scarce Federal resources as far as 
possible.'' As OPA continues to improve and enhance oversight 
of the 340B program, the Committee urges OPA to implement 
policies that maximize the healthcare safety net and expand 
patient access to healthcare.
    The Committee continues to note that there is currently no 
way for eligible entities to know if they are paying 
manufacturers the correct prices for 340B drugs. The ACA 
requires HRSA to make 340B ceiling prices available to covered 
entities through a secure Web site. Given that the new cost 
recovery fee is being paid by 340B participating entities, the 
Committee directs HRSA to make this Web site the first activity 
funded by the fee.
    The Committee commends HRSA for delaying the enforcement of 
the group purchasing exclusion guidance promulgated on February 
7, 2013, but remains concerned by HRSA's broad interpretation 
of the term ``covered outpatient drug.'' The Committee urges 
HRSA to create an understanding of the term that is more 
specific to the 340B program. This would allow 340B-
participating entities to use other available purchasing 
methods to obtain access to non-340B drugs at a lower cost.

Poison Control Centers

    The Committee provides $19,793,000 for poison control 
activities. The Poison Control Centers program currently 
supports a mix of grantees. Most serve States; a few serve 
multistate regions; and, in a handful of cases, more than one 
grantee serves a single State.
    Poison control centers respond to nearly 4 million public 
and healthcare professional poisoning, toxic exposure, and 
adverse drug event emergency calls annually. It is estimated 
that the avoidance of these unnecessary hospitalizations save 
more than $1,200,000,000 in healthcare costs annually, of which 
nearly $700,000,000 of these savings accrue to the benefit of 
the Federal Medicare and Medicaid programs. The Committee 
believes these savings can be substantially increased through 
enhanced awareness of poison control centers by all Medicare 
and Medicaid participants. The Committee encourages the 
Secretary to engage in discussions with the Nation's poison 
control centers to develop a plan to achieve these possible 
additional Medicare and Medicaid cost savings.

National Hansen's Disease Program

    The Committee includes $16,013,000 for the National 
Hansen's Disease program. 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 $128,000 for the repair and 
maintenance of buildings at the Gillis W. Long Hansen's Disease 
Center.

Payment to Hawaii for Hansen's Disease Treatment

    The Committee provides $1,956,000 for Hansen's disease 
services. Payments are made to the State of Hawaii for the 
medical care and treatment of persons with Hansen's disease in 
hospital and clinic facilities at Kalaupapa, Molokai, and 
Honolulu. Expenses above the level of appropriated funds are 
borne by the State of Hawaii.

                              RURAL HEALTH

Appropriations, 2013\1\.................................    $139,288,000
Budget estimate, 2014...................................     122,232,000
Committee recommendation................................     141,798,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation for Rural Health programs is 
$141,798,000.
    The Office of Rural Health Policy [ORHP] administers HHS 
rural health programs, coordinates activities related to rural 
healthcare within HHS, and analyzes the possible effects of 
policy on 62 million residents of rural communities. ORHP 
advises the Secretary on the effects of Medicare and Medicaid 
on rural citizens' access to care, the viability of rural 
hospitals, and the availability of physicians and other health 
professionals.
    The Committee commends ORHP for its increased collaboration 
with the Department of Veterans Affairs and other agencies of 
the Federal Government. ORHP has significant experience in the 
areas of information technology, workforce recruitment and 
retention, and improved access to care. The Committee urges 
ORHP to continue providing its expertise across the government 
in ways that improve healthcare delivery in rural areas. The 
Committee directs the Administrator to report to Congress in 
the fiscal year 2015 budget justification on ORHP's efforts in 
this area.

Rural Health Outreach

    The Committee provides $55,442,000 for the Rural Health 
Outreach program.
    This program supports projects that demonstrate new and 
innovative models of outreach in rural areas, such as 
integration and coordination of health services.
    The Committee recommendation includes sufficient funding to 
continue the five key program areas identified in the 
President's budget: outreach services grants, rural network 
development grants, network planning grants, small healthcare 
provider quality improvement grants, and the Delta States 
network grant program.
    The Committee commends HRSA on its work to develop a 
generalizable formula to allow rural communities to measure the 
economic impact of their health investment. The Committee is 
gratified to learn that $1.50 is generated in the community for 
every $1 invested by HRSA in rural health outreach.
    Frontier Extended Stay Clinics.--The Committee is aware 
that the Frontier Extended Stay Clinic demonstration concluded 
in April 2013. The Committee urges HRSA to assist clinics in 
maintaining their infrastructure while they wait for CMS' 
evaluation of data from the demonstration.
    Native American Graduate Education.--The Committee is aware 
of significant needs in rural areas of the country for health 
professionals and in particular those areas that have 
significant populations of Native Americans. The Committee 
encourages HRSA to work with institutions in these areas to 
help them identify appropriate graduate health professions 
training programs for the need.
    Oral Health.--The Committee remains concerned about the 
unnecessary use of hospital emergency rooms [ERs] for relief 
but not resolution of oral health maladies. The 2012 report ``A 
Costly Dental Destination'' estimates that 830,590 emergency 
room visits were made across the country in 2009 because of 
preventable dental problems. The Committee is aware of several 
successful community-wide programs that have effectively 
reduced ER visits for oral health patients. The Committee urges 
HRSA to compile best practices related to reductions in 
emergency dental care and disseminate that information to small 
and rural hospitals. In addition, HRSA is encouraged to work 
with CMS and AHRQ to identify gaps in knowledge related to 
these prevention initiatives.

Rural Health Research

    The Committee provides $9,847,000 for the Rural Health 
Research program. Funds are used for rural health research 
centers, the National Advisory Committee on Rural Health, and a 
reference and information service. Supported activities focus 
on improving the delivery of health services to rural 
communities and populations.

Rural Hospital Flexibility Grants

    The Committee provides $40,958,000 for Rural Hospital 
Flexibility grants and the Small Hospital Improvement Program. 
Under these grant programs, 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 recommendation rejects the proposed 
elimination of the Small Hospital Improvement Program.
    The Committee commends HRSA for its work on telehealth and 
electronic health records in rural hospitals, with a focus on 
mental healthcare for veterans. The Committee modifies previous 
bill language to give HRSA flexibility to determine future 
needs in this area.

Rural Access to Emergency Devices

    The Committee provides $5,000,000 for the Rural Access to 
Emergency Devices program. Funding is used to purchase 
automated external defibrillators, place them in public areas 
where cardiac arrests are likely to occur, and train lay 
rescuers and first responders in their use.
    The Committee intends this appropriation to fund the rural 
program authorized in section 413 of the PHS Act and the 
community access demonstration authorized in section 313. 
Funding will be used to buy automated external defibrillators, 
put them in public areas where cardiac arrests are likely to 
occur, and train lay rescuers and first responders in their 
use.

State Offices of Rural Health

    The Committee provides $10,016,000 for State Offices of 
Rural Health. These offices help States strengthen rural 
healthcare delivery systems by enabling them to coordinate care 
and improve support and outreach in rural areas.

Black Lung Clinics

    The Committee provides $7,125,000 for the Black Lung 
Clinics program. 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 $1,931,000 for activities authorized 
by the Radiation Exposure Compensation Act. This program 
provides grants for the education, prevention, and early 
detection of radiogenic cancers and diseases resulting from 
exposure to uranium during mining and milling at nuclear test 
sites.

Telehealth

    The Committee provides $11,479,000 for the Office for the 
Advancement of Telehealth [OAT], which 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 commends OAT for expanding adult mental 
health services to 204 communities and pediatric/adolescent 
mental health services to 239 communities where access to such 
services did not exist prior to receiving Federal telehealth 
funding. The Committee remains strongly supportive of the 
emphasis OAT has placed on expanding access to mental health 
services.

                            FAMILY PLANNING

Appropriations, 2013\1\.................................    $296,244,000
Budget estimate, 2014...................................     327,402,000
Committee recommendation................................     327,402,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee provides $327,402,000 for the Title X Family 
Planning program. This program supports preventive and primary 
healthcare services at clinics nationwide through four key 
functions: (1) providing individuals with comprehensive family 
planning and related preventive health services, including all 
FDA-approved methods of contraception; (2) training for family 
planning clinic personnel; (3) data collection and research 
aimed at improving the delivery of services; and (4) 
information dissemination and community-based education and 
outreach activities.
    The Committee recognizes the ongoing need to support 
publicly funded family planning services and supplies during 
and after implementation of the ACA. Although health reform 
will result in the expansion of insurance coverage, patients 
seeking family planning and reproductive health services often 
have privacy concerns that inhibit the full use of coverage. 
Many of these patients will turn to safety-net settings, such 
as title X-funded health centers, for care. Public funding for 
family planning remains a cost-effective means of providing 
essential health services and will be important to Federal and 
State efforts to implement the ACA.
    Infrastructure.--As essential community providers, title X 
clinics provide primary and preventive care services, including 
cancer screenings and family planning services, to nearly 5 
million women and men each year. The Committee supports the use 
of title X program funds for infrastructure investments, 
including for health information technology, to ensure women's 
health providers can keep pace with the increased demand for 
reproductive health services.
    Tiered Subgranting.--The Committee is aware that some 
traditional grantees of the title X program are implementing 
newly tiered approaches which base subgranting decisions on 
criteria that are unrelated to the performance outcomes of the 
program. The Committee directs HRSA to give funding preference 
to applicants with plans that show that a wide range of 
providers are eligible for subgrants and that funding decisions 
will be made solely on the ability of a clinic to achieve the 
best possible outcomes for the population served.

                           PROGRAM MANAGEMENT

Appropriations, 2013\1\.................................    $161,186,000
Budget estimate, 2014...................................     161,794,000
Committee recommendation................................     161,794,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee provides $161,794,000 for program management 
activities.

               HEALTH EDUCATION ASSISTANCE LOANS PROGRAM

Appropriations, 2013\1\.................................      $2,830,000
Budget estimate, 2014...................................       2,807,000
Committee recommendation................................       2,807,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

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

             VACCINE INJURY COMPENSATION PROGRAM TRUST FUND

Appropriations, 2013\1\.................................    $241,464,000
Budget estimate, 2014...................................     241,477,000
Committee recommendation................................     241,464,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee provides that $241,464,000 be released from 
the Vaccine Injury Compensation Trust Fund in fiscal year 2014. 
Of that amount, $6,464,000 is for administrative costs.
    The National Vaccine Injury Compensation program provides 
compensation for individuals with vaccine-associated injuries 
or deaths. Funds are awarded to reimburse medical expenses, 
lost earnings, pain and suffering, legal expenses, and death 
benefits. The Vaccine Injury Compensation Trust Fund is funded 
by excise taxes on certain childhood vaccines.

               Centers for Disease Control and Prevention

    The Committee recommendation provides $6,183,769,000 in 
this bill for CDC, including $371,357,000 in transfers under 
section 241 of the PHS Act and $55,358,000 in mandatory funds 
under the terms of EEOICPA. In addition, the Committee 
recommends $839,000,000 in transfers from the PPH Fund.
    The total program level recommended for CDC is 
$7,022,769,000.
    The fiscal year 2013 program level is $6,547,169,000 and 
the budget request is $6,644,640,000. The budget request 
includes $617,664,000 in transfers under section 241 of the PHS 
Act and $755,110,000 in transfers from the PPH Fund.
    The activities of CDC focus on several major priorities: 
providing core public health functions; responding to urgent 
health threats; monitoring the Nation's health using sound 
scientific methods; building the Nation's health 
infrastructure; assuring the Nation's preparedness for emerging 
infectious diseases and potential pandemics; and providing 
leadership in the implementation of nationwide prevention 
strategies that are conducive to improving and maintaining 
health. The Committee has deleted references to title VII of 
the PHS Act throughout CDC's appropriation, as requested by the 
President's budget, in recognition of the fact that activities 
authorized in title VII are outside the scope of CDC's mission.
    The funding levels for the fiscal year 2014 budget request 
are not easily comparable to the fiscal year 2013 and 
Committee-recommended levels. The President proposes to 
implement the Working Capital Fund [WCF] through each 
individual program line. The Committee rejects that approach 
and recommends implementing the WCF through a transfer of funds 
in the first quarter of fiscal year 2014, in accordance with 
statutory transfer provisions provided in the fiscal year 2013 
continuing resolution and this bill. For that reason, prior 
year and Committee-recommended funding levels for each activity 
reflect the programmatic costs of such activities, and the 
total business service costs for CDC are appropriated 
separately in the CDC-wide appropriation. In contrast, the 
President's request assumes business service costs are built 
into each funded activity at the level of that activity's 
business service consumption in fiscal year 2011. In many 
cases, a proposed increase for an activity in the budget 
request simply reflects the addition of the existing business 
service cost.

                 IMMUNIZATION AND RESPIRATORY DISEASES

Appropriations, 2013\1\.................................    $587,959,000
Budget estimate, 2014\2\................................     681,560,000
Committee recommendation................................     587,959,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.
\2\Assumes a realignment of $35,915,000 in business service funding.

    The Committee recommendation for the activities of the 
National Center for Immunization and Respiratory Diseases is 
$587,959,000; this amount includes $12,864,000 in transfers 
available under section 241 of the PHS Act.
    In addition, the Committee recommends transferring 
$150,000,000 to the Center from the PPH Fund. The President's 
budget proposed transferring $72,460,000 from the PPH Fund; 
$90,883,000 was transferred from the PPH Fund in fiscal year 
2013.
    The total program level recommended for the Center is 
$737,959,000.
    The mission of the National Center for Immunization and 
Respiratory Diseases is the prevention of disease, disability, 
and death through immunization and by control of respiratory 
and related diseases.
    The Committee recommendation includes funding for the 
following activities in the following amounts:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                                  Fiscal year
                      Budget activity                         Fiscal year 2013  2014 request\2\     Committee
                                                              appropriation\1\                    recommendation
----------------------------------------------------------------------------------------------------------------
Immunization...............................................          520,340           580,959          579,457
    National Immunization Survey (non-add).................          (12,864)          (12,864)         (12,864)
Influenza Planning and Response............................          158,502           173,061         158,502
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
  reprogrammings allowed under Public Law 113-6.
\2\Includes $35,915 in funds from the Working Capital Fund realignment.

    Cost Estimates.--The Committee requests an updated report 
on Federal immunization programs no later than February 1, 
2014, to reflect fiscal year 2015 cost estimates, optimum 
funding to support State and local operations, and a continued 
discussion of the evolving role of Federal programs as expanded 
coverage for vaccination becomes more available from private 
and public sources.
    Exemption Rates.--The Committee urges CDC to continue 
working with State and local governments to ensure that the 
universal immunization recommendations, as defined by the 
Advisory Committee on Immunization Practices, are implemented. 
The Committee encourages CDC to work with States to track 
exemption rates and assess the impact that exemptions may have 
on vaccine-preventable disease rates. CDC should provide to 
State and local health officials, the provider community, and 
the public, scientifically accurate information on vaccines and 
vaccine-preventable diseases that is presented in culturally 
and linguistically appropriate manners.
    Public Health Role.--As more individuals have access to 
vaccines through health insurance coverage, the Committee 
believes that the public health role in vaccination will shift 
but not diminish. The Nation's public health immunization 
infrastructure will be called upon to ensure the quality and 
safety of our vaccines, monitor increasing vaccination rates 
and remaining gaps, provide science-based education on vaccine 
risks and benefits, and respond to outbreaks. The Committee has 
combined the funding amounts for section 317 vaccine purchase 
with funding for program implementation and accountability to 
allow CDC maximum flexibility to increase quality and safety 
activities as insurance coverage rates change over time. The 
Committee urges CDC to use this flexibility to shift resources 
to better reflect the changing public health role. 
Specifically, the Committee recommends that CDC increase 
resources to: (1) modernize immunization information systems; 
(2) prepare public health departments for changes in the 
healthcare delivery system, including new billing procedures 
related to privately insured patients; (3) strengthen the 
evidence base to inform immunization policy; and (4) improve 
program monitoring, including vaccine-preventable disease 
surveillance, vaccine coverage assessment, adverse event 
reporting, and laboratory training. The Committee directs that 
intramural costs within the immunization be funded at the 
fiscal year 2013 level.
    Vaccine Purchase Formula Change.--The Committee supports 
CDC's policy decision to limit the conditions under which fully 
insured individuals may receive vaccines purchased through 
section 317 funds. The Committee believes that section 317 
should be the payer of last resort for vaccination. However, 
the Committee has some concerns about the administration's plan 
to change from a vaccine purchase allocation formula that is 
based strictly on each State's total population to a formula 
based on Census estimates of each State's uninsured population. 
The Committee notes that this change would inadvertently 
penalize uninsured and underinsured individuals in States that 
are using all available tools to insure their populace. The 
Committee urges CDC to develop a component in the formula that 
would provide an incentive to States to administer section 317-
funded vaccines in a way that addresses coverage gaps which 
cannot be filled with other available Federal programs.

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

Appropriations, 2013\1\.................................  $1,097,823,000
Budget estimate, 2014\2\................................   1,176,942,000
Committee recommendation................................   1,097,823,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.
\2\Assumes a realignment of $53,030,000 in business service funding.

    The Committee recommendation for the activities of the 
National Center for HIV, Viral Hepatitis, Sexually Transmitted 
Diseases [STDs], and TB Prevention is $1,097,823,000.
    In addition, the Committee recommends transferring 
$10,000,000 to the Center from the PPH Fund. The President's 
budget did not recommend transferring funds from the PPH Fund; 
however, the budget request did propose a transfer of 
$3,000,000 under section 241 of the PHS Act.
    The total program level recommended for the Center is 
$1,107,823,000.
    The Center administers CDC's activities on HIV/AIDS, viral 
hepatitis, STDs, and TB, with the exception of the Global AIDS 
program, which is housed in the Center on Global Health.
    The Committee recommends funding for the following 
activities in the following amounts:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year     Fiscal year
                         Budget activity                               2013            2014          Committee
                                                                   comparable\1\    request\2\    recommendation
----------------------------------------------------------------------------------------------------------------
HIV Prevention by Health Department.............................         334,422         399,744         392,636
National Programs To Identify and Reach High Risk Populations...  ..............         400,985         362,189
HIV School Health...............................................          29,778          35,395          29,778
HIV Surveillance................................................         116,797  ..............  ..............
Enhanced HIV Testing Initiative.................................          64,918  ..............  ..............
Improving HIV Program Effectiveness.............................         101,649  ..............  ..............
National, Regional, Local, Community and Other Organizations....         137,039  ..............  ..............
Viral Hepatitis.................................................          19,640          31,410          29,640
Sexually Transmitted Infections.................................         153,523         161,710         153,523
Tuberculosis....................................................         140,057         147,698        140,057
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
  reprogrammings allowed under Public Law 113-6.
\2\Includes $53,030 in funds from the Working Capital Fund realignment.

    Hepatitis C Prevention.--The Committee is concerned by 
increasing rates of new hepatitis C infections that are 
associated with the injection of prescription opioids and 
heroin, particularly among young people. The Committee 
encourages the Division of Viral Hepatitis to continue 
coordinating efforts with the Assistant Secretary for Health, 
SAMHSA, and NIDA to address these outbreaks by disseminating 
timely information on evidence-based prevention strategies and 
providing technical assistance to health departments and 
community-based organizations.
    HIV Prevention.--The Committee accepts the administration 
proposal to realign and consolidate the various funding streams 
that are awarded to State health departments for the 
surveillance and prevention of HIV. The Committee believes this 
consolidation will allow needed flexibility while the public 
health system adapts to the expansion of preventive services 
brought about by the implementation of the ACA. The Committee 
requests that CDC provide an accurate picture of how States are 
using this additional flexibility in future budget 
justifications.
    Liver Disease.--Liver diseases of all kinds have a 
significant impact on the health and well-being of Americans. 
The Committee notes that liver diseases are addressed by 
several Centers of CDC. For example, public health efforts 
around hepatitis are housed in this Center, but fatty liver 
disease is associated with obesity, the prevention of which is 
led by the Center on Chronic Diseases. The Committee encourages 
CDC to consider ways to coordinate public health efforts on 
liver diseases across Centers.
    Viral Hepatitis Screening.--The Committee urges CDC to 
prioritize testing activities and initiatives to identify 
people infected with asymptomatic forms of hepatitis. The 
Committee further encourages CDC to conduct prevention research 
to identify and disseminate best practices for implementing 
viral hepatitis screening, including new tests and testing 
procedures, standards of preventive care, and prompt linkage of 
persons testing positive for viral hepatitis to needed medical 
management and treatment. CDC should investigate opportunities 
to make purchasing options for hepatitis testing supplies more 
streamlined and efficient.

               EMERGING AND ZOONOTIC INFECTIOUS DISEASES

Appropriations, 2013\1\.................................    $252,043,000
Budget estimate, 2014\2\................................     380,664,000
Committee recommendation................................     283,237,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.
\2\Assumes a realignment of $57,917,000 in business service funding.

    The Committee recommendation for the activities of the 
National Center for Emerging and Zoonotic Diseases is 
$283,237,000. In addition, the Committee recommends 
transferring $52,000,000 to the Center from the PPH Fund. The 
President's budget proposed transferring $51,750,000 from the 
PPH Fund; $44,174,000 was transferred from the PPH Fund in 
fiscal year 2013.
    The total program level recommended for the Center is 
$335,237,000.
    The National Center for Emerging and Zoonotic Infectious 
Diseases aims to detect, prevent, and control infectious 
diseases from spreading, whether they are naturally occurring, 
unintentional, or the result of terrorism.
    The Committee recommendation includes funding for the 
following activities in the following amounts:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                                    Fiscal year
                       Budget activity                          Fiscal year 2013       2014          Committee
                                                                appropriation\1\    request\2\    recommendation
----------------------------------------------------------------------------------------------------------------
Infectious Disease Core Funding..............................            19,789           24,339          19,789
Vector-borne Diseases........................................            23,044           28,326          23,044
Lyme Disease.................................................             8,702           10,701           9,702
Prion Disease................................................             4,960            6,089           4,960
Chronic Fatigue Syndrome.....................................             4,699            5,778           4,699
Emerging Infectious Diseases.................................           123,147          151,521         123,147
Food Safety..................................................            27,067           49,223          35,067
National HealthCare Safety Network...........................            14,814           31,562          16,814
Quarantine...................................................            25,821           33,125          26,015
Advanced Molecular Detection.................................  .................          40,000          20,000
Epidemiology and Laboratory Improvement program..............            32,424           40,000          40,000
Healthcare-Associated Infections.............................            11,750           11,750         12,000
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
  reprogrammings allowed under Public Law 113-6.
\2\Includes $57,917 in funds from the Working Capital Fund realignment.

    Advanced Molecular Detection.--The Committee strongly 
supports CDC's mission to improve our Nation's capability to 
detect and treat infectious diseases and food-borne illnesses. 
Therefore, the Committee recommendation includes the full 
amount requested for improving pathogen identification, 
enhancing sustainable laboratory information systems, and 
improving modeling and early recognition of pathogens, as the 
first investment in CDC's proposed 5-year initiative. The 
Committee recommends that CDC use the first year of funding to 
begin building the science base of this initiative before 
funding the coordination of States. In starting this 
initiative, the Committee notes that this is a focused, time-
limited effort on a particular genetic sequencing capability 
that has implications across many of CDC's program areas. To 
the extent that this capability reveals a potential advance 
that is limited to an issue area covered by other programs and 
Centers of CDC, the Committee expects CDC to transition the 
research and implementation of that new technique to the 
relevant condition-specific and laboratory support programs of 
CDC. The Committee strongly supports ongoing innovation in all 
programs of CDC and intends this initiative to strengthen that 
commitment across the agency.
    Antibiotic Resistance.--The Committee commends CDC for 
committing to develop the report requested in fiscal year 2013 
on the available data on antibiotic consumption and resistance 
trends. The Committee recognizes that the report requires 
substantial effort and looks forward to receiving it on CDC's 
proposed timetable.
    Antimicrobial Resistance.--The Committee urges CDC to work 
with State health departments to expand the work of prevention 
collaboratives, which seek to interrupt and prevent the 
transmission of significant antibiotic-resistant pathogens 
across healthcare settings. CDC, with the collaboratives, 
should evaluate the impact of possible interventions on 
hospital readmissions, healthcare-associated infection rates, 
or other measures relevant to health or economic activity. CDC 
and the Prevention Epicenters are encouraged to continue 
evaluating interventions to prevent or limit the development of 
antimicrobial resistance, facilitating public health research 
on the prevention and control of resistant organisms, and 
assessing the appropriateness of current surveillance and 
prevention programs in healthcare and institutional settings.
    Epidemiology Laboratory Capacity [ELC] Cooperative 
Agreement.--The Committee is aware that some confusion exists 
between the ELC program funding and the ELC cooperative 
agreement. The ELC cooperative agreement is a flexible funding 
mechanism that is used to award ELC program funds to States, 
and is also used to award funds that are appropriated for a 
variety of condition-specific activities in this report. To 
eliminate this unnecessary and unhelpful confusion, the 
Committee has renamed the ELC program ``the Epidemiology and 
Laboratory Improvement program''. The Committee intends this to 
be a clarifying change only. CDC should maintain the prior 
purpose, award mechanism, and allocation of this funding.
    Food Safety.--The Committee recommendation includes 
additional funding to maintain appropriate staffing levels and 
enhance laboratory capacity in States to identify food-borne 
illnesses and effectively confine outbreaks. Further, the 
Committee continues to support the integrated Food Safety 
Centers of Excellence. These Centers, housed within State 
health departments, serve a critical role in developing and 
disseminating best practices and tools in food safety 
surveillance and outbreak response.
    Healthcare-Associated Infections [HAIs].--Researchers 
estimate that excess medical costs from HAIs in U.S. hospitals 
range from $28,000,000,000 to $33,000,000,000 every year. The 
Committee continues to support the monitoring, response, and 
prevention efforts that have led to promising reductions in 
HAIs in recent years. The Committee recommendation is 
sufficient to expand the National Healthcare Safety Network, an 
HAI surveillance system used by over 5,000 facilities, 
including hospitals in all 50 States and nonhospital settings 
throughout the country.
    Infectious Diseases.--The core Infectious Disease program 
provides funding to States to identify and monitor the 
occurrence of known infectious diseases, identify newly 
emerging infectious diseases, and identify and respond to 
outbreaks. The Committee notes that this funding has supported 
the public health response in virtually every major infectious 
disease outbreak in recent years.
    Quarantine.--The Committee recommendation includes a new 
provision, requested by the administration, to reimburse States 
for the cost of isolation and quarantine. The Committee 
modifies the requested statutory language to limit 
reimbursement to the costs States incur following a Federal 
quarantine order, rather than reimburse States for quarantines 
that originate under State laws.
    Unsafe Injection Practices.--The Committee remains troubled 
by outbreaks of and ongoing public exposure to life-threatening 
infections and bacteria caused by unsafe injection practices in 
healthcare facilities, including the misuse of vials and 
syringes. Outbreaks are entirely preventable when evidence-
based infection control practices are followed. CDC is 
encouraged to continue its injection safety activities, 
including provider education and awareness, detection, 
tracking, and response. The Committee encourages broader 
outreach to healthcare providers and State and local health 
departments to disseminate the standards-based resources and 
toolkits that were created through previous investments of this 
Committee and through the PPH Fund. The Committee is aware that 
CMS is collecting additional data on infection control 
procedures of ambulatory surgical centers, beginning in fiscal 
year 2013, and encourages CDC to collaborate with CMS to 
analyze this data and use it to target prevention resources 
more effectively.

            CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION

Appropriations, 2013\1\.................................    $755,079,000
Budget estimate, 2014\2\................................     620,189,000
Committee recommendation................................     774,831,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.
\2\Assumes a realignment of $43,939,000 in business service funding.

    The Committee recommendation for the activities of the 
National Center for Chronic Disease Prevention and Health 
Promotion is $774,831,000. In addition, the Committee 
recommends transferring $485,700,000 to the Center from the PPH 
Fund. The President's budget proposed transferring $415,904,000 
from the PPH Fund; $233,033,000 was transferred from the PPH 
Fund in fiscal year 2013.
    The total program level recommended in this bill for the 
Center is $1,260,531,000.
    The mission of the National Center for Chronic Disease 
Prevention is to provide national leadership in promoting 
health and well-being through prevention and control of chronic 
diseases. Nearly one-half of all American adults have at least 
one chronic illness; such diseases account for nearly 70 
percent of all U.S. deaths and three-quarters of all healthcare 
costs in the United States.
    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                         Fiscal year 2013  2014 request\2\     Committee
                                                              appropriation\1\                    recommendation
----------------------------------------------------------------------------------------------------------------
Tobacco....................................................          168,194           212,360          202,892
Chronic Disease State Grants:
    Heart Disease and Stroke...............................           54,881            58,870           54,881
    Diabetes...............................................           64,323            69,260           64,323
    School Health..........................................           13,499            14,703           17,199
        Food Allergy (non-add).............................             (486)   ...............            (486)
        National School Food Marketing Assessment (non-add)  .................  ...............          (1,700)
    Nutrition, Physical Activity and Obesity...............           42,763            47,400           51,311
National Diabetes Prevention Program.......................  .................          10,000           10,000
Community Health Promotion.................................            6,096             6,636            6,096
Glaucoma...................................................            3,313             3,591            3,313
Visual Screening Education.................................              507               551              507
Alzheimer's Disease........................................            1,799             1,949            1,799
Inflammatory Bowel Disease.................................              676               733              676
Interstitial Cystitis......................................              650               704              650
Excessive Alcohol Use......................................            2,436             2,647            2,436
Chronic Kidney Disease.....................................            2,078             2,251            2,078
Oral Health................................................           14,619            15,921           15,000
Safe Motherhood/Infant Health..............................           43,727            49,322           43,727
Prevention Research Centers................................           24,325            25,041           27,869
Breast and Cervical Cancer.................................          204,427           184,560          204,427
    WISEWOMAN (non-add)....................................          (20,594)          (21,413)         (20,594)
Breast Cancer Awareness for Young Women....................            4,872             5,067            4,872
Cancer Registries..........................................           49,928            51,915           49,928
Colorectal Cancer..........................................           42,756            40,577           42,756
Comprehensive Cancer State Grants..........................           20,165            20,967           20,165
Johanna's Law..............................................            4,962             5,161            4,962
Ovarian Cancer.............................................            4,873             5,068            4,873
Prostate Cancer............................................           13,092            13,612           13,092
Skin Cancer................................................            2,135             2,219            2,135
Cancer Survivorship Resource Center........................              494               514              494
Arthritis and Other Chronic Diseases.......................           25,152            26,654           25,152
    Arthritis..............................................           12,979    ...............          12,979
    Epilepsy...............................................            7,743    ...............           7,743
    National Lupus Patient Registry........................            4,430    ...............           4,430
Racial and Ethnic Approach to Community Health.............           13,916    ...............          53,916
Community Transformation Grants............................          146,340           146,340          290,000
Obesity Prevention in High-Obesity Regions.................  .................  ...............           5,000
Million Hearts.............................................            4,612             5,000            5,000
Workplace Wellness.........................................  .................  ...............          10,000
Let's Move--National Early Child Care Collaboratives.......            4,000             4,000            4,000
Breastfeeding Promotion and Support........................            2,500             2,500           15,000
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
  reprogrammings allowed under Public Law 113-6.
\2\Includes $43,939 in funds from the Working Capital Fund realignment.

    Breast and Cervical Cancer Screening.--While the Committee 
understands that more women will have insurance in fiscal year 
2014 and thus more women will have access to breast and 
cervical cancer screening through their coverage, this program 
remains vitally important for the outreach and education it 
provides on the need for screening. Such efforts will be 
critical to ensuring that newly insured women actually receive 
these life-saving services. For that reason, the Committee 
includes the provision requested by the administration to 
eliminate the cap on State outreach activities; however, while 
the administration proposed giving this needed flexibility to 
just 10 States, the Committee recommends that it should be 
provided to all States.
    Cardiomyopathy.--The Committee continues to support CDC's 
efforts to track the rates of sudden cardiac arrest [SCA], 
develop evidence-based prevention strategies for SCA deaths in 
youth, and disseminate information to schools, coaches, and 
parents.
    Coordinated Chronic Disease Funding.--The Committee 
commends CDC on the release of the February 2013 funding 
opportunity announcement [FOA] ``State Public Health Actions to 
Prevention and Control Diabetes, Heart Disease, Obesity and 
Associated Risk Factors and Promote School Health.'' This 
announcement implements an approach requested by the Committee 
for the past 3 years.
    The Committee is aware that ensuring some level of chronic 
disease funding to all States, combined with the implementation 
of overall funding cuts in fiscal year 2013, resulted in 
drastic reductions for some States. The Committee 
recommendation includes additional funding in the Nutrition, 
Physical Activity, and Obesity, and School Health programs to 
increase the base grant component of the coordinated FOA. This 
investment, when combined with the $6,000,000 CDC awarded to 
all States in fiscal year 2013 to align the timing of these 
four grants, should increase each State's annual award by an 
average of $440,000. This level is sufficient to reduce by over 
two-thirds the number of States funded below the level they 
were awarded in fiscal year 2012.
    The Committee believes this approach will achieve three 
important goals: better align the distribution of CDC funding 
to chronic disease rates in the States, increase the ability of 
State health officials to move beyond planning activities into 
implementation of prevention strategies, and improve health 
outcomes for all Americans. CDC is expected to demonstrate that 
funds are spent in the amounts allocated and for the purposes 
specified in this report.
    Colorectal Cancer.--The Committee requests a report 
detailing CDC's activities in each State regarding colorectal 
cancer.
    Community Transformation Grants [CTGs].--The Committee 
recommendation includes an additional $143,660,000 above the 
fiscal year 2013 level for CTGs. The Committee directs CDC to 
award this funding in another round of community grants in 
fiscal year 2014. The Committee directs CDC to give a priority 
to communities that request funding to implement ``Blue Zone'' 
goals and strategies, in particular multi-sector approaches to 
public health interventions in areas such as transportation, 
agriculture, and housing. Blue Zones implement evidence-based 
practices identified in groups and cultures from around the 
world where people live measurably longer lives. In addition, 
priority should be given to communities and clusters of 
contiguous communities that are economically disadvantaged and 
whose residents have disproportionately poor health outcomes.
    Diabetes.--The Committee remains impressed by the 
implementation of the evidence-based National Diabetes 
Prevention Program [DPP] and includes $10,000,000 to expand the 
use of this model. The Committee notes 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 directs CDC 
to ensure that diabetes prevention activities are conducted by 
all States within the coordinated chronic disease efforts.
    Diet and Nutrition.--The Committee believes that attention 
to the flavor of food is critical to inspiring the consumption 
of healthy and nutritious food. For that reason, the Committee 
continues to strongly support CDC's initiatives to develop 
training resources for foodservice professionals and employees 
on the preparation of foods that are healthful, flavorful, and 
delivered in the most cost-effective manner. In particular, CDC 
is encouraged to produce and disseminate digital media 
instruction on best practices for delivering healthy meals in 
large volume settings.
    Epilepsy.--The Committee applauds the CDC epilepsy program 
for the progress it has made in advancing a public health 
agenda that seeks to improve the lives of people living with 
this disease. The Committee encourages CDC to continue 
expanding collaborations and addressing the recommendations of 
the 2012 IOM report ``Epilepsy Across the Spectrum: Promoting 
Health and Understanding.''
    Heart Disease and Stroke.--The Committee continues to 
support strongly the Paul Coverdell National Acute Stroke 
Registry. In addition, the Committee eagerly anticipates the 
upcoming release of data from the NCHS heart attack follow-up 
study, funded with PPH funding beginning in fiscal year 2011. 
Through this study, CDC is reviewing past medical records of 
individuals who are treated for heart attack in emergency 
rooms, to determine if patterns exist for earlier intervention. 
CDC is directed to move expeditiously to incorporate any 
lessons learned into the State programs.
    Inflammatory Bowel Disease.--The Committee continues to 
prioritize CDC's inflammatory bowel disease epidemiology study, 
and requests a report on the ongoing activities in this 
important area.
    Interstitial Cystitis.--The Committee commends CDC's work 
to raise awareness of interstitial cystitis, particularly as 
emerging epidemiology data indicates that this condition is 
underdiagnosed in the male population. The Committee continues 
to prioritize the Interstitial Cystitis Education and Awareness 
Program and encourages CDC to partner with the advocacy 
community on this issue.
    Lupus Patient Registry.--The Committee applauds the efforts 
of the National Lupus Patient Registry. The Committee 
recommendation includes funding to conduct cohort and burden of 
illness studies to help study long-term outcomes, socioeconomic 
burdens, and mortality associated with lupus. Given the 
complexity of and difficulty in diagnosing the disease, the 
Committee is concerned that individuals with lupus could be 
missing from the registries. To address this concern, the 
Committee urges CDC to develop a national campaign focused on 
healthcare provider education and improved public understanding 
of lupus. The Committee directs CDC to work with the Office of 
Minority Health to ensure that all provider education efforts 
are coordinated and not duplicative.
    Maternal Mortality Reviews.--The Committee continues to 
support CDC's work to standardize core data sets for State-
based maternal mortality reviews, which identify deaths, review 
associated factors, and take action to institute changes to 
decrease pregnancy-related and pregnancy-associated mortality. 
The Committee looks forward to the dissemination of the final 
case abstraction form in the coming year.
    National Early Care and Education Collaboratives.--
According to statistics published in the Journal of American 
Medical Association, over a quarter of children aged 2 to 5 are 
overweight or obese. An estimated 12 million children spend 
time in early care and education [ECE] settings on a regular 
basis. The Committee recommendation includes $4,000,000 to 
continue the highly successful collaboratives, which assist ECE 
providers in six States adopt policies and practices related to 
nutrition, breastfeeding support, physical activity, and screen 
time.
    National School Food Marketing Assessment.--The Committee 
continues to be concerned that more than one-third of children 
and adolescents in the United States are overweight or obese. 
The Committee commends CDC for expanding the 2014 School Health 
Policies and Practices Study [SHPPS] to include additional 
questions related to food and beverage marketing. In support of 
this effort, the Committee recommendation for School Health 
includes an additional $1,700,000 in transfers from the PPH 
Fund for a SHPPS follow-up observational study related to food 
marketing.
    The primary objective of this follow-up component to the 
study shall be to assess the extent and types of marketing in 
elementary and secondary schools and on school grounds related 
to food and beverages. Coupled with the 2014 SHPPS 
questionnaire, this component shall assess ways through which 
foods and beverages are marketed to children in schools, 
including but not limited to brand and product logos, names, or 
information on educational materials, school supplies, 
displays, signage, equipment, buses, and other school property; 
educational incentive programs; label redemption programs; in-
school media; free samples and coupons; branded fundraising 
activities; market research activities; and product displays 
and placements. The Committee further directs CDC to integrate 
the observational data into the 2014 SHPPS fact sheets and make 
publicly available a fact sheet on food marketing. The 
Committee encourages CDC to make the observational data 
available to external researchers to the greatest extent 
possible.
    Obesity Outreach.--While some indicators show slight drops 
in obesity rates recently, the Committee remains concerned that 
there has been little change in the areas where the problem is 
worst, particularly in rural areas. The Committee 
recommendation includes $5,000,000 in PPH Fund competitive 
funding to conduct pilot programs that focus on the use of 
existing extension and outreach services in the counties with 
the highest prevalence of obesity. All counties with an obesity 
prevalence of over 40 percent, as determined by CDC's latest 
county level data in the Behavioral Risk Factor Surveillance 
System, shall be eligible to participate in this extension and 
outreach program.
    Office on Smoking and Health [OSH].--The Committee expects 
OSH to transfer at least the same amount it did in fiscal year 
2013 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. The Committee is pleased with 
the reported results of the OSH media campaign, ``Tips from 
Former Smokers.'' In its first year, the Tips campaign 
generated more than 207,000 additional calls to State quitlines 
and more than 510,000 hits to www.smokefree.gov, the 
Government's Web site offering quit assistance. Research has 
shown that at least five to six smokers try to quit on their 
own for every one person who calls a quitline. The Committee 
expects OSH to commit at least the same amount in fiscal year 
2014 for a media campaign and quitlines as it did in fiscal 
year 2013.
    Oral Health.--The Committee recommendation includes funding 
for States to strengthen their capacities to assess the 
prevalence of oral diseases and to target resources and 
interventions, such as community prevention and school-linked 
sealant programs, to the underserved. The Committee is pleased 
with CDC's work on the new communications plan related to 
prevention initiatives, and includes additional funding to 
implement the plan. The Committee continues to support the 
development of an oral health literacy program in response to 
recommendations from the IOM.
    Ovarian Cancer.--Within the funds provided for Johanna's 
Law, up to $1,000,000 shall be used for a review of the state 
of the science on ovarian cancer. To conduct this review, CDC 
should engage all relevant operating divisions of HHS, as well 
as stakeholders and experts from the private and nonprofit 
sectors. The review should include: an evaluation and summary 
of the existing state of the science; an assessment of existing 
government initiatives; and identification of and 
recommendations for other public and private sector efforts 
that would help the Nation make progress in reducing the 
incidence and mortality of ovarian cancer. In addition, the 
Committee requests an update in the fiscal year 2015 budget 
justification on CDC's effort to integrate ovarian cancer into 
other related programs at the CDC.
    Psoriasis.--The Committee commends CDC on the release of 
the report ``Developing and Addressing the Public Health Agenda 
for Psoriasis and Psoriatic Arthritis,'' funded under the 
jurisdiction of this Committee in fiscal year 2010 and released 
in February 2013. The Committee encourages the Center on 
Chronic Disease Prevention and Health Promotion to collaborate 
with the National Center for Health Statistics to identify 
survey instruments that could be used to implement this agenda.
    Racial and Ethnic Approaches to Community Health [REACH].--
The Committee strongly supports the REACH model of partnering 
with communities that are underserved and often disaffected, 
both to identify health disparities of concern to the community 
and then to implement community-based, evidence-based, and 
culturally competent approaches to reduce or eliminate those 
disparities. The Committee believes that REACH complements the 
CTG program by providing a more intense partnership with the 
leadership of communities that suffer from marked health 
disparities. Due to the relative lack of resources and 
organizing capacity, these communities need a longer 
engagement, with more intense community planning, smaller match 
requirements, and more significant technical assistance. For 
that reason, the Committee directs CDC to implement the model 
of REACH that existed prior to 2012, when CDC began supporting 
shorter commitments with a smaller level of funding.
    Safe Motherhood Initiative.--Although nearly 50 percent of 
all premature births have no known cause, there are prevention 
strategies that work, such as reducing early elective 
deliveries. Funding is provided to maintain current preterm 
birth research and prevention initiatives.
    School-Based Food Allergy Guidelines.--Deaths from 
anaphylactic reactions to food allergens are entirely 
preventable. Nevertheless, these tragedies continue to occur 
when epinephrine is not readily accessible for prompt 
administration or bystanders are not adequately prepared to 
respond. Many State legislatures have passed or are considering 
legislation to require or allow schools to stock epinephrine. 
The Committee recommendation includes funding to support the 
dissemination and implementation of the food allergy school 
guidelines, which CDC is expected to issue this fall. CDC is 
encouraged to consider making epinephrine purchase an allowable 
use of School Health funds, subject to terms and conditions 
related to storage and appropriate use.
    WISEWOMAN.--The Committee is aware that CDC is undertaking 
an open competition for WISEWOMAN, allowing new States to apply 
for the first time since 2008 and requiring all 20 funded 
States to recompete. WISEWOMAN helps uninsured and underinsured 
low-income women avoid heart disease and stroke by providing 
preventive health services, referrals to local healthcare 
providers, and lifestyle counseling and behavioral 
interventions tailored to particular factors.

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

Appropriations, 2013\1\.................................    $137,051,000
Budget estimate, 2014\2\................................      67,148,000
Committee recommendation................................     123,483,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.
\2\Assumes a realignment of $11,205,000 in business service funding.

    The Committee recommendation for the activities of the 
National Center on Birth Defects and Developmental Disabilities 
[NCBDDD] is $123,483,000. The budget requests an additional 
$74,796,000 in transfers from the PPH Fund.
    This Center improves the health of children and adults by 
preventing birth defects, developmental disabilities, and 
complications of heredity blood disorders and by promoting 
optimal child development and health and wellness among 
children and adults living with disabilities.
    Within the total provided, the following amounts are 
provided for the following categories of funding:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                                   Fiscal year
                       Budget activity                         Fiscal year 2013       2014          Committee
                                                               appropriation\1\    request\2\     recommendation
----------------------------------------------------------------------------------------------------------------
Birth Defects...............................................           20,157            21,798          18,352
    Fetal Death (non-add)...................................             (806)   ..............            (806)
Fetal Alcohol Syndrome......................................            9,845            10,789           9,845
Folic Acid..................................................            2,774             3,160           2,774
Infant Health...............................................            7,854             8,899           7,854
Autism......................................................           21,228            23,098          21,228
Disability, Development, and Health.........................           17,748            18,941          17,748
Limb Loss...................................................            2,815             3,095           2,600
Tourette Syndrome...........................................            1,695             1,842           1,695
Early Hearing Detection and Intervention....................           10,612            11,253          10,612
Muscular Dystrophy..........................................            5,818             6,364           5,818
Paralysis Resource Center...................................            6,689    ..............  ...............
Attention Deficit Hyperactivity Disorder....................            1,712             1,828           1,712
Fragile X...................................................            1,678             1,802           1,678
Spina Bifida................................................            5,725             6,265           5,725
Congenital Heart Failure....................................            1,986             2,138           2,986
Thallasemia.................................................            1,856    ..............           1,856
Public Health Approach to Blood Disorders...................              226            20,672           4,000
Hemophilia..................................................           16,633    ..............           7,000
    CDC Activities..........................................  .................  ..............           2,000
    Hemophilia Treatment Centers............................  .................  ..............          5,000
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
  reprogrammings allowed under Public Law 113-6.
\2\Includes $11,205 in funds from the Working Capital Fund realignment.

    Congenital Heart Defects [CHDs].--CHDs continue to be the 
most common birth defect and leading cause of infant mortality 
in the United States. Even those who receive successful 
intervention will need lifelong, costly, specialized cardiac 
care. Estimates suggest there are over 2 million people alive 
today with CHDs. The Committee commends CDC for its increasing 
efforts to address the lifelong needs of this growing 
population, particularly in collaboration with other Federal 
agencies and private organizations. However, the Committee is 
concerned that there continues to be a lack of rigorous 
epidemiological and longitudinal data on individuals of all 
ages with CHDs and includes funding to continue initial efforts 
to compile this information. The Committee provides $3,000,000 
to collect and analyze nationally representative, population-
based epidemiological and longitudinal data on infants, 
children, and adults, with the goal of improving estimates of 
CHD incidence, prevalence, and disease burden, which can be 
used to better assess the public health impact of this 
condition.
    Duchenne Care Considerations.--The Committee recognizes the 
value the Duchenne ``Care Considerations'' guidelines have had 
in improving the standardization of care and quality of life 
for patients with Duchenne muscular dystrophy and in extending 
the lifespan of Duchenne patients. The Committee encourages 
CDC, in collaboration with other Federal health agencies, to 
issue updated care recommendations and to develop new adult 
care recommendations expeditiously. Further, the Committee 
encourages CDC to evaluate whether outcomes are improved by 
care that is consistent with the existing guidelines.
    Fragile X and Fragile X-Associated Disorders [FXD].--The 
Committee continues to support CDC's efforts to identify and 
define the population impacted by FXD, with the goal of 
understanding the public health impact of these conditions. 
Given the connection between fragile X syndrome and autism, the 
prospect of targeted treatments for both conditions, and 
current budgetary constraints, the Committee urges CDC to 
explore ways to create greater efficiency and synergy between 
programs addressing each condition.
    Hemophilia Treatment Centers.--The Committee is 
disappointed that funds appropriated specifically to address 
hemophilia have been used to develop public health approaches 
to other blood disorders. The Committee recommendation for 
hemophilia more closely aligns to a true accounting of funds 
spent on hemophilia and the Committee expects no further 
diversion of funds. The Committee includes sufficient funding 
to maintain and expand the surveillance and research activities 
of the national network of hemophilia treatment centers and 
CDC's national outreach and prevention programs on hemophilia. 
The CDC hemophilia programs provide critical information to 
better understand risk factors for complications and identify 
high-risk populations for prevention measures.
    Limb Loss Resource Center.--The Committee is disappointed 
to learn that $1,000,000 appropriated for outreach and 
education on limb loss has been diverted to support broad 
activities that may not be of benefit to individuals who have 
lost a limb. The Committee directs that CDC allocate the full 
$2,600,000 provided herein for a limb loss resource center to 
that activity in fiscal year 2014.
    Paralysis Resource Center.--The Committee has transferred 
funding for the Paralysis Resource Center program to ACL, as 
requested by the administration. The Committee expects CDC to 
work with ACL to ensure a smooth transition for grantees and 
those served by this program.
    Public Health Approach to Blood Disorders.--The Committee 
includes $4,000,000 to support broad public health approaches 
to blood disorders.
    Spina Bifida.--The Committee recommendation includes 
sufficient funding to continue the patient registry on spina 
bifida to improve the efficacy and quality of care for people 
with this disease.
    Tourette Syndrome.--The Committee commends CDC for its 
national public health education and research program on 
Tourette syndrome. The Committee intends that funds be used to 
continue to educate physicians, educators, clinicians, allied 
professionals, and the general public about the disorder and to 
improve scientific knowledge on prevalence, risk factors and 
co-morbidities of Tourette syndrome.
    Tuberous Sclerosis Complex [TSC].-- Because TSC is a 
leading genetic cause of more prevalent neurological disorders 
such as autism and epilepsy, the Committee encourages CDC to 
incorporate information about TSC in CDC's surveillance systems 
for those conditions.

                   PUBLIC HEALTH SCIENTIFIC SERVICES

Appropriations, 2013\1\.................................    $391,495,000
Budget estimate, 2014\2\................................     469,305,000
Committee recommendation................................     391,495,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.
\2\Assumes a realignment of $55,721,000 in business service funding.

    The Committee recommendation for Public Health Scientific 
Services is $391,495,000. This amount includes $247,769,000 in 
transfers available under section 241 of the PHS Act, the same 
amount as was transferred in fiscal year 2013. The President's 
budget proposed $324,889,000 in section 241 transfers.
    In addition, the Committee recommends transferring 
$58,100,000 to these activities from the PPH Fund. The 
President's budget proposed transferring $70,000,000 from the 
PPH Fund; $51,501,000 was transferred from the PPH Fund in 
fiscal year 2013.
    The total program level recommended in this bill for these 
services is $449,595,000.
    This funding supports the work of all of the CDC Centers by 
compiling statistical information to inform public health 
policy. In particular, these activities assure the accuracy and 
reliability of laboratory tests; apply digital information 
technology to help detect and manage diseases, injuries, and 
syndromes; and develop and inform the public health community 
on sound public health surveillance, laboratory protocols, and 
epidemiological practices.
    The Committee recommendation includes funding for the 
following activities in the following amounts:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                                    Fiscal year
                       Budget activity                          Fiscal year 2013       2014          Committee
                                                                appropriation\1\    request\2\    recommendation
----------------------------------------------------------------------------------------------------------------
Health Statistics............................................           138,683          181,475         138,683
Guide to Community Preventive Services.......................             7,378           10,000           7,400
Public Health Research.......................................  .................           5,000  ..............
Surveillance, Epidemiology, and PH Informatics...............           245,459          275,799         251,945
Public Health Workforce and Career Development...............            51,476           67,031         51,567
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
  reprogrammings allowed under Public Law 113-6.
\2\Includes $55,721 in funds from the Working Capital Fund realignment.

    Integrated Public Health Surveillance.--The Committee 
believes that significant opportunities exist to create 
scientific, administrative, and fiscal efficiencies in the 
reporting of public health surveillance data as a result of the 
widespread adoption of electronic health records. For that 
reason, the Committee directs CDC to develop a comprehensive 
plan for public health surveillance that includes the 
advantages, costs, and barriers to integrated surveillance 
approaches, along with specific recommendations for increasing 
the efficiency of State and local health reports to CDC. The 
Director shall work with State and local health officials to 
submit the report not later than 180 days after the date of 
enactment of this act. The report should include full 
consideration of information technology platforms that would 
allow data brokering, validation, access, analysis, and 
visualization tools to be shared within the public health 
community and that would establish an integrated approach for 
sharing of State and local data across CDC surveillance 
programs. The Committee notes that some States and local 
jurisdictions have invested significant resources in developing 
surveillance systems in advance of this effort. CDC's plan 
should build off those investments and identify ways that 
jurisdictions can plan future modifications to those systems
    Vital Statistics.--The Committee recommendation includes 
sufficient funding to collect 12 months of vital statistics 
data within the calendar year. In addition, the Committee notes 
that standard certificates of births and deaths were finalized 
10 years ago, yet 10 States have not fully adopted the 2003 
modifications. The Committee urges CDC to survey States about 
their reasons for and against adoption, prior to engaging in 
any process to update the certificates again. The Committee 
remains committed to expansions in the quality and timeliness 
of vital statistics data, which can help prevent identity theft 
and the fraudulent use of Federal and State benefits.

                          ENVIRONMENTAL HEALTH

Appropriations, 2013\1\.................................    $104,819,000
Budget estimate, 2014\2\................................     126,126,000
Committee recommendation................................     113,827,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.
\2\Assumes a realignment of $18,235,000 in business service funding.

    The Committee recommendation for the National Center for 
Environmental Health is $113,827,000.
    In addition, the Committee recommends transferring 
$39,200,000 to the Center from the PPH Fund. The President's 
budget proposed transferring $29,000,000 from the PPH Fund; 
$20,740,000 was transferred from the PPH Fund in fiscal year 
2013.
    The total program level recommended in the bill for this 
Center is $153,027,000.
    The National Center for Environmental Health addresses 
emerging pathogens and environmental toxins that pose 
significant challenges to public health. The Center conducts 
surveillance and data collection to determine which substances 
in the environment are getting into people and to what degree. 
The Center also determines whether these substances are harmful 
to humans and at what level of exposure.
    The Committee recommendation includes funding for the 
following activities:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                                    Fiscal year
                       Budget activity                          Fiscal year 2013       2014          Committee
                                                                appropriation\1\    request\2\    recommendation
----------------------------------------------------------------------------------------------------------------
Environmental Health Laboratory..............................            42,310           50,607          46,510
    Core Operations..........................................            34,534           50,607          34,534
    Newborn Screening Quality Assurance......................             6,813   ..............           6,813
    Newborn Screening for SCID...............................               963   ..............             963
    Chronic Disease Biomarkers...............................  .................  ..............           4,200
Environmental Health Research................................            12,337           42,096          12,337
Safe Water...................................................             7,097   ..............           7,097
ALS Registry.................................................             5,859   ..............           6,859
Built Environment & Health Initiative........................             2,624            3,132           2,624
Climate Change...............................................             7,346            8,165           7,346
Environmental and Health Outcome Tracking Network............            20,740           29,000          35,000
Asthma.......................................................            25,254           28,435          25,254
Healthy Homes/Childhood Lead Poisoning.......................             1,992            4,988         10,000
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
  reprogrammings allowed under Public Law 113-6.
\2\Includes $18,235 in funds from the Working Capital Fund realignment.

    Chronic Disease Biomarkers.--Biomarkers are a uniquely 
powerful tool to identify high-risk individuals, diagnose 
disease conditions promptly and accurately, and effectively 
track prevention and treatment efforts. However, biomarkers can 
only be effective if the measurement tool can be standardized 
and the quality of the testing assured. For example, the 
Committee is aware of methods to screen for cholesterol that 
examine not just the type of lipid particles but the size. 
Researchers have demonstrated that this information can be used 
to better determine the risk for heart disease; however, there 
exists no standard to help clinicians interpret the data. As a 
result, patients who receive advanced cholesterol tests can 
receive dramatically disparate results. CDC's Environmental 
Health Laboratory is one of the premier institutions for the 
development of standards and the quality assurance of measuring 
for biomarkers. The Committee recommendation includes funding 
to begin the development of reference methods and materials for 
several cardiovascular disease biomarkers, including small low-
density lipoprotein, apolipoprotein D, high-sensitivity C-
reactive protein, and troponin. In addition, CDC is encouraged 
to begin development of a reference method and reference 
materials for measurement of estrogen. 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 healthcare programs including Medicare and 
Medicaid.
    Healthy Homes and Lead Poisoning Prevention Program.--The 
Committee recommendation includes sufficient funding for 
national surveillance efforts that can better target HUD lead 
poisoning prevention efforts, technical assistance to local 
public health officials, and national leadership on the science 
of lead poisoning.
    National Environmental Public Health Tracking Network.--The 
Committee recommendation is sufficient to continue to support 
the 23 States and one city that were funded through this 
program in fiscal year 2012. This investment allows State, 
local, and tribal governments to evaluate potential linkages 
between disease and environmental exposures in their areas. The 
Committee encourages CDC to explore the feasibility of creating 
interoperability between the tracking network and major 
electronic health record systems to facilitate a more robust 
collection of de-identified data from which to compare health 
outcomes with environmental exposures.

                     INJURY PREVENTION AND CONTROL

Appropriations, 2013\1\.................................    $137,456,000
Budget estimate, 2014\2\................................     181,585,000
Committee recommendation................................     162,456,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.
\2\Assumes a realignment of $8,611,000 in business service funding.

    The Committee recommendation for the National Center for 
Injury Prevention and Control is $162,456,000.
    In addition, the Committee recommends transferring 
$3,000,000 to the Center from the PPH Fund. The President's 
budget included a proposed transfer of $5,000,000 under section 
241 of the PHS Act.
    The total program level recommended in this bill for the 
Center is $165,456,000.
    CDC is the lead Federal agency for injury prevention and 
control. Programs are designed to prevent premature death and 
disability and reduce human suffering and medical costs caused 
by fires and burns, poisoning, drowning, violence, and traffic 
accidents. The national injury control program at CDC 
encompasses non-occupational injury and applied research in 
acute care and rehabilitation of the injured.
    The Committee recommendation includes funding for the 
following activities:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                                    Fiscal year
                       Budget activity                          Fiscal year 2013       2014          Committee
                                                                appropriation\1\    request\2\    recommendation
----------------------------------------------------------------------------------------------------------------
Domestic Violence and Sexual Violence........................            30,989           32,611          30,989
Youth Violence Prevention....................................            14,942           15,890          14,942
Domestic Violence Community Projects.........................             5,402            5,738           5,402
Rape Prevention..............................................            39,320           41,729          39,320
Gun Violence Prevention Research.............................  .................          10,000          10,000
National Violent Death Reporting System......................             3,465           23,570          18,465
Injury Control Research Centers..............................             9,957           10,220           9,957
Traumatic Brain Injury.......................................             6,016   ..............           6,016
Elderly Falls................................................             1,955   ..............           4,955
All Other Unintentional Injury...............................            22,942           33,794          22,942
All Other Intentional Injury.................................             2,468            3,033          2,468
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
  reprogrammings allowed under Public Law 113-6.
\2\Includes $8,611 in funds from the Working Capital Fund realignment.

    Falls Prevention Interventions.--The Committee includes 
$3,000,000 from the PPH Fund to expand older adult falls 
prevention activities at CDC, in coordination with ACL. The 
Committee intends that CDC use the funding to conduct research 
to evaluate and disseminate the most effective fall prevention 
interventions and that ACL use the funding provided that agency 
to conduct outreach and demonstration programs to expand the 
implementation of effective interventions.
    National Violent Death Reporting System [NVDRS].--The 
Committee recommendation includes $18,465,000 to allow CDC to 
expand the NVDRS beyond the current 18 States. NVDRS is a 
surveillance system that pools information from State and local 
medical examiners, coroners, law enforcement, crime labs, and 
vital statistics into a single incident record which presents a 
more complete picture of the circumstances surrounding a 
violent death. An enhanced NVDRS will provide States, 
communities, and researchers the ability to identify the 
preventable characteristics of violent deaths, including both 
homicides and suicides, at a more localized level. The 
Committee encourages CDC to plan how best to disseminate the 
new data on the magnitude, trends, and characteristics of 
violent deaths to prevention researchers, practitioners, and 
policymakers. The Committee intends this expansion to aid in 
the development, implementation, and evaluation of violence 
prevention strategies at the national, State, and local levels.
    Sports-Related Injuries.--The Committee is concerned about 
the number and severity of injuries related to sports 
activities at every age and experience level, from professional 
sports to sports programs for children. While physical activity 
is an important part of a healthy lifestyle and should be 
promoted as a national public health goal, the number of 
injuries, particularly those related to head injury and 
concussion, is a matter of grave concern. The Committee 
believes that new developments in sports safety equipment can 
reduce the number of injuries to participants in sports 
activities. In addition, safer technologies that have already 
been implemented in one sport can be applied to safety 
equipment in other sports, yielding widespread improvements in 
safety and injury reduction. For example, the Committee is 
aware of new designs for football helmets aimed at reducing or 
eliminating the injuries that contribute to concussions and 
traumatic brain injuries. The Committee encourages CDC to test 
and improve these new helmet designs in cooperation with 
academic centers, sports sanctioning organizations, and 
equipment manufacturers.
    TBI.--The Committee encourages CDC to consider supporting 
multidisciplinary approaches to early identification and 
treatment of TBI cases.

                     OCCUPATIONAL SAFETY AND HEALTH

Appropriations, 2013\1\.................................    $292,275,000
Budget estimate, 2014\2\................................     271,911,000
Committee recommendation................................     292,275,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.
\2\Assumes a realignment of $32,693,000 in business service funding.

    The Committee recommendation for National Institute for 
Occupational Safety and Health [NIOSH] programs is 
$292,275,000; this amount includes $110,724,000 in transfers 
available under section 241 of the PHS Act.
    NIOSH is the only Federal agency responsible for conducting 
research and making recommendations for the prevention of work-
related illness and injury. The NIOSH mission is implemented by 
conducting basic and applied scientific research 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                         Fiscal year 2013  2014 request\2\     Committee
                                                              appropriation\1\                    recommendation
----------------------------------------------------------------------------------------------------------------
National Occupational Research Agenda......................          111,365            98,926          111,365
Education and Research Centers.............................           24,226    ...............          24,226
Healthier Workforce Centers................................            5,007             5,433            5,007
Mining Research............................................           52,273            62,374           52,273
Other Occupational Safety and Health Research..............           99,404           105,178           99,404
    Miners Choice (non-add)................................             (645)   ...............            (645)
    National Mesothelioma Registry and Tissue Bank (non-              (1,018)   ...............          (1,018)
     add)..................................................
    NanoTechnology (non-add)...............................           (9,310)          (11,150)          (9,310)
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
  reprogrammings allowed under Public Law 113-6.
\2\Includes $32,693 in funds from the Working Capital Fund realignment

    Facilities.--The Committee is proud of the decade of 
investments made to implement the CDC Master Facilities Plan, 
which recently concluded with the opening of Building 107. One 
of the strategic goals of that plan was to move CDC from leased 
facilities into federally owned property to reduce facility-
related costs to the agency. In furtherance of that goal, the 
Committee directs NIOSH to maximize the use of existing 
federally owned research facilities and property to conduct its 
work. In particular, the Committee is concerned that NIOSH has 
expanded its leasing activities while there remains unused 
space it owns.
    Mining Research.--The Committee appreciates the mine 
research data submitted in the ``Significant Items'' section of 
the fiscal year 2014 congressional budget justification and 
requests that it be updated and included in the NIOSH section 
of future justifications.
    Mining Research Regional Approaches.--The Committee 
strongly supports mine research done to prevent injury and 
improve conditions in metal/non-metal mines located 
predominantly in the western half of the country, including 
mines in the newly revitalized Silver Valley of Idaho, the gold 
mining areas of Nevada, the platinum area in Montana, the trona 
mines in Wyoming, and the mines of various types in Alaska. In 
particular, the Committee strongly supports the Catastrophic 
Failure Detection and Prevention, Mining Injury and Disease 
Prevention, and Mining and Surveillance and Statistical 
programs. The Committee urges NIOSH to coordinate research 
goals with mine operators and unions in the various regions of 
the country.
    National Occupational Research Agenda [NORA].--The 
Committee includes no less than the fiscal year 2012 level for 
the Agriculture, Forestry and Fishing Program within NORA.
    Other Occupational Safety and Health Research.--The 
Committee appreciates the occupational safety and health 
research data submitted in the ``Significant Items'' section of 
the fiscal year 2014 congressional budget justification and 
requests that it be updated and included in the NIOSH section 
of future justifications.
    Skin Cancer.--The Committee directs NIOSH to conduct 
research on the incidence of skin cancers among occupational 
workers who spend a majority of their work hours in vehicles or 
equipment operated outdoors. Such vehicles or equipment include 
trucks, transit vehicles, tractors and related farm equipment, 
and construction equipment. The Committee encourages NIOSH to 
identify technologies to mitigate incidences of skin cancers 
among this group of occupational workers by reducing worker 
exposure to UVA and UVB radiation.

         ENERGY EMPLOYEES OCCUPATIONAL INJURY COMPENSATION ACT

Appropriations, 2013\1\.................................     $55,358,000
Budget estimate, 2014...................................      55,358,000
Committee recommendation................................      55,358,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

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

                             GLOBAL HEALTH

Appropriations, 2013\1\.................................    $346,964,000
Budget estimate, 2014\2\................................     393,024,000
Committee recommendation................................     391,964,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.
\2\Assumes a realignment of $29,014,000 in business service funding.

    The Committee recommends $391,964,000 for global health-
related activities at CDC.
    The Center for Global Health leads international programs 
and coordinates CDC's global efforts with the goal of promoting 
health and preventing disease in the United States and abroad. 
The Center has a particular focus on ensuring rapid detection 
and response to emerging health threats.
    The Committee recommendation includes funding for the 
following activities in the following amounts:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                                   Fiscal year
                       Budget activity                         Fiscal year 2013       2014          Committee
                                                               appropriation\1\    request\2\     recommendation
----------------------------------------------------------------------------------------------------------------
Global AIDS Program.........................................           116,883          131,942         116,883
Polio Eradication...........................................           111,094          131,053         146,094
Other Global Immunization...................................            48,917           51,950          48,917
Global Disease Detection and Emergency Response.............            41,530           45,580          41,530
Parasitic Diseases and Malaria..............................            19,334           22,231          19,334
Global Public Health Capacity Development...................             9,206           10,268          19,206
    National Public Health Institutes (non-add).............  .................  ..............         (10,000)
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
  reprogrammings allowed under Public Law 113-6.
\2\Includes $29,014 in funds from the Working Capital Fund realignment

    National Public Health Institutes [NPHIs].--In many 
countries around the world, public health functions are spread 
across varying divisions of the ministry of health. Laboratory 
work, surveillance, outbreak response, and budget are often 
disconnected and fragmented, making public health efforts less 
efficient and less effective. This fragmentation is a barrier 
to collaboration among nations on preventing the spread of 
infectious diseases and setting common health research goals. 
NPHIs are science-based organizations that administer the 
public health functions of a government. They use evidence to 
inform health practice and policies, determine the 
effectiveness of health investments and practices, and provide 
a locus of coordination for donor resources in developing 
nations.
    The Committee is aware that the International Association 
of National Public Health Institutes has begun to transfer its 
technical assistance functions to CDC, making CDC the global 
leader on building NHPI capacity around the world.
    The Committee includes a new initiative to support the 
creation of NPHIs in developing countries. The Committee 
provides $10,000,000 to be available over a 2-year period for 
CDC to work in at least five countries. The Committee expects 
CDC's engagement to be time-limited, extending from 3 to 5 
years. The Committee further expects this initiative to engage 
countries in all regions of the world; however, the Committee 
understands that any participating country must show a high 
level of commitment to reorganize its ministry of health in 
this manner.
    Polio Eradication.--The Committee continues to support 
strongly the worldwide partnership to eradicate endemic polio, 
which now exists in only three countries in the world. The 
Committee includes an increase of $35,000,000, or 32 percent 
over the fiscal year 2013 level, in recognition of the 
difficulty involved in the final phase of eradication, 
including the need for enhanced security measures for 
vaccination workers. Including this investment, this 
subcommittee has provided over $1,700,000,000 since the 
worldwide eradication effort began to ramp up in 1991, with 
additional Federal resources provided through the State and 
Foreign Operations subcommittee.

                PUBLIC HEALTH PREPAREDNESS AND RESPONSE

Appropriations, 2013\1\.................................  $1,297,248,000
Budget estimate, 2014\2\................................   1,334,316,000
Committee recommendation................................   1,292,498,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.
\2\Assumes a realignment of $52,338,000 in business service funding.

    The Committee recommendation for the Office of Public 
Health Preparedness and Response [PHPR] is $1,292,498,000.
    The mission of PHPR is to build and strengthen national 
preparedness for public health emergencies including natural, 
biological, chemical, radiological, and nuclear incidents. PHPR 
administers national response programs and assets, as well as 
grants to States and localities to enhance preparedness efforts 
across the country.
    The Committee recommendation includes funding for the 
following activities in the following amounts:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                                    Fiscal year
                       Budget activity                          Fiscal year 2013       2014          Committee
                                                                appropriation\1\    request\2\    recommendation
----------------------------------------------------------------------------------------------------------------
State and Local Preparedness and Response Capability.........           656,289          658,026         659,719
    Public Health Emergency Preparedness Cooperative                    640,570          658,026         644,000
     Agreement...............................................
    Academic Centers for Public Health Preparedness..........             7,966   ..............           7,966
    All Other State and Local Capacity.......................             7,753   ..............           7,753
CDC Preparedness and Response Capability.....................           138,031          166,012         137,177
    Biosense.................................................            20,692   ..............          20,692
    Real-time Lab Reporting..................................             8,061   ..............           8,061
    Core Preparedness and Response...........................           109,278   ..............         108,424
Strategic National Stockpile.................................           502,928          510,278        495,602
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
  reprogrammings allowed under Public Law 113-6.
\2\Includes $52,338 in funds from the Working Capital Fund realignment.

    Public Health Emergency Preparedness Cooperative 
Agreement.--A critical component of protecting and securing our 
Nation's public health is having State, local, and territorial 
agencies prepared to prevent, detect, respond to, and rapidly 
recover from a variety of threats. The Committee notes that the 
level recommended is sufficient to return to a minimum State 
grant level of $5,000,000 once the WCF transfer is completely 
made.
    Coordination.--The Committee encourages CDC to continue 
efforts to align its preparedness grant programs with programs 
of the Departments of Homeland Security and Transportation that 
have complementary goals. As those efforts progress, the 
Committee encourages CDC to seek greater efficiencies in 
applications, reporting, and data collection for State and 
local grantees.
    Strategic National Stockpile.--When the WCF transfer is 
accounted for, the Committee recommendation is the same level 
as the President's request for the stockpile.

                          CDC-WIDE ACTIVITIES

Appropriations, 2013\1\.................................    $616,854,000
Budget estimate, 2014\2\................................     131,402,000
Committee recommendation................................     616,563,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.
\2\Assumes a realignment of $398,618,000 in business service funding.

    The Committee provides $616,563,000 for public health 
leadership and support activities at CDC.
    In addition, the Committee includes $41,000,000 in 
transfers from the PPH Fund. The President's budget proposed 
transferring $41,200,000 from the PPH Fund; $22,585,000 was 
transferred from the PPH Fund in fiscal year 2013.
    The Committee recommendation includes funding for the 
following activities in the following amounts:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                                    Fiscal year
                       Budget activity                          Fiscal year 2013       2014          Committee
                                                                appropriation\1\    request\2\    recommendation
----------------------------------------------------------------------------------------------------------------
Preventive Health and Health Services Block Grant............            79,409   ..............          79,409
Business Services Support / Working Capital Fund.............           394,004   ..............         394,004
Building and Facilities Improvement..........................            24,903           14,591          24,805
Public Health Leadership and Support.........................           118,538          116,812         118,345
National Public Health Improvement Initiative................            21,663           40,200          40,000
National Prevention Strategy.................................               922            1,000          1,000
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
  reprogrammings allowed under Public Law 113-6.
\2\Includes a reduction of $398,618 for the Working Capital Fund realignment.

    The Committee is once again pleased with the progress CDC 
made in improving its congressional budget justification in 
fiscal year 2014, and continues to urge CDC to give a clear 
accounting of how funds are being spent in this annual budget 
document. In particular, the Committee appreciates the detailed 
information on grant awards, staffing levels, and facility 
needs. In addition, the Committee finds helpful the updated 
statistics on the public health need that the funding is 
requested to address. The Committee encourages CDC to include 
in each future budget justification a chart on the funding 
level and structure of CDC's laboratories. The Committee 
expects progress on transparency to continue as CDC seeks 
additional funding flexibility.
    Buildings and Facilities.--The Committee includes 
sufficient funding for CDC to complete the repairs and 
improvements identified as necessary in the fiscal year 2014 
budget justification. The Committee directs CDC to continue to 
provide updated information in this format in all future 
justification documents. The Committee notes that the building 
and facilities funding is provided in a flexible manner with 
respect to time limitations, individual project budgets, and 
the variety of activities allowable in a given fiscal year, 
such as acquisition, construction, and repair. When choosing 
among current and prior year available funding for a specific 
project, the Committee encourages CDC to obligate the most 
restricted funding first, so as to allow maximum flexibility 
within the carryover funding available for the acquisition and 
equipping of a replacement site for the Lake Lynn laboratory. 
While this flexibility may result in a different source year of 
available funding for mine research lab replacement, the 
Committee expects that the total funding level reserved for 
this replacement effort be strictly maintained.
    Preventive Health and Health Services [PHHS] Block Grant.--
The PHHS Block Grant allows each State to address its most 
critical public health needs. The Committee notes that, in 
approximately one-third of all States, the PHHS Block Grant is 
either a significant source or the only source of funding to 
support emergency medical services and trauma systems.
    Transfer Authority.--The Committee declines to provide the 
additional transfer authority that was requested in the budget 
for the Director of CDC. The Committee notes that section 206 
of this act provides authority for transfer and reprogramming 
of CDC's funds within certain parameters and once certain 
notifications are made. In fact, CDC funds were transferred in 
two separate actions under similar authority in fiscal year 
2013. The Director of CDC should use the authority provided in 
section 206 of this act to implement any transfer of funds he 
deems necessary.
    Working Capital Fund [WCF].--The Committee is pleased with 
the progress CDC has made to set up the new WCF. The WCF is a 
revolving fund that pays for consolidated business services for 
CDC. The Centers of CDC will pay into the fund according to the 
amount of services they use. CDC is in the process of setting 
up an audited and transparent system, in which the Center 
directors participate in decisionmaking, to determine those 
amounts.
    The Committee includes funding for the WCF in the CDC-wide 
appropriation along with transfer authority to implement the 
WCF in the first quarter of fiscal year 2014. The Committee 
included statutory language in both the fiscal year 2012 and 
2013 appropriation laws to allow CDC to implement the WCF 
through a transfer early in the first quarter of fiscal year 
2014. The Committee continues to direct CDC to implement the 
WCF in this fashion, and rejects the proposal in the 
President's budget to implement the WCF by adjusting each 
individual program, project, and activity level herein. The 
Committee notes that identical transfer authority was provided 
in Public Law 113-6 to give CDC the ability to plan in advance 
for this first quarter transfer. If CDC is operating under a 
continuing resolution in October, the Committee directs CDC to 
transfer the apportioned amount of the fiscal year 2014 working 
capital fund appropriation to each program of CDC according to 
the formula agreed upon for the WCF.

                     National Institutes of Health

    The mission of NIH is to seek fundamental knowledge about 
the nature and behavior of living systems and then to apply 
that knowledge to enhance human health, lengthen life, and 
reduce illness and disability. No other entity in the world has 
performed that mission so successfully. Yet there are signs 
that other countries are beginning to close the gap.
    While China and India are investing heavily in biomedical 
research, NIH funding has dropped significantly, in real terms, 
since the end of the 5-year doubling in fiscal year 2003. An 
investigator's chance of winning an NIH grant has fallen from 
approximately 3 in 10 a decade ago to roughly 1 in 6 today. At 
a time when the promise for medical advances has never been 
greater, the Nation cannot afford to lose any more ground in 
the life sciences.
    The Committee provides $30,954,976,000 for NIH activities 
within the jurisdiction of this bill, including $8,200,000 in 
transfers available under section 241 of the PHS Act. The 
budget request is $31,101,976,000, which the administration has 
described as approximately $471,000,000 higher than the fiscal 
year 2012 level. However, this proposed increase is smaller 
than it appears. As explained in the introduction to the HHS 
title in this report, the administration also proposes to 
increase the program evaluation tap on PHS agencies, including 
NIH, from 2.5 percent to 3 percent. That would effectively cut 
NIH funding by approximately $147,000,000, all of which would 
be redirected to other operating divisions within HHS. The 
Committee rejects the proposed increase in the tap. The 
Committee's recommended total for NIH is effectively equal to 
the budget request.

                       NATIONAL CANCER INSTITUTE

Appropriations, 2013\1\.................................  $5,062,039,000
Budget estimate, 2014...................................   5,125,951,000
Committee recommendation................................   5,091,885,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends an appropriation of $5,091,885,000 
for NCI. Of this amount, $8,000,000 is available for repairs 
and improvements to the NCI facility in Frederick, Maryland.
    Cancer Centers.--The Committee urges NCI to put a higher 
priority on linking its designated cancer centers with 
community health providers in order to better reach underserved 
and rural populations with state-of-the-art treatment and care. 
Strengthening these networks could help reduce disparities in 
cancer survival rates among racial, ethnic minority, and rural/
non-rural groups.
    Gastric Cancer.--The Committee continues to be concerned 
about gastric cancer, particularly among young people, and is 
pleased that gastric cancer has been selected for study under 
The Cancer Genome Atlas [TCGA]. Given that research on gastric 
cancer is less advanced than that of many other cancers, the 
Committee urges NCI to put a priority on helping investigators 
in this field make the best possible use of genomic data from 
the TCGA.
    Gastrointestinal Stromal Tumor [GIST].--Despite significant 
treatment advances over the past decade, metastatic GIST 
remains largely incurable. The Committee encourages NCI to 
intensify its research on GIST and explore with NCATS whether 
any drugs that have been approved for other uses could be 
repurposed to treat this disease.
    Information Technology.--Certain health behaviors, 
including diet, exercise, and smoking, play a key role in 
cancer risk. As new technologies that may address behavioral 
risk factors are developed, the Committee urges NCI to expand 
research opportunities into how information technology and 
telecommunications can be leveraged to reduce these risks.
    Liver Cancer.--The Committee continues to urge NCI to put a 
higher priority on liver cancer research. In particular, the 
Committee urges the Institute to develop sustaining models of 
liver cancer for therapeutic drug development as well as to 
continue work in the area of biomarkers and drug discovery.
    Lung Cancer.--The Committee urges NCI to collaborate 
closely with international lung cancer experts to continue to 
explore ways to translate the findings from the National Lung 
Cancer Screening Trial into public health recommendations that 
will reduce the mortality and morbidity of this deadly form of 
cancer.
    Melanoma.--The Committee continues to put a high priority 
on melanoma research. The Committee notes that increased 
translational work into wild-type BRAF melanomas, which 
represent 50 percent of tumors, is critical to spearhead drug 
development. The recent discoveries of unique mutations in 
uveal melanoma also warrant additional research. The Committee 
continues to urge research into the mechanisms and early 
detection of drug resistance in BRAF mutant melanoma; further 
mapping of melanoma genetics and epigenetics; and clinical 
research into immune therapy checkpoint inhibitors, including 
biomarker research for response and lack of response, 
mechanistic analyses in patient-derived samples, and the 
testing of combination therapies that incorporate these 
inhibitors. The Committee continues to urge NCI to support 
research directed at the biology of tumor initiation and 
metastasis, risk reduction, and the relative utility of novel 
early detection strategies. The Committee requests an update in 
the fiscal year 2015 congressional budget justification on 
NCI's melanoma research portfolio.
    Metastasis.--Although 90 percent of cancer deaths are 
associated with metastasis, this phenomenon is not widely 
studied due to its complexity and corresponding requirement for 
the involvement of scientists representing multiple 
disciplines. The Committee encourages NCI to develop a 
consortium of institutions with expertise in cancer metastasis 
and metastasis genetics to leverage the unique strengths of 
each institution and facilitate progress toward controlling the 
most deadly attribute of cancer cells.
    Metastasis to Bone.--The Committee urges additional 
research on how to repair bone defects caused by cancer cells. 
Basic research is needed to understand the impact of matrix 
properties on cell behavior. 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.
    Minority Population Cancer Rates.--The Committee remains 
concerned by the disproportionately high cancer rates in 
minority populations. The Committee requests an update from NCI 
and NIMHD on efforts to address this disparity, including the 
possibility of establishing centers of excellence focused on 
research, treatment, prevention, and communication and outreach 
to minority communities for early intervention.
    Neuroblastoma.--The Committee commends NCI for its 
leadership in convening a consensus panel to revise the 
international neuroblastoma response criteria. The Committee 
encourages NCI to expand its research portfolio on this 
devastating pediatric cancer with a focus on new treatment 
options for relapse patients.
    Obesity.--Excess body weight is linked to increased risk of 
primary diagnosis of colon, endometrium, kidney, esophageal, 
and postmenopausal breast cancers. Obesity is also linked to 
poor prognosis once cancer develops, especially in breast 
cancer and likely for prostate and colon cancer, the three most 
prevalent cancer types. Numerous underserved and minority 
groups have higher than average rates of obesity and as a 
result they suffer from higher obesity-related morbidity and 
mortality from cancer compared to other groups. Despite this 
statistic, these groups are typically underrepresented in 
obesity-related cancer prevention trials. In particular, nearly 
20 percent of adults in the United States reside in a rural 
area, representing one of the largest medically underserved 
populations in the Nation and among the most understudied 
groups of cancer patients and survivors. The Committee urges 
NCI to focus research efforts on the effects of obesity on 
cancer outcomes in these underserved groups.
    Ovarian Cancer.--The Committee urges NCI to integrate 
expertise in cancer biology, drug discovery and development, 
bioinformatics, and pharmacogenomics to advance treatment 
options for patients with ovarian cancer. The Institute is also 
encouraged to collaborate with NCATS on drug repurposing 
efforts.
    Pancreatic Cancer.--The Committee strongly supports the 
goals of the Recalcitrant Cancer Research Act of 2012, a law 
that provides NCI with the tools to develop a scientific 
framework for addressing the deadliest forms of cancer, 
including pancreatic cancer. While maintaining the integrity of 
the peer review system, the scientific framework will enable 
NCI to capitalize on the full range of its expertise, and that 
of extramural scientists, to assess scientific progress against 
the Nation's most lethal cancers, starting with pancreatic and 
lung cancer, and to develop a research agenda to reduce 
morbidity and mortality. The Committee urges the Institute to 
ensure that the final framework for pancreatic cancer fully 
addresses all aspects of the statute. The Committee also notes 
that the new law reinforces NCI's authority to award 
``exception funding'' when relevant to a scientific framework.
    Pediatric Cancer.--The Committee encourages NCI to put a 
higher priority on pediatric cancer, as cancer remains the 
leading cause of disease-related death in children. More 
effective and less toxic treatments are needed, including 
materials-based strategies for localized drug delivery.
    Robotic Biorepositories.--To determine the genetic 
differences in the development, progression, and response to 
treatment of individuals with cancer, biospecimens must be 
collected and evaluated. As more are collected, NCI should 
consider the application of new technologies such as automated 
robotics to ensure an adequate supply of biospecimens and to 
promote better standardization of the collection process. The 
introduction of automated processes in biospecimen collection 
may also help to ensure an adequate supply of high-quality 
human biospecimens from multiethnic communities for research to 
understand and overcome cancer health disparities. NCI has 
established networks for biospecimen collection that can be 
used to assess the application of robotic technology and 
determine if robotics can improve the functions of the 
biorepository network. The Committee encourages NCI to consider 
a pilot robotic biorepository project to determine if this 
technology can enhance the goals of NIH programs.
    Slow-Growing Children's Brain Tumors.--The Committee urges 
NCI to address the shortage of tissue samples for slow-growing 
children's brain tumors by incentivizing researchers to 
centralize and share such samples, and to support the 
development of preclinical mouse models and other nonmammalian 
models for pediatric brain tumors. The Committee requests an 
update on these issues in the fiscal year 2015 congressional 
budget justification.
                                     

               NATIONAL HEART, LUNG, AND BLOOD INSTITUTE

Appropriations, 2013\1\.................................  $3,072,863,000
Budget estimate, 2014...................................   3,098,508,000
Committee recommendation................................   3,077,916,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $3,077,916,000 for 
NHLBI.
    Cardiovascular Disease.--The costs of heart disease, 
stroke, and other forms of cardiovascular disease, in terms of 
lives lost and resources spent, remain the highest of any 
disease in the Nation. The Committee continues to believe that 
research against these devastating diseases should be a top NIH 
priority. The Committee recommends that NHLBI allocate 
resources for cardiovascular disease research according to the 
priority areas included in the Division of Cardiovascular 
Diseases Strategic Plan.
    Cell-Based Regenerative Treatments.--The Committee commends 
the Institute for its effort to harness the potential of cell-
based regenerative treatments to address lung diseases and 
encourages additional work in this area.
    Centers for Advanced Diagnostics and Experimental 
Therapeutics [CADET].--The Committee applauds the Institute's 
efforts to accelerate the translation of basic research 
findings into clinical advances in respiratory diseases through 
the CADET program.
    Chronic Obstructive Pulmonary Disease [COPD].--The 
Committee applauds NHLBI for leading a cross-agency effort to 
respond to COPD, including collaborating with CDC in releasing 
the first-ever, State-by-State prevalence data on this disease. 
The Committee encourages the Institute to move forward with 
this important initiative.
    Congenital Heart Defects.--The Committee commends NHLBI for 
its increasing efforts to develop translational research 
activities related to congenital heart disease through programs 
such as Bench to Bassinet and participation in the Congenital 
Heart Public Health Consortium. The Committee urges NHLBI to 
continue its work with other Federal agencies, as well as 
professional and patient organizations, to expand collaborative 
research initiatives and other related activities targeted to 
the diverse life-long needs of individuals living with 
congenital heart disease.
    Jackson Heart Study.--The Committee continues to recognize 
the efforts of the Jackson Heart Study to work with individuals 
and family members across generations in this longitudinal 
study of cardiovascular disease among African Americans. The 
Committee acknowledges the continued need for comprehensive 
research to address health disparities and the important 
implications for such research to all persons threatened by 
cardiovascular disease.
    Lymphangioleiomyomatosis [LAM].--The Committee continues to 
support both intramural and extramural means of expanding 
research on LAM and urges NHLBI to use all available mechanisms 
as appropriate to stimulate a broad range of clinical and basic 
research on this often fatal lung disease. The Committee 
commends NIH for supporting the MILES trial, which has shown 
that sirolimus suppresses disease activity in patients with 
moderate LAM. Additional controlled trials are needed to 
determine if the disease can be arrested in early stages. The 
Committee also applauds NHLBI for working with the LAM patient 
community to organize patient populations in a manner that 
facilitates clinical research.
    Mind-Body Interventions.--The Committee understands that 
mind-body interventions such as meditation have the potential 
to contribute to the prevention of cardiovascular disease. The 
Committee urges NHLBI to support multicenter, phase III 
randomized controlled trials, and pilot studies to prepare for 
such trials, of mind-body interventions that have shown promise 
in phase II trials to reduce cardiovascular risk factors, 
surrogate endpoints, and clinical events such as mortality, 
nonfatal myocardial infarction, and stroke.
    Pediatric Cardiomyopathy.--The Committee urges NHLBI to 
work with private and nonprofit stakeholders to develop and 
disseminate to the public a research agenda and 3-year 
strategic plan with specific activities to address gaps in 
research related to the causes, screening, diagnosis, and 
treatment of pediatric cardiomyopathy. Emphasis should be given 
on children who are at the highest risk for cardiomyopathy-
related mortality.
    Pulmonary Fibrosis.--The Committee applauds NHLBI for 
convening a workshop to develop a strategic plan for pulmonary 
fibrosis and supports efforts to enhance research on this 
disease.
    Scleroderma.--The Committee recognizes that pulmonary 
fibrosis is a complication of scleroderma and the most common 
cause of death in a diagnosed patient. Therefore, the Committee 
encourages NHLBI to expand scleroderma research related to 
pulmonary complications and facilitate collaboration and data 
sharing among scleroderma investigators.
    Sleep Disorders.--The Committee continues to support the 
implementation of the National Sleep Disorders Research Plan, 
including the emphasis on cross-Institute collaborations.

         NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH

Appropriations, 2013\1\.................................    $409,889,000
Budget estimate, 2014...................................     411,515,000
Committee recommendation................................     409,947,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $409,947,000 for 
NIDCR.
    Temporomandibular Disorders [TMD].--The Committee 
appreciates the advances that have been made as a result of 
NIDCR funding of research on TMD pain and urges the Institute 
to continue to lead this effort. Major findings that have 
emerged confirm that TMD is one of several chronic pain 
conditions co-occurring in some patients at odds greater than 
chance. The Committee strongly urges NIDCR to collaborate with 
other ICs to address these co-morbid conditions. The Committee 
commends the Institute for working with NIAMS and NIBIB to 
organize the Temporomandibular Joint Working Group, which is 
charged with assessing the state of the science on the 
temporomandibular joint and identifying research gaps and 
future scientific opportunities.

    NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES

Appropriations, 2013\1\.................................  $1,793,450,000
Budget estimate, 2014...................................   1,811,786,000
Committee recommendation................................   1,799,745,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $1,799,745,000 in 
this bill for NIDDK.
    Diabetes.--The Committee recognizes that diabetes is the 
leading cause of both kidney failure and adult-onset blindness. 
The Committee therefore urges NIDDK to fund basic research to 
better understand the causes of diabetic kidney and eye 
disease, as well as clinical studies to test potential 
therapies to prevent and treat these ailments.
    Gestational Diabetes.--The Committee recognizes that women 
with gestational diabetes and their babies face long-term 
health consequences as a result of the disease, including an 
increased risk of developing type 2 diabetes. Therefore, the 
Committee urges NIDDK to explore additional opportunities for 
research on gestational diabetes, a disease affecting up to 18 
percent of all pregnant women.
    Functional Gastrointestinal Disorders [FGIDs].--The 
Committee continues to urge NIDDK to engage in multi-Institute 
collaborations to improve understanding of FGIDs.
    Inflammatory Bowel Disease.--The Committee commends NIDDK 
for its continued support of the Human Microbiome Project and 
urges the Institute to put a high priority on using the results 
to advance the understanding of inflammatory bowel disease and 
its impact on pediatric patients. The Committee requests an 
update on this program in the fiscal year 2015 congressional 
budget justification.
    Interstitial Cystitis.--The Committee commends NIDDK for 
its leadership in interstitial cystitis research and notes that 
researchers are making progress to dispel myths about this 
condition and identify potential therapeutic strategies. 
Recognizing that patients turn to a variety of treatments, from 
pharmaceutical to changes in diet and lifestyle, the Committee 
encourages NIDDK to continue its focus on interstitial cystitis 
research and to partner with NCCAM to study the impact of 
complementary therapies on this condition.
    Obesity.--The Committee supports the NIH strategic plan for 
obesity research, which emphasizes a transdisciplinary approach 
to addressing the growing obesity problem in the United States. 
However, the Committee believes that additional efforts are 
needed to increase the involvement of high-risk communities in 
obesity studies and preventative research, particularly in 
rural areas, among low-income and racial minorities. The 
Committee urges NIH to prioritize its efforts on those areas of 
the country with the highest obesity rates by utilizing the 
existing resources of NIH-funded Nutrition Obesity Research 
Centers and academic schools of public health located in high-
risk areas.
    Pancreatitis.--The Committee encourages NIDDK to create a 
long-term scientific framework for pancreatitis including 
evaluating current efforts and making recommendations on ways 
to accelerate progress and improve outcomes. The Committee 
requests an update on this effort in the fiscal year 2015 
congressional budget justification.
    Pediatric Kidney Disease.--The Committee encourages NIDDK 
to assign a higher priority to research that explores pediatric 
renal disease. Because of the unique challenges of recruiting 
children into clinical trials, the Committee urges NIDDK to 
support research endeavors that include funding for 
infrastructure and the enhancement of collaborative and 
comparative multicenter, pediatric, prospective clinical/
translational trials that improve patient outcomes.
    Pelvic Pain.--The Committee is pleased that the 
Multidisciplinary Approach to the Study of Chronic Pelvic Pain 
[MAPP] Research Network has moved to its second phase. The 
Committee encourages NIDDK to continue these activities, 
including finding new treatment approaches, identifying risk 
factors, and helping to predict which patients may respond to 
various interventions for interstitial cystitis and other 
comorbid pelvic pain conditions.
    Prostatitis.--The Committee urges NIDDK to continue the 
MAPP initiative's support of research on the cause, cure, and 
prevention of prostatitis.

        NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

Appropriations, 2013\1\.................................  $1,623,113,000
Budget estimate, 2014...................................   1,642,619,000
Committee recommendation................................   1,631,703,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $1,631,703,000 for 
NINDS.
    Cerebral Cavernous Malformation [CCM].--The Committee urges 
NINDS to put a higher priority on CCM by coordinating existing 
research and surveillance activities as well as expanding 
clinical and research centers with the potential to manage a 
multisite clinical drug trial.
    Duchenne Biomarkers.--The Committee recognizes the 
importance of biomarkers and related surrogate endpoints for 
application in clinical trials of potential therapies for 
Duchenne muscular dystrophy. Therefore, the Committee urges 
NINDS, in collaboration with the FDA, to develop a plan of 
action to support the development and qualification of Duchenne 
biomarkers and to support the regulatory science relevant to 
advancing new technologies to treat this disease.
    Epilepsy.--The Committee commends NINDS for its leadership 
in sponsoring the April 2013 conference ``Curing the Epilepsies 
2013: Pathways Forward'' and for evaluating and guiding 
progress toward finding cures for the epilepsies through the 
community's epilepsy research benchmarks. The Committee 
applauds the enhanced focus of the NINDS Anticonvulsant 
Screening Program on developing new compounds to better address 
the needs of the patients for whom current therapies are not 
effective and to focus on prevention and disease modification. 
The Committee encourages the continuation of the targeted 
Epilepsy Centers Without Walls grants to support 
multidisciplinary, collaborative research in targeted areas 
that can advance progress in the prevention, diagnosis, and 
treatment of epilepsy and related comorbidities, including 
mortality from epilepsy. The Committee also remains supportive 
of Exceptional Unconventional Research Enabling Knowledge 
Acceleration [EUREKA] grants and research in epileptogenesis, 
comorbidities, translational research on epilepsies, treatment 
resistant epilepsy, and sudden unexplained death in epilepsy. 
Further, the Committee encourages the continuation of the 
Interagency Collaborative to Advance Research in Epilepsy 
[ICARE], led by NINDS, to coordinate the research efforts of 
Federal agencies and voluntary organizations and to identify 
areas for collaboration.
    Headache.--The Committee commends NIH for efforts to 
increase its focus on headache disorders over the past several 
years, especially in encouraging more junior investigators to 
enter the field. However, NIH's investment in this research is 
still not commensurate with the enormous disease burden of 
headache disorders. The Committee encourages intensified 
efforts to understand the causes, prevention, treatment, and 
eventual cure of headache disorders, including migraine, 
cluster headache, and chronic daily headache. In particular, 
the Committee urges NINDS to follow through on the 
recommendations from the May 2010 NIH Headache Research 
Planning Workshop by issuing requests for applications and 
program announcements for fundamental and translational 
research on headache disorders and providing career training 
and transition awards specifically devoted to the investigation 
of headache disorders.
    Inflammatory Nervous System Disorders.--The Committee urges 
NINDS to pursue expanded research focused on inflammatory 
disorders impacting the peripheral nervous system such as 
Guillain-Barre syndrome, chronic inflammatory demyelinating 
polyneuropathy, and related conditions.
    Muscular Dystrophy Coordinating Committee [MDCC].--The 
Committee understands that the MDCC's next meeting is planned 
for August 2013--more than 2 years since the last meeting--and 
that the Action Plan for Muscular Dystrophy has not been 
updated in 5 years. The MDCC's charter stipulates that meetings 
of the full committee should be held not less than once each 
fiscal year; the Committee strongly urges MDCC to resume a more 
regular schedule. In addition, the Committee urges the MDCC to 
review and revise the action plan so that it is relevant to the 
full range of Duchenne patients, including adults and different 
racial and ethnic populations affected by muscular dystrophy, 
and informed by Duchenne patient, caregiver, clinician, and 
research stakeholders.
    Network for Excellence in Neuroscience Clinical Trials.--
The Committee is pleased that NINDS plans to expand its support 
of the Network for Excellence in Neuroscience Clinical Trials 
[NeuroNEXT] program. The Committee urges NINDS to increase the 
efficiency of clinical trials conducted through NeuroNEXT, 
facilitate patient recruitment and retention, and increase the 
quality of the neuroscience trials.
    Stroke.--The Committee continues to commend the effective 
leadership role of NINDS in stroke research planning and 
prioritization and congratulates the Institute for its efforts 
that have culminated in the identification of nine top areas in 
stroke prevention, treatment, and recovery research. The 
Committee urges NINDS to stimulate investment in each of these 
areas.

         NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES

Appropriations, 2013\1\.................................  $4,481,730,000
Budget estimate, 2014...................................   4,578,813,000
Committee recommendation................................   4,548,383,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $4,548,383,000 for 
NIAID.
    Antibiotic-Resistant Infections.--The Committee remains 
concerned about the need to develop and approve new 
antibiotics. The Committee urges NIAID to facilitate, through 
its new antibiotic-resistant bacterial infections clinical 
research infrastructure, studies that lead to new endpoints for 
serious and life-threatening infections caused by multidrug-
resistant pathogens, and in particular hospital-acquired and 
ventilator-associated bacterial pneumonias. NIAID also should 
support research leading to a better understanding of the 
natural history of pneumonia and other antibiotic-resistant 
infections.
    Autoimmune Diseases.--The Committee urges NIAID and the 
Autoimmune Disease Coordinating Committee to establish programs 
to investigate common biological pathways of autoimmune 
diseases and potential therapies that can broadly prevent and 
treat them. The Committee requests an update on NIAID's current 
activities and plans for additional research in the fiscal year 
2015 congressional budget justification.
    Food Allergy.--The Committee is aware of the promising 
research on oral immunotherapy being funded by the Consortium 
of Food Allergy Research [CoFAR]. The Committee strongly urges 
NIAID to increase both the budget for and the number of 
institutions funded by CoFAR when the program is renewed. In 
addition, NIH should initiate other mechanisms of support for 
research and career development of investigators focused on 
food allergy research. The Committee also encourages NIAID to 
continue its public-private partnerships in support of 
complementary clinical immunological, immunomodulator, 
mechanistic, and genetic studies with private donors and 
foundations as components of ongoing food allergy clinical 
trials.
    Influenza Antivirals.--The Committee encourages NIAID to 
invest in research on new antiviral drugs that are easy to use 
and effective against emerging drug-resistant influenza 
variants, as well as influenza diagnostics. NIAID should give 
special consideration to treatment for the pediatric and 
obstetric populations.
    Microbicides.--The Committee encourages NIAID to continue 
coordination with USAID, the State Department, and others to 
advance the development of antiretroviral-based microbicides.
    Tuberculosis [TB].--The Committee continues to urge NIAID 
to expand its research into the development of new TB 
diagnostic tests, drugs, and vaccines to prevent, detect, and 
treat TB. In particular, the Committee encourages more research 
on developing shorter treatments for multidrug-resistant TB.

             NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES

Appropriations, 2013\1\.................................  $2,425,175,000
Budget estimate, 2014...................................   2,401,011,000
Committee recommendation................................   2,435,570,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $2,435,570,000 for 
NIGMS.
    Critical Care.--The Committee recognizes that the burden 
associated with the provision of care for critically ill 
patients is expected to increase significantly as the 
population ages. The Committee encourages NIGMS, through the 
new Office of Emergency Care Research, to heed the 
recommendations of the Critical Care Societies Collaborative in 
developing future research directions on critical care.
    Institutional Development Awards [IDeA].--The Committee 
continues to recognize the importance of the IDeA program and 
its focus on improving the necessary biomedical research 
infrastructure and capacity of research institutions within 
IDeA States. The Committee believes the IDeA program has made a 
significant contribution to biomedical research and efforts to 
create a skilled workforce in IDeA States. Therefore, the 
Committee rejects the President's proposal to cut IDeA funding 
to $225,438,000 and instead recommends $275,957,000, the same 
as the fiscal year 2012 level, for this purpose. However, the 
Committee is concerned that the eligibility criteria for IDeA 
established when the program was created 20 years ago are no 
longer relevant and have led to inequities. No States have been 
added to or dropped from the list of States that are eligible 
for this funding since 1997. The same 23 States have been 
eligible for IDeA for the past 16 years and the same 27 States 
have been ineligible. In addition, the authorizing statute says 
a State's eligibility for the program is to be determined by 
whether its research institutions have a low aggregate success 
rate, relative to other States, of obtaining NIH funds. But 
today, several IDeA States have higher success rates than those 
of non-IDeA States. The Committee is aware that the National 
Academy of Sciences [NAS] is conducting a study of the 
Experimental Program to Stimulate Competitive Research [EPSCoR] 
and related programs, such as IDeA, across the Federal 
Government. The Committee directs NIH to provide a report to 
the House and Senate Committees on Appropriations, as well as 
the relevant authorizing committees, that responds to the NAS 
analysis of IDeA and addresses whether changes to its 
eligibility criteria are warranted. The report, which should be 
delivered no later than 120 days after the release of the NAS 
study, should include a discussion of whether all States that 
are eligible for EPSCoR should be eligible for IDeA.

  EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN 
                              DEVELOPMENT

Appropriations, 2013\1\.................................  $1,318,755,000
Budget estimate, 2014...................................   1,339,360,000
Committee recommendation................................   1,330,459,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $1,330,459,000 for 
NICHD.
    Chromosome Abnormalities.--The Committee commends NIH's 
efforts to categorize genes, which are useful for the diagnosis 
of chromosome abnormalities. The path to treatment requires a 
greater understanding of gene function as it relates to 
abnormal gene copy number. The Committee again asks NICHD to 
hold a state of the science meeting focused on strategies for 
devising treatments for nonrecurring as well as recurring gene 
copy number changes. The Committee further urges new funding to 
support other investigators of chromosome abnormalities, 
particularly those involving chromosome 18.
    Demographic Research.--The Committee is pleased that 
NICHD's recent reorganization and Scientific Vision initiative 
reflect the integral role that demographic, or population, 
research plays in the Institute's mission. As such, the 
Committee urges NICHD to include the Population Dynamics branch 
in all appropriate research mechanisms and programs. Further, 
the Committee encourages NICHD to sustain its support of large-
scale, longitudinal surveys, particularly the National 
Longitudinal Survey of Adolescent Health and the Panel Study of 
Income Dynamics Child Supplement Survey.
    Preterm Birth.--The Committee notes that the Institute's 
new Scientific Vision highlights pregnancy and pregnancy 
outcomes as a priority for NICHD research. The Committee 
encourages NICHD to continue to emphasize its support of 
extramural preterm birth prevention research, the Maternal-
Fetal Medicine Units Network, the Neonatal Research Network, 
and the intramural research program related to prematurity. The 
Committee also encourages NICHD to support transdisiplinary 
science as recommended in the Scientific Vision and to fund 
transdisiplinary research grants to study and identify the 
complex causes of prematurity.
    Psychotropic Medications and Children.--The Committee 
understands that little is known about the short- and long-term 
effects of psychotropic medications on children's physical and 
mental development. The Committee encourages NICHD to undertake 
a concerted effort to determine the safety and efficacy of 
these medications in children, and to explore research into the 
effectiveness of evidence-based psychosocial therapies used 
instead of, or in combination with, psychotropic medications.
    Vulvodynia.--The Committee is pleased with the progress 
that NICHD has made to implement the major recommendations from 
the NIH Research Plan on Vulvodynia, particularly in convening 
the May 2013 workshop to develop research diagnostic criteria. 
The Committee urges NICHD to continue its work with the patient 
advocacy, medical, and scientific communities to develop these 
criteria, as well as common data elements to be collected 
across clinical studies to allow for the comparison of study 
populations and findings. The Committee also encourages the 
Institute to expand the cadre of basic and clinical 
investigators conducting vulvodynia research by helping 
interested researchers obtain greater expertise in pain 
research methodology and pelvic/urogenital neurobiology; 
encouraging NIH-funded investigators from various fields to 
expand their research to include vulvodynia; and reissuing a 
general funding opportunity with a special review panel that 
addresses foundational priority areas delineated in the 
vulvodynia research plan.

                         NATIONAL EYE INSTITUTE

Appropriations, 2013\1\.................................    $701,307,000
Budget estimate, 2014...................................     699,216,000
Committee recommendation................................     701,407,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $701,407,000 for NEI.
    Diabetic Retinopathy.--The Committee understands that 
diabetic eye disease is the leading cause of blindness in 
working age adults and urges NEI to continue its support of the 
Diabetic Retinopathy Clinical Research Network.
    Marfan Syndrome.--The Committee understands the negative 
health effects that Marfan syndrome can have on the human eye 
and vision. The Committee encourages NEI to initiate research 
activities in this area.
    Usher Syndrome.--The Committee urges NEI to put a higher 
priority on Usher syndrome, the leading cause of deaf-
blindness.

          NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES

Appropriations, 2013\1\.................................    $684,200,000
Budget estimate, 2014...................................     691,348,000
Committee recommendation................................     686,753,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $686,753,000 for 
NIEHS.
    Childhood Lead Poisoning.--The Committee understands that 
lead poisoning remains a serious health risk for children, with 
life-long developmental consequences, and encourages NIEHS to 
prioritize research in this area.
    Environmental Exposures and Reproductive Health.--
Environmental exposures can have significant ramifications for 
reproductive health, such as infertility, sterility, and birth 
defects, in addition to causing other serious health conditions 
including osteoporosis, heart attack, and stroke. The Committee 
believes it is critical to examine these ramifications for both 
men and women. NIEHS is urged to place a greater priority on, 
and invest more funding in, environmental, sex-based, 
reproductive health research.
    National Toxicology Program [NTP].--The Committee urges NTP 
to be highly precise when describing the results of its studies 
on particular extracts of an herbal species to avoid any 
possible confusion about the relevance of such studies to other 
extracts of the species. The Committee also encourages NTP to 
reinstitute its practice of making available on its Web site a 
transcript and/or recording of its public meetings.

                      NATIONAL INSTITUTE ON AGING

Appropriations, 2013\1\.................................  $1,101,234,000
Budget estimate, 2014...................................   1,193,370,000
Committee recommendation................................   1,185,439,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $1,185,439,000 for 
NIA.
    Alzheimer's Disease.--The President's budget calls for an 
increase of $80,000,000 over the fiscal year 2012 level for 
Alzheimer's disease research at NIA. In keeping with 
longstanding practice, the Committee does not recommend a 
specific amount of NIH funding for this purpose, or for any 
other individual disease. Doing so would establish a dangerous 
precedent that could politicize the NIH peer review system. 
Nevertheless, recognizing that Alzheimer's disease poses a 
unique and serious threat to the Nation's long-term health and 
economic stability, the Committee expects that a significant 
portion of the recommended increase for NIA should be directed 
to research on Alzheimer's. The exact amount should be 
determined by the scientific opportunity of additional research 
on this disease and the quality of grant applications that are 
submitted for Alzheimer's relative to those submitted for other 
diseases. The Committee encourages NIA to continue addressing 
the research goals set forth in the National Plan to Address 
Alzheimer's Disease, as well as the recommendations from the 
Alzheimer's Disease Research Summit 2012. In addition, the 
Committee continues to urge NIH to take advantage of existing 
well-characterized, longitudinal, population-based cohort 
studies to provide new insights into risk factors and 
protective factors related to cognitive decline and dementia. 
The Committee also continues to encourage additional research 
in minority populations that are at particularly high risk for 
cognitive decline and dementia.
    Demographic, Economic, and Behavioral Research.--The 
Committee recognizes NIA for investing in large-scale 
longitudinal surveys, including the National Health and Aging 
Trends Study and the Health and Retirement Study. Further, the 
Committee applauds NIA for contributing to the recent National 
Academies report ``Shorter Lives, Poorer Health,'' which found 
that Americans live shorter lives and are in poorer health than 
people in other high-income countries and that behaviors and 
social circumstances are major contributing factors.

 NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES

Appropriations, 2013\1\.................................    $534,715,000
Budget estimate, 2014...................................     540,993,000
Committee recommendation................................     537,398,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $537,398,000 for 
NIAMS.
    Heritable Connective Tissue Disorders.--The Committee 
commends NIAMS for ongoing research efforts into heritable 
connective tissue disorders like Marfan syndrome.
    Osteogenesis Imperfecta [OI].--The Committee continues to 
be concerned that the impact of OI on adults is not well 
understood and that very few primary care physicians or 
specialists possess training or experience in treating adults 
with OI. The Committee continues to encourage NIAMS to support 
natural history studies of OI and subsequent clinical research 
activities that will facilitate the development of clinical 
practice guidelines for adults with OI. The Committee also 
urges NIAMS to partner with the relevant professional 
societies, the OI advocacy community, and other stakeholders to 
develop opportunities for primary care physicians and 
specialists to receive education and training on providing care 
to adults with OI.
    Scleroderma.--The Committee notes recent advances in 
scleroderma research, particularly in systemic scleroderma, and 
encourages NIAMS to provide sustained investments in this area.
    Temporomandibular Disorders [TMD].--Many people who have 
TMD suffer from conditions that routinely affect other joints 
in the body, such as trauma, arthritis, and fibromyalgia. 
However, researchers investigating other joints too often 
ignore TMD because they consider temporomandibular joints to be 
a subject for dental researchers only. The Committee notes that 
the Temporomandibular Joint Working Group has improved 
collaborations among ICs that should have a role in TMD 
research but believes that NIAMS, as well as NIBIB, should 
participate more fully, so that NIDCR is not expected to carry 
the workload alone.

    NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS

Appropriations, 2013\1\.................................    $415,440,000
Budget estimate, 2014...................................     422,936,000
Committee recommendation................................     420,125,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $420,125,000 for 
NIDCD.
    Central Auditory Plasticity.--The Committee continues to 
support research in animals and humans on changes in the 
functional organization of neural circuits along all of the 
pathways in the brain that process sound, following both 
temporary and permanent developmental and adult hearing loss.
    Eustachian Tubes.--The Committee urges NIDCD to conduct 
additional studies on potential treatments for dysfunctional 
eustachian tubes.
    Genetic Causes of Communication Disorders.--The Committee 
recommends additional efforts by NIDCD to identify and 
understand the structure, function, and regulation of genes 
whose mutations are responsible for congenital and age-related 
deficits. Research to develop high-throughput platforms for 
testing of individuals is also encouraged.
    Hearing Aids and Cochlear Implants.--The Committee strongly 
urges NIDCD to support research grants that could lead to less 
expensive hearing aids, so such aids could become accessible 
and affordable to more people. The Committee also supports 
device research to improve users' understanding of speech 
through background noise. In addition, the Committee supports 
research that would enable users of cochlear implants to 
experience high-quality speech and music perception, as well as 
studies that would improve bilateral implants, short electrode 
implants, and hybrid cochlear implant/hearing aids.
    Inner Ear Hair Cell Regeneration.--The Committee is aware 
of advances being made in the identification of cells in the 
inner ear that can be induced or reprogrammed to replace cells 
lost in deafness. Additional research to understand the 
processes of possible regeneration or transdifferentiation of 
inner ear hair cells to restore natural hearing is strongly 
encouraged. The Committee recommends funding to develop this 
therapeutic approach and move it into clinical applications.
    Noise-Induced Hearing Loss.--Hearing loss resulting from 
noise damage represents a major form of acquired deafness. The 
Committee therefore recommends studies to better understand the 
pathogenesis of noise-induced hearing loss and encourages NIDCD 
to continue to promote public awareness of the importance of 
protecting hearing from noise, through public service 
announcements or other means.
    Otitis Media.--The Committee encourages NIDCD to accelerate 
its research into susceptibility to and pathogenesis of otitis 
media and its consequences, and into new treatments for chronic 
and recurrent cases. In particular, the Committee urges studies 
related to genetic risk factors, bacterial biofilms, and the 
impact of vaccination on disease prevention.
    Presbycusis.--The Committee urges NIDCD to continue to 
delineate the multiple physiological and neurological processes 
resulting in presbycusis, or age-related hearing loss.
    Tinnitus.--The Committee urges NIDCD to continue basic 
research on the specific neural dysfunction responsible for 
tinnitus as well as clinical trials to translate basic science 
into therapies.
    Vestibular Research.--The danger of injury from falls is a 
health hazard, especially in the elderly. Therefore, the 
Committee urges NIDCD to conduct further basic vestibular-
system studies to understand the cellular mechanisms involved 
in the coding of head movements necessary to assure an 
individual's ability to maintain balance.

                 NATIONAL INSTITUTE OF NURSING RESEARCH

Appropriations, 2013\1\.................................    $144,479,000
Budget estimate, 2014...................................     146,244,000
Committee recommendation................................     145,272,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $145,272,000 for 
NINR.

           NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM

Appropriations, 2013\1\.................................    $458,600,000
Budget estimate, 2014...................................     463,848,000
Committee recommendation................................     460,765,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $460,765,000 for 
NIAAA.
    Functional Integration Initiative.--The Committee applauds 
the Trans-NIH Substance Use, Abuse, and Addiction Functional 
Integration initiative to help NIAAA, NIDA, NCI, and other ICs 
work more closely together on substance use, abuse, and 
addiction research.

                    NATIONAL INSTITUTE ON DRUG ABUSE

Appropriations, 2013\1\.................................  $1,051,261,000
Budget estimate, 2014...................................   1,071,612,000
Committee recommendation................................   1,064,490,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $1,064,490,000 for 
NIDA.
    Drug Abuse and HIV/AIDS.--The Committee understands that 
drug abuse and addiction continue to fuel the spread of HIV/
AIDS and that drug abuse prevention and treatment interventions 
can be very effective in reducing HIV risk. Research should 
continue to examine every aspect of this relationship. The 
Committee is also concerned about drug abuse and HIV/AIDS in 
criminal justice populations. Research efforts to empirically 
test and expand the ``seek, test, treat, and retain'' paradigm 
are encouraged.
    Marijuana.--NIDA is encouraged to continue to fund research 
on preventing and treating marijuana abuse and addiction, as 
well as the possible health and policy implications of 
proposals to implement ``medical marijuana'' or marijuana 
legalization programs.
    Pain Medications.--The Committee remains concerned about 
the continued crisis of prescription drug abuse. NIDA is 
strongly urged to continue its support of research on pain, 
including the development of pain medications with reduced 
abuse liability. In addition, NIDA should continue to fund 
research to better prevent and treat prescription drug abuse.
    NIDAMed.--The Committee is pleased with NIDAMed, the 
Institute's physicians outreach initiative. The Committee urges 
NIDA to continue its focus on providing physicians and other 
medical professionals with the tools and skills they need to 
incorporate drug abuse screening and treatment into their 
clinical practices.
    Tobacco Addiction.--The Committee applauds the recent 
progress of NIDA-supported researchers toward identifying 
genetic factors that contribute to nicotine dependence and 
affect the efficacy of smoking cessation treatments. NIDA is 
urged to continue developing evidence-based treatments, 
medications, and prevention strategies to combat nicotine 
addiction.

                  NATIONAL INSTITUTE OF MENTAL HEALTH

Appropriations, 2013\1\.................................  $1,477,304,000
Budget estimate, 2014...................................   1,465,782,000
Committee recommendation................................   1,456,041,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $1,456,041,000 for 
NIMH. The decrease from fiscal year 2013 reflects a shift of 
AIDS research funding to NIAID, not a cut to core NIMH 
activities.
    Autism.--The Committee continues to urge NIMH to focus on 
genetic as well as possible environmental causes of autism.
    Autism and Telehealth.--The Committee is aware of the 
increasing use of telehealth resources in the diagnosis and 
treatment of autism spectrum disorders [ASD]. The NIMH has 
funded a small number of grants to examine whether such 
technologies can specifically be used to improve ASD diagnosis 
and treatment in underserved areas of rural States. Given the 
significant expansion in recent years of telehealth networks in 
rural States and the potential promise of such networks to 
significantly lower costs while expanding care, the Committee 
urges NIMH to expand its support of this research.
    Premature Mortality.--The Committee continues to be 
concerned about premature mortality and lower life expectancy 
experienced by adults living with serious mental illness as a 
result of treatable medical conditions such as cardiovascular, 
pulmonary, endocrine, and infectious diseases. The Committee 
urges NIMH to 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 2015 budget 
justification.

                NATIONAL HUMAN GENOME RESEARCH INSTITUTE

Appropriations, 2013\1\.................................    $511,847,000
Budget estimate, 2014...................................     517,319,000
Committee recommendation................................     513,881,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $513,881,000 for 
NHGRI.

      NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING

Appropriations, 2013\1\.................................    $337,681,000
Budget estimate, 2014...................................     338,892,000
Committee recommendation................................     337,728,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $337,728,000 for 
NIBIB.

       NATIONAL CENTER FOR COMPLEMENTARY AND ALTERNATIVE MEDICINE

Appropriations, 2013\1\.................................    $127,800,000
Budget estimate, 2014...................................     129,041,000
Committee recommendation................................     128,183,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $128,183,000 for 
NCCAM.

      NATIONAL INSTITUTE ON MINORITY HEALTH AND HEALTH DISPARITIES

Appropriations, 2013\1\.................................    $275,887,000
Budget estimate, 2014...................................     283,299,000
Committee recommendation................................     281,416,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $281,416,000 for 
NIMHD.
    Diabetes in Minorities.--The Committee continues to urge 
NIMHD to support research and other activities with respect to 
pre-diabetes and diabetes, particularly type 2 diabetes, in 
minority populations.
    Mental Health Disparities.--The lack of access to mental 
health services in rural areas presents unique challenges in 
providing services to an especially vulnerable population. 
Greater poverty rates in rural areas, cultural attitudes toward 
mental illness, and limited transportation options all 
contribute to isolating individuals with mental health needs 
from access to care. In addition, individuals with mental 
health problems are at greater risk of poverty so the situation 
becomes part of a cycle of poverty and mental illness. The use 
of telemedicine in cooperation with community mental health 
programs in rural areas presents a new and effective way of 
providing for diagnosis and treatment of mental health 
problems. The Committee encourages NIMHD to fund research 
efforts to find innovative ways to address mental health 
disparities in underserved populations, such as telepsychiatry 
programs, especially in designated Psychiatric Manpower 
Shortage Areas.
    Research Centers in Minority Institutions [RCMI].--The 
Committee continues to recognize the critical role played by 
minority institutions, especially at the graduate level, in 
addressing the health research and training needs of minority 
populations. In particular, the RCMI program fosters the 
development of new generations of minority scientists for the 
Nation and provides support for crucial gaps in the biomedical 
workforce pipeline. The RCMI program has the capability to 
promote solutions to the significant gap in R01 grant funding 
among black and other minority researchers when compared to 
nonminority researchers. The Committee requests that NIH 
describe in the fiscal year 2015 congressional budget 
justification the extent to which the RCMI program is 
addressing R01 funding disparities.

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

Appropriations, 2013\1\.................................     $69,483,000
Budget estimate, 2014...................................      72,864,000
Committee recommendation................................      72,380,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $72,380,000 for the 
Fogarty International Center.
    The Center plays an essential role in global health 
research and training that can both assist developing countries 
advance their own research and health solutions and help the 
United States form partnerships to fight malaria, neglected 
tropical diseases, and other infectious diseases that 
disproportionately impact the global poor. The Committee urges 
FIC to continue this important work.

          NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES

Appropriations, 2013\1\.................................    $574,216,000
Budget estimate, 2014...................................     665,688,000
Committee recommendation................................     661,264,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $661,264,000 for 
NCATS. The Committee includes bill language allowing up to 
$50,000,000 of this amount, the same as the budget request, to 
be used for the Cures Acceleration Network [CAN]. The fiscal 
year 2013 funding level for CAN is $9,961,000.
    Clinical and Translational Science Awards [CTSAs].--The 
Committee strongly endorses IOM's recommendations in its June 
2013 report, ``The CTSA Program at NIH: Opportunities for 
Advancing Clinical and Translational Research.'' In particular, 
the Committee agrees that NCATS should provide leadership to 
help the CTSAs function more as a network than as a collection 
of discrete centers; only then will the full potential of the 
program be realized. In addition, the Committee agrees with the 
IOM that the CTSA program should address the full spectrum of 
clinical and translational research. This should include 
research on changing behaviors that impact the prevention and 
outcome of diseases and conditions such as obesity and type 2 
diabetes.
    Cures Acceleration Network.--The Committee encourages NCATS 
to look at existing successful public-private co-investment 
models and partnerships, particularly In-Q-Tel and SEMATECH, in 
establishing CAN's strategic focus, operating procedures, and 
processes.
    Drug Rescue and Repurposing.--NCATS' drug rescue and 
repurposing initiatives have shown success since the Center's 
establishment 2 years ago. Because rescue and repurposing 
builds upon previous research and development efforts, new 
candidate therapies could be ready for clinical trials quickly, 
advancing the timeframe for FDA approval and their integration 
into healthcare. The Committee notes with particular interest 
the success of The Learning Collaborative, which has had 
significant success employing drug repurposing strategies to 
rapidly advance new blood cancer therapies. The Committee 
encourages NCATS to pursue similar efforts for other rare 
diseases and unmet medical needs.
    Guillain-Barre Syndrome [GBS].--The Committee notes that 
the causes of GBS and related inflammatory disorders which 
impact the nervous system remain unknown. The Committee 
encourages ORDR to initiate research activities in this area to 
improve our scientific understanding of these conditions.
    Hereditary Angioedema [HAE].--The Committee continues to 
recognize that few treatment options are available for HAE and 
that they are not effective for all patients. The Committee 
continues to encourage the Center to convene a state of the 
science conference on this rare disease.
    Multifocal Motor Neuropathy [MMN].--The Committee 
understands that ORDR will soon issue a new funding opportunity 
announcement for the Rare Disease Clinical Research Network. 
Given the importance of appropriate and early diagnosis of 
patients with MMN, the Committee encourages ORDR to give 
appropriate consideration to approving funding for a consortium 
for MMN that includes a registry for patients diagnosed with 
the disease.
    Pulmonary Arterial Hypertension [PAH].--The Committee 
recognizes that pulmonary arterial hypertension is a rare and 
often fatal condition. The Committee encourages ORDR to expand 
research in this area by collaborating on research projects 
with the Pulmonary Hypertension Clinical Research Network, and 
the Committee encourages NCATS to consider pursuing indications 
for current drugs that have shown the potential to improve 
health outcomes for PAH patients.

                      NATIONAL LIBRARY OF MEDICINE

Appropriations, 2013\1\.................................    $345,163,000
Budget estimate, 2014...................................     390,452,000
Committee recommendation................................     387,912,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $387,912,000 for NLM. This amount 
includes $8,200,000 from transfers available under section 241 
of the PHS Act. Of the funds provided, $4,000,000 is for the 
improvement of information systems, to remain available until 
September 30, 2015.
    Communication of Research Findings.--The Committee is 
pleased that NLM has expanded the readership of NIH MedlinePlus 
magazine and the bilingual NIH MedlinePlus Salud magazine, 
which provide consumers and health professionals easy-to-read 
health information based on the latest NIH-supported research. 
The Committee urges NLM to continue exploring new avenues of 
online distribution that extends the publications' reach to the 
public.

                         OFFICE OF THE DIRECTOR

Appropriations, 2013\1\.................................  $1,525,125,000
Budget estimate, 2014...................................   1,473,398,000
Committee recommendation................................   1,463,606,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $1,463,606,000 for 
the Office of the Director [OD]. Within this total, 
$568,151,000 is provided for the Common Fund.
    The Committee includes bill language allowing up to 
$165,000,000 to be used for continuation of the National 
Children's Study. The budget request includes $165,000,000 for 
this purpose but does not specify an amount in bill language.
    The Committee does not include bill language requested by 
the administration that would provide additional transfer 
authority to the Director beyond that which is already provided 
to the Secretary.
    The President's budget recommends eliminating the Science 
Education and Partnership Awards [SEPA] program within OD and 
consolidating it within the Education Department as part of a 
governmentwide reorganization of STEM education activities. The 
proposed consolidation would also affect the Office of Science 
Education within OD and several other smaller STEM programs 
throughout NIH. The Committee is not convinced that the quality 
of these programs would be maintained if they were moved to 
other Federal agencies. Therefore, the Committee directs NIH to 
continue funding these programs in fiscal year 2014. The 
Committee includes sufficient funding within OD to support SEPA 
and the Office of Science Education.
    Alzheimer's Disease.--The Committee commends NIH for the 
recent use of its transfer authority and other means to direct 
additional funding to research on Alzheimer's disease within 
very tight budgets, with the goal of finding an effective 
prevention or treatment by 2025.
    Amyloidosis.--The Committee encourages NIH to continue its 
research efforts into amyloidosis, a group of rare diseases 
characterized by abnormally folded protein deposits in tissues. 
The Committee requests an update in the fiscal year 2015 
congressional budget justification on the steps taken to 
understand the causes of amyloidosis and efforts to improve the 
diagnosis and treatment.
    Angiogenesis.--The Committee commends the research NIH is 
conducting on angiogenesis, specifically examining the need to 
address the lack of predictive markers for angiogenic therapies 
and the prospects for dietary modifications with anti-
angiogenic properties to improve cancer prevention. The 
Committee urges NIH to further examine angiogenic predictive 
markers across NCI, NHLBI, NEI, NIDDK, and NICHHD and to also 
consider focusing on angiogenic dietary modifications to reduce 
cancer risks.
    Basic Research.--The Committee urges the Director to 
maintain the NIH's current focus on the funding of basic 
biomedical research. The purpose of basic research is to 
discover the nature and mechanics of disease and identify 
potential therapeutic avenues likely to lead to the prevention 
and treatment of human disease. Without this early scientific 
investigation, future development of treatments and cures would 
be impossible.
    Biomedical Research Workforce Diversity.--The Committee 
supports the Director's efforts to increase racial and ethnic 
minority researchers in the biomedical research workforce 
through the Building Infrastructure Leading to Diversity 
[BUILD] and the National Research Mentoring Network programs. 
The Committee encourages NIH to promote partnerships with 
historically black colleges, universities, medical schools, and 
other graduate research institutions that have demonstrated a 
past commitment to this goal and proven achievement in 
recruiting, training, and mentoring racial and ethnic minority 
researchers. The Committee requests an update in the fiscal 
year 2015 congressional budget justification on this effort.
    BRAIN Initiative.--The Committee strongly commends NIH for 
leading the Brain Research through Application of Innovative 
Neurotechnologies [BRAIN] Initiative, a multi-agency effort 
that also involves the National Science Foundation and the 
Defense Advanced Research Projects Agency as well as several 
private sector partners. Numerous researchers are already 
working to accelerate the development and application of new 
technologies that will help explain how the brain records, 
processes, uses, stores, and retrieves information. The BRAIN 
Initiative will help catalyze and integrate these efforts. The 
Committee understands that this work may take decades before it 
results in cures or treatments, but could eventually help 
unlock the secrets behind diseases such as Alzheimer's and 
epilepsy. The President's budget requests $40,000,000 for this 
initiative in fiscal year 2014, to be pooled from several ICs 
and the OD. The Committee supports that amount as an initial 
investment but awaits more detailed budget projections for 
future years.
    Career Development Awards for Clinical Researchers.--The 
Committee recommends continued support for ``K'' awards to 
ensure the next generation of clinical researchers is properly 
trained.
    Chemical Risk Assessments.--The Committee supports NIH's 
leadership role in the creation of a new paradigm for chemical 
risk assessment based on the incorporation of advanced 
molecular biological and computational methods in lieu of 
animal toxicity tests. NIH has indicated that development of 
this science is critical to several of its priorities, from 
personalized medicine to tackling specific diseases such as 
cancer and diabetes and including critical initiatives such as 
BRAIN. The Committee encourages NIH to continue to expand both 
its intramural and extramural support for the use of human 
biology-based experimental and computational approaches in 
health research to further define human biology, disease 
pathways, and toxicity and to develop tools for their 
integration into evaluation strategies. Extramural and 
intramural funding should be made available for the evaluation 
of the relevance and reliability of human biology-based and 
Tox21-related methods and prediction tools to assure readiness 
and utility for regulatory purposes, including pilot studies of 
pathway-based risk assessments. The Committee requests an 
update on current activities, a plan for future activities, and 
the fiscal year 2014 funding level for this area of research in 
the fiscal year 2015 congressional budget justification.
    Chimpanzees.--The Committee strongly commends NIH for its 
recent decision to substantially reduce the use of chimpanzees 
in NIH-funded biomedical research and designate for retirement 
most of the chimpanzees it currently owns or supports. However, 
technical changes in NIH's legal authority are needed to retire 
additional chimpanzees to the Federal Sanctuary System. 
Therefore, the Committee includes a new general provision that 
will allow NIH to achieve this goal. Specifically, the 
Chimpanzee Health Improvement, Maintenance and Protection 
[CHIMP] Act limits the amount of financial resources NIH may 
put toward retiring chimpanzees and caring for them in the 
Federal Sanctuary System. The CHIMP Act does not limit the 
amount of funding NIH may provide for chimpanzees who are not 
in the Federal Sanctuary System. The general provision modifies 
the CHIMP Act so that NIH funds that would otherwise be used to 
care only for non-Federal Sanctuary System chimpanzees can also 
be used for sanctuary chimpanzees.
    Chronic Fatigue Syndrome [CFS].--The Committee commends the 
Office of Disease Prevention for agreeing to review the case 
definition for CFS, also known as ME/CFS, as part of an 
evidence-based methodology workshop. NIH is urged to include 
experienced professionals in the ME/CFS research and clinical 
fields as well as patients and their advocates in this process. 
Further, the Committee encourages NIH to issue a special 
funding opportunity to spur research into ME/CFS using the 
clinical specimens collected under an NIAID-funded study. This 
resource could help speed diagnostics and better understanding 
of the pathophysiology of this severely disabling condition.
    Congenital Diaphragmatic Hernia [CDH].--The Committee 
encourages NIH to put a higher priority on CDH research. In 
particular, the Committee urges NHLBI to investigate the 
pulmonary effects of this birth defect and requests NICHD to 
support additional research on whether the timing of surgical 
repair to the diaphragm can increase an infant's chances of 
survival. Along with ORDR, these two Institutes are also 
encouraged to promote greater research interest in CDH by 
supporting a scientific meeting on this condition.
    Cystic Fibrosis [CF].--The Committee encourages new 
personalized approaches to CF therapeutics, including new means 
to identify and characterize the efficacy of multidrug therapy 
that addresses the mutant protein which is the underlying cause 
of cystic fibrosis in the majority of those with the disease. 
The Committee supports research into nonsense mutations of CF, 
which impact about 10 percent of the CF population. In 
addition, the Committee urges further research into live 
imaging modalities that are able to characterize mucus and 
monitor mucociliary clearance, defense mechanisms at the heart 
of CF and many other respiratory diseases.
    Down Syndrome.--The Committee applauds NIH for the 
establishment of the Down Syndrome Patient Registry. The 
Committee urges continued investment and development of the 
registry to fully realize its potential as a tool to stimulate 
meaningful clinical trials and research. The Committee 
recognizes that investing in Down syndrome-focused research has 
the potential to benefit many other diseases and conditions 
such as Alzheimer's disease. Therefore, the Committee urges NIH 
to seek public-private partnerships aimed at developing 
preventive therapies for the dementia associated with both Down 
syndrome and Alzheimer's disease. The Committee remains 
troubled by the stagnant number of investigator-driven research 
awards given in the area of Down syndrome and supports efforts 
to increase the Federal investment. The Committee requests a 
status update in the fiscal year 2015 congressional budget 
justification. The Committee urges the NIH to continue to 
utilize the Down Syndrome Consortium as it updates and 
implements the NIH Down Syndrome Research Plan.
    Drug Allergy.--The Committee commends NIAID for leading a 
recent workshop to develop a research agenda on the diagnosis 
and management of patients with drug hypersensitivity. The 
Committee urges NCATS, NCI, NHLBI, NIAMS, and other relevant 
Institutes to collaborate with NIAID to support research in 
this area, as there is a critical need for better tools to 
predict patient drug allergies and for improved drug 
desensitization protocols. The Committee encourages NIH to 
consider a multi-Institute, multidisciplinary collaborative 
effort in this area that might include support for centers of 
excellence as well as the development of a patient registry.
    Eosinophil-Associated Disorders.--The Committee is pleased 
that NIAID recently convened the Task Force on Research Needs 
of Eosinophil-Associated Diseases [TREAD], which produced a 
research agenda to improve the diagnosis and treatment of these 
debilitating and often painful diseases. The Committee urges 
NIDDK, NHLBI, NICHD, NIAMS, and NIMH to join NIAID's efforts to 
foster research in this area.
    Fragile X-Associated Disorders [FXD].--The Committee 
commends NICHD for leading the effort to map the molecular, 
physiological, biological, and genetic connections between 
Fragile X (and the Fragile X protein) and autism. The Committee 
urges all ICs with Fragile X and autism portfolios to explore 
these connections with the goals of better understanding both 
conditions and shortening the time it will take to bring 
effective treatments for both conditions to market. The 
Committee also commends NICHD and its NIH partners for leading 
the effort to update the NIH Research Plan on Fragile X 
Syndrome and Associated Disorders, and urges NIH to fully 
implement the updated recommendations.
    Health Disparities in Children and Adolescents.--The 
Committee urges NIH to put a high priority on improving the 
health status of children and adolescents, especially those 
living in poverty.
    Hepatitis B.--While hepatitis B is preventable as a result 
of a safe and effective vaccine, this disease is not currently 
curable for those who are already infected. An estimated 
800,000 to 1.4 million Americans are infected with hepatitis B 
and most do not know it. The Committee urges NIH to move 
aggressively to research a cure. In particular, the Committee 
urges more work in antiviral drug development and continued 
support and use of appropriate animal models to study the 
disease.
    Human Microbiome Project.--The Committee commends NIH for 
establishing the Common Fund Human Microbiome Project, which 
has great potential to advance scientific understanding of many 
important areas of human health, including the immune system, 
and urges NIH to continue to work to understand the basis of 
healthy microbiome-induced immunoregulation and how it is 
altered in disease.
    Human Tissue Supply.--The Committee continues to urge NIH 
to support its nationwide human tissue and organ procurement 
program.
    Interstitial Cystitis.--The Committee commends ORWH for its 
continued collaborations with NIDDK to support research on 
interstitial cystitis, which disproportionately affects women.
    Lupus.--The Committee urges the Director to promote 
collaboration among NIAMS, NIAID, NHLBI, NIDDK, NIEHS, NINDS, 
NICHD, and NIMHD on efforts to expand and intensify genetic, 
clinical, and basic research on lupus. Given the complexity and 
impact of lupus, the Committee urges a particular focus on 
understanding the underlying mechanisms of the disease, gene-
gene and gene-environmental interactions, its relationship to 
kidney disease, biomarkers, pediatric research, and factors 
related to the health disparities and comorbidities associated 
with lupus.
    Lymphatic Research and Lymphatic Disease.--The Committee 
commends the trans-NIH Coordinating Committee for Lymphatic 
Research [CCLR] and, in particular, NHLBI, NIAID, and NIDDK for 
their efforts to advance research on the lymphatic system and 
medical care for lymphatic diseases. The Committee urges 
greater participation from other Institutes in the CCLR, 
particularly NIAMS, NHGRI, and NIBIB. The Committee encourages 
the reconvening of a trans-NIH Working Group to evaluate the 
implementation of the recommendations it made in 2007. 
Continued efforts within the ICs to create support for 
extramural interdisciplinary research training relevant to the 
lymphatic system in health and disease and within the Center 
for Scientific Review to incorporate reviewer expertise in 
lymphatic biology/disease in the pertinent study sections are 
also requested.
    Mitochondrial Disease.--The Committee commends NIH for 
supporting a 2-day workshop on ``Translational Research in 
Primary Mitochondrial Diseases,'' which led to the development 
of a white paper that identifies barriers to progress and makes 
recommendations for addressing those barriers. NIH has also 
created a working group on mitochondrial disease research with 
broad participation from various Institutes and Centers. The 
Committee urges NIH to expand its mitochondrial research 
portfolio and fully implement the recommendations contained in 
the white paper.
    Mucopolysaccharidosis [MPS].--The Committee continues to 
urge NIH to put a high priority on better understanding and 
treating MPS and related diseases. The Committee commends NIH 
for allocating funds to discover, develop, define, and make 
available for research animal models of human genetic disease. 
The Committee also commends NIDDK for funding gene therapy 
efforts. Continued funding of these grants is critical to 
understanding these diseases and evaluating the efficacy and 
safety of combination therapies. The Committee encourages 
NINDS, NIDDK, and ORDR to continue supporting the Lysosomal 
Disease Network.
    National Primate Research Centers [NPRCs].--The Committee 
continues to support NPRCs, which are essential to ensuring the 
availability of nonhuman primate models and the expertise 
needed to help researchers pursue new drugs, treatments, and 
vaccines.
    Natural Product Collections.--The Committee continues to 
urge NIH to increase access to comprehensive and professionally 
organized natural product libraries.
    Neurofibromatosis [NF].--The Committee commends NIH for its 
continued support of NF research and again requests an update 
in the fiscal year 2015 congressional budget justification of 
relevant activities at NCI, NHLBI, NINDS, NICHD, NIMH, NIAMS, 
NIDCD, and NEI.
    OppNet.--The Committee commends NIH for its commitment to 
the Basic Behavioral and Social Science Opportunity Network 
[OppNet] initiative launched in 2009. Basic behavioral science 
research helps improve human health by contributing to our 
understanding of the complex factors that influence 
individuals. As fiscal year 2014 is the fifth year of this 
initiative, the Committee requests an update in the fiscal year 
2015 congressional budget justification on the contributions 
made by the initiative along with recommendations on how best 
to continue the program and the OppNet mission.
    Overlapping Chronic Pain Conditions.--The Committee 
continues to strongly support an expanded trans-NIH research 
effort to better understand and identify effective treatments 
for overlapping chronic pain conditions that disproportionately 
impact women, including chronic fatigue syndrome, 
endometriosis, fibromyalgia, interstitial cystitis, irritable 
bowel syndrome, chronic headache, temporomandibular disorders, 
and vulvodynia. The Committee urges NIH to promptly implement 
the recommendations from the August 2012 NIH scientific 
workshop on this topic. These include: developing a case 
definition and research diagnostic criteria for chronic 
overlapping pain conditions; leveraging existing patient 
cohorts, resources, and data repositories to achieve cost 
savings; conducting prospective population-based 
epidemiological studies to determine the natural history of and 
risk factors for onset and progression of disease; developing 
common data elements, standardized outcome measures, and 
methods to classify phenotypic subgroups; studying central 
sensitization as a theme for discovery of common mechanisms of 
disease, diagnostics, and treatment; and developing 
multidisciplinary training programs for scientists and 
clinicians. As no one Institute has the responsibility for 
addressing all overlapping chronic pain conditions, the 
Committee strongly urges multiple Institutes to combine their 
efforts through centers of excellence or other appropriate 
means of carrying out these recommendations.
    Polycystic Kidney Disease [PKD].--The Committee continues 
to urge NIH to put a high priority on PKD research.
    Pregnancy Health Status.--The Committee commends NIH for 
its work on the relationship between a woman's health status 
during pregnancy and her health post-pregnancy. The Committee 
urges NIH to prioritize the joint NICHD-NHLBI funding 
opportunity ``Pregnancy as a Window to Future Cardiovascular 
Disease,'' as potential life-threatening conditions such as 
heart disease can be prevented based on clues during a woman's 
pregnancy. The Committee also urges NICHD to ensure that short-
term studies on lifestyle interventions and treatment for 
preeclampsia, as well as interventional studies that go beyond 
weight management to include gestational and type 2 diabetes, 
cardiovascular disease, and other chronic diseases, can be 
translated into longer-term trials that will ultimately lead to 
changes in obstetrical practice which result in a healthier 
population.
    Psoriasis.--The Committee commends NIH for addressing the 
significant public health burden resulting from psoriasis and 
psoriatic arthritis, the Nation's most common autoimmune 
disease. In order to address the connection between these 
diseases and other serious, life-threatening comorbid 
conditions such as cardiovascular disease, diabetes, stroke, 
and cancer, the Committee urges NIH to further promote 
integrated, interdisciplinary research on the inflammatory 
nature of these diseases.
    Rehabilitation Research.--The Committee recognizes the 
importance of rehabilitation research and commends the agency 
for its work to evaluate the performance of the National Center 
for Medical Rehabilitation Research. The Committee further 
recommends that NIH continue to implement the recommendations 
included in the final December 2012 report titled, ``Blue 
Ribbon Panel on Medical Rehabilitation Research at the NIH.''
    Sleep Disorders.--The Committee urges NIH to initiate new 
training programs in sleep and circadian sciences in all 
relevant Institutes and Centers, consistent with the NIH Sleep 
Disorders Research Plan.
    Spinal Muscular Atrophy [SMA] Carrier Screening.--The 
Committee continues to support the development of a pan-ethnic 
carrier screening program for SMA. The Committee remains 
concerned that contradicting SMA carrier screening 
recommendations from professional societies persist and that 
this inconsistency creates confusion among health professionals 
and the public. The Committee encourages NHGRI, NICHD, and 
NINDS to collaborate with stakeholders from government, 
academia, professional societies, advocacy groups, and industry 
to resolve the discrepancy and develop unified and consistent 
recommendations, guidelines, and educational materials on SMA 
carrier screening for providers and patients.
    Traumatic Brain Injury [TBI].--The Committee understands 
that current brain imaging technology is inadequate to 
accurately characterize the various degrees of TBI. The 
Committee urges support for the development of new brain 
imaging technologies to address this challenge.
    Tuberous Sclerosis Complex [TSC].--The Committee continues 
to encourage NIH to coordinate a multi-Institute approach to 
finding a cure for TSC. NINDS and NCATS should play leading 
roles, given the promising translational potential of new 
therapeutics for treating the neurological conditions of TSC, 
including autism and epilepsy. Other Institutes involved in 
this collaborative effort should include NCI, NIAMS, NHLBI, 
NIDDK, NINDS, NICHD, and NIBIB, as well as ORDR.
    Veterinary Medicine Loan Repayment Programs.--The Committee 
recognizes the important role that doctors of veterinary 
medicine [DVMs] play in the biomedical research enterprise 
because of their background and training in disease processes 
across all animals, including cross-species virus transmission, 
and animal models. Like other medical professionals, a large 
debt load upon graduation influences their choice to pursue 
careers in biomedical research. The Committee was gratified 
that eligibility for the loan repayment programs was expanded 
to include DVMs and would like NIH to report to the Committee 
if this change increased DVM participation in these programs. 
Given the vital part DMVs play in clinical research, NIH is 
encouraged to continue to make this eligibility change more 
widely known to potential applicants, ICs, and reviewers.

                        OFFICE OF AIDS RESEARCH

    OAR coordinates the scientific, budgetary, legislative, and 
policy elements of the NIH AIDS research program. The Committee 
recommendation does not include a direct appropriation for OAR. 
Instead, the Director of OAR and the Director of NIH together 
determine the total for AIDS research within the total NIH 
appropriation, and the Director of OAR determines and allocates 
distribution of those funds to the ICs and OAR. The 
recommendation includes a general provision permitting the NIH 
Director and OAR to shift up to 3 percent of AIDS research 
funding among Institutes and Centers throughout the year if 
needs change or unanticipated opportunities arise.
    The Committee commends NIH for supporting the AIDS and non-
AIDS funding allocations at their current relative rates and 
endorses the continuation of this policy. The Committee 
recognizes that OAR's AIDS allocation to each IC is based on 
scientific need and opportunity. Therefore, individual IC AIDS 
budgets may not each grow at the same rate, but total AIDS and 
non-AIDS funding will continue to grow at a comparable rate.
    The Committee includes bill language permitting OAR to use 
up to $8,000,000 for construction or renovation of National 
Primate Research Centers. This amount is the same as the fiscal 
year 2013 level and the budget request.

                        BUILDINGS AND FACILITIES

Appropriations, 2013\1\.................................    $125,093,000
Budget estimate, 2014...................................     126,111,000
Committee recommendation................................     125,308,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

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

       Substance Abuse and Mental Health Services Administration

    The Committee recommends $3,529,944,000 for SAMHSA. The 
recommendation includes $132,667,000 in transfers available 
under section 241 of the PHS Act. In addition, the Committee 
recommends transferring $92,000,000 to SAMHSA from the PPH 
Fund. The total program level assumed in this bill for SAMHSA 
is $3,621,944,000.
    SAMHSA is responsible for supporting mental health programs 
and alcohol and other drug abuse prevention and treatment 
services throughout the country, primarily through categorical 
grants and block grants to States.
    The Committee recommendation includes $119,000,000 in new 
funding throughout SAMHSA to increase access to mental health 
services. This includes a total of $95,000,000 for the 
administration's Now is the Time initiative. The Committee 
provides $15,000,000 for Mental Health First Aid programs that 
teach individuals to identify and respond to the signs of 
mental illness; $40,000,000 for Project AWARE State grants, 
which will focus on making schools safer and connecting young 
people with mental health services; and $40,000,000 to address 
shortages in the behavioral health workforce, including a 
$5,000,000 increase for the Minority Fellowship program. In 
addition, the Committee includes a new 5 percent setaside 
within the Community Mental Health Services Block Grant [MHBG] 
that will allocate $24,187,000 to evidence-based programs 
addressing the needs of individuals with the early signs of 
serious mental illness.
    The Committee is disappointed that the administration has 
continued to use the Substance Abuse Prevention and Treatment 
[SAPT] Block Grant and the MHBG as sources for program 
evaluation transfers pursuant to section 241 of the PHS Act. 
The Committee directs SAMHSA and the Department to exempt these 
two programs from being used as a source for PHS evaluation 
transfers in fiscal year 2014, as was done prior to fiscal year 
2012.
    The Committee does not include new bill language requested 
by the administration that would require States to set aside at 
least 3 percent of both the SAPT Block Grant and MHBG to assist 
providers in improving their enrollment, billing, and business 
practices. The Committee recognizes the challenges faced by 
some mental health and substance abuse providers in 
implementing the ACA but notes that States are at varying 
stages of progress in expanding insurance coverage and 
increasing access to behavioral health services, and therefore 
may not find this requirement necessary. The Committee also 
notes that enrollment and provider business practice activities 
are allowable block grant activities under current law. Rather 
than impose a new ``one size fits all'' requirement, the 
Committee believes that rules governing both block grants 
should be as flexible as possible in order to allow States the 
ability to address their own unique needs related to mental 
health, substance abuse prevention, treatment, and recovery 
services.
    The Committee is concerned that the combined block grant 
application for fiscal years 2014-2015 does not make clear 
that, in the absence of congressional action, using funds to 
improve provider enrollment and billing practices is an 
allowable use of funds but is not a requirement. The Committee 
directs SAMHSA to clarify with State mental health and 
substance abuse authorities which block grant activities are 
required and which are optional.

                   CENTER FOR MENTAL HEALTH SERVICES

Appropriations, 2013\1\.................................    $952,260,000
Budget estimate, 2014...................................   1,011,380,000
Committee recommendation................................   1,059,282,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $1,059,282,000 for mental health 
services. The recommendation includes $21,039,000 in transfers 
available under section 241 of the PHS Act. In addition, the 
Committee recommends transferring $27,000,000 to CMHS from the 
PPH Fund. The total program level assumed in this bill for CMHS 
is $1,086,282,000. Included in the recommendation is funding 
for programs of regional and national significance, the MHBG, 
children's mental health services, PATH, and PAIMI.

             PROGRAMS OF REGIONAL AND NATIONAL SIGNIFICANCE

    The Committee recommends $357,191,000 for PRNS within CMHS. 
In addition, the Committee recommends that $27,000,000 be 
transferred to PRNS from the PPH Fund. The total program level 
assumed in this bill for PRNS at CMHS is $384,191,000. These 
programs address priority mental health needs through 
developing and applying evidence-based practices, offering 
training and technical assistance, providing targeted capacity 
expansion grants, and changing the delivery system through 
family, client-oriented, and consumer-run activities.
    Within the total provided for PRNS, the Committee 
recommendation includes funding for the following activities:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                              Fiscal year 2013    Fiscal year       Committee
                      Budget activity                         appropriation\1\    2014 request    recommendation
----------------------------------------------------------------------------------------------------------------
CAPACITY:
    Seclusion and Restraint................................            $2,439           $1,149           $1,150
    Youth Violence Prevention..............................            23,110           23,156           23,156
    Project AWARE State Grants.............................  .................          40,000           40,000
    Mental Health First Aid................................  .................          15,000           15,000
        Prevention and Public Health Fund (non-add)........  .................  ...............         (15,000)
    Healthy Transitions....................................  .................          25,000   ...............
    National Child Traumatic Stress Initiative.............            45,622           45,714           46,000
    Children and Family Programs...........................             6,461            6,474            6,474
    Consumer and Family Network Grants.....................             6,212            4,966            4,966
    MH System Transformation and Health Reform.............            10,582           10,603           10,582
    Project LAUNCH.........................................            34,571           34,640           34,640
    Primary and Behavioral Healthcare Integration..........            30,687           26,004           65,000
        Prevention and Public Health Fund (non-add)........  .................         (26,004)  ...............
    National Strategy for Suicide Prevention...............  .................           2,000            2,000
        Prevention and Public Health Fund (non-add)........  .................  ...............          (2,000)
    Suicide Lifeline.......................................             5,501            5,512            7,212
        Prevention and Public Health Fund (non-add)........  .................  ...............          (1,700)
    GLS Youth Suicide Prevention (State Grants)............            29,622           29,682           35,500
        Prevention and Public Health (non-add).............  .................  ...............          (5,800)
    GLS Youth Suicide Prevention (Campus Grants)...........             4,956            4,966            6,500
        Prevention and Public Health Fund (non-add)........  .................  ...............          (1,500)
    AI/AN Suicide Prevention Initiative....................             2,933            2,938            2,938
    Homelessness Prevention Programs.......................            30,710           30,772           30,772
    Tribal Behavioral Grants...............................  .................  ...............           5,000
    Minority AIDS..........................................             9,247           22,770            9,247
    Criminal and Juvenile Justice Programs.................             6,658            4,280            4,280
    Grants for Adult Trauma Screening and Brief              .................           2,896            2,896
     Intervention..........................................
SCIENCE AND SERVICE:
    GLS Suicide Prevention Resource Center.................             4,938            4,948            6,000
        Prevention and Public Health Fund (non-add)........  .................  ...............          (1,000)
    Practice Improvement and Training......................             7,847            7,863            7,847
    Primary and Behavioral Healthcare Integration T.A......             1,992            1,996            1,996
        Prevention and Public Health Fund (non-add)........  .................          (1,996)  ...............
    Consumer and Consumer Support T.A. Centers.............             1,920            1,923            1,923
    Minority Fellowship Program............................             5,079   ...............           8,079
    Disaster Response......................................             1,050            2,950            1,958
    Homelessness...........................................             2,297            2,302            2,302
    HIV/AIDS Education.....................................               771              773             773
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
  reprogrammings allowed under Public Law 113-6.

    Primary and Behavioral Healthcare Integration.--The 
Committee provides funding for this program through budget 
authority rather than through transfers from the PPH Fund as 
requested by the administration. The Committee continues to 
direct SAMHSA to ensure that new Integration grants awarded for 
fiscal year 2014 are funded under the authorities in section 
520K of the PHS Act.
    Psychotropic Medications and Children.--The Committee has 
become increasingly concerned about the safe, appropriate, and 
effective use of psychotropic medications and children, 
particularly children in foster care settings. According to a 
December 2012 GAO report, an alarming 18 percent of foster 
children are prescribed psychotropic medications, compared with 
4.8 percent of privately insured children. The Committee 
strongly encourages SAMHSA to establish meaningful partnerships 
with Medicaid, the foster care program, medical specialty 
societies, and treatment centers to develop new strategies for 
treating this vulnerable population. The Committee would like 
an update in next year's congressional justification on the 
steps SAMHSA has taken to promote the most effective and 
appropriate treatment approaches, including the use of 
evidence-based psychosocial therapies instead of, or in 
combination with, psychotropic medications.
    Suicide Prevention in Indian Populations.--In order to 
address the high incidence of substance abuse and suicide in 
American Indian/Alaska Native [AI/AN] populations, the 
Committee recommends $5,000,000 for competitively awarded 
grants targeting tribal entities with the highest rates of 
suicide per capita over the past 10 years. The Committee 
expects funds to be used for effective and promising strategies 
that address the problems of substance abuse and suicide and 
promote mental health among AI/AN young people.

              COMMUNITY MENTAL HEALTH SERVICES BLOCK GRANT

    The Committee recommends $483,744,000 for the MHBG. The 
recommendation includes $21,039,000 in transfers available 
under section 241 of the PHS Act.
    The MHBG distributes funds to 59 eligible States and 
territories through a formula based on specified economic and 
demographic factors. Grant applications must include an annual 
plan for providing comprehensive community mental health 
services to adults with a serious mental illness and children 
with a serious emotional disturbance.
    The Committee does not include bill language requested by 
the administration requiring States to set aside 5 percent of 
MHBG funds for effective mental health prevention and treatment 
programs. The Committee is concerned that this language is too 
broad to target early treatment services to those who need it 
most: individuals with serious mental illness. Instead, the 
Committee bill requires States to set aside 5 percent of their 
MHBG funds for evidence-based programs that address the needs 
of individuals with early serious mental illness, including 
psychotic disorders.
    The Committee notes that the majority of individuals with 
severe mental illness experience their first symptoms during 
adolescence or early adulthood. Despite the existence of 
effective treatments, there are often long delays--years, and 
sometimes decades--between the first onset of symptoms and when 
people receive help. The consequences of delayed treatment can 
include loss of family and social supports, disruption of 
employment, substance abuse, increased hospitalizations, and 
reduced prospects for long-term recovery.
    One promising model that seeks to address serious mental 
illness at an early stage is called First Episode Psychosis 
[FEP], currently being used in Canada, the United Kingdom, and 
Australia. This early treatment model may help reduce symptoms, 
reduce relapse rates, and prevent deterioration of cognitive 
function in individuals suffering from psychotic illness. The 5 
percent setaside will provide $24,817,000 to programs such as 
FEP. The Committee provides an increase to the block grant over 
the fiscal year 2013 level to help States meet this new 
requirement without losing funding for existing services. The 
Committee directs SAMHSA to collaborate with NIMH in developing 
guidelines to States regarding effective programs funded by 
this setaside.

                   CHILDREN'S MENTAL HEALTH SERVICES

    The Committee recommends $117,315,000 for the Children's 
Mental Health Services program. 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

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

      PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS

    The Committee recommends $36,238,000 for PAIMI. This 
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.

                  CENTER FOR SUBSTANCE ABUSE TREATMENT

Appropriations, 2013\1\.................................  $2,196,938,000
Budget estimate, 2014...................................   2,124,650,000
Committee recommendation................................   2,128,307,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $2,128,307,000 for substance abuse 
treatment programs, including programs of regional and national 
significance and the substance abuse prevention and treatment 
block grant to the States. The recommendation includes 
$81,200,000 in transfers available under section 241 of the PHS 
Act. In addition, the Committee recommends transferring 
$50,000,000 to CSAT from the PPH Fund. The total program level 
assumed in this bill for CSAT in fiscal year 2014 is 
$2,178,307,000.

             PROGRAMS OF REGIONAL AND NATIONAL SIGNIFICANCE

    The Committee recommends $308,451,000 for PRNS within CSAT. 
The recommendation includes $2,000,000 in transfers available 
under section 241 of the PHS Act. In addition, the Committee 
recommends transferring $50,000,000 to PRNS from the PPH Fund. 
The total program level assumed in this bill for PRNS in fiscal 
year 2014 is $358,451,000.
    Programs of regional and national significance include 
activities to increase capacity by implementing service 
improvements using proven evidence-based approaches as well as 
science-to-services activities that promote the identification 
of practices thought to have potential for broad service 
improvement.
    Within the total provided for PRNS, the Committee 
recommendation includes funding for the following activities:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                              Fiscal year 2013    Fiscal year       Committee
                      Budget activity                         appropriation\1\    2014 request    recommendation
----------------------------------------------------------------------------------------------------------------
CAPACITY:
    Opioid Treatment Programs/Regulatory Activities........            8,868             8,746            8,746
    Screening, Brief Intervention and Referral to Treatment           28,135            30,000           52,000
        Section 241 transfer (non-add).....................           (2,000)   ...............          (2,000)
        Prevention and Public Health Fund (non-add)........  .................         (30,000)  ...............
    TCE--General...........................................           27,924            13,256           13,256
    Pregnant and Postpartum Women..........................           15,938            15,970           15,970
    Strengthening Treatment Access and Retention...........            1,668             1,000            1,668
    Recovery Community Services Program....................            2,440             2,562            2,440
    Access to Recovery.....................................           98,071            65,000           50,000
        Prevention and Public Health Fund (non-add)........  .................  ...............         (50,000)
    Children and Families..................................           30,559            29,678           29,678
    Treatment Systems for Homeless.........................           41,488            41,571           41,488
    Minority AIDS..........................................           65,732            52,359           65,732
    Criminal Justice Activities............................           67,372            65,135           64,446
SCIENCE AND SERVICE:
    Addiction Technology Transfer Centers..................            9,046             8,081            9,046
    Minority Fellowship Program............................              545    ...............           2,545
    Special Initiatives/Outreach...........................            2,262             1,436           1,436
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
  reprogrammings allowed under Public Law 113-6.

    Addiction Technology Transfer Centers [ATTCs].--The 
Committee continues to direct SAMHSA to ensure ATTCs continue 
to maintain a primary focus on addiction treatment and recovery 
services in order to strengthen the addiction workforce.
    Addiction Workforce.--The Committee notes that several 
studies conducted over the past decade suggest that lack of 
information about the addiction field and the perception that 
addiction counselors are not viewed as a valued profession 
appear to be recruitment barriers for the addiction workforce. 
This is particularly concerning given that the demand for 
substance abuse services is anticipated to increase in the 
coming years as a result of the ACA and the Mental Health 
Parity and Addictions Equity Act. The Committee strongly urges 
SAMHSA to work with community colleges, universities, and State 
substance abuse agencies to develop ways to encourage 
individuals to enter the addiction prevention, treatment, and 
recovery workforce.
    Drug Treatment Courts.--The Committee continues to direct 
SAMHSA to ensure that all funding appropriated for Drug 
Treatment Courts is allocated to serve people diagnosed with a 
substance use disorder as their primary condition. The 
Committee expects CSAT to ensure that non-State substance abuse 
agency applicants for any drug treatment court grant in its 
portfolio continue to demonstrate extensive evidence of working 
directly and extensively with the corresponding State substance 
abuse agency in the planning, implementation, and evaluation of 
the grant.
    Infectious Disease Testing.--The Committee remains 
concerned by the high incidence of viral hepatitis and HIV 
among the populations that SAMHSA serves. The Committee 
encourages SAMHSA to continue to support hepatitis and HIV 
testing within its activities and to utilize rapid tests to 
encourage patient receipt of results. In addition, SAMHSA is 
encouraged to continue surveillance of these activities in 
order to monitor the progress of infectious diseases screening.
    Minority AIDS Initiative.--The Committee rejects the 
administration request to move funds to CMHS from the Minority 
AIDS Initiative administered by CSAT. The Committee urges 
SAMHSA to focus its efforts on building capacity and outreach 
to individuals at risk for or with a primary substance use 
disorder and to improve efforts to identify such individuals to 
prevent the spread of HIV.
    Screening, Brief Intervention, and Referral to Treatment 
[SBIRT].--The Committee provides funding for SBIRT through 
budget authority rather than through transfers from the PPH 
Fund as requested by the administration. The Committee 
continues to direct SAMHSA to ensure that funds provided for 
SBIRT are used for existing evidence-based models of providing 
early intervention and treatment services to those at risk of 
developing substance abuse disorders.
    Workforce Development.--The Committee is concerned that 
only 50 to 55 percent of addiction counselors hold a master's 
degree. While 75 percent hold at least a bachelor's degree, the 
remainder have only a high school diploma or equivalent. The 
Committee urges SAMHSA to work with HRSA to ensure that 
programs aimed at mental health and substance use disorder 
professionals are available to addiction professionals seeking 
to move from a bachelor's level to a master's level.

          SUBSTANCE ABUSE PREVENTION AND TREATMENT BLOCK GRANT

    The Committee recommends $1,819,856,000 for the SAPT block 
grant. 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 States according to a formula.
    Overdose Fatality Prevention.--The Committee is deeply 
concerned about the increasing number of unintentional overdose 
deaths attributable to prescription and nonprescription 
opioids. The Committee urges SAMHSA to take steps to encourage 
and support the use of SAPT Block Grant funds for opioid safety 
education and training, with a focus on initiatives that 
improve access of naloxone to public health and law enforcement 
professionals.

                 CENTER FOR SUBSTANCE ABUSE PREVENTION

Appropriations, 2013\1\.................................    $185,637,000
Budget estimate, 2014...................................     175,560,000
Committee recommendation................................     175,631,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $175,631,000 for CSAP, the sole 
Federal organization with responsibility for improving 
accessibility and quality of substance abuse prevention 
services.

             PROGRAMS OF REGIONAL AND NATIONAL SIGNIFICANCE

    The Committee provides $175,631,000 for PRNS within CSAP. 
Through these programs, CSAP supports: development of new 
practice knowledge on substance abuse prevention; 
identification of proven effective models; dissemination of 
science-based intervention information; State and community 
capacity building for implementation of proven, effective 
substance abuse prevention programs; and programs addressing 
new needs in the prevention system.
    Within the total provided for PRNS, the Committee 
recommendation includes funding for the following activities:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                Fiscal year 2013    Fiscal year      Committee
                       Budget activity                          appropriation\1\   2014 request   recommendation
----------------------------------------------------------------------------------------------------------------
CAPACITY:
    Strategic Prevention Framework/Partnership for Success...           109,587          109,754         109,754
    Mandatory Drug Testing...................................             5,186            4,906           4,906
    Minority AIDS............................................            41,224           41,307          41,307
    Sober Truth on Preventing Underage Drinking (STOP Act)...             6,973            7,000           7,000
SCIENCE AND SERVICE:
    Fetal Alcohol Spectrum Disorder..........................             9,783            1,000           1,000
    Center for the Application of Prevention Technologies....             8,043            7,511           7,511
    Science and Service Program Coordination.................             4,770            4,082           4,082
    Minority Fellowship Program..............................                71   ..............             71
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
  reprogrammings allowed under Public Law 113-6.

    The Committee recommendation provides $109,754,000 for the 
Strategic Prevention Framework State Incentive Grant [SPFSIG] 
and Partnerships for Success programs. The Committee intends 
that these two programs continue to focus exclusively on: 
addressing State- and community-level indicators of alcohol, 
tobacco, and drug use; targeting and implementing appropriate 
universal prevention strategies; building infrastructure and 
capacity; and preventing substance use and abuse. The Committee 
does not concur with SAMHSA's proposal to allow grantees to use 
funds to address trauma, as this would serve to redirect the 
program's purpose. In addition, the Committee intends that the 
specific drug and alcohol issues chosen by a grantee should be 
dictated by its own unique needs as reflected by an analysis of 
community-level epidemiological data. Grantees should emphasize 
prevention of underage alcohol use or prescription drug abuse 
only if the data support this need.
    Given that youth drug use is on the rise and perceptions of 
harm are waning, the Committee directs that all of the money 
appropriated explicitly for substance abuse prevention purposes 
both in CSAP's PRNS lines as well as the funding from the 20 
percent prevention set-aside in the SAPT Block Grant be used 
only for bona fide substance abuse prevention programs and 
strategies and not for any other purposes.

                HEALTH SURVEILLANCE AND PROGRAM SUPPORT

Appropriations, 2013\1\.................................    $136,109,000
Budget estimate, 2014...................................     201,119,000
Committee recommendation................................     166,724,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $166,724,000 for Health 
Surveillance and Program Support activities. The recommendation 
includes $30,428,000 in transfers available under section 241 
of the PHS Act. In addition, the Committee recommends 
transferring $15,000,000 to this account from the PPH Fund. The 
total program level assumed in this bill for health 
surveillance and support is $181,724,000.
    This activity supports Federal staff and the administrative 
functions of the agency. It also provides funding to SAMHSA's 
surveillance and data collection activities, including national 
surveys such as the National Survey on Drug Use and Health.
    The Committee does not include bill language requested by 
the administration that would provide additional transfer 
authority to the Administrator beyond that which is already 
provided to the Secretary.
    Within the total provided for Health Surveillance and 
Program Support, the Committee recommendation includes funding 
for the following activities:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                              Fiscal year 2013    Fiscal year       Committee
                      Budget activity                         appropriation\1\    2014 request    recommendation
----------------------------------------------------------------------------------------------------------------
Health Surveillance........................................          $44,153           $47,428          $47,428
    Section 241 transfer (non-add).........................          (27,428)          (45,428)         (30,428)
    Prevention and Public Health Fund (non-add)............          (14,733)   ...............         (15,000)
Program Management.........................................           76,740            72,729           72,729
Military Families..........................................            3,486    ...............  ...............
Public Awareness and Support...............................           13,518            13,571           13,571
    Section 241 transfer (non-add).........................  .................         (13,571)  ...............
Performance and Quality Info Systems.......................           12,945            12,996           12,996
    Section 241 transfer (non-add).........................  .................         (12,996)  ...............
Minority Fellowship Program................................  .................           9,395   ...............
Peer Professional Workforce Development....................  .................          10,000   ...............
Mental and Behavioral Education and Training Program.......  .................          35,000          35,000
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013, sequester of funds under Public Law 112-25 and excludes transfers and
  reprogrammings allowed under Public Law 113-6.

    Mental and Behavioral Health Education and Training.--The 
Committee recommendation includes $35,000,000 for the joint 
effort with HRSA to increase the clinical service capacity of 
the behavioral health workforce through the Mental and 
Behavioral Health Education and Training Grant program. 
Eligible entities for this program shall include accredited 
programs that train master's level social workers, 
psychologists, and marriage and family therapists; psychology 
doctoral interns; and paraprofessionals.
    Minority Fellowships.--The Committee recommendation 
includes $10,695,000 for the Minority Fellowship program, a 
$5,000,000 increase above the fiscal year 2013 level. The 
Committee provides funding for this program within the three 
Centers as it has done in previous years, rather than in the 
Health Surveillance and Program Support account as requested by 
the administration. The Committee intends that the increase 
provided in CSAT for Minority Fellowship be used to increase 
the number of addiction counselors receiving Master's level 
training.
    National Survey on Drug Use and Health [NSDUH].--The 
Committee is concerned about the exclusion of American Samoa, 
Guam, the Northern Mariana Islands, Puerto Rico and the U.S. 
Virgin Islands from NSDUH. The exclusion is especially 
troubling with respect to Puerto Rico and the U.S. Virgin 
Islands, which are designated as a high intensity drug 
trafficking area, because NSDUH is a leading evidence-based 
resource used to measure the effectiveness of Federal drug 
control policies and programs. The Committee encourages SAMHSA 
to consider fully incorporating each territory into the 
redesign of NSDUH.

               Agency for Healthcare Research and Quality

Appropriations, 2013\1\.................................    $369,053,000
Budget estimate, 2014...................................     333,697,000
Committee recommendation................................     364,008,000

\1\Excludes transfers and reprogrammings allowed under Public Law 113-6.

    The Committee provides $364,008,000 for AHRQ through 
transfers available under section 241 of the PHS Act. In 
addition, the Committee recommends transferring $7,000,000 to 
AHRQ from the PPH Fund. The total program level assumed in this 
bill for AHRQ is $371,008,000.
    AHRQ was established in 1990 to enhance the quality, 
appropriateness, and effectiveness of health services, as well 
as access to such services. AHRQ conducts, supports, and 
disseminates scientific and policy-relevant research on topics 
such as promoting high-quality care, eliminating healthcare 
disparities, using information technology, and evaluating the 
effectiveness of clinical services.
    The Committee strongly supports AHRQ's unique mission 
within the Department to fund health services research that 
improves patient safety and promotes the delivery of high-
quality healthcare. Whereas NIH conducts biomedical research to 
prevent, diagnose, and treat diseases, and CDC focuses on 
population health and community-based interventions, only AHRQ 
supports research that identifies the most effective clinical 
and system-level interventions, prevents medical errors, and 
promotes the wide-scale adoption of proven safety and quality 
practices throughout the healthcare system. The Committee 
recognizes the Comprehensive Unit-based Safety Program [CUSP] 
as an example of successful AHRQ-funded research aimed at 
preventing healthcare-associated infections [HAIs]. Within 3 
months of being implemented in Michigan hospitals, this program 
reduced the rate of central line-related blood stream 
infections by two-thirds in more than 100 intensive care units, 
and within 18 months saved more than 1,500 lives and nearly 
$200,000,000. The Committee supports AHRQ's efforts in fiscal 
year 2014 to expand the implementation of CUSP to include other 
healthcare settings and other HAIs.

                  HEALTH COSTS, QUALITY, AND OUTCOMES

    The Committee provides $231,384,000 for research on health 
costs, quality, and outcomes [HCQO]. In addition, the Committee 
recommends that $7,000,000 be transferred to HCQO from the PPH 
Fund. The total program level assumed in this bill for HCQO is 
$238,384,000. The HCQO research activity is focused upon 
improving clinical practice, improving the healthcare system's 
capacity to deliver quality care, and tracking progress toward 
health goals through monitoring and evaluation.
    Within the total provided for HCQO, the Committee 
recommendation includes funding for the following activities:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                               Fiscal year 2013    Fiscal year      Committee
                       Budget activity                         appropriation\1\   2014 request    recommendation
----------------------------------------------------------------------------------------------------------------
Research on Health Costs, Quality, and Outcomes:
    Patient-Centered Health Research........................          $16,600    ..............  ...............
    Prevention/Care Management..............................           22,369           $20,704         $22,904
        Prevention and Public Health Fund (non-add).........           (6,465)   ..............          (7,000)
    Value...................................................            3,730             3,252           3,252
    Health Information Technology...........................           25,572            25,572          29,572
    Patient Safety..........................................           65,585            62,614          71,584
    Research Innovations....................................          108,377            88,931         111,072

----------------------------------------------------------------------------------------------------------------
\1\Excludes transfers and reprogrammings allowed under Public Law 113-6.

    Within the Prevention portfolio, the Committee recommends 
that $7,000,000 from the PPH Fund be transferred to support the 
U.S. Preventive Services Trust Fund, which works to improve 
healthcare by making evidence-based recommendations about 
clinical preventive services such as screenings, counseling 
services, or preventive medications.
    Coordination of Health Services Research.--The Committee is 
concerned that the various Federal agencies conducting health 
services research do not sufficiently coordinate their efforts 
to optimize Federal investments in patient safety, especially 
regarding HAIs. As the lead agency for health services 
research, the Committee requests that AHRQ examine health 
services research efforts in patient safety (including HAIs) 
supported by Federal agencies since fiscal year 2010. In 
particular, AHRQ should identify research gaps, areas that 
could be consolidated, and emerging research priorities, and 
propose strategies for better coordination among Federal 
agencies. The Committee requests that AHRQ report on its 
findings no later than 1 year after the enactment of this act.
    Health IT Safety.--The Committee is aware that the 2011 IOM 
report, ``Health IT and Patient Safety: Building Safer Systems 
for Better Care,'' found large gaps in our knowledge of how 
health IT impacts overall patient safety. Despite the clear 
potential for health IT to improve overall healthcare quality, 
patients can be harmed if IT systems fail, are poorly designed, 
or provide bad information. The Committee recommendation 
includes $4,000,000 for AHRQ to research safe health IT 
practices specifically related to the design, implementation, 
usability, and safe use of these systems. The Committee hopes 
that this investment will generate new evidence on safe health 
IT practices that would ultimately be used by ONC, FDA, CMS, 
and others to inform certification and other policy 
interventions.
    Healthcare Delivery Systems.--The Committee notes that 
identifying and disseminating improvements to the design of 
hospital rooms and healthcare facilities has the potential to 
prevent medical errors, reduce associated costs, and save 
lives. Within the Patient Safety portfolio, the Committee 
includes $5,000,000 for research grants authorized by section 
933 of the PHS Act. This funding will support grants for 
multidisciplinary teams, consisting of patients and their 
families, clinicians, technology experts, and engineers, to 
develop and test best practices in healthcare delivery. This is 
a new activity that was not funded in fiscal year 2013 or 
requested by the administration.
    Investigator-Initiated Research.--The Committee believes 
that investigator-initiated research forms the backbone of 
AHRQ's ability to improve healthcare with creative, 
groundbreaking approaches to ongoing and emerging healthcare 
issues. Within the Research Innovations portfolio, the 
Committee provides $45,882,000 for investigator-initiated 
research. The fiscal year 2013 level for this research is 
$43,364,000 and the administration request is $29,259,000.
    Training Grants.--The Committee continues to be concerned 
by the reduction in training grants for health services 
researchers. The Committee requests an update from AHRQ in next 
year's budget justification outlining the recent status of 
``K'' and ``T'' awards and other training activities.

                   MEDICAL EXPENDITURES PANEL SURVEYS

    The Committee provides $63,811,000 for Medical Expenditure 
Panel Surveys [MEPS], which collect detailed information 
annually from households, healthcare providers, and employers 
regarding how Americans use and pay for healthcare. The data 
from MEPS are used to develop estimates of healthcare 
utilization, expenditures, sources of payment, and the degree 
of health insurance coverage of the U.S. population.

                            PROGRAM SUPPORT

    The Committee recommends $68,813,000 for program support. 
This activity funds the overall management of AHRQ, including 
salaries, benefits, and overhead costs such as rent.

               Centers for Medicare and Medicaid Services


                     GRANTS TO STATES FOR MEDICAID

Appropriations, 2013

                                                        $178,575,680,000

Budget estimate, 2014

                                                         177,872,985,000
Committee recommendation
                                                         177,872,985,000

    The Committee recommends $177,872,985,000 in mandatory 
funding for Grants to States for Medicaid.
    The fiscal year 2014 recommendation excludes 
$106,335,631,000 in fiscal year 2013 advance appropriations for 
fiscal year 2014. As requested by the administration, 
$103,472,323,000 is provided for the first quarter of fiscal 
year 2015.
    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, 2013\1\

                                                        $234,265,790,000

Budget estimate, 2014

                                                         255,185,000,000
Committee recommendation
                                                         255,697,000,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $255,697,000,000 in mandatory 
funding for payments to healthcare trust funds.
    This entitlement account includes the general fund subsidy 
to the Federal Supplementary Medical Insurance Trust Fund for 
Medicare part B benefits and for Medicare part D drug benefits 
and administration, plus other reimbursements to the Federal 
Hospital Insurance Trust Fund for part A benefits and related 
administrative costs that have not been financed by payroll 
taxes or premium contributions.
    The Committee provides $194,565,000,000 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 $58,596,000,000 for the 
general fund share of benefits paid under Public Law 108-173, 
the Medicare Prescription Drug, Improvement and Modernization 
Act of 2003. As in previous years, the Committee includes bill 
language requested by the administration providing indefinite 
authority for paying the general revenue portion of the part B 
premium match and provides resources for the part D drug 
benefit program in the event that the annual appropriation is 
insufficient.
    The Committee recommendation also includes $373,000,000 to 
be transferred to the Supplementary Insurance Trust Fund as the 
general fund share of part D administrative expenses. The 
Committee recommendation includes $640,000,000 in 
reimbursements to the HCFAC fund.

  REDUCED COST SHARING FOR INDIVIDUALS ENROLLING IN QUALIFIED HEALTH 
                                 PLANS

Appropriations, 2013....................................................
Budget estimate, 2014...................................  $3,977,893,000
Committee recommendation................................................

    The Committee recommendation does not include a mandatory 
appropriation, requested by the administration, for reduced 
cost sharing assistance for individuals enrolling in qualified 
health plans purchased through the Health Insurance 
Marketplace, as provided for in sections 1402 and 1412 of the 
ACA.
    This program helps eligible low- and moderate-income 
individuals and families afford the out-of-pocket costs 
associated with healthcare services.

                           PROGRAM MANAGEMENT

Appropriations, 2013\1\.................................  $3,864,571,000
Budget estimate, 2014...................................   5,217,357,000
Committee recommendation................................   5,217,357,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $5,217,357,000 for CMS program 
management, which includes funding for research, program 
operations, survey and certification programs, and Federal 
administration.

Research, Demonstrations, and Evaluations

    The Committee has consolidated the research office into 
program operations, as requested by the President.

Program Operations

    The Committee recommends $4,011,200,000 for the Program 
Operations account, which covers a broad range of activities 
including claims processing and program safeguard activities 
performed by Medicare contractors. These contractors also 
provide information, guidance, and technical support to both 
providers and beneficiaries.
    The Committee includes additional funding for program 
operations above the fiscal year 2013 level to support 
expanding workloads due to the enrollment of the baby boom 
generation in the Medicare program and to support the work 
required of CMS to implement the ACA.
    Fiscal year 2014 begins on the very same day the ACA will 
open enrollment for new health coverage in the Health Insurance 
Marketplace, which will for the first time offer Americans a 
single place where they can compare the costs and benefits of 
different health insurance plans and choose the one that fits 
their needs. Funding in this bill will be used to oversee the 
operations in the first year of the Marketplace, ensuring that 
Americans get access to affordable health coverage and 
understand their rights as they begin to use that coverage. In 
addition, CMS will ensure compliance with the Patient's Bill of 
Rights and other insurance market rules, help States enforce 
the Medical Loss Ratio regulations, and implement additional 
quality measures to improve healthcare services for all 
Americans.
    The Committee recommendation also includes funding to 
continue and expand data initiatives that, for the first time, 
give consumers information about healthcare costs and 
utilization. For example, in 2013, CMS released data on what 
hospitals charge for common procedures across the country and 
data on how much Medicare spends on a State-by-State and 
county-by-county basis. Businesses and consumers can use this 
detailed pricing data to make important choices about needed 
healthcare and health coverage. The Committee believes that 
this transparency will reduce and rationalize healthcare costs 
in the future.
    Antimicrobial Stewardship.--The Committee continues to be 
concerned by the growing problem of antimicrobial resistance. 
The Committee encourages CMS to collaborate with participating 
healthcare institutions to develop and implement antimicrobial 
stewardship programs in all healthcare facilities, including 
hospitals, long-term care facilities, long-term acute care 
facilities, ambulatory surgical centers, and dialysis centers.
    Community Living.--The Committee encourages CMS and ACL to 
continue their joint expansion and support of home- and 
community-based services for individuals with disabilities 
through the Money Follows the Person program, the Community 
First Choice Option, and other programs. In support of this 
effort, the Committee encourages CMS and ACL to provide 
regulatory guidance and technical assistance to States and 
other interested parties regarding the various Federal tools 
that have been created to help them expand access to home- and 
community-based long-term services and supports. In addition, 
the Committee encourages CMS and ACL to create an interagency 
task force on implementing the Olmstead decision.
    Critical Access Hospitals.--The Committee requests a list 
of critical access hospitals that would be re-designated under 
the administration's proposal to remove critical access 
hospital status from facilities located less than 10 miles from 
another hospital. CMS is encouraged to work with the Office of 
Rural Health Policy at HRSA to ensure that rural patients 
maintain access to necessary health services.
    Dental Services.--The Committee commends CMS on its plan to 
clarify dental payment policy through a State Medicaid Director 
letter in 2013. CMS is directed to notify the Committee when 
the letter is issued.
    Frontier Health.--The Committee notes that the Frontier 
Extended Stay Clinic Demonstration program reached its 
statutorily mandated completion in April 2013. The Committee 
directs CMS to submit a report on the outcomes of this 
demonstration no later than 90 days after enactment of this 
act. In addition, the Committee includes $150,000 for the 
planned implementation of the Frontier Community Health 
Integration Demonstration program, slated to begin in fiscal 
year 2014.
    Hepatitis C Screening.--The Committee is aware that the 
U.S. Preventive Services Task Force recently recommended that 
all Americans born between 1945 and 1965 receive one-time 
screening for hepatitis C. Given that this population is 
currently aging into Medicare, the Committee urges CMS to 
include this one-time screening in the Welcome to Medicare 
physical exam.
    Immunization Payment.--The Committee strongly supports 
efforts to vaccinate Americans for preventable conditions. The 
Committee is concerned that a new coding rule for preventive 
services when administered in conjunction with immunization may 
undermine such efforts by discouraging the provision of 
immunizations at well baby and well child visits. The Committee 
urges CMS to reconsider this change. The Committee directs CMS 
to submit a report no later than 180 days after the 
implementation of the new coding rule on the impact of the 
change in policy on immunization rates.
    Influenza Vaccine for Healthcare Workers.--The Committee 
supports the new requirement for acute care hospitals 
participating in the CMS Inpatient Prospective Payment System 
Hospital Inpatient Quality Reporting Program to submit summary 
data on influenza vaccination of healthcare personnel via CDC's 
National Healthcare Safety Network. The Committee encourages 
CMS to expand required reporting to all hospitals, skilled 
nursing facilities, and nursing facilities.
    Infusion Pumps.--The Committee encourages CMS to conduct 
further research and analysis that will determine whether small 
volume infusion pumps could be used to improve patient care and 
reduce healthcare costs.
    Integrative Medicine.--The Committee is aware of controlled 
clinical trials that have shown promising results for mind-body 
approaches to preventing and treating hypertension, other 
cardiovascular risk factors, and cardiovascular disease. 
Additional research is warranted to determine if integrative 
medicine interventions offer a unique opportunity to improve 
the quality of care while reducing healthcare costs from the 
Nation's leading causes of death. The Committee encourages CMS 
to test integrative health interventions to determine health 
outcomes and the potential for healthcare savings. In 
particular, the Committee is supportive of research into mind-
body interventions for cardiovascular disease that have been 
previously shown in peer-reviewed publications of clinical 
trials to reduce cardiovascular risk factors, mortality, 
myocardial infarction, and stroke.
    Outpatient Drug Dispensing.--The Committee is strongly 
committed to eliminating waste in Medicare part D and believes 
that more should be done to reduce wasteful spending on 
outpatient prescription drugs in long-term care facilities. The 
Committee directs the Administrator of CMS to develop 
additional proposals designed to encourage short-cycle 
dispensing of outpatient prescription drugs in long-term care 
facilities and investigate the effects of dispensing fee 
changes on cost savings in the short-cycle dispensing program. 
These proposals should be submitted to the Committee no later 
than 180 days after enactment of this act.
    Provider Nondiscrimination.--Section 2706 of the ACA 
prohibits certain types of health plans and issuers from 
discriminating against any healthcare provider who is acting 
within the scope of that provider's license or certification 
under applicable State law, when determining networks of care 
eligible for reimbursement. The goal of this provision is to 
ensure that patients have the right to access covered health 
services from the full range of providers licensed and 
certified in their State. The Committee is therefore concerned 
that the FAQ document issued by HHS, DOL, and the Department of 
Treasury on April 29, 2013, advises insurers that this 
nondiscrimination provision allows them to exclude from 
participation whole categories of providers operating under a 
State license or certification. In addition, the FAQ advises 
insurers that section 2706 allows discrimination in 
reimbursement rates based on broad ``market considerations'' 
rather than the more limited exception cited in the law for 
performance and quality measures. Section 2706 was intended to 
prohibit exactly these types of discrimination. The Committee 
believes that insurers should be made aware of their obligation 
under section 2706 before their health plans begin operating in 
2014. The Committee directs HHS to work with DOL and the 
Department of Treasury to correct the FAQ to reflect the law 
and congressional intent within 30 days of enactment of this 
act.
    Research.--The Committee strongly supports the research 
activities that CMS undertakes to improve the efficiency of 
payment, delivery, access, and quality of Medicare, Medicaid, 
and ACA programs. In particular, the Committee supports the 
proposed increase for the Chronic Conditions Data Warehouse, 
which makes data on chronic disease rates and health 
utilization trends within the beneficiary population available 
to researchers. In addition, the Committee recommendation 
includes sufficient funding to fulfill the President's request 
for the Medicare Current Beneficiaries Survey, the Research 
Data Assistance Center, public use data files, and Medicaid 
Analytic Data.
    Treatment of Hard-to-Heal Wounds.--The Committee 
recommendation includes $500,000 for CMS to initiate a pilot 
study on the health outcomes of new medical technologies for 
treating hard-to-heal wounds. This pilot study should focus on 
medical technologies that are not currently eligible for 
reimbursement in CMS programs.

State Survey and Certification

    The Committee recommends $412,353,000 for State Survey and 
Certification activities, which 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.
    Infection Control Surveillance in Ambulatory Surgery 
Centers.--The Committee recommendation includes full funding of 
the President's requested increase for surveying ambulatory 
surgical centers [ASCs], particularly in the area of infection 
control surveillance. In response to a July 2012 GAO report, 
CMS committed to collecting data using the agency's ASC 
Infection Control Surveyor Worksheet. The Committee supports 
this effort and encourages CMS to continue collecting and 
analyzing the findings from this surveillance tool to inform 
the agency's education and surveillance efforts moving forward. 
In addition, the Committee encourages CMS to make the aggregate 
data publicly available to build a better understanding of 
current and future injection practices in ASCs.

High-Risk Insurance Pools

    The Committee includes $22,004,000 for High-Risk Insurance 
Pools. This amount is intended to reimburse States for 
operational losses incurred by such pools during the first 6 
months of fiscal year 2013, which allows a 3-month period for 
beneficiaries to make the transition to the health insurance 
marketplace.

Federal Administration

    The Committee recommends $771,800,000 for Federal 
Administration, which funds the majority of CMS' staff and 
operating expenses for routine activities such as planning, 
implementing, evaluating, and ensuring accountability in the 
programs administered by CMS.

                  HEALTH CARE FRAUD AND ABUSE CONTROL

Appropriations, 2013\1\.................................    $309,170,000
Budget estimate, 2014...................................     311,000,000
Committee recommendation\2\.............................     640,000,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.
\2\Includes funding available under program integrity cap adjustment 
provided by Public Law 112-25.

    The Committee recommends $640,000,000, to be transferred 
from the Medicare trust funds, for Health Care Fraud and Abuse 
Control [HCFAC] activities.
    The Committee recommendation includes a base amount of 
$311,000,000 and an additional $329,000,000 through a budget 
cap adjustment authorized by section 251(b) of the Balanced 
Budget and Emergency Deficit Control Act of 1985.
    Funding in this bill, in addition to the $1,320,554,000 in 
mandatory monies for these activities, will provide a total of 
$1,960,554,000 for HCFAC activities in fiscal year 2014.
    Secure Medicare Card Pilot Project.--The Committee commends 
CMS on the completion of a Medicare smart card pilot project 
for providers. When analysis of the data is complete, CMS is 
directed to submit a report of the findings of this project to 
the Committees on Appropriations. The report should include 
recommendations on further study of smart card use in the 
beneficiary context. Smart card technology may hold promise for 
reducing identity theft and increasing the accuracy of Medicare 
billing.

                Administration for Children and Families


  PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY SUPPORT 
                                PROGRAMS

Appropriations, 2013\1\.................................  $2,903,752,000
Budget estimate, 2014...................................   2,965,245,000
Committee recommendation................................   2,965,245,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $2,965,245,000 in 
fiscal year 2014 mandatory funds for Child Support Enforcement 
and Family Support programs. In addition, the Committee 
recommends $1,250,000,000 in advance funding for the first 
quarter of fiscal year 2015.
    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 noncustodial parents and their children; 
payments to territories for benefits to certain aged, blind, or 
disabled individuals; and temporary benefits for certain 
repatriated citizens.

               LOW INCOME HOME ENERGY ASSISTANCE PROGRAM

Appropriations, 2013\1\.................................  $3,464,729,000
Budget estimate, 2014...................................   3,020,000,000
Committee recommendation................................   3,614,729,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $3,614,729,000 for LIHEAP, which 
provides home heating and cooling assistance to low-income 
households, generally in the form of payments to energy vendors 
on behalf of the recipient. Within the total, the Committee 
recommendation includes up to $2,988,000 for program integrity 
and oversight efforts, the same as the fiscal year 2013 level.
    The Committee recommendation provides the full amount for 
LIHEAP under the State formula grant and does not include 
funding for the contingency fund. The Committee recommendation 
also does not include funding for new energy burden reduction 
grants requested by the administration.

                     REFUGEE AND ENTRANT ASSISTANCE

Appropriations, 2013\1\.................................  $1,013,968,000
Budget estimate, 2014...................................   1,123,432,000
Committee recommendation................................   1,121,432,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $1,121,432,000 for Refugee and 
Entrant Assistance programs. These programs provide a variety 
of benefits and services to refugees, asylees, Cuban and 
Haitian entrants, trafficking victims, and torture victims 
(collectively referred to below as ``refugees''). The programs 
also fund temporary shelter and services for unaccompanied 
alien children apprehended by law enforcement who are in 
Federal custody awaiting adjudication of their immigration 
status.

Transitional and Medical Services

    The Committee recommendation includes $391,477,000 for 
Transitional and Medical Services [TAMS]. This program provides 
grants to States and nonprofit organizations to provide up to 8 
months of cash and medical assistance to incoming refugees as 
well as foster care services to unaccompanied minors.
    Within the total, the Committee recommendation includes not 
less than $65,000,000 for the Voluntary Agencies Matching Grant 
program, which provides grants to resettlement agencies to 
support comprehensive services for arriving refugees with the 
goal of refugees becoming self-sufficient within their first 4 
months in the United States.

Victims of Trafficking

    The Committee recommendation includes $15,775,000 for 
Victims of Trafficking programs. Within this amount, the 
Committee recommendation includes $12,775,000 for programs 
serving foreign national victims and $3,000,000 for a new 
program to improve services available to U.S. citizens and 
legal permanent residents who are victims of trafficking.
    U.S. citizens and permanent residents who are victims of 
trafficking, or at risk of becoming victims, are likely to 
receive services from a number of existing programs that serve 
vulnerable populations, including runaway and homeless youth 
shelters, domestic violence programs, and organizations working 
within the criminal justice system. However, these programs may 
not have the capacity to provide for the unique needs of this 
particularly vulnerable population. This new funding will 
increase the capacity of existing programs and the availability 
of services to all victims of trafficking.

Social Services

    The Committee recommendation includes $153,407,000 for 
Social Services programs for refugees. 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.
    The Committee continues to strongly encourage ORR to 
explore the use of existing discretionary funds for case 
management services and emergency housing assistance for 
particularly vulnerable refugee populations.

Preventive Health

    The Committee recommendation includes $4,730,000 for 
Preventive Health services for refugees. This program funds 
grants to coordinate and promote refugees' access to health 
screening, treatment, and follow-up services.

Targeted Assistance

    The Committee recommendation includes $48,401,000 for the 
Targeted Assistance program. This program provides additional 
funds to States with an influx of refugee arrivals and a high 
concentration of refugees facing difficulties achieving self-
sufficiency.

Unaccompanied Alien Children

    The Committee recommendation includes $494,597,000 for the 
UAC program. The UAC program provides shelter and support 
services to unaccompanied alien children apprehended in the 
United States by the Department of Homeland Security or other 
law enforcement agencies. Children are taken into HHS' care 
pending resolution of their claims for relief under U.S. 
immigration law or release to an adult family member or 
guardian.
    There has been a significant increase in the number of 
unaccompanied alien children arriving in the United States in 
recent years, from approximately 7,100 in fiscal year 2011 to 
an estimated 23,500 in fiscal year 2013. Many of the children 
placed into HHS's care are fleeing dangerous situations in 
their home country and are victims of severe forms of abuse, 
neglect, or trafficking. The Committee expects HHS to continue 
to provide it periodic updates on this situation. In addition, 
the Committee continues to be concerned about the impact of 
this dramatic increase in the number of children on the 
availability of support services, including access to pro bono 
legal representation, child advocates, social workers, 
physicians, and psychologists. Accordingly, within the total 
for the UAC program, the Committee recommendation includes 
$13,000,000, an approximately $3,327,000 increase over the 
fiscal year 2013 level, for the pro bono legal services 
initiative. This funding supports legal representation for both 
released and detained children. Given that the vast majority of 
children are released to a family member or sponsor pending 
resolution of their immigration status, the Committee directs 
ACF to allocate a significant portion of this increase to 
improve the availability of legal representation for released 
children. In addition, the Committee recommendation includes 
$1,000,000 for the child advocate program. This program helps 
protect the interests and rights of the most vulnerable 
children while awaiting adjudication of their immigration 
status.

Victims of Torture

    The Committee recommendation includes $13,045,000 for the 
Victims of Torture program. This program provides treatment, 
social, and legal services to victims of torture and training 
to healthcare providers on treating the physical and 
psychological effects of torture.

   PAYMENTS TO STATES FOR THE CHILD CARE AND DEVELOPMENT BLOCK GRANT

Appropriations, 2013\1\.................................  $2,323,656,000
Budget estimate, 2014...................................   2,478,313,000
Committee recommendation................................   2,500,000,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $2,500,000,000 for the CCDBG, a 
State formula grant that provides financial assistance to low-
income families to help pay for child care and to improve the 
quality of child care programs.
    The Committee recommendation provides $110,000,000 of the 
increase over the fiscal year 2013 level for formula grants to 
States, tribes, and territories to improve the quality of child 
care programs. In May 2013 the administration announced new 
rules to strengthen State child care standards and requirements 
to improve the health, safety, and school readiness of children 
in child care. These funds will support these and other efforts 
to improve the quality of child care programs across all States 
and settings. Funds should be used to help States raise the bar 
on quality, including through training, education, and other 
professional development for staff (including coaching, 
mentoring, and other on-site training and technical 
assistance); technical assistance to help providers become 
licensed and comply with licensing and regulatory requirements; 
scholarships for further education; compensation improvement 
(including rewards or bonuses) linked to increased credential 
or degree completion; and improving health and safety 
standards. States should work with their State Early Childhood 
Advisory Councils in coordinating these activities. States 
applying for these funds should provide assurances that funds 
will be prioritized first in areas with significant 
concentrations of poverty and unemployment and that lack access 
to high-quality early care and education programs, or for 
otherwise underserved populations such as children with 
disabilities or special needs. Additionally, any use of child 
assessments should conform to the recommendations of the 
National Research Council's reports on early childhood and 
assessment. Finally, these funds should be used to supplement 
and not to supplant Federal, State, and local funds otherwise 
used for these purposes.
    The Committee directs the remaining $66,344,000 increase 
over the fiscal year 2013 level to the base block grant. In 
recent years, many States have struggled to maintain key child 
care policies and have tightened eligibility requirements, 
added to waitlists, increased family copayments, and frozen 
reimbursement rates for providers. As a result, fewer families 
are receiving assistance and many that do are struggling to 
find quality affordable child care options. This increase will 
help improve low-income families' access to quality affordable 
child care.
    The Committee recommendation also maintains several 
existing set-asides at their fiscal year 2013 level. This 
includes $996,000 for a national toll-free referral line and 
Web site to provide child care consumer education information 
to low-income families, including information about the quality 
of child care programs, such as information under a State or 
local quality rating and improvement system, and information to 
help families access available child care in their community 
through linkages to State and local data sources. Funds set 
aside for quality improvement activities within the block grant 
are in addition to the $110,000,000 in new formula funds 
described above and the 4 percent quality improvement set-aside 
established in the authorizing legislation.

                      SOCIAL SERVICES BLOCK GRANT

Appropriations, 2013\1\.................................  $1,700,000,000
Budget estimate, 2014...................................   1,700,000,000
Committee recommendation................................   1,700,000,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $1,700,000,000 in mandatory funds 
for the SSBG, 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, 2013\1\.................................  $9,927,328,000
Budget estimate, 2014...................................  11,088,944,000
Committee recommendation................................  11,417,876,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $11,417,876,000 in budget 
authority for Children and Families Services programs, 
including $5,762,000 in transfers available under section 241 
of the PHS Act. These funds support a variety of programs for 
children, youth, and families; the developmentally disabled; 
Native Americans; victims of child abuse, neglect, and domestic 
violence; and other vulnerable populations.

Head Start

    The Committee recommendation includes $9,621,070,000 for 
Head Start. Head Start provides grants directly to local public 
and private organizations to provide comprehensive early 
childhood education services to low-income children and their 
families, from before birth to age 5.
    The Committee recommendation includes bill language that 
restores funding for current grantees to their fiscal year 2012 
funding level and then further allows for a 1.9 percent cost of 
living adjustment. This will help current grantees retain and 
recruit highly qualified staff and keep pace with rising costs 
to maintain high-quality services.
    Within the total for Head Start, the Committee 
recommendation also includes $1,430,376,000 to expand Early 
Head Start services through new and existing Early Head Start 
providers and through new Early Head Start-Child Care 
Partnerships, as requested by the administration. Early Head 
Start, which provides services to children and their families 
from before birth to age 3, currently serves less than 5 
percent of eligible children, yet research increasingly 
supports the importance and benefits of high-quality early 
childhood education beginning at the earliest ages, including 
for families before birth. This increase in funding will nearly 
double enrollment in Early Head Start.
    Through Early Head Start-Child Care Partnerships, Early 
Head Start providers will partner with local center and family-
based child care providers, leveraging current investments 
through the Child Care and Development Fund, to increase the 
quality of existing child care programs. Early Head Start 
providers will enter into contractual relationships with local 
child care programs to provide training, technical assistance, 
and funding to raise the bar on the quality of those programs 
to meet Early Head Start program performance standards. The 
Committee includes bill language specifying that partnering 
child care providers have 18 months to meet such standards 
before being subject to the requirements of the Designation 
Renewal System [DRS]. HHS should establish standards to ensure 
that the responsibilities and expectations of the Early Head 
Start provider and partnering child care providers, 
respectively, are clearly defined. The Committee recommendation 
also includes bill language specifying that funding for Early 
Head Start-Child Care Partnerships may be used to provide 
services for children through age 3.
    In awarding Early Head Start expansion funds, the Committee 
urges HHS to prioritize organizations that seek to develop a 
unified birth-to-school-entry continuum through alignment with 
maternal and infant health home visiting programs, State funded 
pre-K programs, and other federally, State, or locally funded 
early childhood care and education programs. Moreover, HHS 
should prioritize organizations that seek to work with child 
care providers across settings, including center and home-based 
programs. The Committee also urges HHS to encourage a wide-
range of organizations to apply, including States, and new and 
existing Early Head Start providers. Early Head Start expansion 
funds, including funding for Early Head Start-Child Care 
Partnerships, should be allocated to States proportionally 
based on the number of young children from families whose 
income is below the poverty line. Further, the Secretary shall 
reserve no less than 3 percent for Indian Head Start programs 
and no less than 4.5 percent for migrant and seasonal Head 
Start programs, to expand services for children and their 
families from before birth through age 3 in those programs.
    Within the total for Head Start, the Committee 
recommendation also includes up to $25,000,000, as requested by 
the administration, for transition-related costs associated 
with the Head Start DRS. Under the DRS, each year certain Head 
Start programs are required to recompete for continued funding. 
These funds support start-up and other transition-related costs 
to ensure that new grantees are fully operational when an 
incumbent grant ends. This minimizes any disruption in services 
for children and families. In addition, the Committee continues 
to encourage HHS to consider the unique challenges faced by 
Head Start providers in remote and frontier areas when 
reviewing grantees as part of the DRS.

Consolidated Runaway and Homeless Youth Program

    The Committee recommendation includes $99,355,000 for the 
Consolidated Runaway and Homeless Youth program. This program 
supports the Basic Centers program, which provides temporary 
shelter, counseling, and after-care services to runaway and 
homeless youth under age 18 and their families; the 
Transitional Living Program, which provides longer-term shelter 
and services for older youth; and a national toll-free runaway 
and homeless youth crisis hotline.
    The Committee recommendation for runaway and homeless youth 
programs does not include funding for the ``Prevalence, Needs 
and Characteristics of Homeless Youth'' study, as requested by 
the administration. Instead, the Committee directs new funding 
provided over the fiscal year 2013 level to the core runaway 
and homeless youth programs. The Committee includes $54,636,000 
for the Basic Centers program and $44,719,000 for the 
Transitional Living program. The fiscal year 2013 level for the 
Basic Centers program is $53,429,000 and the budget request is 
$53,536,000. The fiscal year 2013 level for the Transitional 
Living program is $43,731,000 and the budget request is 
43,819,000.

Education and Prevention Grants To Reduce Sexual Abuse of Runaway Youth

    The Committee recommendation includes $17,865,000 for 
Education and Prevention Grants to Reduce Sexual Abuse of 
Runaway and Homeless Youth. This program provides competitive 
grants for street-based outreach and education services for 
runaway and homeless youth who are subjected to or are at risk 
of being subjected to sexual abuse or exploitation.

Child Abuse Prevention and Treatment State Grants

    The Committee recommendation includes $26,379,000 for the 
Child Abuse Prevention and Treatment State Grant program. This 
program provides formula grants to States to improve their 
child protective service systems.

Child Abuse Discretionary Activities

    The Committee recommendation includes $25,693,000 for Child 
Abuse Discretionary Activities. This program supports 
discretionary grants for research, demonstration, and technical 
assistance to increase the knowledge base of evidence-based 
practices and to disseminate information to State and local 
child welfare programs.

Community-Based Child Abuse Prevention

    The Committee recommendation includes $41,444,000 for the 
Community-Based Child Abuse Prevention program. This program 
provides formula grants to States that then disburse funds to 
local, community-based organizations to improve local child 
abuse prevention and treatment efforts, including providing 
direct services and improving the coordination between State 
and community-based organizations.

Abandoned Infants Assistance

    The Committee recommendation includes $11,530,000 for the 
Abandoned Infants Assistance program. This program provides 
discretionary grants to public and private community and faith-
based organizations to develop, implement, and operate 
demonstration projects that prevent the abandonment of infants 
and young children impacted by substance abuse and HIV. Funds 
may be used to provide respite care for families and 
caregivers, allow abandoned infants and children to reside with 
their natural families or in foster care, and carry out 
residential care programs for abandoned infants and children 
who are unable to reside with their families or be placed in 
foster care.

Child Welfare Services

    The Committee recommendation includes $280,088,000 for 
Child Welfare Services. This formula grant program helps State 
and tribal public welfare agencies improve their child welfare 
services with the goal of keeping families together. These 
funds help States and tribes provide a continuum of services 
that prevent child neglect, abuse or exploitation; allow 
children to remain with their families, when appropriate; 
promote the safety and permanence of children in foster care 
and adoptive families; and provide training and professional 
development to the child welfare workforce.

Child Welfare Research, Training, and Demonstration

    The Committee recommendation includes $26,039,000 for child 
welfare research, training, and demonstration projects. This 
program provides grants to public and nonprofit organizations 
for demonstration projects that encourage experimental and 
promising types of child welfare services, as well as projects 
that improve education and training programs for child welfare 
service providers.
    The Committee continues to encourage ACF to work with ACL 
and other HHS agencies to evaluate intergenerational approaches 
for improving outcomes for at-risk youth and families. The 
Committee strongly encourages HHS to use existing discretionary 
resources for such initiatives.

Adoption Opportunities

    The Committee recommends $44,100,000 for the Adoption 
Opportunities program. This 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.
    Within the total, the Committee recommendation includes 
$7,500,000 for discretionary grants to test intensive and 
exhaustive child-focused adoptive parent recruitment strategies 
for children in foster care. Such intensive recruitment 
strategies have been shown to move foster youth into permanent 
families at a much higher rate than traditional recruitment 
approaches. These programs should focus on children that are 
hardest to place because of age, disability, or sibling group 
membership. In addition, the Committee encourages HHS to 
provide guidance to State child welfare agencies on the use of 
title IV-E Foster Care and Adoption Assistance training funds 
for the implementation of intensive child-focused recruitment 
strategies and other evidence-based models that have been shown 
to increase the rate of placement of children in foster care, 
particularly older children, into adoptive families.
    The Committee remains concerned about the availability of 
post-adoption services for children and their adoptive families 
and strongly encourages ACF to increase funding within this 
program explicitly available for such activities. The Committee 
also directs ACF to submit a report by July 31, 2014, on how 
ACF has used, and plans to use, Adoption Opportunities funding 
to strengthen post-adoption services.

Adoption Incentives

    The Committee recommends $39,268,000 for the Adoption 
Incentives program. This program provides formula-based 
incentive payments to States to encourage them to increase the 
number of adoptions of children from the foster care system, 
with an emphasis on children who are the hardest to place.

Social Services and Income Maintenance Research

    The Committee recommends $14,762,000 for Social Services 
and Income Maintenance Research, including $5,762,000 funded 
through transfers available under the PHS Act. These funds 
support research and evaluation of cost-effective programs that 
increase the stability and economic independence of families 
and contribute to the healthy development of children and 
youth.
    Within the total, as requested by the administration, the 
Committee recommendation includes $3,000,000 for a rigorous 
evaluation to examine which features of early care and 
education programs most influence child and family outcomes, 
and how those features interact with other child, family, and 
community-level characteristics to affect such outcomes.
    Within the total, the Committee recommendation also 
includes $6,000,000 for the National Survey of Child and 
Adolescent Well-Being, as requested by the administration.
    The Committee recommendation does not include funding 
requested by the administration for a new initiative addressing 
financial deterrents to marriage.

Developmental Disabilities and Voting Access for Individuals with 
        Disabilities

    In order to better align disability and aging policies and 
programs, in 2012 HHS moved the Administration on Developmental 
Disabilities from ACF to the newly established ACL. The 
Committee supports this administrative change and accordingly 
funds these programs within ACL in fiscal year 2014.

Native American Programs

    The Committee recommends $48,486,000 for Native American 
programs. These funds support a variety of programs to promote 
self-sufficiency and cultural preservation activities among 
Native American, Native Hawaiian, Alaska Native, and Pacific 
Islander organizations and communities.
    Within the total, the Committee recommendation includes 
$12,000,000 for Native American language preservation 
activities, including no less than $4,000,000 for language 
immersion programs authorized by section 803C(b)(7)(A)-(C) of 
the Native American Programs Act, as amended by the Esther 
Martinez Native American Language Preservation Act of 2006. The 
Committee strongly encourages ACF to give priority to grantees 
with rigorous immersion programs.

Community Services Block Grant

    The Committee recommendation includes $676,003,000 for the 
Community Services Block Grant [CSBG]. The CSBG is a formula 
grant to States and Indian tribes to provide a wide range of 
services to alleviate causes of poverty in communities and to 
assist low-income individuals in becoming self-sufficient. 
States are required to pass on at least 90 percent of these 
funds to local community-based organizations, the vast majority 
of which are community action agencies.
    The Committee rejects the administration's proposed cut to 
the CSBG and continues to strongly support the program, which 
provides critical and flexible funding for local organizations 
that serve as a central source of assistance for low-income 
populations at the local level.

Community Economic Development

    The Committee recommendation includes $29,883,000 for the 
Community Economic Development [CED] program. This program 
provides grants to community development corporations to 
support employment and business development opportunities for 
low-income individuals. Within the total for the CED program, 
the Committee recommendation includes up to $10,000,000 for the 
Healthy Foods Financing Initiative [HFFI].
    The administration proposed eliminating the CED program and 
moving CED funding for HFFI to the Department of the Treasury, 
which also provides funding for HFFI through the Community 
Development Financial Institutions [CDFI] program. The 
Committee rejects this elimination and continues to allow 
funding for HFFI within the CED program. The Committee strongly 
encourages continued collaboration between HHS and Treasury but 
notes that HFFI projects funded under CED are distinct from 
those funded under CDFI.
    Within the HFFI program, the Committee encourages ACF to 
promote the establishment of food hubs in local communities. 
Food hubs address challenges in both the distribution and 
retail of healthy foods by connecting local producers to the 
market. Specifically, food hubs aggregate locally grown 
products from a group of producers and distribute and market 
them to consumers, whether households, retailers, or 
wholesalers.

Rural Community Facilities

    The Committee recommendation includes $5,971,000 for the 
Rural Community Facilities program. This program provides 
grants to regional nonprofit organizations to provide training 
and technical assistance to low-income rural communities in 
developing and managing safe and affordable water and 
wastewater treatment facilities. These funds support projects 
in communities that generally cannot access resources and 
services through similar programs at the Department of 
Agriculture and the Environmental Protection Agency.

Assets for Independence

    The Committee recommendation includes $20,000,000 for the 
Assets for Independence [AFI] program. The AFI program provides 
discretionary grants to organizations to support individual 
development accounts that encourage low-income individuals to 
create savings accounts for dedicated purposes, such as buying 
a home, paying for college, or starting a business.
    In addition, the Committee recommendation includes new bill 
language requested by the administration that will allow HHS to 
recapture unused funds by grantees and reallocate them to new 
or existing projects. AFI grantees are required to match 
individual savings with equal amounts of Federal and non-
Federal funds. Grantees have 5 years to expend funds but some 
have struggled to encourage enough savings or to provide a 
sufficient match to be able to expend their full grant during 
that time.

National Domestic Violence Hotline

    The Committee recommendation includes $4,500,000 for the 
National Domestic Violence Hotline. This national, toll-free 
hotline provides information and assistance to victims of 
domestic violence 24 hours a day.

Family Violence Prevention and Services

    The Committee recommendation includes $135,000,000 for 
Family Violence Prevention and Services programs. These funds 
support programs to prevent family violence and provide 
immediate shelter and related assistance for victims of 
domestic violence and their dependents. The Committee 
recommends an increase for this program, as well as for the 
National Domestic Violence Hotline, to improve the availability 
of services for victims of domestic violence. According to a 
2012 survey, on any given day domestic violence programs must 
turn down over 15 percent of requests for services, the vast 
majority of which are for emergency shelter and housing, 
because of a lack of resources.

Chafee Education and Training Vouchers

    The Committee recommendation includes $45,084,000 for the 
Chafee Education and Training Voucher program. This program 
supports vouchers to foster care youth to help pay for expenses 
related to postsecondary education and vocational training.

Disaster Human Services Case Management

    The Committee recommends $1,988,000 for Disaster Human 
Services Case Management. 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 
monitoring through the recovery process.

Program Administration

    The Committee recommendation includes $203,368,000 for the 
Federal costs of administering ACF programs. This amount 
includes up to $1,368,000 for the Center for Faith-Based and 
Neighborhood Partnerships. The Committee recommendation for ACF 
program administration does not include costs for administering 
developmental disabilities programs and the Voting Access for 
Individuals with Disabilities program, which have moved to ACL.
    The Committee urges ACF to ensure that the interests of 
Hispanic children and families, as well as other underserved 
populations, are considered throughout their grant programs and 
processes, including in grant announcements, review panels, and 
evaluation activities. The Committee directs ACF to provide a 
report no later than March 31, 2014, on its current and planned 
efforts to meet this priority.

                   PROMOTING SAFE AND STABLE FAMILIES

Appropriations, 2013\1\.................................    $407,938,000
Budget estimate, 2014...................................     408,065,000
Committee recommendation................................     408,065,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

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

                PAYMENTS FOR FOSTER CARE AND PERMANENCY

Appropriations, 2013\1\.................................  $4,817,220,000
Budget estimate, 2014...................................   4,806,000,000
Committee recommendation................................   4,806,000,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $4,806,000,000 in mandatory funds 
for Payments for Foster Care and Permanency. In addition, the 
Committee recommends $2,200,000,000 in advance mandatory 
funding for the first quarter of fiscal year 2015. These funds 
support programs that assist States with the costs of 
maintaining eligible children in foster care, prepare children 
for living on their own, assist relatives with legal 
guardianship of eligible children, and find and support 
adoptive homes for children with special needs.

                  Administration for Community Living


                 AGING AND DISABILITY SERVICES PROGRAMS

Appropriations, 2013\1\.................................  $1,467,974,000
Budget estimate, 2014...................................   1,714,755,000
Committee recommendation................................   1,716,664,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends an appropriation of $1,716,664,000 
for ACL, which includes $52,115,000 in Medicare trust funds. In 
addition, the Committee recommends that $31,700,000 be 
transferred to ACL from the PPH Fund. The total program level 
assumed in this bill for ACL is $1,748,364,000. Both the budget 
request and Committee recommendation reflect a consolidated 
account structure for ACL, which was established by HHS in 
April 2012 by combining the organizational components of AoA, 
the HHS Office on Disability, and the Administration on 
Developmental Disabilities. The fiscal year 2013 total for ACL 
does not reflect this reorganization, and therefore is not 
directly comparable to fiscal year 2014.
    ACL was created with the goal of increasing access to 
community supports for older Americans and people with 
disabilities. It is charged with administering programs 
authorized under the Older Americans Act [OAA] and the 
Developmental Disabilities Act, as well as promoting community 
living policies throughout the Federal Government for older 
Americans and people with disabilities.

Home- and Community-Based Supportive Services

    The Committee recommends an appropriation of $366,916,000 
for the Home- and Community-Based Supportive Services program. 
This program provides formula grants to States and territories 
to fund a wide range of social services that enable seniors to 
remain independent and in their homes for as long as possible. 
State agencies on aging award funds to designated area agencies 
on aging that, in turn, make awards to local service providers. 
This activity supports services such as transportation, adult 
day care, physical fitness programs, and in-home assistance 
such as personal care and homemaker assistance.

Preventive Health Services

    The Committee recommends $20,944,000 for Preventive Health 
Services. This program funds activities such as medication 
management and enhanced fitness and wellness programs. These 
programs help seniors stay healthy and avoid chronic disease, 
thus reducing the need for costly medical interventions. The 
Committee maintains bill language that requires States to use 
these funds to support evidence-based models that enhance the 
wellness of seniors.

Protection of Vulnerable Older Americans

    The Committee recommends $21,797,000 for grants to States 
for the Long-term Care Ombudsman program and the Prevention of 
Elder Abuse program. Both programs provide formula grants to 
States to prevent the abuse, neglect, and exploitation of older 
individuals. The ombudsman program focuses on the needs of 
residents of nursing homes and other long-term care facilities, 
while the elder abuse prevention program targets the elderly 
community at large.
    The Committee urges the Long-term Care Ombudsman program to 
include ombudsman training on the possible dangers of chemical 
and physical restraints, including portable adult bedrails, and 
how to safely minimize their use.

National Family Caregiver Support Program

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

Native American Caregiver Support Program

    The Committee recommendation includes $6,364,000 to carry 
out the Native American Caregiver Support program. This program 
provides grants to tribes for the support of American Indian, 
Alaskan Native, and Native Hawaiian families caring for older 
relatives with chronic illness or disability, as well as for 
grandparents caring for grandchildren.

Congregate and Home-Delivered Nutrition Services

    The Committee recommends an appropriation of $439,070,000 
for congregate nutrition services and $216,830,000 for home-
delivered meals. These programs address the nutritional needs 
of older individuals, thus helping them to stay healthy and 
reduce their risk of disability. Funded projects must make 
home-delivered and congregate meals available at least once a 
day, 5 days a week, and each meal must meet a minimum of one-
third of daily dietary requirements. While States receive 
separate allotments of funds for congregate meals, home-
delivered meals, and supportive services, they have flexibility 
to transfer funds between these programs.

Nutrition Services Incentives Program

    The Committee recommendation includes $160,389,000 for the 
Nutrition Services Incentives Program [NSIP]. NSIP augments 
funding for congregate and home-delivered meals provided to 
older adults. States and tribes may choose to receive all or 
part of their funding in the form of commodities from the 
Department of Agriculture.

Aging Grants to Indian Tribes and Native Hawaiian Organizations

    The Committee recommends $27,601,000 for grants to Native 
Americans. This program provides grants to eligible tribal 
organizations for the delivery of nutrition and supportive 
services to Native Americans.

Aging Network Support Activities

    The Committee recommends $7,873,000 for Aging Network 
Support activities. These funds support activities that expand 
public understanding of aging and the aging process, apply 
social research and analysis to improve access to and delivery 
of services for older individuals, test innovative ideas and 
programs, and provide technical assistance to agencies that 
administer programs authorized by the OAA.
    Improving Transportation for Older Americans.--The 
Committee is aware of the growing need for transportation 
services for older Americans and urges ACL to support efforts 
to encourage private-public partnerships to carry out section 
416 of the OAA.

Alzheimer's Disease Demonstration Grants to States

    The Committee recommendation includes $4,002,000 for 
Alzheimer's Disease Demonstration Grants to States. This 
program funds competitive grants to States to test and 
implement new models of care for individuals with Alzheimer's 
disease.

Alzheimer's Disease Initiative

    The Committee recommends $14,700,000 in mandatory funding 
be transferred from the PPH Fund to ACL for the Alzheimer's 
Disease Initiative. Of the total, $10,500,000 is provided to 
expand the availability of home- and community-based dementia 
services and supports. The remaining $4,200,000 is provided for 
a public awareness outreach campaign regarding Alzheimer's 
disease.

Lifespan Respite Care

    The Committee recommends $2,490,000 for the Lifespan 
Respite Care 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 to and quality of respite 
care services, thereby reducing family caregiver strain.

Chronic Disease Self-Management Program

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

Elder Falls Prevention

    The Committee recommends that $7,000,000 in mandatory 
funding be transferred from the PPH Fund for Elder Falls 
Prevention activities at ACL. Preventing falls will help 
seniors stay independent and in their homes and avoid costly 
hospitalizations and hip fractures, which frequently lead to 
nursing home placement. The Committee intends that these funds 
should be used in coordination with CDC for public education 
about the risk of these falls, as well as implementation and 
dissemination of community-based strategies that have been 
proven to reduce the incidence of falls among seniors.

Adult Protective Services Demonstrations

    The Committee recommendation includes $8,000,000 for Adult 
Protective Services Demonstrations. This new program, as 
authorized in the Elder Justice Act, will provide competitive 
grants to States to test and evaluate innovative approaches to 
preventing and responding to elder abuse. The Committee 
encourages ACL to test innovative practices in local 
communities that develop partnerships across disciplines for 
the prevention, investigation, and prosecution of abuse, 
including financial abuse against the elderly.

Senior Medicare Patrol

    The Committee recommends $9,402,000 for the Senior Medicare 
Patrol program. These funds support a network of retired senior 
volunteers who educate older adults on preventing and 
identifying healthcare fraud and abuse.

Elder Rights Support Activities

    The Committee recommends $4,088,000 for Elder Rights 
Support activities. This activity supports programs that 
provide information, training, and technical assistance to 
legal and aging services organizations in order to prevent and 
detect elder abuse and neglect.

Aging and Disability Resource Centers

    The Committee recommendation includes $6,444,000 for ADRCs. 
These centers provide information, one-on-one counseling, and 
access for individuals to learn about their long-term services 
and support options with the goal of allowing seniors and 
individuals with disabilities to maintain their independence. 
The Committee urges ACL to improve coordination among ADRCs, 
area agencies on aging, and centers for independent living to 
ensure that there is ``no wrong door'' to access services.

State Health Insurance Assistance Program

    The Committee recommendation includes $52,115,000 for State 
Health Insurance Assistance Programs [SHIPs], which provide 
accurate and understandable health insurance information to 
Medicare beneficiaries and their families.
    The Committee concurs with the administration's proposal to 
transfer this grant program to ACL from CMS and includes bill 
language that reflects this transfer. About two-thirds of the 
54 State SHIPs are already administered by State units on 
aging. SHIP activities are aligned with ACL's mission to 
develop a comprehensive system of home- and community-based 
services to help seniors maintain their health and 
independence.

National Clearinghouse on Long-Term Care Information

    The Committee recommendation includes $3,000,000 for the 
National Clearinghouse on Long-Term Care Information. The 
Clearinghouse supports activities that raise awareness of 
public and private options available for long-term care needs.

Community Service Employment for Older Americans

    The budget request proposes moving the CSEOA program to 
ACL. The Committee rejects that change and continues to provide 
funding for this program in the Department of Labor.

Paralysis Resource Center

    The Committee recommendation includes $6,700,000 for the 
Paralysis Resource Center [PRC], which provides comprehensive 
information and referral services to people living with 
paralysis and their families. The Committee concurs with the 
administration request to transfer funding and administrative 
responsibility for the PRC from CDC to ACL. The Committee 
believes the PRC will benefit from ACL's goals of maximizing 
the independence and well-being of people with disabilities, as 
well as its ties to disability networks.

Developmental Disabilities State Councils

    The Committee recommendation includes $74,774,000 for State 
councils on developmental disabilities. These councils work to 
develop, improve, and expand the system of services and 
supports for people with developmental disabilities at the 
State and local level. Councils engage in activities such as 
training, educating the public, building capacity, and 
advocating for change in State policies with the goal of 
furthering the inclusion and integration of individuals with 
developmental disabilities in all aspects of community life.

Developmental Disabilities Protection and Advocacy

    The Committee recommendation includes $40,865,000 for 
protection and advocacy programs for people with developmental 
disabilities. This formula grant program provides funds to 
States to establish and maintain protection and advocacy 
systems to protect the legal and human rights of persons with 
developmental disabilities who are receiving treatment, 
services, or rehabilitation.

Voting Access for Individuals With Disabilities

    The Committee recommendation includes $5,235,000 to improve 
voting access for individuals with disabilities. This program 
provides grants to protection and advocacy organizations to 
ensure that individuals with disabilities have the opportunity 
to participate in every step of the electoral process, 
including registering to vote, accessing polling places, and 
casting a vote.

Developmental Disabilities Projects of National Significance

    The Committee recommendation includes $9,317,000 for 
projects of national significance to assist persons with 
developmental disabilities. 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.
    Human Services Transportation.--The Committee 
recommendation includes $1,000,000 for a competitive grant or 
contract for the purpose of providing generally available 
technical assistance to local government and nonprofit 
transportation providers. This assistance should focus on the 
most cost-effective ways to provide transportation assistance 
to all persons of any age with disabilities. The activities 
should be limited to onsite technical assistance, establishment 
of a technical assistance Web site, a toll free hotline and 
preparation of technical material. In addition, because of 
rising fuel prices, such technical assistance should include 
expanding the use of accessible, fuel-efficient taxi service 
for persons with disabilities and those receiving dialysis.

University Centers for Excellence in Developmental Disabilities

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

Program Administration

    The Committee recommends $30,035,000 for program 
administration at ACL. These funds support salaries and related 
expenses for program management and oversight activities. The 
Committee recommendation includes the administrative costs 
associated with the Administration on Developmental 
Disabilities and the Office on Disability, which are now part 
of ACL. The fiscal year 2013 level does not reflect the 
administrative costs of these other components and therefore is 
not directly comparable to fiscal year 2014.

                        Office of the Secretary


                    GENERAL DEPARTMENTAL MANAGEMENT

Appropriations, 2013\1\.................................    $542,585,000
Budget estimate, 2014...................................     421,276,000
Committee recommendation................................     517,381,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $517,381,000 for General 
Departmental Management [GDM]. The recommendation includes 
$70,173,000 in transfers available under section 241 of the PHS 
Act.
    This appropriation supports activities that are associated 
with the Secretary's role as policy officer and general manager 
of the Department. It supports health activities performed by 
the Office of the Assistant Secretary for Health [ASH], 
including the Office of the Surgeon General. GDM funds also 
support the Department's centralized services carried out by 
several Office of the Secretary staff divisions, including 
personnel management, administrative and management services, 
information resources management, intergovernmental relations, 
legal services, planning and evaluation, finance and 
accounting, and external affairs.
    The Committee recommendation includes $250,000 for 
continued support of the Advisory Council on Alzheimer's 
Research, Care, and Services.
    Adolescent Health.--The Committee supports the efforts of 
the Office of Adolescent Health [OAH] to improve health and 
reduce risky behaviors among adolescents. The recommendation 
includes not less than $1,500,000 for OAH to coordinate 
activities within the Department with respect to adolescent 
health, including program design and support, trend monitoring 
and analysis, research projects, the training of healthcare 
professionals, and demonstration projects to improve adolescent 
health.
    Alzheimer's Disease.--The Committee strongly supports the 
National Plan to Address Alzheimer's Disease and its goal of 
preventing and effectively treating Alzheimer's disease by 
2025. The Committee encourages the Department to include 
specific annual milestones as well as measures to assess 
progress within each annual report authorized by the National 
Alzheimer's Project Act. To ensure all appropriate Federal 
departments and agencies are informing the plan, the Department 
should consider adding representatives from NCATS and the 
Office of Science and Technology Policy to the Advisory Council 
on Alzheimer's Research, Care and Services. The Committee also 
encourages the Department to ensure the perspectives of 
patients with Alzheimer's disease are represented by 
establishing a patient representative position to the council.
    Asthma.--The Committee is concerned that in the 6 years 
since the release of NIH's Expert Panel Guidelines for the 
Diagnosis and Management of Asthma, very few children being 
treated in a primary care setting are receiving in vitro 
testing or skin testing to manage their asthma more effectively 
with an increased focus on achieving and maintaining good 
asthma control over time. The Committee directs the Secretary 
to report to the Committee within 60 days of enactment of this 
act on the barriers to primary care adoption of standardized 
and reproducible allergy tests for children and adults with 
asthma and related conditions. The report should recommend 
actions to remove such barriers to testing, which is a critical 
component of the guidelines.
    Chronic Fatigue Syndrome [CFS].--The Committee endorses the 
Department's continued support of the CFS Advisory Committee 
and urges accelerated progress to enact its recommendations to 
strengthen research, education, training, care, and services to 
better address the needs of one million Americans living with 
CFS.
    Federal E-Health Working Group.--The Committee encourages 
the Secretary to convene a national working group on e-health 
and telemedicine to improve communication, coordination and 
collaboration among relevant Federal agencies regarding e-
health needs, standards, Federal goals, and Federal efforts. 
Such a working group should seek to reduce duplication and e-
health incompatibility, as well as improve health quality, 
effectiveness, and outcomes.
    Hiring Individuals With Disabilities.--The Committee is 
very supportive of Executive Order 13548 and the Department's 
goal to raise the representation of individuals with 
disabilities in its workforce from 9 percent in fiscal year 
2011 to 11 percent by fiscal year 2015. However, the Committee 
understands that the Department is not on pace to meet this 
target. The Committee encourages the Department to accelerate 
its efforts toward achieving the goals of this important 
executive order.
    Immunotherapy and Asthma.--The Committee notes that an AHRQ 
review published earlier this year concluded that allergy 
immunotherapy is an effective treatment for allergic rhinitis, 
reduces asthma symptoms, lowers the use of asthma medications, 
and improves patient quality of life. Studies have also shown 
that allergy immunotherapy is highly cost-effective and 
severely underutilized. The Committee encourages the Secretary 
to develop a multi-agency initiative involving the NIH, AHRQ, 
CMS, and CDC to support research that will identify patient, 
healthcare provider, and systems barriers to initiation and 
adherence to allergy immunotherapy and develop interventions to 
address these problems.
    National Advisory Committee on Children and Disasters.--The 
Committee is concerned about the Nation's preparedness to meet 
the needs of children and pregnant women during disasters. The 
Committee notes that the Pandemic and All-Hazards Preparedness 
Reauthorization Act of 2013 requires the Secretary to establish 
a National Advisory Committee on Children and Disasters which 
would bring together Federal and non-Federal experts to provide 
advice and recommendations on medical and public health 
preparedness before, during, and after a disaster or public 
health emergency. The Committee requests a report from the 
Secretary on the status of the National Advisory Committee 
within 90 days of enactment of this act.
    Overdose Prevention.--The Committee notes that accidental 
deaths from overdose, particularly from prescription drugs such 
as opioids, are on the rise and have become the leading cause 
of preventable death for individuals under the age of 65 in the 
United States. The Committee is concerned that many healthcare 
professionals, treatment providers and at-risk populations are 
unaware of overdose prevention and reversal strategies. The 
Committee urges the Secretary, in collaboration with other 
agencies such as SAMHSA and CDC, to raise awareness of the 
symptoms and risk factors of overdose, how to deploy naloxone, 
rescue breathing and emergency services for someone 
experiencing an overdose, and how to help individuals make the 
linkage to treatment and recovery services.
    Prescriber Education.--The administration's ``Prescription 
Drug Abuse Plan'' called on the Department to work with the 
Department of Justice and the Office of National Drug Control 
Policy on ways to educate practitioners on safe and proper 
prescribing of opioid painkillers as a prequalification for 
those individuals obtaining a Drug Enforcement Administration 
license to prescribe and dispense controlled substances. The 
Committee requests an update on these efforts in next year's 
congressional justification.
    Urban-Based Network.--The Committee continues to support 
the efforts of the Secretary and other agencies within the 
Department, such as HRSA, AHRQ, CDC, CMS, NIMHD, and the Office 
of Minority Health, to support a network of urban-based 
institutions focused on addressing recruitment and training 
needs of minority and urban underserved populations and 
reducing health disparities in these urban communities.

Teen Pregnancy Prevention

    The Committee recommendation includes $113,245,000 for the 
Teenage Pregnancy Prevention program. The recommendation 
includes $8,455,000 in transfers available under section 241 of 
the PHS Act. The Committee provides $104,790,000 in funding for 
this activity through budget authority, rather than through 
transfers from the PPH Fund as requested by the administration. 
This program supports competitive grants to public and private 
entities to replicate evidence-based teen pregnancy prevention 
approaches.

Office of Minority Health

    The Committee recommends $42,560,000 for OMH. This Office 
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 $2,000,000 to 
continue the national health education program on lupus for 
healthcare providers, with the goal of improving diagnosis for 
those with lupus and reducing health disparities. The Committee 
continues to strongly support this program, which is intended 
to engage healthcare providers, educators, and schools of 
health professions in working together to improve lupus 
diagnosis and treatment through education.
    Chronic Kidney Disease [CKD].--The Committee continues to 
encourage OMH to prioritize early detection and treatment of 
CKD in minority communities to improve health outcomes and 
eliminate these severe health disparities.
    Offices of Minority Health.--The Committee continues to 
support the Department's implementation of the Action Plan to 
Reduce Racial and Ethnic Health Disparities, as well as the 
National Stakeholder Strategy for Achieving Health Equity. The 
Committee notes that the Offices of Minority Health in the 
Office of the Secretary, AHRQ, CDC, CMS, FDA, HRSA, and SAMHSA 
are charged with leading the strategy.

Abstinence Education

    The Committee recommendation does not include funding for 
abstinence education. Instead of funding a separate program for 
this purpose, the Committee supports the Teen Pregnancy 
Prevention program, which funds evidence-based strategies to 
reduce teen pregnancy, including those that emphasize 
abstinence.

Office of Women's Health

    The Committee recommends $26,808,000 for OWH. This office 
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, in 
order to address the disparities in women's health.
    The Committee recommendation includes $2,300,000 to 
continue the violence against women's health initiative. This 
initiative provides a public health response to abuse by 
training healthcare providers in interventions that identify, 
assess, and refer victims of domestic and sexual violence.

HIV/AIDS in Minority Communities

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

Embryo Donation and Adoption

    The Committee does not provide funding for embryo donation 
and adoption awareness activities. The Committee notes that 
this program has had a limited number of applicants since its 
inception and the administration has been unable to demonstrate 
its effectiveness.

                OFFICE OF MEDICARE HEARINGS AND APPEALS

Appropriations, 2013\1\.................................     $71,867,000
Budget estimate, 2014...................................      82,381,000
Committee recommendation................................      82,381,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee provides $82,381,000 for OMHA. This Office is 
responsible for hearing Medicare appeals at the administrative 
law judge level, which is the third level of Medicare claims 
appeals. OMHA ensures that Medicare beneficiaries who are 
dissatisfied with the initial decisions about their benefits or 
eligibility can appeal and exercise their right to a hearing in 
front of an administrative law judge. The Committee 
recommendation provides additional funding for OMHA to hire 
more administrative law judge teams and increase its capacity 
to process its rising caseload.
    The Committee is concerned by both the growing backlog of 
cases at OMHA and the high rate of claims overturned by the 
Office. Over half of the cases sent to OMHA are overturned; of 
the remaining cases, 37 percent are overturned through the 
departmental appeal process. The Department is urged to work 
with providers at the early stages of the audit process so that 
only a small number of cases are ultimately appealed and the 
loss of provider time, energy, and resources due to incorrect 
audit results are limited.

  OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION TECHNOLOGY

Appropriations, 2013\1\.................................     $61,193,000
Budget estimate, 2014...................................      76,883,000
Committee recommendation................................      71,597,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee makes available $71,597,000 to ONC, which 
includes $51,307,000 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.
    The Committee includes new bill language providing ONC with 
the authority to collect and spend user fees authorized in a 
new general provision. These user fees will support its 
electronic health record certification and standards 
development activities. These activities previously were 
supported with funding appropriated in the American Recovery 
and Reinvestment Act. This appropriation will expire at the end 
of fiscal year 2013.

                      OFFICE OF INSPECTOR GENERAL

Appropriations, 2013\1\.................................     $49,983,000
Budget estimate, 2014...................................      68,879,000
Committee recommendation................................      59,879,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends an appropriation of $59,879,000 
for the HHS OIG. In addition to discretionary funds provided in 
this act, the Health Insurance Portability and Accountability 
Act of 1996 provides a permanent appropriation of $200,279,000 
for OIG.
    OIG conducts audits, investigations, and evaluations of the 
programs administered by the Department's operating and staff 
divisions, including the recipients of the Department's grant 
and contract funds. In doing so, OIG addresses issues of waste, 
fraud, and abuse and makes recommendations to improve the 
efficiency and effectiveness of the Department's programs and 
operations.

                        OFFICE FOR CIVIL RIGHTS

Appropriations, 2013\1\.................................     $40,857,000
Budget estimate, 2014...................................      42,205,000
Committee recommendation................................      42,205,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $42,205,000 for OCR, which is 
responsible for enforcing civil rights-related statutes in 
healthcare and human services programs. To enforce these 
statutes, OCR investigates complaints of discrimination, 
conducts program reviews to correct discriminatory practices, 
and implements programs to generate voluntary compliance among 
providers and constituency groups of health and human services. 
The recommendation will allow OCR to strengthen its capacity to 
enforce Federal standards for health information privacy and 
security called for in the Health Insurance Portability and 
Accountability Act.

     RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS

Appropriations, 2013....................................    $527,151,000
Budget estimate, 2014...................................     550,372,000
Committee recommendation................................     550,372,000

    The Committee provides an estimated $550,372,000 in 
mandatory funds for Retirement Pay and Medical Benefits for 
Commissioned Officers of the U.S. Public Health Service [PHS]. 
This account provides for retirement payments to PHS officers 
who are retired due to age, disability, or length of service; 
payments to survivors of deceased officers; and medical care to 
Active Duty and retired officers, as well as their dependents.

            PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND

Appropriations, 2013\1\\2\..............................  $1,799,207,000
Budget estimate, 2014...................................   1,289,530,000
Committee recommendation................................   1,304,400,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.
\2\Includes emergency funding of $800,000,000 in the Disaster Relief 
Appropriations Act, 2013 (division A of Public Law 113-2).

    The Committee recommends $1,304,400,000 for the Public 
Health and Social Services Emergency Fund [PHSSEF]. This 
appropriation supports the activities of ASPR and other 
components within the Office of the Secretary to prepare for 
the health consequences of bioterrorism and other public health 
emergencies, including pandemic influenza. It also provides 
funding for the Department's cybersecurity efforts.

Office of the Assistant Secretary for Preparedness and Response

    The Committee recommendation includes $1,065,817,000 for 
activities administered by ASPR. This Office was created by the 
Pandemic and All-Hazards Preparedness Act to lead the 
Department's activities regarding preventing, preparing for, 
and responding to public health emergencies, including 
disasters and acts of terrorism.
    Public Health Emergency Research.--The Committee recognizes 
that important infectious diseases research often must be 
conducted during a public health emergency and that the lack of 
clear Federal guidelines in this area presents barriers to 
researchers. The Committee encourages ASPR to consult with the 
Office for Human Research Protections and other HHS offices and 
agencies about establishing a public health emergency research 
review board. ASPR also should work to coordinate and 
strengthen research capacities between CDC, NIH, FDA, DOD, the 
VA, and the academic medical community.
    Virtual Training.--The Committee continues to note the need 
for realistic virtual reality simulation training technologies 
at the local community level that will help prepare medical 
responders and hospitals for public health emergencies. The 
Committee encourages ASPR to develop core competencies and 
standardized curricula for virtual training using state-of-the-
art, simulation medical response technology.
            Hospital Preparedness Program
    The Committee's recommendation includes $254,555,000 for 
the Hospital Preparedness Program. This program provides grants 
to States to build healthcare coalitions that enhance regional 
and local hospital preparedness and improve overall surge 
capacity in public health emergencies.
            Emergency System for Advance Registration of Volunteer 
                    Health Professionals [ESAR VHP]
    The Committee recommendation includes $505,000 for the ESAR 
VHP program, which has established a national network of health 
professionals who provide assistance during an emergency. 
Funding will provide technical support to States to continue 
the program's mission.
            Biomedical Advanced Research and Development
    The Committee recommendation includes $415,000,000 for 
advanced research and development. The Committee provides 
funding for BARDA through budget authority rather than through 
transfers from the Project BioShield Special Reserve Fund [SRF] 
advance appropriation, as it has done in previous years. 
BioShield SRF balances will expire at the end of fiscal year 
2013.
    Anthrax Vaccine.--While the Committee remains concerned 
about the Nation's preparedness against biological threats, it 
recognizes that BARDA has made strides in developing and 
acquiring products to combat anthrax, including a next-
generation recombinant anthrax vaccine. The Committee 
encourages the continuation of these targeted efforts toward a 
clinically advanced and affordable vaccine.
    Antimicrobial Development.--The Committee is aware that CDC 
recently reported a four-fold increase in multidrug-resistant 
bacteria over the last 10 years. Unfortunately, existing 
treatment options are limited and few new drugs are likely to 
become available to address these bacterial threats in the near 
term. The Committee strongly encourages BARDA to prioritize its 
Broad Spectrum Antimicrobial program.
            Strategic Investor
    The Committee recommendation includes $15,000,000 to create 
the Strategic Investor program. This program will provide 
financial support and business expertise to emerging biodefense 
companies that develop medical countermeasures for the Federal 
stockpile.
            Medical Countermeasure Dispensing
    The Committee recommendation includes $5,000,000 for the 
Medical Countermeasure Dispensing program. Funding provided by 
the Committee will support the continued implementation of the 
National Postal Model, which provides for the delivery of 
medical countermeasures through the U.S. Postal Service during 
a bioterrorist attack.
            Project BioShield Special Reserve Fund
    The Committee recommendation includes $250,000,000 for the 
Project BioShield SRF. The Committee strongly supports the 
mission of Project BioShield and intends to continue providing 
support for the procurement of medical countermeasures [MCMs] 
in future fiscal years. The Committee includes a new general 
provision requested by the administration allowing BARDA to 
enter into incrementally funded, multiyear contracts for up to 
10 years rather than the standard limit of 5 years. The new 
provision also modifies existing multiyear contracting 
authority by allowing BARDA to repurpose unused termination 
costs to pay contract invoices in subsequent years. These 
modifications will allow BARDA to use multiyear authority to 
engage in long-term contracts with companies that develop 
medical countermeasures.
    The Committee directs BARDA to utilize this new multiyear 
contracting authority, providing for termination as appropriate 
in the event that funds are not made available in future fiscal 
years, to meet the known current and future national need for 
particular MCMs. The Committee believes that the multiyear 
contracts will provide a clear indicator to industry of the 
Federal Government's future support for medical countermeasure 
development, while at the same time promoting economy in the 
administration, performance, and operation of BARDA. The 
Committee requests that BARDA provide a 5-year spend plan for 
fiscal years 2014-2018, which shall be made public, detailing 
the funding amounts required to support advanced development 
contracts for these products.
            Other Activities
    The Committee recommendation includes the following amounts 
for the following activities within ASPR:
  --Operations.--$33,213,000;
  --Preparedness and Emergency Operations.--$24,789,000;
  --National Disaster Medical System.--$52,502,000; and
  --Policy and Planning.--$15,253,000.

Office of the Assistant Secretary for Administration

    The Committee recommends $41,125,000 for information 
technology cybersecurity in the Office of the Assistant 
Secretary for Administration. These funds provide for 
continuous monitoring and security incident response 
coordination for the Department's computer systems and 
networks.

Office of the Assistant Secretary for Health

    The Committee recommendation includes $8,979,000 for the 
Medical Reserve Corps program in ASH. This program is a 
national network of local volunteers who work to strengthen the 
public health infrastructure and preparedness capabilities of 
their communities.

Office of the Secretary

    The Committee recommendation includes $188,479,000 for 
activities within the Office of the Secretary.
            Pandemic Influenza Preparedness
    The Committee recommendation includes $140,009,000 for 
Pandemic Influenza Preparedness. Of the total, $32,009,000 is 
provided in annual funding and $108,000,000 in no-year funding. 
Since fiscal year 2012 the Department's pandemic flu activities 
have been funded from existing balances from prior supplemental 
appropriations. However, HHS anticipates spending all of these 
balances by the end of fiscal year 2013. The Committee 
recommendation will support the goals defined in the HHS 
Pandemic Influenza Plan, which includes maintaining the 
Department's egg supply program, developing new methods for 
extending the life of vaccines in the Strategic National 
Stockpile, maintaining a fill-finish manufacturing network, and 
supporting the advancement of vaccine capability in other 
countries.
            Lease Replacement
    The Committee recommendation includes $41,000,000 for space 
consolidation for several HHS agencies, as well as fit-out 
costs for lease replacement.
            Office of Security and Strategic Information
    The Committee includes $7,470,000 for the Office of 
Security and Strategic Information to maintain the security of 
the Department's personnel, systems, and critical 
infrastructure.

                   PREVENTION AND PUBLIC HEALTH FUND

    The PPH Fund was created in the ACA and provides 
$13,500,000,000 in mandatory funds over the next 10 years to 
supplement investments in public health and prevention. The 
Committee strongly believes that additional resources for 
prevention will improve people's health and reduce healthcare 
costs over the long term. Recognizing the Committee's 
responsibility to determine funding levels for community-based 
prevention and public health programs, the ACA specifically 
gives the Committee authority to transfer funds into Federal 
programs that support the goal of making America healthier.
    In fiscal year 2014, the level appropriated for the fund is 
$1,000,000,000, the same as the fiscal year 2013 level. The 
Committee includes bill language in section 220 of this act 
that requires that funds be transferred within 45 days of 
enactment of this act to the following accounts, for the 
following activities, and in the following amounts:

----------------------------------------------------------------------------------------------------------------
                                                                                                     Committee
                 Agency                             Account                     Program           recommendation
----------------------------------------------------------------------------------------------------------------
HRSA....................................  Health Workforce..........  Alzheimer's Disease             $5,300,000
                                                                       Education and Outreach.
HRSA....................................  Health Workforce..........  Public Health Training          25,000,000
                                                                       Centers.
CDC.....................................  Immunization and            Immunization program......     150,000,000
                                           Respiratory Diseases.
CDC.....................................  HIV/AIDS, Viral Hepatitis,  Viral Hepatitis screening       10,000,000
                                           STD, and TB Prevention.     and prevention.
CDC.....................................  Emerging and Zoonotic       Epidemiology and                40,000,000
                                           Infectious Diseases.        Laboratory Improvement
                                                                       program.
CDC.....................................  Emerging and Zoonotic       Healthcare-Associated           12,000,000
                                           Infectious Diseases.        Infections.
CDC.....................................  Chronic Disease             Breastfeeding Promotion         15,000,000
                                           Prevention, Health          and Support program.
                                           Promotion, and Genomics.
CDC.....................................  Chronic Disease             Community Transformation       280,000,000
                                           Prevention, Health          Grants.
                                           Promotion, and Genomics.
CDC.....................................  Chronic Disease             Diabetes Prevention             10,000,000
                                           Prevention, Health          Program.
                                           Promotion, and Genomics.
CDC.....................................  Chronic Disease             High-Obesity Regions......       5,000,000
                                           Prevention, Health
                                           Promotion, and Genomics.
CDC.....................................  Chronic Disease             Let's Move (National Early       4,000,000
                                           Prevention, Health          Care and Education
                                           Promotion, and Genomics.    Collaboratives).
CDC.....................................  Chronic Disease             Million Hearts............       5,000,000
                                           Prevention, Health
                                           Promotion, and Genomics.
CDC.....................................  Chronic Disease             National School Food             1,700,000
                                           Prevention, Health          Marketing Assessment.
                                           Promotion, and Genomics.
CDC.....................................  Chronic Disease             Nutrition, Physical             10,000,000
                                           Prevention, Health          Activity, Obesity  Grants.
                                           Promotion, and Genomics.
CDC.....................................  Chronic Disease             Office of Smoking and           95,000,000
                                           Prevention, Health          Health.
                                           Promotion, and Genomics.
CDC.....................................  Chronic Disease             Prevention Research             10,000,000
                                           Prevention, Health          Centers.
                                           Promotion, and Genomics.
CDC.....................................  Chronic Disease             Racial and Ethnic               40,000,000
                                           Prevention, Health          Approaches to Community
                                           Promotion, and Genomics.    Health.
CDC.....................................  Chronic Disease             Workplace Wellness grants.      10,000,000
                                           Prevention, Health
                                           Promotion, and Genomics.
CDC.....................................  Public Health Scientific    Guide to Community               7,400,000
                                           Services.                   Preventive Services.
CDC.....................................  Public Health Scientific    National Center for Health      35,000,000
                                           Services.                   Statistics.
CDC.....................................  Environmental Health......  Chronic Disease Biomarkers       4,200,000
CDC.....................................  Environmental Health......  Environmental and Health        35,000,000
                                                                       Outcome Tracking Network.
CDC.....................................  Injury Prevention and       Falls Prevention                 3,000,000
                                           Control.                    activities.
CDC.....................................  CDC-Wide Activities.......  National Prevention,             1,000,000
                                                                       Health Promotion and
                                                                       Public Health Council.
CDC.....................................  CDC-Wide Activities.......  Public Health                   40,000,000
                                                                       Infrastructure grants.
CDC.....................................  CDC-Wide Activities.......  Public Health Workforce...      15,700,000
SAMHSA..................................  Mental Health.............  Mental Health First Aid...      15,000,000
SAMHSA..................................  Mental Health.............  Suicide Prevention........      12,000,000
SAMHSA..................................  Substance Abuse Treatment.  Access to Recovery........      50,000,000
SAMHSA..................................  Health Surveillance and     Surveillance activities...      15,000,000
                                           Program Sup-  port.
AHRQ....................................  Health Costs, Quality, and  U.S. Preventive Services         7,000,000
                                           Outcomes.                   Task Force.
ACL.....................................  Aging and Disability        Alzheimer's Disease Self-       14,700,000
                                           Services Programs.          Management.
ACL.....................................  Aging and Disability        Chronic Disease Self-           10,000,000
                                           Services Programs.          Management.
ACL.....................................  Aging and Disability        Falls Prevention..........       7,000,000
                                           Services Programs.
----------------------------------------------------------------------------------------------------------------

                           General Provisions

    Section 201. The bill continues a provision placing a 
$50,000 ceiling on official representation expenses.
    Section 202. The bill continues a provision that limits the 
assignment of certain public health personnel.
    Section 203. The bill continues a provision limiting the 
use of certain grant funds to pay individuals more than an 
annual rate of executive level II.
    Section 204. The Committee recommendation continues a 
provision restricting the Secretary's use of taps for program 
evaluation activities unless a report is submitted to the 
Appropriations Committees of the House and Senate on the 
proposed use of funds.
    Section 205. The Committee recommendation continues a 
provision authorizing the transfer of up to 2.5 percent of PHS 
Act funds for evaluation activities.
    Section 206. The Committee recommendation continues a 
provision restricting transfers of appropriated funds and 
requires a 15-day notification to both the House and Senate 
Appropriations Committees.
    Section 207. The Committee recommendation continues a 
provision permitting the transfer of up to 3 percent of AIDS 
funds among ICs by the Director of NIH and the Director of the 
Office of AIDS Research at NIH.
    Section 208. The Committee recommendation retains language 
which requires that the use of AIDS research funds be 
determined jointly by the Director of NIH and the Director of 
the Office of AIDS Research and that those funds be allocated 
directly to the Office of AIDS Research for distribution to the 
Institutes and Centers consistent with the AIDS research plan.
    Section 209. The Committee recommendation continues a 
provision regarding requirements for family planning 
applicants.
    Section 210. The Committee recommendation retains language 
which states that no provider services under title X of the PHS 
Act may be exempt from State laws regarding child abuse.
    Section 211. The Committee recommendation retains language 
which restricts the use of funds to carry out the Medicare 
Advantage Program if the Secretary denies participation to an 
otherwise eligible entity.
    Section 212. The Committee recommendation modifies a 
provision which facilitates the expenditure of funds for 
international health activities.
    Section 213. The Committee recommendation continues a 
provision authorizing the Director of NIH to enter into certain 
transactions to carry out research in support of the NIH Common 
Fund.
    Section 214. The Committee continues a provision that 
permits CDC and the Agency for Toxic Substances and Disease 
Registry to transfer funds that are available for Individual 
Learning Accounts.
    Section 215. The Committee recommendation continues a 
provision permitting NIH to use up to $3,500,000 per project 
for improvements and repairs of facilities.
    Section 216. The Committee recommendation includes a 
provision that transfers funds from NIH to HRSA and AHRQ, to be 
used for National Research Service Awards.
    Section 217. The Committee recommendation includes a new 
provision allowing continued funding of the Sanctuary System 
for Surplus Chimpanzees.
    Section 218. The bill continues a provision prohibiting the 
use of funds for lobbying activities related to gun control.
    Section 219. The Committee recommendation modifies a 
provision requiring a publicly available Web site that details 
expenditures from the PPH Fund.
    Section 220. The Committee recommendation includes a new 
provision transferring mandatory funds from section 4002 of the 
Patient Protection and Affordable Care Act to accounts within 
the Department for activities outlined under the heading 
``Prevention and Public Health Fund'' in this report.
    Section 221. The Committee recommendation includes a new 
provision authorizing user fee collections to the Office of the 
National Coordinator for Health Information Technology to 
support certification and standards activities.
    Section 222. The Committee recommendation includes a new 
provision that provides BARDA with authority to enter into a 
multiyear contract for up to 10 years and to repurpose unused 
termination costs to pay contract invoices.
    Section 223. The Committee recommendation includes a new 
provision requiring fiscal year 2015 budget justifications to 
include certain FTE information with respect to ACA.
    Section 224. The bill includes a new general provision 
allowing National Health Service Corps contracts to be canceled 
up to 60 days after award.
    Section 225. The Committee recommendation includes a new 
general provision that ensures that NIH has the contracting 
flexibility it needs to efficiently manage the federally Funded 
Research and Development Center it sponsors while also ensuring 
that all financial obligations incurred in fiscal year 2014 are 
fully funded with fiscal year 2014 appropriations.
    Section 226. The bill includes a new provision expressing 
the sense of the Senate on income verification for ACA exchange 
plans.
    Section 227. The bill includes a new provision related to 
ACA exchange funding transparency.

                               TITLE III

                        DEPARTMENT OF EDUCATION

                    Education for the Disadvantaged

Appropriations, 2013\1\................................. $15,710,221,000
Budget estimate, 2014...................................  15,655,002,000
Committee recommendation................................  15,875,231,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends an appropriation of 
$15,875,231,000 for education for the disadvantaged.
    The President's budget was based on the administration's 
proposal to reauthorize the ESEA, but no such bill has passed 
the Senate. As a result, the Committee bill is based on current 
law for programs authorized under the ESEA.
    The programs in the Education for the Disadvantaged account 
help ensure that poor and low-achieving children are not left 
behind in the Nation's effort to raise the academic performance 
of all children and youth. Funds appropriated in this account 
primarily support activities in the 2014-2015 school year.

Grants to Local Educational Agencies

    Title I Grants to LEAs provide supplemental education 
funding, especially in high-poverty areas, for local programs 
that provide extra academic support to help raise the 
achievement of eligible students or, in the case of schoolwide 
programs, help all students in high-poverty schools meet 
challenging State academic standards. Title I Grants are 
distributed through four formulas: basic, concentration, 
targeted, and education finance incentive grant.
    The Committee recommends $14,612,425,000 for the Title I 
Grants to LEAs program. Of the funds available for Title I 
Grants to LEAs, up to $4,000,000 shall be available on October 
1, 2013, and may be transferred to the Census Bureau for 
poverty updates; $3,767,248,000 will become available on July 
1, 2014; and $10,841,177,000 will become available on October 
1, 2014. The funds that become available on July 1, 2014, and 
October 1, 2014, will remain available for obligation through 
September 30, 2015.
    The Committee notes that the biggest barrier for homeless 
children and youth attempting to enroll in and attend school 
regularly is the lack of transportation. The Committee bill 
includes a new provision clarifying that title I funds may be 
used to address this transportation issue, as well as support 
homeless liaisons.

School Improvement Grants

    The Committee recommendation includes $567,485,000 for the 
SIG program.
    The Committee continues authority provided by prior 
appropriations acts that addresses several issues. First, it 
continues the expansion of the number of schools that may 
receive funds through the program. This language allows schools 
to be eligible for SIG if they are eligible for title I and 
have not made adequate yearly progress for at least 2 years or 
are in the State's lowest quintile of performance based on 
proficiency rates. Second, States may make subgrants of not 
more than $2,000,000 to each participating school. And, a set-
aside of up to 5 percent of the SIG appropriation may be used 
for national activities.
    The Committee notes that Federal and non-Federal 
investments in school turnaround and comprehensive school 
reform have identified, developed, or supported research-
proven, replicable models for struggling schools. Such schools 
now have a growing number of options to match their needs. 
Therefore, the Committee bill includes new language that will 
allow schools that receive SIG funds the flexibility to choose 
and implement a research-proven, whole-school reform model.
    The bill also provides new flexibility to LEAs that are 
eligible to receive services under the Rural Education 
Achievement Program to modify not more than one element 
required under a school improvement model. The bill also 
includes new language allowing SEAs, with the approval of the 
Secretary, the ability to establish an alternative State-
determined school improvement strategy that may be used by LEAs 
under the SIG program. The purpose of this alternative strategy 
is to allow SEAs to develop their own flexible models that can 
be implemented by LEAs that receive SIG funds.
    The Committee expects that any approach taken with SIG 
funds should address schoolwide factors, whole school culture, 
the individual needs of the students, and the use of data to 
inform instruction and provide continuous improvement; ensure 
that the needs of the students are met through the organization 
of the school, curriculum and instruction, and social and 
emotional support services; and improve teacher and leader 
effectiveness, including through training and support for 
teachers and school leaders in school improvement efforts and 
in the needs of students.
    The Committee bill also includes new language that extends 
the availability of SIG funds in order to provide LEAs and 
schools with the time needed to implement effective, 
sustainable turnaround efforts. The Committee believes that 
this flexibility should be used to provide schools with the 
opportunity to receive performance-based grant extensions.

Striving Readers Comprehensive Literacy Program

    The Committee recommends $164,378,000 to continue the 
Striving Readers Comprehensive Literacy program.
    The Committee bill includes language that continues the 
competitive portion of the program as it was established in the 
fiscal year 2010 appropriations act. Striving Readers is a 
birth-through-12th grade comprehensive initiative focused on 
data and assessment, systemic interventions, professional 
development, and explicit literacy instruction. To strengthen 
State grantees' ability to improve students' literacy skills, 
the Committee directs the Secretary to provide it with a report 
within 60 days of enactment of this act on the Department's 
policies and procedures for providing timely, evidence-based, 
and effective technical assistance and support, particularly 
with regard to State grantees' evaluation activities. In 
addition, the program offers an important opportunity to test, 
learn, and share effective policies and practices to strengthen 
student literacy. Therefore, the Committee directs the 
Secretary to utilize the 5 percent set-aside for national 
activities to implement a national evaluation of the Striving 
Readers program.

Migrant Education Program

    The Committee recommends $392,450,000 for the title I 
Migrant Education program.
    This funding supports grants to SEAs for programs to meet 
the special educational needs of the children of migrant 
agricultural workers and fishermen. Funding 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 $50,130,000 for the title I 
Neglected and Delinquent program.
    This program provides financial assistance to SEAs for 
education services to neglected and delinquent children and 
youth in State-run institutions and for juveniles in adult 
correctional institutions. States are authorized to set aside 
at least 15 percent, but not more than 30 percent, of their 
Neglected and Delinquent funds to help students in State-
operated institutions make the transition into locally operated 
programs and to support the successful reentry of youth 
offenders who are age 20 or younger and have received a 
secondary school diploma or its recognized equivalent.

Evaluation

    The Committee recommends $3,028,000 for evaluation of title 
I programs.
    Evaluation funds are used to support large-scale national 
surveys that examine how the title I program is contributing to 
student academic achievement. Funds also are used to evaluate 
State assessment and accountability systems and analyze the 
effectiveness of educational programs supported with title I 
funds.
    The Committee bill also includes a new general provision in 
this title that clarifies the Department's authority to reserve 
up to 0.5 percent of each ESEA appropriation in the bill, 
except for titles I and III of the ESEA, for evaluation of ESEA 
programs funded in this act. The Department is required to 
provide the Senate Committees on Appropriations and HELP an 
operating plan describing the proposed uses of this new 
evaluation authority as well as the source appropriation for 
such activities. In addition, not later than 45 days prior to 
the submission of the required operating plan, the Department 
shall brief the Senate Committees on Appropriations and HELP on 
the programs and activities being considered for inclusion in 
the plan. Further, the Committee expects the Department to 
include in future congressional budget justifications a 
discussion of its planned use of this new authority.

High School Graduation Initiative

    The Committee recommends $48,809,000 for the High School 
Graduation Initiative under title I, part H of the ESEA.
    The High School Graduation Initiative provides competitive 
grants to LEAs or SEAs to implement effective high school 
graduation and reentry strategies in schools and districts that 
serve students in grades 6 through 12 and have annual school 
dropout rates that are above their State's average. Funds also 
are used for certain national activities, including evaluation, 
technical assistance, and dissemination of information on 
effective programs and best practices.

Special Programs for Migrant Students

    The Committee recommends $36,526,000 for Special Programs 
for Migrant Students, which consist of HEP and CAMP.
    HEP projects are 5-year grants to institutions of higher 
education and other nonprofit organizations to recruit migrant 
students ages 16 and older and provide the academic and support 
services needed to help them obtain a high school equivalency 
certificate and subsequently gain employment, attain admission 
to a postsecondary institution or a job training program, or 
join the military.
    CAMP projects are 5-year grants to institutions of higher 
education and nonprofit organizations to provide tutoring, 
counseling, and financial assistance to migrant students during 
their first year of postsecondary education.

                            School Readiness

Appropriations, 2013....................................................
Budget estimate, 2014...................................    $750,000,000
Committee recommendation................................     750,000,000

    The Committee recommends $750,000,000 to create a new 
Preschool Development Grants program.
    This program will award competitive grants to States to 
support their efforts to expand or create high-quality 
preschool systems for 4-year-olds from low- and moderate-income 
families, including children with disabilities. Preschool 
Development Grants will complement the administration's 
Preschool for All proposal, which will provide matching 
mandatory funds to States for improving access to such high-
quality preschool systems. The Department will award two types 
of grants, one to low-capacity States with small or no State-
funded preschool programs and another to high-capacity States 
that have a larger State-funded preschool program. These grants 
will help States address fundamental needs including workforce 
development, quality improvement efforts, and the scale-up of 
proven preschool models. The bill allows States to subgrant 
funds to LEAs and to LEAs in partnership with other early 
learning providers. The Committee directs the Department to 
require any use of child assessments to conform to the 
recommendations and cautions of reports by the National 
Research Council on assessments of children.
    This new program, combined with investments in programs 
administered by HHS, will help improve the quality of early 
learning and development programs for ages birth through 5 and 
help close the achievement gap for children from low-income 
families.

                               Impact Aid

Appropriations, 2013\1\.................................  $1,288,603,000
Budget estimate, 2014...................................   1,224,239,000
Committee recommendation................................   1,290,945,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $1,290,945,000 for the Impact Aid 
program.
    Impact aid provides financial assistance to school 
districts for the costs of educating children when enrollments 
and the availability of revenues from local sources have been 
adversely affected by the presence of Federal activities.
    Children who reside on Federal or Indian lands generally 
constitute a financial burden on local school systems because 
these lands do not generate property taxes--a major revenue 
source for elementary and secondary education in most 
communities. In addition, realignments of U.S. military forces 
at bases across the country often lead to influxes of children 
into school districts without producing the new revenues 
required to maintain an appropriate level of education.
    The Committee bill retains language that provides for 
continued eligibility for students affected by the deployment 
or death of their military parent, as long as these children 
still attend schools in the same school district.
    Basic Support Payments.--The Committee recommends 
$1,153,540,000 for the Basic Support Payments program. 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 Committee bill also includes new language that would 
continue heavily impacted payments through 2014 for LEAs that 
received such payments in 2009.
    Payments for Children With Disabilities.--The Committee 
bill includes $48,316,000 for Payments for Children With 
Disabilities. Under this program, additional payments are made 
for certain federally connected children eligible for services 
under IDEA.
    Facilities Maintenance.--The Committee recommends 
$4,835,000 for Facilities Maintenance. This activity provides 
funding for emergency repairs and comprehensive capital 
improvements to certain school facilities owned by the 
Department and used by LEAs to serve federally connected 
military dependent students. Funds appropriated for this 
purpose are available until expended.
    Construction.--The Committee recommends $17,441,000 for 
eligible LEAs for emergency repairs and modernization of school 
facilities.
    The Committee recommendation includes bill language 
allowing these funds to be awarded entirely through the 
authorized formula. The budget request proposes to award funds 
on a competitive basis. Fiscal year 2012 and 2013 funds were 
available for distribution only under the competitive portion 
of the program.
    Payments for Federal Property.--The Committee recommends 
$66,813,000 for Payments for Federal Property. These payments 
compensate LEAs in part for revenue lost due to the removal of 
Federal property from local tax rolls.
    The Committee bill includes new language allowing a 
district to carry its section 8002 eligibility to a new school 
district that was formed as a result of district consolidation.

                      School Improvement Programs

Appropriations, 2013\1\.................................  $4,535,506,000
Budget estimate, 2014...................................   2,028,313,000
Committee recommendation................................   4,621,862,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommendation includes $4,621,862,000 for 
the School Improvement Programs account.
    The President's budget was based on the administration's 
proposal to reauthorize the ESEA, but no such bill has passed 
the Senate. As a result, programs in this account are based 
generally on current law, as authorized under the ESEA.

State Grants for Improving Teacher Quality

    The Committee recommends $2,461,634,000 for State Grants 
for Improving Teacher Quality.
    The appropriation for this program primarily supports 
activities associated with the 2014-2015 academic year. Of the 
funds provided, $780,193,000 will become available on July 1, 
2014, and $1,681,441,000 will become available on October 1, 
2014. These funds will remain available for obligation through 
September 30, 2015.
    States and LEAs may use funds for a range of activities 
related to the certification, recruitment, professional 
development, and support of teachers and administrators. 
Activities may include reforming teacher certification and 
licensure requirements, addressing alternative routes to State 
certification of teachers, recruiting teachers and principals, 
and implementing teacher mentoring systems, teacher testing, 
merit pay, and merit-based performance systems. These funds may 
also be used by districts to hire teachers to reduce class 
sizes.
    The Committee bill modifies a set-aside for the Supporting 
Effective Educator Development program, which provides 
competitive awards to national not-for-profit organizations for 
recruiting, training, or providing professional enhancement 
activities for teachers and school leaders, particularly for 
high-need schools most likely to face shortages in these areas. 
These funds may be used to support such activities in civic 
learning. The Committee recommends that up to 5.5 percent of 
funds available for State Grants for Improving Teacher Quality 
shall be used for this purpose; in fiscal year 2013, the set-
aside was 1.5 percent. The bill language also differs slightly 
from prior years by allowing up to 10 percent of the set-aside 
funds to be used for related research, development, evaluation, 
dissemination, and technical assistance.

Mathematics and Science Partnerships

    The Committee recommends $149,417,000 for the Mathematics 
and Science Partnerships program.
    At the recommended funding level, the ESEA requires the 
Department to award grants by formula to States for competitive 
awards to eligible partnerships, which must include an 
engineering, math, or science department of an institution of 
higher education and a high-need LEA. Partnerships will seek to 
improve the performance of students in the areas of math and 
science, including engineering, by bringing math and science 
teachers in elementary and secondary schools together with 
scientists, mathematicians, and engineers to increase the 
teachers' subject-matter knowledge and improve their teaching 
skills.

Supplemental Education Grants

    The Committee recommendation includes $17,583,000 for 
supplemental education grants to the Republic of Marshall 
Islands [RMI] and the Federated States of Micronesia [FSM].
    This grant program was authorized by the Compact of Free 
Association Amendments Act of 2003. These funds will be 
transferred from the Department to the Secretary of the 
Interior for grants to these entities. The Committee bill 
continues language that allows up to 5 percent to be used by 
FSM and RMI to purchase oversight and technical assistance, 
which may include reimbursement to the Departments of Labor, 
HHS, and Education for such services.

21st Century Community Learning Centers

    The Committee recommends an appropriation of $1,200,000,000 
for the 21st Century Community Learning Centers [21st CCLC] 
program.
    Funds are allocated to States by formula, which in turn, 
award at least 95 percent of their allocations to LEAs, 
community-based organizations, and other public and private 
entities. Grantees use these resources to establish or expand 
community learning centers that provide activities offering 
significant extended learning opportunities, such as before- 
and 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 to students who attend schools that are eligible 
to operate a schoolwide program under title I of the ESEA or 
serve high percentages of students from low-income families.
    The Committee is aware of a growing interest in extending 
the school day and/or school year as a means of providing 
additional educational opportunities to students. Therefore, 
the Committee includes new bill language that will give LEAs 
the option of using 21st CCLC subgrants for extended learning 
time programs. LEAs will continue to be able to use the funding 
for high-quality, afterschool, before school, and summer 
learning programs if they choose.
    The Committee believes that SEAs should award grants to 
high-quality programs that address individual student learning 
needs and student well-being. Funded programs should deliver 
services through a variety of high-quality and effective 
strategies for boosting learning and enrichment including 
afterschool, before school, summer school, or expanded day, 
week, or year opportunities; align with and complement, rather 
than replicate, the regular school day, by offering a range of 
activities that capture student interest and support student 
engagement to promote higher class attendance, reduce risk for 
retention or dropping out, and foster good health; integrate 
academics, enrichment, and skill development through hands-on 
experiences that make learning relevant and engaging; and 
actively address the specific learning needs and interests of 
all types of students, especially those who may benefit from 
approaches and experiences not offered in the traditional 
classroom setting. The Committee directs the Department to 
refrain from giving priority to, showing preference for, or 
providing direction about whether communities should use these 
funds for afterschool, before school, summer school, or 
expanded school day programs, unless specifically requested by 
SEAs or LEAs.
    The Committee urges the Department to provide guidance and 
technical assistance to States, schools, and community partners 
on how to develop and maintain strong community-school 
partnerships, particularly in data-sharing arrangements; 
implement continuous quality improvement processes; and ensure 
that programs meet the needs of individual students. The 
Committee also urges the Department to consult with experts in 
the field, including State and local intermediaries, in 
creating and providing such guidance and technical assistance. 
The Committee also believes SEAs should ensure that local 
communities receiving 21st CCLC program funds identify 
strategies for students to engage in programs and services 
during the afternoon and early evening hours while most parents 
or guardians are at work.
    The Committee is aware that many States already have the 
option of using 21st CCLC funding for extended learning time 
through the ESEA-No Child Left Behind waiver process. The 
Committee directs the Secretary to provide it with a report on 
the impact of the flexibility provided to SEAs under waiver 
option 11 on the 21st CCLC program. The Department should 
report on the number of children served and the centers/sites 
offering expanded learning in the 3 years preceding the waiver 
approval and the 3 years following waiver approval, as well as 
the number of hours of and diversity of programming available 
to students through such grants at each site and the average 
cost of the programs (per student and per site) before and 
after waiver approval. All data should be provided at the State 
level.

State Assessments and Enhanced Assessment Instruments

    The Committee recommends $408,436,000 for the State 
Assessments and Enhanced Assessment Instruments program.
    This program has two components. The first provides formula 
grants to States to pay the cost of developing and implementing 
standards and assessments required by the ESEA. The Committee 
provides not less than $398,436,000 for this purpose.
    Under the second component--grants for enhanced assessment 
instruments--appropriations in excess of the State assessment 
program are used for a competitive grant program designed to 
support efforts by States to improve the quality and 
reliability of their assessment systems. The Committee 
recommendation for the second component is up to $10,000,000.

Javits Gifted and Talented Education

    The Committee recommends $15,000,000 for the Javits Gifted 
and Talented Students Education program. Funds will be used for 
awards to State and local educational agencies, institutions of 
higher education, and other public and private agencies for 
research, demonstration, and training activities designed to 
enhance the capability of elementary and secondary schools to 
meet the special educational needs of gifted and talented 
students, including those from disadvantaged and 
underrepresented populations.
    Within these funds, the Committee also directs the 
Department to support a National Research Center on the Gifted 
and Talented.

Education for Homeless Children and Youth

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

Training and Advisory Services

    For Training and Advisory Services authorized by title IV 
of the Civil Rights Act, the Committee recommends $6,947,000.
    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 $34,181,000.
    The Committee bill continues a provision that allows 
funding provided by this program to be used for construction.

Alaska Native Educational Equity

    The Committee recommends $33,185,000 for the Alaska Native 
Educational Equity Assistance program.
    These funds address the severe educational handicaps of 
Alaska Native schoolchildren. Funds are used for the 
development of supplemental educational programs to benefit 
Alaska Natives. The Committee bill continues language that 
allows funding provided by this program to be used for 
construction. The Committee bill also includes language 
overriding the authorizing statute's requirement to make 
noncompetitive awards to certain organizations.
    The Committee is concerned that the fiscal year 2012 
competition for this program did not sufficiently recognize the 
statutory provisions related to applications from Alaska Native 
regional nonprofit organizations or from consortia that include 
at least one Alaska Native regional nonprofit organization. The 
Committee notes that two competitive preference points were 
awarded for applications from such organizations, and nine 
points were awarded for non-statutory priorities established by 
the Department. The Committee finds this unacceptable and 
directs the Department to more appropriately adhere to sections 
7304(c) and 7305(b) of the ESEA in all future funding decisions 
and grant competitions and ensure that all grantees have 
meaningful plans for consultation with Alaska Native leaders.
    The Committee also directs the Department to prepare and 
submit a report, within 180 days of the enactment of this act, 
on how the Department will work to improve consultation with 
and promote the maximum participation of Alaska Native 
organizations, Alaska Native regional nonprofit organizations, 
and consortia that include at least one Alaska Native regional 
nonprofit organization in the program. The report should also 
outline steps the Department will take to ensure that all 
current grantees have meaningful plans for consultation with 
Alaska Native organizations.

Rural Education

    The Committee recommends $179,193,000 for rural education 
programs.
    The Committee expects that rural education funding will be 
equally divided between the Small, Rural School Achievement 
Program, which provides funds to LEAs that serve a small number 
of students, and the Rural and Low-Income School Program, which 
provides funds to LEAs that serve concentrations of poor 
students, regardless of the number of students served.
    The Committee notes that almost one-third of the Nation's 
schools are in rural areas. The GAO and others have noted the 
unique challenges faced by these schools, including recruiting 
and retaining highly qualified teachers; offering access to 
advanced coursework, such as Advanced Placement courses; 
meeting transportation costs that diminish resources available 
for academic and enrichment programs; and writing successful 
applications for grant competitions given their more limited 
administrative capacity. The Committee is very concerned that 
the Department has generally failed to recognize these 
challenges over the past 4 years, particularly in some of its 
grant competitions. The Investing in Innovation program offers 
a welcome departure from this pattern, as the Department 
altered its competition to provide an absolute priority for 
rural applicants, instead of the competitive preference 
priority it established in the initial competition. The 
Committee directs the Department to immediately take action to 
improve its record in the area of rural education. The 
Committee requests a report not later than 30 days after 
enactment of this act describing the actions the Department has 
taken and will take to ensure that the needs of students in 
rural schools are effectively met by the programs it 
administers. The report should specifically address how the 
Department organizes or will organize itself to ensure rural 
expertise is available to program staff throughout the 
Department, and strategies the Department is taking or will 
take to ensure that students in rural LEAs are able to benefit 
from competitive grant opportunities and other resources 
available through Department's discretionary appropriations.

Comprehensive Centers

    The Committee recommends $51,113,000 for the Comprehensive 
Centers program.
    These funds provide support to a network of comprehensive 
centers that are operated by research organizations, agencies, 
institutions of higher education, or partnerships thereof, and 
provide training and technical assistance on various issues to 
States, LEAs, and schools as identified through needs 
assessments undertaken in each region. The system currently 
includes 15 regional centers, which are charged with providing 
intensive technical assistance to SEAs to increase their 
capacity to assist LEAs and schools with meeting the goals of 
the ESEA, and 7 content centers, which are organized by topic 
area.
    The Committee strongly supports the mission of the centers, 
particularly with regard to their role in helping develop State 
capacity to meet the needs of LEAs and schools. The Committee 
also believes that the centers play an important part in the 
Department's system of technical assistance and appreciates the 
steps the Department has taken to align and coordinate its 
various technical assistance activities. The Committee 
encourages the Department to continue its efforts in 
coordinating its technical assistance activities and requests 
that the Department describe these efforts and future plans in 
the fiscal year 2015 congressional budget justification.

                            Indian Education

Appropriations, 2013\1\.................................    $130,318,000
Budget estimate, 2014...................................     130,779,000
Committee recommendation................................     130,318,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $130,318,000 for Indian education 
programs.

Grants to Local Educational Agencies

    For grants to LEAs, the Committee recommends $105,710,000. 
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 
LEAs, schools supported and operated by the Department of the 
Interior/Bureau of Indian Education, and in some cases directly 
to Indian tribes.

Special Programs for Indian Children

    The Committee recommends $18,948,000 for special programs 
for Indian children.
    Funds are used for demonstration grants to improve Indian 
student achievement through early childhood education and 
college preparation programs, and for professional development 
grants for training Indians who are preparing to begin careers 
in teaching and school administration.

National Activities

    The Committee recommends $5,660,000 for national 
activities.
    Funds will be used to expand efforts to improve research, 
evaluation, and data collection on the status and effectiveness 
of Indian education programs, and to continue grants to tribal 
educational departments for education administration and 
planning.

                       Innovation and Improvement

Appropriations, 2013\1\.................................  $1,524,482,000
Budget estimate, 2014...................................   5,699,092,000
Committee recommendation................................   1,331,598,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $1,331,598,000 for programs within 
the innovation and improvement account.
    The President's budget was based on the administration's 
proposal to reauthorize the ESEA, but no such bill has passed 
the Senate. As a result, programs in this account are based 
generally on current law.

Race to the Top

    The Committee recommendation includes $250,000,000 to 
create a new Race to the Top for College Affordability and 
Completion [RTT-CAC] initiative to incentivize State-level 
postsecondary education reform. State investments in 
postsecondary education have declined over the past several 
years, shifting the cost burden to students and families 
through higher tuition and fees. At the same time, total 
student loan debt has crossed the $1,000,000,000,000 mark and 
average student loan debt has topped nearly $27,000.
    Given that public colleges and universities educate about 
three-quarters of all students, States are in a critical 
position to reform policies that will improve student outcomes 
and lead to lower costs. The RTT-CAC initiative will reward and 
incentivize States that undertake reforms, including: 
modernizing funding policies that incentivize completion and 
maintaining fiscal support for education; supporting innovative 
methods of student learning; empowering consumer choice through 
increased transparency; and, improving the transition from 
secondary into postsecondary education and between institutions 
of higher education. The majority of funding will flow through 
States to institutions of higher education and support 
innovative practices that increase productivity and reduce 
costs. The Committee directs the Secretary to prioritize 
applications that will specifically address college 
affordability and completion issues facing low-income, 
minority, and nontraditional students and students with 
disabilities.

Investing in Innovation

    The Committee recommends $170,000,000 for the Investing in 
Innovation program.
    Investing in Innovation, which was established in ARRA, 
provides funding 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 absolute priority given to rural 
applicants in previous competitions and believes that this 
priority should continue to be used in the fiscal year 2014 
competition. The Committee expects the Department to distribute 
grants equally among the absolute priority categories unless 
there are an insufficient number of qualified grants for a 
particular category.
    The Committee bill continues language from last year's bill 
providing up to 5 percent of the appropriation for this program 
to be used for evaluation and technical assistance. The 
Committee expects to be notified in advance of the proposed 
uses of these funds.
    The bill also includes new language providing that funds 
for this program are available until expended. This authority 
will ensure that funds can be used to effectively implement and 
evaluate program models being tested under this program.

Effective Teachers and Leaders

    The Committee recommends no funding to create the Effective 
Teachers and Leaders State Grant program.
    The Committee has provided $2,461,634,000 for State Grants 
for Improving Teacher Quality within the School Improvement 
Programs account. These funds may be used for purposes that are 
similar to those under this proposed program.

Effective Teaching and Learning: Literacy

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

Effective Teaching and Learning for a Well-Rounded Education

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

College Pathways and Accelerated Learning

    The Committee recommends no funds for the proposed College 
Pathways and Accelerated Learning program. 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.

Science, Technology, Engineering, and Mathematics [STEM] Innovation

    The Committee does not recommend creating a new STEM 
Innovation program, a collection of STEM activities requested 
by the administration. Instead, the bill provides funding for 
some of the same proposed activities through existing programs, 
including $55,000,000 within FIE for STEM Innovation Networks.
    The proposed STEM Innovation initiative is comprised of 
STEM Innovation Networks, STEM Teacher Pathways, the STEM 
Master Teacher Corps, and the Effective Teaching and Learning: 
STEM program. These programs are intended to develop, validate, 
and scale up effective practices in pre-K-12 STEM instruction; 
increase student engagement in STEM subjects; and recruit, 
prepare, and further develop highly effective STEM educators.

High School Redesign

    The Committee recommends no funds for the proposed High 
School Redesign program because of budget constraints.
    This program would promote the whole school redesign of the 
high school experience in order to provide students with 
challenging and relevant academic and career-related learning 
experiences that prepare them for postsecondary education and 
careers.

Expanding Educational Options

    The Committee recommends no funding to create the Expanding 
Educational Options program. The program would generally 
support competitive grants to SEAs, LEAs, charter school 
authorizers, charter management organizations, and other 
nonprofit organizations to start or expand high-performing 
charter schools and other autonomous public schools.
    The Committee provides resources under current law programs 
that may be used for purposes that are similar to those 
proposed under this new program.

Transition to Teaching

    The Committee recommends no funds for the Transition to 
Teaching program.
    This program has provided 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.

School Leadership

    The Committee recommends $64,049,000 for the School 
Leadership 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 district and school leaders and managers 
play in creating an environment that fosters effective teaching 
and high academic achievement for students. The Committee bill 
includes new language allowing grant funds to be awarded 
directly to not-for-profit organizations and to be used to 
train district leaders and managers, in addition to school 
leaders. The Committee bill also includes new language that 
allows the Secretary to further define eligibility as a high-
need LEA.

Charter Schools

    The Committee recommends a total of $254,326,000 for the 
support of charter schools.
    The Committee allocates the recommended funding as follows: 
$175,326,000 for Charter School Grants, up to $11,000,000 for 
State Facilities incentives, not less than $12,000,000 for the 
Credit Enhancement for Charter Schools Facilities program, and 
up to $11,000,000 for national activities designed to support 
local, State, and national efforts to increase the number of 
high-quality charter schools.
    Charter Schools Grants support the planning, development, 
and initial implementation of charter schools. SEAs that have 
authority under State law to approve charter schools are 
eligible to compete for grants. If an eligible SEA does not 
participate, charter schools from the State may apply directly 
to the Secretary.
    Under the State facilities program, the Department awards 
5-year competitive grants to States that operate per-pupil 
facilities aid programs for charters schools. Federal funds are 
used to match State-funded programs in order to provide charter 
schools with additional resources for charter school facilities 
financing.
    The credit enhancement program provides assistance to help 
charter schools meet their facility needs. Funds are provided 
on a competitive basis to public and nonprofit entities to 
leverage non-Federal funds that help charter schools obtain 
school facilities through purchase, lease, renovation, and 
construction.
    The Committee continues bill language that allows the 
Secretary to reserve a portion of the charter school grant 
funds to make multiple awards to charter management 
organizations and other entities for the replication and 
expansion of successful charter school models that have a track 
record of success. In addition, this year's bill requires that 
not less than $45,000,000 of funds available for charter school 
grants shall be used for this purpose.
    The Committee urges the Department to continue using a 
portion of the funds available for national activities to 
address issues related to services to students with 
disabilities enrolled in or interested in enrolling in charter 
schools, as well as efforts to strengthen charter authorizing 
practices that will result in a greater share of high-quality 
charter schools.
    The Committee bill also includes new language that allows 
charter school funds to be used for preschool programs in 
charter schools.

Magnet Schools Assistance

    The Committee recommends $99,611,000 for the Magnet Schools 
Assistance program.
    This program supports grants to LEAs to establish and 
operate magnet schools that are part of a court-ordered or 
federally approved voluntary desegregation plan. Magnet schools 
are designed to attract substantial numbers of students from 
different social, economic, ethnic, and racial backgrounds. 
Grantees may use funds for planning and promotional materials, 
salaries of instructional staff, and the purchase of 
technology, educational materials, and equipment.

Fund for the Improvement of Education

    The Committee recommends an appropriation of $137,644,000 
for FIE.
    Within programs of national significance, the Committee 
includes $29,000,000 to continue an initiative of competitive 
awards to national not-for-profit organizations or school 
libraries for providing books and childhood literacy activities 
to children and families living in high-need communities. The 
Committee expects no less than 50 percent of these funds to be 
awarded to school libraries proposing high-quality projects for 
increasing access to a wide range of print and electronic 
resources that provide learning opportunities to all students, 
but particularly those less likely to have access to such 
materials at home.
    The bill also includes $55,000,000 for grants to support 
STEM Innovation Networks. These funds will be used to make 
competitive awards to LEAs or groups of LEAs, in partnership 
with institutions of higher education, not-for-profit 
organizations, museums, and businesses, to transform STEM 
teaching and learning, particularly for high-need students and 
underrepresented populations, as well as support a virtual 
learning network for STEM educators. The goal of the networks 
is to increase the number of students interested in and 
prepared for postsecondary education and STEM careers. The 
Committee is particularly interested in approaches that will 
engage students in the early grades.
    The Committee urges the Department to put a priority on 
reaching underrepresented populations, such as girls and 
minorities, and using nontraditional STEM teaching activities, 
including robotics competitions, as a means of further engaging 
and inspiring students to pursue further study or careers in 
STEM education.
    The Committee recommendation also includes $17,000,000 for 
the Improving Mathematics Achievement and Transition to College 
from High School [IMATCH] program. These funds will be used 
jointly with funds provided to NSF for a program using a 
tiered-evidence model, similar to the Investing in Innovation 
program, that seeks to develop, evaluate, and scale up proven 
practices that can help improve teaching and learning in 
mathematics in the last 2 years of high school and first 2 
years of college.
    The Committee is particularly interested in available funds 
being used to encourage, engage, inspire, and motivate students 
to enter and succeed in the STEM fields.
    The Committee is aware of specialized teacher preparation 
programs at university-based schools of education that prepare 
teachers to work in urban school districts and support hands-on 
science and math curriculum in middle schools. These programs 
provide tuition assistance and specialized coursework to 
teacher candidates and partner with local school districts to 
support co-teaching by master teachers, mentorships, and field 
placements. The Committee supports high-quality programs that 
focus on meeting the needs of children in urban school systems.
    Within programs of national significance, the Committee 
also recommends $2,024,000, combined with funds available 
through the Department's new Disability Innovation Fund and the 
Department of Labor, to support interagency strategies to 
strengthen reengagement activities and outcomes of Federal 
programs serving disconnected youth including through 
performance partnership pilots, $5,344,000 to continue awards 
for full-service community schools, $1,176,000 for data quality 
and evaluation initiatives, and $100,000 for peer review. It 
also includes $1,000,000 to continue the education facilities 
clearinghouse, which will provide information on planning, 
designing, financing, building, maintaining, and operating 
safe, healthy, high-performance educational facilities, 
including early learning centers.
    Within the amount for FIE, the Committee also includes 
$27,000,000 for the Arts in Education program. The budget 
request includes funds for similar activities under its 
proposed Effective Teaching and Learning for a Well-Rounded 
Education program, but no funds specifically for arts in 
education. The funding is used for competitive awards for 
national nonprofit organizations engaged in arts education, 
professional development activities, and model arts education 
programs. Funds also are used for evaluation and dissemination 
activities, as well as to support a partnership with the 
National Endowment for the Arts.

Teacher Incentive Fund

    The Committee recommendation includes $298,834,000 for TIF.
    The goals of TIF are to improve student achievement by 
increasing teacher and principal effectiveness; reform 
compensation systems to reward gains in student achievement; 
increase the number of effective teachers teaching low-income, 
minority, and disadvantaged students, and students in hard-to-
staff subjects; and other activities designed to increase the 
effectiveness of teachers, principals, and other personnel in 
high-need schools.
    The Committee is concerned that TIF's focus has been 
diverted away from its intended purpose, as first authorized by 
the Department of Education Appropriations Act, 2006, which is 
specifically to develop and implement performance-based teacher 
and principal compensation systems in high-need schools. 
However, the Department's final priorities, requirements, 
definitions, and selection criteria for TIF competitions in 
fiscal year 2012 greatly expanded what Congress intended in 
creating this program. Therefore, the Committee directs the 
Secretary to restore the original focus of TIF by limiting 
awards to eligible entities in support of innovative approaches 
at the State and local level to design, implement, and improve 
performance-based compensation systems for teachers and 
principals in high-need schools.

Effective Teachers and Leaders Innovation Fund

    The Committee recommends no funding to create the Effective 
Teachers and Leaders Innovation Fund proposed in the budget 
request.
    The Committee provides $298,834,000 for the Teacher 
Incentive Fund and additional funds for other current law 
programs that may be used for similar purposes as those 
proposed under this program.

Ready-To-Learn Television

    The Committee recommendation includes $27,139,000 for the 
Ready-to-Learn Television program.
    This program is intended to use the power and reach of 
public television to help prepare children, especially 
disadvantaged children, enter and succeed in school. The ESEA 
requires that all programming and digital content created under 
Ready-to-Learn be specifically designed for nationwide 
distribution over public television stations' digital 
broadcasting channels and the Internet. The act also requires 
funds to be made available to public telecommunications 
entities to ensure that these programs and related educational 
materials are disseminated and distributed to the widest 
possible audience and are made accessible to all Americans.

Advanced Placement

    The Committee recommends $29,995,000 for AP programs.
    Funds have supported two programs: the AP Test Fee program 
and the AP Incentive [API] program. The purpose of both is to 
aid State and local efforts to increase access to AP and 
International Baccalaureate [IB] classes and tests for low-
income students. Under the test fee program, the Department 
makes awards to SEAs to enable them to cover part or all of the 
cost of test fees of low-income students who are enrolled in an 
AP or IB class and plan to take an AP or IB test. Under the API 
program, the Department makes 3-year competitive awards to 
SEAs, LEAs, or national nonprofit educational entities to 
expand access for low-income individuals to AP programs through 
activities including teacher training; development of pre-
advanced placement courses; coordination and articulation 
between grade levels to prepare students for academic 
achievement in AP or IB courses; books and supplies; and 
participation in online AP or IB courses. Under the authorizing 
statute, the Department must give priority to funding the test 
fee program.

                 Safe Schools and Citizenship Education

Appropriations, 2013\1\.................................    $255,241,000
Budget estimate, 2014...................................     580,000,000
Committee recommendation................................     330,481,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends a total of $330,481,000 for 
activities to promote safe schools, healthy students, and 
citizenship education.
    The President's budget was based on the administration's 
proposal to reauthorize the ESEA, but no such bill has passed 
the Senate. As a result, the Committee bill is based on current 
law for programs authorized under the ESEA.

Promise Neighborhoods

    The Committee recommends $56,754,000 for the Promise 
Neighborhoods program.
    Funds are available for obligation through December 31, 
2014. By providing an extra quarter to obligate these funds, 
the Committee gives planning grantees sufficient time to 
develop implementation plans that could be funded by this bill 
and provides the Department ample time to evaluate whether 
prior-year implementation grantees are making significant 
progress required to justify the receipt of continuation 
awards.
    Competitive grants are awarded to not-for-profit, 
community-based organizations for the development of 
comprehensive neighborhood programs designed to combat the 
effects of poverty and improve educational and life outcomes 
for children and youth, from birth through college. Each 
Promise Neighborhood grantee serves a high-poverty urban 
neighborhood or rural community.
    Two types of awards are made under this program: 1-year 
planning grants and implementation grants. Funds for planning 
grants are used by communities to develop a plan for providing 
a continuum of services and supports for the children and youth 
in a particular neighborhood. Implementation grants are awarded 
to organizations with feasible plans for achieving the goals of 
the program.

Successful, Safe, and Healthy Students

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

Safe and Drug-Free National Activities

    The Committee recommendation includes $143,000,000 for the 
national activities portion of the Safe and Drug-Free Schools 
and Communities program. This funding, part of the Committee's 
violence prevention initiative, will help schools address the 
consequences of their students witnessing or being the victim 
of violence and other root causes of unhealthy school climates.
    From the amount available for national activities, the 
Committee recommends $71,500,000 to help schools create 
positive learning environments, including $50,000,000 for a new 
School Climate Transformation Grants program, which will train 
school staff to implement evidence-based strategies, such as 
positive behavioral interventions and supports, to improve 
school climate. The Committee recommendation also provides 
$25,000,000 for grants to SEAs to help LEAs develop, implement, 
and improve their emergency management plans; $25,000,000 for 
Project Prevent, which will award grants to LEAs to help 
schools in troubled communities break the cycle of violence; up 
to $8,000,000, to remain available until expended, for Project 
SERV, which offers education-related services following violent 
or traumatic events; $10,000,000 for other national activities; 
and $3,500,000 for continuation costs related to technical 
assistance contracts awarded in prior years.

Elementary and Secondary School Counseling

    The Committee recommends $52,191,000 to establish or expand 
counseling programs in elementary and secondary schools. As 
authorized, at least $40,000,000 must be used to support 
elementary school counseling programs.

Carol M. White Physical Education for Progress Program

    The Committee recommendation includes $78,536,000 to help 
LEAs and community-based organizations initiate, expand, and 
improve physical education programs for students in grades K-
12. This funding will help schools and communities improve 
their structured physical education programs for students and 
help children develop healthy lifestyles to combat the national 
epidemic of obesity.

                      English Language Acquisition

Appropriations, 2013\1\.................................    $730,680,000
Budget estimate, 2014...................................     732,144,000
Committee recommendation................................     730,680,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends an appropriation of $730,680,000 
for the English Language Acquisition program.
    The President's budget was based on the administration's 
proposal to reauthorize the ESEA, but no such bill has passed 
the Senate. As a result, the Committee bill is based on current 
law for programs authorized under the ESEA.
    The Department makes formula grants to States based on each 
State's share of the Nation's limited-English-proficient and 
recent immigrant student population. The program is designed to 
increase the capacity of States and school districts to address 
the needs of these students. The authorizing statute requires 
that 6.5 percent of the appropriation be used to support 
national activities, which include professional development 
activities designed to increase the number of highly qualified 
teachers serving limited-English-proficient students; a 
National Clearinghouse for English Language Acquisition and 
Language Instructional Programs; and evaluation activities. 
National activities funds shall be available for 2 years.
    The Committee bill continues language that requires the 
Secretary to use a 3-year average of the most recent data 
available from the American Community Survey for calculating 
allocations to all States under this program.

                           Special Education

Appropriations, 2013\1\................................. $12,615,427,000
Budget estimate, 2014...................................  12,657,307,000
Committee recommendation................................  12,803,387,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends an appropriation of 
$12,803,387,000 for special education programs.

Grants to States

    This program provides formula grants to assist States, 
outlying areas, and other entities in meeting the costs of 
providing special education and related services for children 
with disabilities. States pass along most of these funds to 
LEAs, but may reserve some for program monitoring, enforcement, 
technical assistance, and other activities.
    The appropriation for this program primarily supports 
activities associated with the 2014-2015 academic year. Of the 
funds available for this program, $2,439,563,000 will become 
available on July 1, 2014, and $9,283,383,000 will become 
available on October 1, 2014. These funds will remain available 
for obligation through September 30, 2015.
    As requested by the administration, the Committee continues 
bill language capping the Department of the Interior set-aside 
at the prior year level, adjusted by the lower of the increase 
in inflation or the change in the appropriation for grants to 
States. This provision also would prevent a decrease in the 
amount to be transferred in case the funding for this program 
decreases or does not change.
    The bill also continues language clarifying provisions of 
the IDEA. The first provision clarifies that penalties for 
violating the State maintenance of effort [MOE] under part B of 
the IDEA shall be reallocated to States by formula to those 
States that did not violate those requirements. The language 
further clarifies that both the reduced State allocations due 
to penalties paid and increased amounts under the reallocation 
shall not be considered in the current or future years for 
allocations under the statutory formula. These provisions are 
included in the administration's budget request.
    The bill also includes new language clarifying that the 
level of effort under part B that an LEA must meet in the year 
after it fails to maintain its fiscal effort is the most recent 
fiscal year for which the LEA met the MOE compliance standard. 
This language clarifies congressional intent and is consistent 
with OSEP's April 4, 2012, informal guidance letter on the 
issue. Finally, the bill includes language clarifying that 
funds reserved under section 611(c) of the IDEA may be used to 
help improve State capacity to meet data collection 
requirements under the IDEA and improve data collection, 
quality, and use under the act.

Preschool Grants

    The Committee recommends $372,646,000 for Preschool Grants. 
This program provides formula grants to States to assist them 
in making available special education and related services for 
children with disabilities aged 3 through 5. States distribute 
the bulk of the funds to LEAs. States must serve all eligible 
children with disabilities aged 3 through 5 and have an 
approved application under the IDEA.

Grants for Infants and Families

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

State Personnel Development

    The Committee recommends $43,829,000 for the State 
Personnel Development program. Ninety percent of funds must be 
used for professional development activities. The program 
supports grants to SEAs to help them reform and improve their 
personnel preparation and professional development related to 
early intervention, educational, and transition services that 
improve outcomes for students with disabilities. The bill 
includes language proposed in the budget request that allows 
funds under the program to be used for program evaluation.

Technical Assistance and Dissemination

    The Committee recommends $46,688,000 for Technical 
Assistance and Dissemination. This program supports awards for 
technical assistance, model demonstration projects, the 
dissemination of useful information, and other activities. 
Funding supports activities that are designed to improve the 
services provided under the IDEA.

Personnel Preparation

    The Committee recommends $88,122,000 for the Personnel 
Preparation program.
    Funds support competitive awards to help address State-
identified needs for personnel who are qualified to work with 
children with disabilities, including special education 
teachers and related services personnel. The program is 
required to fund several other broad areas, including training 
leadership personnel and personnel who work with children with 
low-incidence disabilities, and providing enhanced support for 
beginning special educators.

Parent Information Centers

    The Committee recommends $28,917,000 for Parent Information 
Centers.
    This program makes awards to parent organizations to 
support parent training and information centers, including 
community parent resource centers. These centers provide 
training and information to meet the needs of parents of 
children with disabilities living in the areas served by the 
centers, particularly underserved parents, and parents of 
children who may be inappropriately identified.

Technology and Media Services

    The Committee recommends $29,529,000 for Technology and 
Media Services. This program makes competitive awards to 
support the development, demonstration, and use of technology 
and educational media activities of value to children with 
disabilities.

PROMISE: Promoting Readiness of Minors in SSI

    As proposed in the budget, the Committee does not continue 
funding for PROMISE in OSEP. Instead, the bill continues 
support for this program by means of unclaimed VR State Grant 
funds and funds provided to SSA.
    The goal of PROMISE is to improve outcomes, such as 
employment and completion of postsecondary education, of 
children who receive SSI, as well as their families.

Special Olympics

    The Committee recommendation includes $8,000,000 for 
Special Olympics education activities. Under the Special 
Olympics Sport and Empowerment Act of 2004, the Secretary is 
authorized to provide financial assistance to Special Olympics 
for activities that promote its expansion and for the design 
and implementation of education activities that can be 
integrated into classroom instruction and are consistent with 
academic content standards.
    Consistent with the President's budget request, the 
Committee bill clarifies that funds made available under the 
Special Olympics Sport and Empowerment Act of 2004 may be used 
to support expenses associated with the Special Olympics 
National and World Games hosted in the United States. This 
language was not included in last year's bill, but has been 
included in bills from prior years.
    The Committee notes that the Special Olympics National 
Games are held only once every 4 years in the United States and 
that the next National Games are to be held in 2014. Through 
the spirit of sport, the National Games showcase and celebrate 
the abilities of athletes with intellectual disabilities and 
promote inclusion and acceptance of all people, most especially 
those with intellectual disabilities. The Committee expresses 
its support for the National Games and recognizes the 
significant contribution that the Special Olympics organization 
has made to children and adults with intellectual disabilities 
across America. The Committee intends that up to $2,000,000 
available under this act be used to support the Games.

            Rehabilitation Services and Disability Research

Appropriations, 2013\1\.................................  $3,619,762,000
Budget estimate, 2014...................................   3,655,577,000
Committee recommendation................................   3,698,174,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.
---------------------------------------------------------------------------

Vocational Rehabilitation State Grants

    The Committee recommends $3,302,053,000 for VR State 
Grants. The Committee recommends the full amount authorized by 
the Rehabilitation Act of 1973 for this mandatory funding 
stream.
    Basic State Grants assist States in providing a range of 
services to help persons with physical and mental disabilities 
prepare for and engage in meaningful employment.
    The Rehabilitation Act requires that not less than 1 
percent and not more than 1.5 percent of the appropriation in 
fiscal year 2014 for VR State Grants be set aside for Grants 
for American Indians.
    The Committee bill includes language, as requested by the 
administration, allowing unmatched funds in excess of any funds 
requested during the reallotment process to support a new 
Disability Innovation Fund [DIF] that will support activities 
aimed at improving outcomes for individuals with disabilities 
as defined in section 7(20)(B) of the Rehabilitation Act, 
including activities under the PROMISE program. Such funds used 
for these activities will remain available for obligation 
through September 30, 2015.
    PROMISE was created in fiscal year 2012 with the goal of 
improving outcomes, such as employment and completion of 
postsecondary education, of children who receive SSI, as well 
as their families. Competitive grants will be awarded in the 
fall of 2013 to a small number of States for a period of 5 
years. States will use funds to improve outcomes, enhance 
coordination, and increase the use of existing services for 
which children receiving SSI and their families are already 
eligible.
    After covering the costs of PROMISE, the administration 
requests and the Committee recommends new authority through the 
DIF to provide $5,000,000 to support a new cross-agency 
initiative aimed at improving the educational and employment 
outcomes for disconnected youth with disabilities and providing 
targeted technical assistance to support performance 
partnership pilots. The Committee expects the initiative to 
serve youth with disabilities between the ages of 14 and 24 who 
are homeless, in foster care, involved in the justice system, 
or are neither employed nor enrolled in an educational 
institution.
    As requested by the administration, the Committee bill also 
includes new bill language that allows the DIF to support Pay 
for Success pilots, which will provide performance-based awards 
to States or local governments and not-for-profit organizations 
providing or arranging services that improve education, 
employment, and other key outcomes for youth with disabilities. 
The Committee expects to be notified prior to the issuance of 
any notice related to Pay for Success activity.
    The DIF will also support a joint SSA-ED demonstration 
targeted at individuals who are likely to be eligible for 
services under the VR State Grant program and at risk of 
becoming future SSI or SSDI beneficiaries. The Committee 
intends for SSA and ED to incentivize State efforts and use 
various State and Federal programs and funding streams, which 
could include the VR State Grant program, to provide early 
intervention services aimed at preserving the well-being and 
work ability of the nonbeneficiaries most at risk of becoming 
severely impaired. The Committee strongly supports 
demonstrations that are focused on college to career pathways.
    The amount of unused VR State Grant funding will not be 
determined until the end of fiscal year 2014. If an excess 
amount of funds are available after supporting PROMISE and the 
disconnected youth and SSA-ED initiatives, the Committee 
expects the DIF to support the development of effective, 
evidence-based strategies to improve the long-term outcomes for 
people with disabilities. The Committee should be notified in 
advance of announcements related to any additional activities.

Client Assistance State Grants

    The Committee recommends $12,215,000 in discretionary funds 
for Client Assistance State Grants.
    This program funds State formula grants to help VR clients 
or client applicants understand the benefits available to them 
and work with service providers. States must operate client 
assistance programs in order to receive VR State Grant funds.

Training

    The Committee recommends $35,444,000 for training 
rehabilitation personnel. The budget request provides 
$30,188,000 and proposes to eliminate funding for the In-
Service Training program. The Committee maintains funding for 
this program.
    Funding for training is intended 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 not-for-profit agencies and organizations, including 
institutions of higher education, to pay all or part of the 
cost of conducting training programs.

Demonstration and Training Programs

    The Committee recommends $6,514,000 for demonstration and 
training programs.
    This program awards grants to States and not-for-profit 
agencies and organizations to develop innovative methods and 
comprehensive services to help individuals with disabilities 
achieve satisfactory vocational outcomes. Demonstration 
programs support projects for individuals with a wide array of 
disabilities.
    The Committee recommendation includes $425,000 for new 
technical assistance activities designed to promote promising 
and evidence-based practices to improve postsecondary and 
employment outcomes for youth with disabilities. The technical 
assistance will include practices developed and implemented by 
RSA's Transition Model Demonstration projects that ended in 
September 2012.
    The Committee recommendation also includes $750,000 to 
support a new competition for parent information and training 
centers, which provide information and training on transition 
planning, the adult service system, and strategies that prepare 
youth for successful employment, postsecondary education, and 
independent living outcomes. The Committee expects RSA to 
coordinate with OSEP in carrying out this activity.

Migrant and Seasonal Farmworkers

    The Committee recommends $1,259,000 for the Migrant and 
Seasonal Farmworkers program. The budget request proposes to 
eliminate this program and to pay continuation costs for fiscal 
year 2014 out of funding for the VR State Grant program.
    This program provides grants for comprehensive 
rehabilitation services to migrant and seasonal farmworkers 
with disabilities and their families.

Protection and Advocacy of Individual Rights

    The Committee recommends $17,995,000 for the Protection and 
Advocacy of Individual Rights program.
    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 $29,010,000 for the Supported 
Employment State Grant program. The budget request does not 
include funding for this program.
    Supported Employment State Grants provide assistance to the 
most severely disabled individuals by providing ongoing support 
needed to obtain competitive employment.

Independent Living State Grants

    The Committee recommends $23,312,000 for Independent Living 
State Grants.
    This program provides formula grants to States to improve 
independent living services, support the operation of centers 
for independent living, conduct studies and analysis, and 
provide training and outreach.

Centers for Independent Living

    The Committee recommends $79,794,000 for Centers for 
Independent Living.
    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.

Independent Living Services for Older Individuals Who Are Blind

    The Committee provides $33,951,000 for the Independent 
Living Services for Older Individuals Who Are Blind 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.

Helen Keller National Center

    The Committee recommends $9,127,000 for the Helen Keller 
National Center for Deaf-Blind Youth and Adults.
    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 11 
regional field offices that provide referral and counseling 
assistance to deaf-blind persons; and an affiliate network of 
agencies.

National Institute on Disability and Rehabilitation Research

    The Committee recommends $110,000,000 for NIDRR. This 
funding level includes $1,200,000, as requested by the 
administration, to support research activities that focus on 
improving employment outcomes for people with disabilities.
    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.

Assistive Technology

    The Committee recommends $37,500,000 for the Assistive 
Technology program.
    This program is designed to improve occupational and 
educational opportunities and the quality of life for people of 
all ages with disabilities through increased access to 
assistive technology services and devices. The program supports 
various activities that help States develop comprehensive, 
consumer-responsive statewide programs that increase access to, 
and the availability of, assistive technology devices and 
services.
    The Committee recommendation will ensure all 50 statewide 
assistive technology programs, the District of Columbia, and 
outlying areas will receive the minimum grant provided under 
statute for the first time.
    The Committee recommendation includes $31,000,000 for State 
grant activities authorized under section 4 of the 
Rehabilitation Act of 1973, $5,500,000 for protection and 
advocacy systems authorized by section 5, and $1,000,000 for 
technical assistance activities authorized under section 6.

           Special Institutions for Persons With Disabilities


                 AMERICAN PRINTING HOUSE FOR THE BLIND

Appropriations, 2013\1\.................................     $24,456,000
Budget estimate, 2014...................................      24,505,000
Committee recommendation................................      24,456,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $24,456,000 to help support APH.
    APH provides educational materials to students who are 
legally blind and enrolled in programs below the college level. 
The Federal subsidy provides approximately 70 percent of APH's 
total sales income. Materials are distributed free of charge to 
schools and States through per capita allotments based on the 
total number of students who are blind. Materials provided 
include textbooks and other educational aids in Braille, large 
type, recorded form, and computer applications. Appropriated 
funds may be used for staff salaries and expenses, as well as 
equipment purchases and other acquisitions consistent with the 
purpose of the Act to Promote the Education of the Blind.
    The Committee notes that APH has established a digital data 
action plan that explores new technologies, and is supportive 
of APH's efforts to improve Braille translation and tactile 
graphics through digital data software.

               NATIONAL TECHNICAL INSTITUTE FOR THE DEAF

Appropriations, 2013\1\.................................     $65,291,000
Budget estimate, 2014...................................      65,422,000
Committee recommendation................................      66,422,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $66,422,000 for NTID.
    The Committee recommendation for NTID consolidates funds 
into the operations line for NTID and does not include funding 
for construction. The Committee will consider funding for 
construction in the future as needs may warrant.
    NTID, located on the campus of the Rochester Institute of 
Technology in Rochester, New York, was created by Congress in 
1965 to provide a residential facility for postsecondary 
technical training and education for persons who are deaf. NTID 
also provides support services for students who are deaf, 
trains professionals in the field of deafness, and conducts 
applied research.

                          GALLAUDET UNIVERSITY

Appropriations, 2013\1\.................................    $125,265,000
Budget estimate, 2014...................................     117,541,000
Committee recommendation................................     118,541,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $118,541,000 for Gallaudet 
University.
    Gallaudet University is a private, not-for-profit 
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 
university's Kendall Demonstration Elementary School develops 
and provides instruction for children from infancy through age 
15.
    The Committee recommendation increases operations funding 
over the fiscal year 2013 level by $1,235,000 but does not 
include funding for construction. Congress appropriated a total 
of $15,934,000 in fiscal years 2012 and 2013 to support 
construction. This funding, combined with approximately 
$13,000,000 available from prior fiscal years, is covering the 
costs of constructing a new 200-bed dormitory to house all 
residential students at the Model Secondary School for the 
Deaf.

                 Career, Technical, and Adult Education

Appropriations, 2013\1\.................................  $1,733,680,000
Budget estimate, 2014...................................   1,750,154,000
Committee recommendation................................   1,743,949,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.
---------------------------------------------------------------------------

Career and Technical Education

    The Committee recommends $1,135,844,000 for the Career and 
Technical Education [CTE] account.
    State Grants.--The Committee recommends $1,123,030,000 for 
CTE State grants.
    Funds provided under the State grant program assist States, 
localities, and outlying areas to expand and improve their CTE 
program and help ensure equal access to CTE for populations 
with special needs. Persons assisted range from secondary 
students in prevocational courses through adults who need 
retraining to adapt to changing technological and labor market 
conditions. Funds are distributed according to a formula based 
on State population and State per capita income.
    Under the Indian and Hawaiian Natives programs, competitive 
grants are awarded to federally recognized Indian tribes or 
tribal organizations and to organizations primarily serving and 
representing Hawaiian Natives for services that are additional 
to what these groups receive under other provisions of the 
Perkins Act.
    Of the funds available for this program, $332,030,000 will 
become available July 1, 2014, and $791,000,000 will become 
available on October 1, 2014. These funds will remain available 
for obligation until September 30, 2015.
    National Programs.--The Committee recommends $12,814,000 
for national research programs and other national activities, 
including $5,000,000 for a new dual enrollment initiative that 
supports CTE career pathways and targets local workforce needs. 
The Committee adds new bill language allowing adult education 
providers as eligible partners and adult education students as 
eligible participants as well as requiring grantees to use 
funding to supplement and not supplant other Federal, State, or 
local public funds used for adult education and literacy 
activities.
    Dual enrollment programs enable high school students and 
adults without a high school equivalency credential to pursue 
postsecondary education and earn course credit that can be 
applied to a college degree or credential. Research shows dual 
enrollment programs are associated with gains in college 
enrollment and credit accumulation and higher grades. The 
Department will make competitive awards that help establish or 
expand dual enrollment programs through partnerships among 
institutions of higher education, LEAs that operate high-need 
public schools or adult education providers, and State and 
local agencies responsible for secondary and adult education 
and workforce training. This funding will provide students with 
support services, including tutoring, assistance completing 
financial aid applications and selecting courses, mentoring, 
career counseling, and assistance transferring from 2-year to 
4-year institutions of higher education. Funds will also 
support activities designed for students with limited 
proficiency in English or from groups traditionally 
underrepresented in postsecondary education, individuals with 
disabilities, students who are homeless or in foster care, or 
disconnected youth.
    The Committee recommendation includes additional funding 
for this dual enrollment initiative in the Government 
Performance and Results Act [GPRA] Data/HEA Program Evaluation 
program.

Adult Education

    The Committee recommends $608,105,000 for Adult Education 
programs.
    Adult Education State Grants.--For adult basic and literacy 
education State grants, the Committee recommends $593,803,000.
    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, 
$74,559,000 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.
    National Leadership Activities.--The Committee recommends 
$14,302,000 for national leadership activities, including 
$3,000,000 to support new awards for prisoner reentry education 
models that build on the success of the Promoting Reentry 
Success through Continuity of Education Opportunities [PRSCEO] 
competition. PRSCEO was funded in fiscal year 2013 with funds 
transferred from the Department of Justice under an interagency 
agreement.
    The Committee recommendation will support projects that 
develop evidence of reentry education's effectiveness and align 
with the model described in ``A Reentry Education Model: 
Supporting Education and Career Advancement for Low-Skill 
Individuals in Corrections,'' published by the Department in 
August 2012.

                      Student Financial Assistance

Appropriations, 2013\1\................................. $24,486,210,000
Budget estimate, 2014...................................  24,685,281,000
Committee recommendation................................  24,536,210,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends an appropriation of 
$24,536,210,000 for programs under the Student Financial 
Assistance account.
    Student Complaint System.--The Committee commends the 
Department for working with the Department of Veterans Affairs 
[VA], DOD, and the Federal Trade Commission to develop a 
uniform student complaint system for students receiving Federal 
education benefits from the VA, DOD, and the Department 
pursuant to Executive Order 13607. The Committee is aware that 
the Department intends to publicize information on its 
StudentAid.gov Web site on how to submit complaints regarding 
institutional issues by the end of fiscal year 2013. While this 
is a positive step, the complaint system would address Federal 
education benefits alone, and only students who receive such 
benefits would be likely to view the Web site. The complaint 
system would not address other types of deceptive and 
misleading conduct by institutions. The Committee directs the 
Department to broaden the scope of the complaint system and 
make it more accessible to all students attending institutions 
of higher education, regardless of their receipt of Federal 
education benefits. The Committee on HELP's recent 
investigation into the practices of proprietary institutions of 
higher education demonstrated that students in all sectors of 
postsecondary education lack a clear understanding of how or 
where to lodge complaints regarding deceptive and misleading 
conduct and other problematic practices, including but not 
limited to problems with accessibility of course materials and 
the physical plant on college campuses. This kind of a 
complaint system would be particularly valuable as online 
postsecondary education programs expand, as students in such 
programs may have no State-specific resource for consumer 
protection. The Committee directs the Department to post 
information on its main Web site about its uniform complaint 
system no later than 6 months after enactment of this act.
    Foster Youth.--The Committee is very concerned that many 
foster youth who are eligible for postsecondary education and 
training financial aid programs outside of support offered 
through the Department, including HHS's John H. Chafee Foster 
Care Independence Program and the Education and Training 
Vouchers Program for Youths Aging Out of Foster Care, are 
unaware that this assistance is available to them. The 
Committee urges the Department to inform foster youth, to the 
extent practicable, of their potential eligibility for 
additional Federal financial assistance, and post information 
about these programs on its Web site. The Committee directs the 
Secretary to submit a report no later than 120 days after 
enactment of this act detailing its outreach efforts to foster 
youth who may be eligible for additional Federal financial aid 
programs and ways in which modifications to the Free 
Application for Federal Student Aid could assist in these 
efforts.

Federal Pell Grant Program

    The Committee recommends $22,778,352,000 in discretionary 
funding for the Pell grant program. This amount will support an 
increase in the maximum Pell grant award from $5,645 in 
academic year 2013-2014 to a projected level of $5,785 in 
academic year 2014-2015.
    Pell grants provide need-based financial assistance that 
helps undergraduate students and their families defray a 
portion of the costs of postsecondary education and vocational 
training. Awards are determined according to a statutory need-
analysis formula that takes into account a student's family 
income and assets, household size, and the number of family 
members, excluding parents, attending postsecondary 
institutions.
    More than 9.3 million students are expected to receive a 
Pell grant during the 2014-2015 academic year. Of the 9.4 
million students who relied on Pell grants during the 2011-2012 
award year, 74 percent had incomes or came from families with 
incomes less than or equal to $30,000.
    The Pell grant program is funded partly through the 
discretionary appropriations process and partly through 
mandatory funding. The HCERA included additional mandatory 
money for the program to increase the maximum grant by the 
Consumer Price Index [CPI] beginning in academic year 2013-2014 
as long as the discretionary portion of the funding is 
sufficient to support $4,860 of the maximum award. The 
Committee recommendation for fiscal year 2014 meets that 
requirement, so it will trigger enough mandatory funding to add 
an estimated $925 ($140 more than in fiscal year 2013) to the 
discretionary portion of the award, for a projected total 
maximum award of $5,785. The Department will rely on CPI data 
available at the end of the 2013 calendar year to determine the 
exact increase for academic year 2014-2015.
    Taking into account mandatory funding provided in the 
fiscal year 2012 Consolidated Appropriations Act, plus 
$9,797,000,000 in cumulative surplus budget authority from 
previous fiscal years, the fiscal year 2014 funding level will 
provide an estimated $4,889,000,000 more than is needed to 
support the discretionary base award of $4,860 and trigger the 
mandatory increase in the maximum award. In fiscal year 2015, 
however, the program will face a funding gap of $793,000,000 
under current projections.

Protecting Financial Aid for Students and Taxpayers

    The Committee is disturbed by recent findings that some 
colleges and universities are using Federal student financial 
assistance funding for aggressive marketing, recruitment, and 
advertising rather than for the programs' intended purpose--to 
help low- and middle-income students access and successfully 
complete a postsecondary education.
    At a time when Federal resources are scarce and students 
and families across the Nation are struggling to afford a 
college education, this practice should not be tolerated.
    To that end, the Committee includes a new general provision 
that prohibits all colleges and universities receiving funding 
through the HEA from spending Federal educational program 
dollars on advertising, marketing, and recruitment. Colleges 
and universities will continue to be free to spend however much 
they want on these activities; this provision simply stipulates 
that they cannot use Federal tax dollars intended for education 
to do so. This reform will target Federal resources at 
educating students, as opposed to online advertisements and 
aggressive recruiting strategies, and help ensure that both 
taxpayers and students receive a good return on their 
investment.
    On a related matter, the Committee is aware that some 
students are wasting their Federal financial aid and going into 
debt to earn occupation-related degrees that they cannot use. 
While postsecondary education institutions as a whole must be 
accredited in order to participate in the Department's 
financial aid programs, there are no accreditation or licensure 
requirements for specific programs. Some students are paying to 
attend a program only to learn that they cannot take the 
licensing exam required for entry into the workforce because 
the program is not accredited or licensed.
    To address this problem, the Committee bill includes a new 
provision requiring postsecondary education programs that 
prepare students for gainful employment in occupations 
requiring licensing or other credentials to meet State 
licensure requirements and programmatic accreditation in order 
to be eligible for HEA funding. This provision will ensure that 
students who receive Federal financial aid to enroll in 
industry-specific programs will be eligible to attain 
credentials they can actually use to enter their chosen 
profession.

Federal Supplemental Educational Opportunity Grant Program

    The Committee recommends $733,130,000 for the SEOG program.
    The SEOG program provides funds to postsecondary 
institutions for need-based grants to undergraduate students. 
Institutions must contribute at least 25 percent toward SEOG 
awards. Students qualify for grants of up to $4,000 by 
demonstrating financial need. Priority is given to Pell grant 
recipients with exceptional need.
    The budget request recommends reforming the SEOG allocation 
formula to target and incentivize SEOG funding toward 
institutions that enroll and graduate comparatively high 
numbers of Pell-eligible students and offer low net tuition and 
fees. The Committee supports the proposals in principle but 
believes they deserve more deliberation in Congress.

Federal Work-Study Program

    The Committee bill provides $1,024,728,000 for the FWS 
program. The budget request proposes to direct new funds to 
institutions opting to participate in an enhanced work-study 
partnership with prospective employers. The Committee 
recommendation does not include this proposal.
    The budget request also recommends reforming the FWS 
allocation formula to target and incentivize funding toward 
institutions that enroll and graduate comparatively high 
numbers of Pell-eligible students and offer low net tuition and 
fees. The budget request does not include bill language on this 
proposal. The Committee supports the administration's goals, 
but believes the proposal deserves more deliberation in 
Congress.
    This program provided grants to approximately 3,400 
institutions and helped an estimated 700,000 undergraduate, 
graduate, and professional students meet the costs of 
postsecondary education through part-time employment in 
academic year 2010-2011. Institutions must provide at least 25 
percent of student earnings.
    The Committee recommendation expects the Department to 
provide $8,390,000 from the FWS program appropriation for the 
Work Colleges program authorized under section 448 of the HEA. 
This is an increase of $2,403,337 over the fiscal year 2013 
level. The recommended level is the amount the seven work 
colleges are capable of matching dollar for dollar.

Federal Perkins Loans

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

                       Student Aid Administration

Appropriations, 2013\1\.................................  $1,041,301,000
Budget estimate, 2014...................................   1,050,091,000
Committee recommendation................................   1,044,301,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $1,044,301,000 for the Student Aid 
Administration account. These funds are available until 
September 30, 2015, and support the Department's student aid 
management expenses.
    The Committee recommendation includes $727,434,000 for 
administrative costs and $316,867,000 for loan servicing 
activities. The Committee recommendation will ensure the 
operational integrity of Federal student aid systems and 
provide high-quality service to student and parent borrowers.
    The budget request includes a new general provision 
transferring the Health Education Assistance Loan program from 
HHS to the Department. The Committee recommendation includes 
bill language authorizing the transfer and provides $2,807,000 
for the costs of managing and servicing outstanding loans.
    The Committee directs the Department to continue to provide 
quarterly reports detailing its obligation plan by quarter for 
spending mandatory and discretionary funding for student aid 
administrative activities broken out by servicer, activity, and 
funding source.

                            Higher Education

Appropriations, 2013\1\.................................  $1,865,915,000
Budget estimate, 2014...................................   2,146,273,000
Committee recommendation................................   1,912,615,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends an appropriation of $1,912,615,000 
for higher education programs.

Aid for Institutional Development

    The Committee recommends $530,014,000 for Aid for 
Institutional Development.
    Strengthening Institutions.--The Committee bill recommends 
$80,462,000 to provide competitive, 1-year planning and 5-year 
development grants for institutions with a significant 
percentage of financially needy students and low educational 
and general expenditures per student in comparison with similar 
institutions. Applicants may use these funds to develop 
faculty, strengthen academic programs, improve institutional 
management, and expand student services.
    Hispanic-Serving Institutions [HSIs].--The Committee 
recommends $100,231,000 for competitive grants to institutions 
at which Hispanic students make up at least 25 percent of 
enrollment. Funds may be used for acquisition, rental, or lease 
of scientific or laboratory equipment; renovation of 
instructional facilities; development of faculty; support for 
academic programs; institutional management; and purchase of 
educational materials. In addition to the Committee-recommended 
level, the HCERA provides $100,000,000 of mandatory funding in 
each fiscal year through 2019 to support HSIs in the 
development of STEM and articulation programs.
    Promoting Postbaccalaureate Opportunities for Hispanic 
Americans.--The Committee recommends $8,992,000 for 
competitive, 5-year grants to HSIs to help Hispanic Americans 
gain entry into and succeed in graduate study. Institutions may 
use funding to support low-income students through outreach 
programs; academic support services; mentoring and financial 
assistance; acquisition, rental, or lease of scientific or 
laboratory equipment; construction and other facilities 
improvements; and purchase of educational materials.
    Strengthening Historically Black Colleges and 
Universities.--The Committee recommends $227,524,000 for the 
Strengthening HBCUs program. The program makes formula grants 
to HBCUs that may be used to purchase equipment; construct and 
renovate facilities; develop faculty; support academic 
programs; strengthen institutional management; enhance 
fundraising activities; provide tutoring and counseling 
services to students; and conduct outreach to elementary and 
secondary school students. In addition to the Committee-
recommended level, this program will receive $85,000,000 of 
mandatory funding through the HCERA in each fiscal year through 
2019.
    Strengthening Historically Black Graduate Institutions 
[HBGIs].--The Committee recommends $58,840,000 for the 
Strengthening HBGIs program. This program provides 5-year 
grants to provide scholarships for low-income students and 
academic and counseling services to improve student success. 
Funds may also be used for construction, maintenance, and 
renovation activities; the purchase or lease of scientific and 
laboratory equipment; and the establishment of an endowment.
    Strengthening Predominately Black Institutions [PBIs].--The 
Committee recommends $9,244,000 for the Strengthening PBIs 
program. This program provides 5-year grants to PBIs to plan 
and implement programs to enhance the institutions' capacity to 
serve more low- and middle-income Black American students. In 
addition to the Committee-recommended level, the HCERA provides 
$15,000,000 of mandatory funding in each fiscal year through 
2019 to support programs at PBIs in the areas of STEM; health 
education; internationalization or globalization; teacher 
preparation; and improving the educational outcomes of African-
American males.
    Strengthening Asian American and Native American Pacific 
Islander-Serving Institutions [AANAPISIs].--The Committee 
recommends $3,113,000 for competitive grants to AANAPISIs that 
have an enrollment of undergraduate students that is at least 
10 percent Asian American or Native American Pacific Islander 
students. Grants may be used to improve their capacity to serve 
Asian American and Native American Pacific Islander students 
and low-income individuals. In addition to the Committee-
recommended level, AANAPISIs will receive $5,000,000 of 
mandatory funding through the HCERA in each fiscal year through 
2019 to develop faculty; strengthen academic programs; improve 
institutional management; expand student services; and 
construct classrooms, libraries, laboratories, and other 
instructional facilities.
    Strengthening Alaska Native and Native Hawaiian-Serving 
Institutions [ANNHSIs].--The Committee recommends $12,833,000 
for the Strengthening ANNHSIs program. In addition to the 
Committee-recommended level, these institutions receive 
$15,000,000 of mandatory funding through the HCERA in each 
fiscal year through 2019.
    The purpose of this program is to improve and expand the 
capacity of institutions serving Alaska Native and Native 
Hawaiian students and low-income individuals. Funds may be used 
to plan, develop, and implement activities that encourage 
faculty and curriculum development; improve administrative 
management; renovate educational facilities; enhance student 
services; purchase library and other educational materials; 
and, provide education or counseling services designed to 
improve the financial and economic literacy of students or 
their families.
    Strengthening Native American-Serving Nontribal 
Institutions.--The Committee recommends $3,113,000 for this 
program, which serves institutions that enroll at least 10 
percent Native American students and at least 50 percent low-
income students. In addition to the Committee-recommended 
level, these institutions receive $5,000,000 of mandatory 
funding through the HCERA in each fiscal year through 2019 to 
help institutions plan, develop, and implement activities that 
encourage faculty and curriculum development; improve 
administrative management; renovate educational facilities; 
enhance student services; and purchase library and other 
educational materials.
    Strengthening Tribally Controlled Colleges and 
Universities.--The Committee recommends $25,662,000 for this 
program. Tribal colleges and universities rely on a portion of 
the funds provided to address developmental needs, including 
faculty development, curriculum, and student services. In 
addition to the Committee-recommended level, this program 
receives $30,000,000 of mandatory funding through the HCERA in 
each fiscal year through 2019.

International Education and Foreign Language Studies

    The bill includes a total of $80,938,000 for International 
Education and Foreign Language Studies programs.
    Funds are used to support visits and study in foreign 
countries by individuals who plan to utilize their language 
skills in areas vital to U.S. national security in the fields 
of government, international development, and the professions.
    Domestic Programs.--The Committee recommends $73,487,000 
for domestic program activities related to international 
education and foreign language studies under title VI of the 
HEA. This is an increase of $7,034,000 over the fiscal year 
2013 level. The majority of funding will support new awards in 
the national resource centers, foreign language and area 
studies fellowships, international business education centers, 
and language resource centers. Funding will also support 
continuation awards in the American overseas research centers 
as well as new and continuation awards in the Undergraduate 
International Studies and Foreign Language Program. The 
Committee urges the Secretary to preserve the program's 
longstanding focus on activities and institutions that address 
the Nation's need for a strong training and research capacity 
in foreign languages and international studies, including 
increasing the pool of international experts in areas that are 
essential to national security and economic competitiveness.
    The Committee recommendation includes $2,000,000 to support 
new awards authorized by section 604(b) of the HEA. The 
Committee recognizes that study abroad helps prepare students 
to function effectively in a global environment and recommends 
funding to expand access to study abroad, particularly for 
underserved student populations and to nontraditional 
destinations, especially in developing countries. The Committee 
expects that competitive grants will be awarded under the 
authority of section 604(b) individually or through 
partnerships to institutions of higher education and public and 
private not-for-profit agencies and organizations, and be 
consistent with the recommendations of the Commission on the 
Abraham Lincoln Study Abroad Fellowship program that Congress 
created in Public Law 108-199.
    The Committee urges the Department to support efforts among 
higher education stakeholders in issuing a comprehensive report 
on meeting the goals of the Lincoln Commission on Study Abroad, 
including hosting a conference on study abroad. The conference 
should address the importance of study abroad in meeting the 
Department's international education goals of global 
competencies, educational diplomacy, and program integration 
and coordination. The conference should solicit ideas from the 
higher education community on how to significantly increase the 
number of American students studying abroad.
    Overseas Programs.--The Committee recommends $7,451,000 for 
overseas programs authorized under the Mutual Educational and 
Cultural Exchange Act of 1961, popularly known as the 
Fulbright-Hays Act. Funding is provided for group, faculty, or 
doctoral dissertation research abroad as well as special 
bilateral projects. Grants focus on training American 
instructors and students in order to improve foreign language 
and area studies education in the United States.

Fund for the Improvement of Postsecondary Education

    The Committee recommends $5,852,000 for FIPSE.
    Training for Realtime Writers.--Within the total for FIPSE, 
the Committee recommendation includes $1,126,000 for the 
Training for Realtime Writers program authorized by section 872 
of the HEA. 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, and trained captioners help 
remove barriers to full-quality captioning of realtime 
television programming such as news, weather, and emergency 
messaging.
    Center for Best Practices To Support Single Parent 
Students.--The Committee recommendation includes $500,000 to 
support a Center for Best Practices to Support Single Parent 
Students, as authorized by section 741(c) of the HEA, to 
promote replication of programs that have proven effective at 
providing postsecondary degree completion opportunities to low-
income single parents. The Center will study and develop best 
practices, and assist other institutions in implementing 
innovative programs that support this target population.
    Analysis of Federal Regulations and Reporting Requirements 
on Institutions of Higher Education.--The Committee directs 
$1,000,000 for the Secretary to enter into an agreement with 
the National Research Council of the National Academy of 
Sciences to conduct a study on the impacts of Federal 
regulations and reporting requirements on institutions of 
higher education as authorized under section 1106 of the Higher 
Education Opportunity Act of 2008. The study shall include 
information describing, by agency, the number of Federal 
regulations and reporting requirements affecting institutions 
of higher education; the estimated time required and costs to 
institutions of higher education (disaggregated by types of 
institutions) to comply with the regulations and reporting 
requirements affecting institutions of higher education; and 
recommendations for consolidating, streamlining, and 
eliminating redundant and burdensome Federal regulations and 
reporting requirements affecting institutions of higher 
education. The study should be submitted to the Senate and 
House Committees on Appropriations, as well as the Committee on 
HELP and the Committee on Education and the Workforce, not 
later than 1 year after the date of enactment of this act.
    Centers for the Study of Distance Education and 
Technological Advancements.--The Committee recommendation 
includes $2,750,000 to carry out section 741(a)(3) of the HEA 
to establish no less than two Centers for the Study of Distance 
Education and Technological Advancements at institutions of 
higher education. At least one of the centers should have a 
minority enrollment of no less than 15 percent and no two 
centers shall be located in the same State.
    The Committee recognizes the increasing role that online 
education plays in postsecondary education. Over 6 million 
college students take at least one online course in a given 
year, representing almost 1 in 3 students nationally. Data are 
needed to understand the outcomes of online learning as well as 
the factors that impact such outcomes. The new centers should 
collaborate with and provide evaluation of learning outcomes 
for students attending institutions of higher education across 
the country and partner with other institutions of higher 
education and organizations interested in online education.

Model Comprehensive Transition and Postsecondary Programs for Students 
        With Intellectual Disabilities

    The Committee recommendation includes $10,935,000 for 
competitive grants to postsecondary institutions to establish 
model programs to help students with intellectual disabilities 
transition to and complete college, as authorized by section 
769 of the HEA. Funds may be used for student support services; 
academic enrichment, socialization, or independent living; 
integrated work experiences; and partnerships with LEAs to 
support students with intellectual disabilities participating 
in the model program who are still eligible for special 
education and related services under the IDEA.
    Funds also support a national coordinating center that is 
charged with conducting and disseminating research on 
strategies to promote positive academic, social, employment, 
and independent living outcomes for students with intellectual 
disabilities.

Minority Science and Engineering Improvement

    The Committee recommends $9,447,000 for the Minority 
Science and Engineering Improvement 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 $8,114,000 for tribally controlled 
postsecondary vocational institutions. 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 $849,932,000 for Federal TRIO 
programs, which provide a variety of services to improve 
postsecondary education opportunities for low-income 
individuals and first-generation college students.
    Upward Bound offers disadvantaged high school students 
academic services to develop the skills and motivation needed 
to pursue and complete a postsecondary education; Student 
Support Services provides developmental instruction, 
counseling, summer programs, and grant aid to disadvantaged 
college students to help them complete their postsecondary 
education; Talent Search identifies and counsels individuals 
between ages 11 and 27 regarding opportunities for completing 
high school and enrolling in postsecondary education; 
Educational Opportunity Centers provide information and 
counseling on available financial and academic assistance to 
low-income adults who are first-generation college students; 
and the Ronald E. McNair Postbaccalaureate Achievement Program 
supports research internships, seminars, tutoring, and other 
activities to encourage disadvantaged college students to 
enroll in doctoral programs.
    The last Upward Bound grant competition may have 
disadvantaged applicants in rural areas. Many of the rural 
programs that were not renewed in the last round are located in 
areas of extreme poverty that would appear to be prime targets 
for Upward Bound grants. The Committee directs the Department 
to provide an analysis within 60 days of enactment of this act 
of how selection criteria and outcomes changed in the past 
Upward Bound grant cycle, to determine whether applicants from 
rural areas were put at a disadvantage compared to other 
applicants.

Gaining Early Awareness and Readiness for Undergraduate Programs

    The Committee recommends $307,244,000 for GEAR UP, which 
provides grants to 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 adds new bill language, as requested by the 
administration, allowing the Department to increase the 
evaluation set-aside from 0.75 percent to 1.5 percent to work 
with the GEAR UP community and grantees to standardize data 
collection, including through the use of third-party data 
systems. The increase in the evaluation set-aside will build 
evidence about effective college access and completion 
strategies and inform the HEA reauthorization process in 2014. 
The Committee directs the Department to submit a report to the 
Senate Committees on Appropriations and HELP that provides an 
update on how GEAR UP evaluation set-aside funds are being used 
and recommendations on how to improve student outcomes; the 
Committee expects the report no later than 6 months after 
enactment of this act.

Graduate Assistance in Areas of National Need and Javits Fellowships

    The Committee recommends $30,848,000 to support the GAANN 
and Javits Fellowships programs.
    In fiscal year 2012, Congress consolidated the GAANN and 
Javits Fellowships programs, as proposed by the administration. 
The Committee recommendation continues bill language allowing 
funds awarded under GAANN to be used to fund continuation costs 
for the Javits Fellowships program.
    GAANN awards competitive grants to graduate academic 
departments and programs for fellowship support in areas of 
national need as determined by the Secretary. Javits 
Fellowships are awarded to students of superior ability who are 
pursuing doctoral degrees in the arts, humanities, and social 
sciences. Each fellowship consists of a student stipend to 
cover living costs and an institutional payment to cover each 
fellow's tuition and other expenses.

Teacher Quality Partnership Program

    The Committee recommends $42,747,000 for the Teacher 
Quality Partnership program. The budget request consolidates 
activities supported by this program into a proposed new 
Effective Teachers and Leaders State Grants authority as part 
of the administration's plan for reauthorizing the ESEA. The 
Teacher Quality Partnership Program helps improve the quality 
of teachers working in high-need schools and early childhood 
education programs by creating model teacher preparation and 
residency programs.

Child Care Access Means Parents in Schools

    The Committee recommends an appropriation of $15,938,000 
for CCAMPIS. This program 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 campus-based child care programs primarily serving 
the needs of low-income students enrolled at the institutions.

GPRA Data/Higher Education Act Program Evaluation

    The Committee recommends $20,606,000 to collect data 
associated with the GPRA and to evaluate programs authorized by 
the HEA. The Committee recommendation includes $15,000,000 to 
support a new dual enrollment demonstration program for low-
income students and evaluate its impact on the success of 
participants. The Committee is concerned that the cost of 
tuition, fees, and supplies for low-income students and 
families could be a deterrent to the students' participation in 
dual enrollment programs that do not cover such costs for low-
income students. The recommended funding level will support 
tuition, fees, and supplies for low-income students enrolled in 
dual enrollment programs who would qualify for Pell grants but 
are not eligible because they do not have a high school 
diploma. Funding for this demonstration is also provided in 
CTE's National Programs. The Department will give priority to 
dual enrollment programs that demonstrate a cost-effective 
approach to providing dual enrollment opportunities to low-
income students.
    Studies on dual enrollment programs have found that student 
participation is positively related to college enrollment and 
persistence and higher college GPAs. Dual enrollment programs 
can also shorten the time to degree or credential completion 
and reduce the cost of college for students and families.
    The Committee recommendation also includes $2,000,000 to 
support an evaluation of the dual enrollment projects to test 
whether providing student aid to low-income students increases 
access to dual enrollment programs, and whether the programs 
improve degree and credential attainment.
    The Committee also provides $3,606,000 to support program 
improvement activities and evaluation, including evaluating the 
impact of loan counseling on borrower behavior; examining the 
effectiveness of allowing institutions of higher education 
additional funding to support Pell grant students if the 
students meet certain outcome measures of success; and 
evaluating the impacts of consumer information on making 
college selection decisions.

                           Howard University

Appropriations, 2013\1\.................................    $233,596,000
Budget estimate, 2014...................................     234,064,000
Committee recommendation................................     234,064,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

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

         College Housing and Academic Facilities Loans Program

Appropriations, 2013\1\.................................        $458,000
Budget estimate, 2014...................................         459,000
Committee recommendation................................         459,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

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

  Historically Black College and University Capital Financing Program 
                                Account

Appropriations, 2013....................................     $20,462,000
Budget estimate, 2014...................................      20,502,000
Committee recommendation................................      20,502,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $20,502,000 for the HBCU Capital 
Financing Program.
    The Committee recommendation includes $20,150,000 to pay 
the loan subsidy costs in guaranteed loan authority under this 
program. This amount will support $320,350,000 in new loan 
volume in fiscal year 2014. The remaining $352,000 will be used 
for administrative expenses.
    The HBCU Capital Financing Program makes capital available 
to HBCUs for construction, renovation, and repair of academic 
facilities by providing a Federal guarantee for private sector 
construction bonds. Construction loans will be made from the 
proceeds of the sale of the bonds. As requested by the 
administration, the Committee retains bill language allowing 
the program to make loans to public and private HBCUs without 
regard to the limitations within section 344(a) of the HEA.
    The Committee recommendation includes new bill language, as 
proposed in the budget request, that allows the loan subsidy 
funding to be available for 2 fiscal years. The Department has 
found that the 1-year timeframe to insure loans constrains the 
planning process for new program loans, decreasing the number 
of projects that can be considered for funding and limiting the 
Department's ability to achieve the statutory mandate of 
ensuring that loans are fairly allocated among as many eligible 
institutions as possible.

                    Institute of Education Sciences

Appropriations, 2013\1\.................................    $592,477,000
Budget estimate, 2014...................................     671,073,000
Committee recommendation................................     652,937,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $652,937,000 for IES. This account 
supports education research, development, dissemination, and 
evaluation; data collection and analysis activities; and the 
assessment of student progress.
    Under the Education Sciences Reform Act of 2002, Congress 
established IES to provide objective and valid research-driven 
knowledge that was free of political influence or bias so as to 
better inform effective education practices at the State and 
local levels. The act required IES, in carrying out its 
mission, ``to compile statistics, develop products, and conduct 
research, evaluations, and wide dissemination activities in 
areas of demonstrated national need . . . and ensure that such 
activities conform to high standards of quality, integrity, and 
accuracy and are objective, secular, neutral, and 
nonideological and are free of partisan political influence.''
    The Committee commends IES for its efforts to improve the 
rigor, relevance, and utilization of education research that 
leads to enhanced education policy and classroom practices. The 
Committee urges IES to consider how it can organize its 
investment opportunities to bring more focus to solving 
specific and enduring problems of practice in our Nation's 
classrooms. The Committee requests that IES include in the 
fiscal year 2015 congressional budget justification the 
specific changes it will make to bring more focus and coherence 
to its investments and how those changes are expected to solve 
specific problems of practice. To the extent that it believes 
that it is achieving this goal, the Committee requests that IES 
identify and describe the problems of practice that have been 
solved through its investments.
    The Committee directs the Director to submit an operating 
plan within 90 days of enactment of this act detailing how IES 
plans to allocate funding available to the Institute for 
research, evaluation, and other activities authorized under 
law.

                RESEARCH, DEVELOPMENT, AND DISSEMINATION

    The Committee recommends $195,000,000 for education 
research, development, and national dissemination activities. 
Funds are available for obligation for 2 fiscal years. These 
funds support activities that are aimed at expanding 
fundamental knowledge of education and promoting the use of 
research and development findings in the design of efforts to 
improve education.

                               STATISTICS

    The Committee recommends $112,000,000 for data gathering 
and statistical analysis activities at NCES. Increased funds 
over the fiscal year 2013 level will allow NCES to provide 
partial support to States that would like to benchmark their 
student performance against countries that participate in the 
Program for International Student Assessment.
    NCES collects, analyzes, and reports statistics on 
education in the United States. Activities are carried out 
directly and through grants and contracts. The Center collects 
data on educational institutions at all levels, longitudinal 
data on student progress, and data relevant to public policy. 
NCES also provides technical assistance to SEAs, LEAs, and 
postsecondary institutions.

                   REGIONAL EDUCATIONAL LABORATORIES

    The Committee recommends $57,311,000 to continue support 
for the Regional Educational Laboratories program. Funds 
available in this bill will continue to support a network of 10 
laboratories. The laboratories are responsible for promoting 
the use and development of knowledge and evidence in broad-
based systemic strategies to increase student learning and 
further school improvement efforts. The Committee appreciates 
the efforts of IES to strengthen the connections between 
practitioners and the research community, so that federally 
supported research is timely, relevant, and responsive to the 
needs of the field.

              RESEARCH AND INNOVATION IN SPECIAL EDUCATION

    The Committee recommends $69,905,000 for research and 
innovation in special education conducted by the National 
Center for Special Education Research [NCSER]. This amount 
should enable NCSER to fund roughly $20,000,000 in new awards 
in fiscal year 2014.
    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.
    The Committee commends NCSER for the rigor and relevancy of 
its research. NCSER-supported research has informed early 
identification, the development and testing of interventions to 
improve school outcomes, and the validation of assessments to 
help identify and monitor the progress of the Nation's 6 
million children with disabilities. An investment in research 
continues to fill a critical need to better understand the most 
effective ways of educating and improving school outcomes for 
those with or at risk for disabilities.

               SPECIAL EDUCATION STUDIES AND EVALUATIONS

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

                         STATEWIDE DATA SYSTEMS

    The Committee recommendation includes $75,000,000 for the 
Statewide Data Systems program.
    This program supports competitive grants to SEAs to enable 
such agencies to design, develop, and implement statewide, 
longitudinal data systems to manage, analyze, disaggregate, and 
use individual data for students of all ages. Early childhood, 
postsecondary, and workforce information systems may be linked 
to such systems or developed with program funds. The Committee 
believes the Department should continue its efforts to ensure 
every State has the base support necessary to develop effective 
systems. Funds are available for obligation for 2 fiscal years.
    The Committee bill allows up to $21,000,000 to be used for 
awards to public or private agencies or organizations to 
support activities to improve data coordination, quality, and 
use at the local, State, and national levels. The Committee 
requests that, prior to obligating any funds for this purpose, 
the Department provide to the Committee an operating plan 
describing the proposed purpose and use of such funds.

                               ASSESSMENT

    The Committee recommends $132,306,000 to provide support 
for NAEP, a congressionally mandated assessment created to 
measure and report the educational achievement of American 
students in a range of subjects and analyze trends over time.
    Within the funds appropriated, the Committee recommends 
$7,690,000 for NAGB, which is responsible for formulating 
policy for NAEP.

                        Departmental Management


                         PROGRAM ADMINISTRATION

Appropriations, 2013\1\.................................    $445,366,000
Budget estimate, 2014...................................     463,450,000
Committee recommendation................................     447,366,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $447,366,000 for program 
administration.
    Funds support personnel compensation and benefits, travel, 
rent, communications, utilities, printing, equipment and 
supplies, automated data processing, and other services 
required to award, administer, and monitor Federal education 
programs. Support for program evaluation and studies and 
advisory councils also is provided under this account.
    The Committee recommendation includes $2,000,000 for 
building modernization activities for the Department.
    The Committee is very supportive of Executive Order 13548 
and the Department's goal to raise the representation of 
individuals with disabilities in its workforce from 6.25 
percent in fiscal year 2010 to 9 percent in fiscal year 2015. 
However, fiscal year 2012 results demonstrate a lack of 
progress, with representation falling below the fiscal year 
2011 level. The Committee encourages the Department to 
accelerate its efforts toward achieving the goals of this 
important executive order.
    The Committee is concerned about the number of children, in 
particular children with disabilities and children of racial 
and ethnic minorities, that are subject to the abusive and 
potentially deadly application of restraint and seclusion 
techniques in our Nation's schools. Every child has the right 
to be safe at school.
    The Committee commends the Department for releasing its 
``Restraint and Seclusion: Resource Document.'' The Committee 
directs the Department to issue guidance that, at minimum, is 
consistent with the 15 principles identified in the Resource 
Document that help ensure that restraint or seclusion in 
schools should not occur except when there is a threat of 
imminent danger of serious physical harm to the student or 
others. If these practices are used, they must be carried out 
in a manner that protects the safety of all children and adults 
at a school. Finally, the Committee requests that the 
Department co-convene with SAMHSA a stakeholder summit on 
reducing and preventing the use of restraint and seclusion in 
schools.
    The Committee is concerned with deficiencies in geography 
education research and geography education at the elementary 
and secondary education levels. The Committee recognizes that a 
sound understanding of geography is critical to ensuring that 
the American workforce is qualified for jobs in geospatial 
technologies and other emerging industries. The Committee 
directs GAO to conduct a study on the status of geographic 
education and the ability of U.S. graduates to fill and retain 
skilled jobs, particularly in geospatial technologies. 
Additionally, recognizing fiscal constraints on States and 
LEAs, the Committee further directs GAO to report on the 
challenges elementary and secondary schools face in providing 
geographic education with limited resources.
    The Committee is disappointed that the administration 
failed to meet its scheduled March 2013 release date for the 
notice of proposed rulemaking related to the phasing out of 
alternate assessments based on modified academic achievement 
standards. The Committee supports this phase-out and believes 
the administration should move forward expeditiously in this 
rulemaking.
    The Committee appreciates and strongly supports Executive 
Order 13592 related to improving educational outcomes for 
American Indian and Alaska Native students. The Committee 
believes that the establishment of the Interagency Working 
Group on American Indian and Alaska Native Education, co-
chaired by the Secretaries of Education and the Interior, and 
Memorandum of Agreement between the two Departments are 
important steps forward in this effort. The Committee requests 
that the Department include in the fiscal year 2015 and future 
congressional budget justifications the goals, benchmarks, and 
key activities accomplished and planned for improving 
educational outcomes for American Indian and Alaska Native 
students.

                        OFFICE FOR CIVIL RIGHTS

Appropriations, 2013\1\.................................    $102,418,000
Budget estimate, 2014...................................     107,500,000
Committee recommendation................................     102,418,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $102,418,000 for OCR.
    OCR is responsible for the enforcement of laws that 
prohibit discrimination on the basis of race, color, national 
origin, sex, disability, and age in all programs and 
institutions that receive financial assistance from the 
Department. To carry out this responsibility, OCR investigates 
and resolves discrimination complaints, monitors desegregation 
and equal educational opportunity plans, reviews possible 
discriminatory practices by recipients of Federal education 
funds, and provides technical assistance to recipients of funds 
to help them meet these civil rights requirements.

                    OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2013\1\.................................     $59,700,000
Budget estimate, 2014...................................      62,347,000
Committee recommendation................................      59,700,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $59,700,000 for OIG.
    OIG has the authority to investigate all departmental 
programs and administrative activities, including those under 
contract or grant, to prevent and detect fraud and abuse, and 
to ensure the quality and integrity of those programs. The 
Office investigates alleged misuse of Federal funds and 
conducts audits to determine compliance with laws and 
regulations, efficiency of operations, and effectiveness in 
achieving program goals.

                           General Provisions

    Section 301. The bill continues a provision prohibiting the 
use of funds for the transportation of students or teachers in 
order to overcome racial imbalance.
    Section 302. The bill continues a provision prohibiting the 
involuntary transportation of students other than to the school 
nearest to the student's home.
    Section 303. The bill continues a provision prohibiting the 
use of funds to prevent the implementation of programs of 
voluntary prayer and meditation in public schools.
    Section 304. The bill continues a provision giving the 
Secretary authority to transfer up to 1 percent of any 
discretionary funds between appropriations.
    Section 305. The bill continues a provision that allows the 
outlying areas to consolidate funds under title V of the ESEA.
    Section 306. The bill continues a provision that allows the 
Republic of Palau to receive certain Federal funds.
    Section 307. The bill includes a new provision changing the 
name of the Office of Vocational and Adult Education to the 
Office of Career, Technical, and Adult Education.
    Section 308. The bill contains a new provision that 
clarifies the Department's authority to reserve up to 0.5 
percent of each ESEA appropriation in the bill for evaluation 
of ESEA programs funded in this act. These resources are in 
addition to any funds specifically provided for evaluation 
purposes.
    Section 309. The bill includes a new provision prohibiting 
all colleges and universities that receive funding through HEA 
from spending Federal educational program dollars on 
advertising, marketing, and recruitment.
    Section 310. The bill includes a new provision related to 
eligibility under the Impact Aid program.
    Section 311. The bill includes a new provision concerning 
licensing, certification, and accreditation requirements for 
certain postsecondary education programs.
    Section 312. The bill includes a new provision that 
modifies the Free Application for Federal Student Aid and 
requires the Department to inform foster youth of their 
eligibility for certain financial aid programs.

                                TITLE IV

                            RELATED AGENCIES

 Committee for Purchase From People Who Are Blind or Severely Disabled

                         SALARIES AND EXPENSES

Appropriations, 2013\1\.................................      $5,364,000
Budget estimate, 2014...................................       5,396,000
Committee recommendation................................       5,396,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $5,396,000 for the Committee for 
Purchase from People Who Are Blind or Severely Disabled.
    The primary purpose of this program is to increase the 
employment opportunities for people who are blind or have other 
severe disabilities and, whenever possible, to prepare them to 
engage in competitive employment.

             Corporation for National and Community Service

    CNCS, a corporation owned by the Federal Government, was 
established to enhance opportunities for national and community 
service. CNCS administers programs authorized under the 
Domestic Volunteer Service Act, the National and Community 
Service Trust Act, and the SERVE America Act. Grants are 
awarded to States, public and private nonprofit organizations, 
and other entities to create service opportunities for 
students, out-of-school youth, adults, and seniors.
    The Committee recommendation for CNCS provides a total 
program level of $1,061,156,000, a level sufficient to maintain 
the number of AmeriCorps members at over 82,000.

                           OPERATING EXPENSES

Appropriations, 2013\1\.................................    $748,752,000
Budget estimate, 2014...................................     760,264,000
Committee recommendation................................     756,641,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $756,641,000 for the operating 
expenses of CNCS.

                VOLUNTEERS IN SERVICE TO AMERICA [VISTA]

    The Committee recommends $94,820,000 for VISTA. This 
program provides capacity building for small, community-based 
organizations with a mission of combating poverty. VISTA 
members raise resources, recruit and organize volunteers, and 
establish and expand programs in housing, employment, health, 
and economic development activities.

                    NATIONAL SENIOR VOLUNTEER CORPS

    The Committee recommends $207,491,000 for the National 
Senior Volunteer Corps programs, a collection of programs that 
connect Americans older than the age of 55 with opportunities 
to contribute their job skills and expertise to community 
projects and organizations. Programs include the Retired Senior 
Volunteer Program, the Foster Grandparent Program, and the 
Senior Companion Program.
    The Committee recommendation includes funding for each of 
the Senior Corps programs at no less than fiscal year 2013 
levels.

                  AMERICORPS STATE AND NATIONAL GRANTS

    The Committee recommends $345,800,000 for AmeriCorps State 
and National Grants, which provide funds to local and national 
organizations and agencies to address community needs in 
education, public safety, health, and the environment.
    Each of these organizations and agencies, in turn, uses its 
AmeriCorps funding to recruit, place, and supervise AmeriCorps 
members. AmeriCorps members receive a modest living allowance 
and other benefits proportional to their level of time 
commitment.

National Civilian Community Corps [NCCC]

    The Committee recommendation includes $30,000,000 for NCCC. 
The recommended reduction reflects the completion of one-time 
relocation activities related to the loss of the Perry Point 
campus in Maryland.
    NCCC 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.

          INNOVATION, DEMONSTRATION, AND ASSISTANCE ACTIVITIES

    The Committee recommendation includes $58,224,000 for 
innovation, demonstration, and assistance activities.
    Within the funds provided, the Committee recommendation 
includes $46,724,000 for the Social Innovation Fund authorized 
under section 1807 of the SERVE America Act. The fiscal year 
2013 level is $44,726,000. The budget request is $48,815,000. 
The increase provided is intended to fund Pay for Success pilot 
programs. The Committee has included statutory language needed 
for this program, identical to language included in the fiscal 
year 2013 President's budget and Senate bill.
    In addition, $5,000,000 is included for the Volunteer 
Generation Fund authorized under section 198P of the SERVE 
America Act, compared to $3,976,000 enacted in fiscal year 2013 
and $10,000,000 in the budget request. The Committee 
recommendation also provides $1,000,000 for MLK Service Day, 
which was eliminated by the administration in fiscal year 2013 
and not requested in the fiscal year 2014 budget request.
    The Committee recommendation includes $1,000,000 for a new 
national initiative on volunteerism. Volunteerism is a type of 
community service that is distinct from most of the programs of 
CNCS because of its unpaid and intermittent nature. For 
example, many AmeriCorps members build capacity at 
organizations by recruiting and coordinating volunteers for a 
series of individual projects. The AmeriCorps member devotes a 
year of sustained service, while the volunteers come 
episodically to engage on a particular task. The Committee 
intends for this new effort to build a shared knowledge base 
among CNCS and long standing organizations with deep expertise 
in volunteer engagement. National volunteer organizations 
include youth sports leagues, youth service organizations, 
charitable food preparation and delivery organizations, 
churches, and other entities that have large, ever-rotating 
volunteer pools. The Committee believes that CNCS should 
convene these organizations and develop shared resources on 
recruitment, training, and retention efforts. The Committee 
expects this initiative to be primarily intramural, and expects 
that it will not be implemented exclusively or primarily 
through intermediary organizations. CNCS should build direct 
partnerships to ensure that the knowledge gained in this effort 
immediately informs the work of all of CNCS' staff and 
programs.

                               EVALUATION

    The Committee recommendation includes $5,000,000 for CNCS 
evaluation activities. The Committee intends that part of the 
increase in evaluation funds be used to continue the Civic 
Health Assessment, which is funded in Training and Technical 
Assistance in fiscal year 2013.
    The Committee strongly supports efforts of CNCS to evaluate 
the impact of service on both the lives of those served and the 
lives of those serving. In particular, the Committee is pleased 
to see research progressing on the impact of a service 
experience on an individual's employment options. Congress 
provided for a dramatic expansion of AmeriCorps and VISTA in 
the American Recovery and Reinvestment Act in response to a 
body of research that shows that individuals who graduate 
college during a recession have reduced employment options and 
earnings that persist throughout their lifetimes. The Committee 
encourages CNCS to consider evaluating whether participating in 
federally funded service programs mitigated the negative 
effects of graduating during the recent recession, in whole or 
in part.

                        STATE COMMISSION GRANTS

    The Committee recommendation includes $15,306,000 for State 
Commission Grants.
    The recommended increase over the budget request reflects 
the Committee's intention to consolidate the training and 
technical assistance grants into the State Commission Grants. 
The Committee continues to believe that this consolidation will 
create efficiencies at both the Federal and State levels of 
government by combining two State grants with overlapping 
purposes. In implementing this consolidation, the Committee 
expects CNCS to develop measures to ensure that States 
adequately train new applicants and newly awarded grantees in 
accountability procedures.
    The Committee deletes a provision added in the fiscal year 
2012 bill that lowered the State minimum award to $200,000 from 
the $250,000 level prescribed in the SERVE America Act.

                 PAYMENT TO THE NATIONAL SERVICE TRUST

Appropriations, 2013\1\.................................    $211,373,000
Budget estimate, 2014...................................     207,293,000
Committee recommendation................................     209,840,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends an appropriation of $209,840,000 
for making payments to the National Service Trust.
    The National Service Trust makes payments of Segal 
education awards, pays interest that accrues on qualified 
student loans for AmeriCorps participants during terms of 
service in approved national service positions, and makes other 
payments entitled to members who serve in the programs of CNCS.
    The recommended funding level is sufficient to support more 
than 82,000 servicemembers. The Committee is aware of 
significant demand for the Education Award-only Program [EAP] 
and has provided funding above the budget request to address 
this need. In addition, the Committee notes that community 
service can be an important strategy in achieving many national 
and community goals. For that reason, the Committee strongly 
supports the work CNCS is doing to partner with other Federal 
agencies. The Committee believes that EAP awards are a good 
tool to further those partnerships.

                         SALARIES AND EXPENSES

Appropriations, 2013\1\.................................     $82,677,000
Budget estimate, 2014...................................      87,109,000
Committee recommendation................................      88,209,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends an appropriation of $88,209,000 
for CNCS salaries and expenses. The salaries and expenses 
appropriation provides funds for staff salaries, benefits, 
travel, training, rent, equipment, and other operating expenses 
necessary for management of CNCS programs and activities.
    The Committee recommendation rejects the proposed cut to 
the maintenance and improvement of information technology [IT] 
systems. The Committee feels strongly that antiquated 
technology at CNCS creates unacceptable challenges for 
oversight, imposes unnecessary burdens in grantee reporting, 
and reduces the efficiency of the programs as a whole. CNCS is 
directed to place a high priority on the goals and objectives 
of the CNCS IT Strategic Plan, with a particular emphasis on 
streamlining the grantee reporting process.
    The Committee reiterates its strong support for efforts to 
redesign the outreach activities meant to recruit and support 
national servicemembers with disabilities. The program should 
build on successful models of integration of persons with 
disabilities. The Committee directs CNCS to report in the 
annual congressional budget justification the amount for 
disability training and support activities proposed for the 
pending fiscal year, the amount estimated for the current 
fiscal year, and the amount obligated in the 3 prior fiscal 
years.

                      OFFICE OF INSPECTOR GENERAL

Appropriations, 2013\1\.................................      $3,984,000
Budget estimate, 2014...................................       6,466,000
Committee recommendation................................       6,466,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends an appropriation of $6,466,000 for 
the CNCS OIG. The OIG's goals are to increase organizational 
efficiency and effectiveness within the Corporation and to 
prevent fraud, waste, and abuse.
    The recommended level of funding should allow the IG to 
hire new criminal investigators, criminal analysts, auditors, 
and audit managers. The Committee intends that the OIG fully 
reclaim the responsibilities CNCS temporarily assumed on behalf 
of the OIG in fiscal year 2012.

                       ADMINISTRATIVE PROVISIONS

    The Committee retains language in previous bills concerning 
four administrative provisions: requiring the Corporation to 
make any significant changes to program requirements or policy 
through rule making (section 401), stipulating minimum share 
requirements (section 402), requiring that donations supplement 
and not supplant operations (section 403), and aligning 
requirements regarding the use of Education Awards at GI bill-
eligible institutions (section 404).
    The Committee adds a provision relating to section 189D of 
the National and Community Service Act of 1990, which requires 
that all applicants for federally funded national service 
positions pass through both a criminal history fingerprint 
check and a check of the National Sex Offender Public Registry. 
Applicants who are considered for positions working with 
vulnerable populations are required to undergo an FBI check or 
go through a waiver process if that check is not made available 
to them. The Committee is aware that States are the sole entity 
with the authority to query the FBI database and that some 
States are not conducting this background check. This is 
leading to an unanticipated flood of individual waiver 
petitions. The Committee rejects the proposal in the 
President's budget to make the FBI check optional for all 
except members applying to work with children. Instead, the 
Committee includes a statutory provision (section 405) allowing 
the required background checks to be processed by States under 
the terms and conditions set out for ``volunteers'' in the 
National Child Protection Act [NCPA]. The Committee notes that 
the definition of a national servicemember who works with 
vulnerable populations included in section 189D falls within 
the definition of those eligible for background checks under 
the NCPA; therefore, the Committee views this provision as a 
clarification of existing authorities. The provision also 
designates State Commissions as eligible recipients of the 
background check information, in addition to the organizations 
which are currently authorized in the NCPA. In some instances 
involving small and local organizations, the Committee believes 
that a State Commission can better secure this criminal history 
information.

                  Corporation for Public Broadcasting

Appropriations, 2015....................................    $445,000,000
Budget estimate, 2016...................................     445,000,000
Committee recommendation, 2016..........................     445,000,000

    The Committee recommends $445,000,000 for CPB as an advance 
appropriation for fiscal year 2016. Two-year advance funding 
has been in place since 1975 to ensure the independence of 
public broadcasting programming.
    The majority of these funds go directly to local public 
television and radio stations to support their programming. CPB 
funds also support the creation of content for radio, 
television, and other platforms; system support activities that 
benefit the entire public broadcasting community; and CPB's 
administrative costs.

               Federal Mediation and Conciliation Service


                         SALARIES AND EXPENSES

Appropriations, 2013\1\.................................     $46,071,000
Budget estimate, 2014...................................      47,620,000
Committee recommendation................................      47,000,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $47,000,000 for the Federal 
Mediation and Conciliation Service [FMCS]. FMCS provides 
mediation, conciliation, and arbitration services to labor and 
management organizations to prevent and minimize work stoppages 
and promote stable labor-management relationships. FMCS is also 
authorized to provide dispute resolution consultation and 
training to all Federal agencies.
    Within the total, the Committee recommendation includes up 
to $400,000, the same amount as the budget request, for labor-
management partnership grants. 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, 2013\1\.................................     $17,569,000
Budget estimate, 2014...................................      16,423,000
Committee recommendation................................      17,000,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $17,000,000 for FMSHRC, which 
provides administrative trial and appellate review of legal 
disputes under the Federal Mine Safety and Health Act of 1977. 
Most cases involve civil penalties proposed by MSHA. FMSHRC's 
administrative law judges [ALJs] decide cases at the trial 
level and the five-member Commission provides review of the ALJ 
decisions.
    FMSHRC received a significant increase in funding in fiscal 
year 2012, continued in fiscal year 2013, to help address the 
growing backlog of contested mine safety cases appealed to the 
commission. This funding also covered the one-time costs of 
developing an electronic case processing system and moving 
FMSHRC to new office space. Funds for those costs are no longer 
required in fiscal year 2014. The Committee recommendation will 
allow FMSHRC to increase staffing to continue to reduce the 
number of pending cases and the average time for processing 
cases.
    The Committee directs FMSHRC, in conjunction with the 
Department of Labor, to provide a joint report to the 
Committees on Appropriations of the House of Representatives 
and Senate for reducing the number of pending cases and average 
case processing time to appropriate levels by the end of fiscal 
year 2015. The report should fully explain how such levels were 
determined. It also should establish goals and metrics for 
determining when the levels will be achieved and how they will 
be maintained in the future.

                Institute of Museum and Library Services


       OFFICE OF MUSEUM AND LIBRARIES: GRANTS AND ADMINISTRATION

Appropriations, 2013\1\.................................    $231,490,000
Budget estimate, 2014...................................     225,813,000
Committee recommendation................................     231,490,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $231,490,000 for IMLS. This agency 
supports programs for museums and libraries that encourage 
innovation, provide lifelong learning opportunities, promote 
cultural and civic engagement, and improve access to a variety 
of services and information.
    Within the total for IMLS, the Committee recommendation 
includes the amounts below:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                Fiscal year 2013    Fiscal year      Committee
                       Budget activity                          appropriation\1\   2014 request   recommendation
----------------------------------------------------------------------------------------------------------------
Library Services Technology Act:
    Grants to States.........................................           156,052          150,000         157,266
    Native American Library Services.........................             3,861            3,869           3,869
    National Leadership: Libraries...........................            11,922           13,200          13,200
    Laura Bush 21st Century Librarian........................            12,499           10,000          10,000
                                                              --------------------------------------------------
      Subtotal, LSTA.........................................           184,335          177,069         184,335
                                                              --------------------------------------------------
Museum Services Act:.........................................
    Museums for America......................................            17,994           22,707          21,119
    21st Century Museum Professionals........................             1,965   ..............  ..............
    Conservations Project Support............................             2,608   ..............  ..............
    Native American/Hawaiian Museum Services.................               924              926             926
    National Leadership: Museums.............................             5,899            7,880           7,880
                                                              --------------------------------------------------
      Subtotal, MSA..........................................            29,390           31,513          29,925
                                                              --------------------------------------------------
    African American History and Culture Act.................             1,407            1,410           1,410
    Administration...........................................            14,476           14,000          14,000
    Policy, Research, Program Evaluation, and Statistics.....             1,882            1,820          1,820
----------------------------------------------------------------------------------------------------------------
\1\Does not reflect the March 1, 2013 sequester of funds under Public Law 112-25 and excludes transfers and
  reprogrammings allowed under Public Law 113-6, and any other re-alignment of funds.
Note: Totals may not add due to rounding.

            Medicaid and CHIP Payment and Access Commission


                         SALARIES AND EXPENSES

Appropriations, 2013....................................      $5,777,000
Budget estimate, 2014...................................       9,500,000
Committee recommendation................................       9,000,000

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

                  Medicare Payment Advisory Commission


                         SALARIES AND EXPENSES

Appropriations, 2013\1\.................................     $11,754,000
Budget estimate, 2014...................................      12,087,000
Committee recommendation................................      11,954,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $11,954,000 for MedPAC, which 
provides independent policy and technical advice on issues 
affecting the Medicare program.

                     National Council on Disability


                         SALARIES AND EXPENSES

Appropriations, 2013\1\.................................      $3,251,000
Budget estimate, 2014...................................       3,345,000
Committee recommendation................................       3,345,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $3,345,000 for the National 
Council on Disability [NCD]. NCD is mandated to make 
recommendations to the President, Congress, the RSA, and NIDRR 
on issues of concern to individuals with disabilities. The 
Council gathers information on the implementation, 
effectiveness, and impact of the Americans with Disabilities 
Act and examines emerging policy issues as they affect persons 
with disabilities and their ability to enter or re-enter the 
Nation's workforce and to live independently.
    The Committee directs NCD to study the accessibility of 
taxicabs in the United States and internationally, and to make 
recommendations about how to increase the number and 
availability of accessible taxicabs in the United States. The 
Committee also directs NCD, in conjunction with the Access 
Board, to work with the World Bank to develop a safeguard on 
disability in order to increase the inclusion and opportunities 
for individuals with disabilities in countries that receive 
funds from the World Bank.

               National Health Care Workforce Commission


                         SALARIES AND EXPENSES

Appropriations, 2013....................................
Budget estimate, 2014...................................      $3,000,000
Committee recommendation................................       3,000,000

    The Committee recommendation includes $3,000,000 for the 
National Health Care Workforce Commission. 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, 2013\1\.................................    $277,749,000
Budget estimate, 2014...................................     284,991,000
Committee recommendation................................     284,991,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $284,991,000 for the NLRB, which 
administers and enforces the National Labor Relations Act and 
protects employee and employer rights provided under that act.
    The General Services Administration [GSA] has mandated that 
the NLRB move into a smaller, more flexible office space, 
consistent with the administration initiative to reduce the 
Federal Government's footprint. GSA estimates this will cost 
approximately $10,000,000 but is expected to reduce rent costs 
by approximately 30 percent, or $4,600,000, annually once 
completed. The Committee recommendation provides sufficient 
funds to execute the move.

                        National Mediation Board


                         SALARIES AND EXPENSES

Appropriations, 2013\1\.................................     $13,384,000
Budget estimate, 2014...................................      13,347,000
Committee recommendation................................      13,384,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $13,384,000 for the National 
Mediation Board [NMB], which mediates labor-management 
relations in the railroad and airline industries under the 
Railway Labor Act. The NMB mediates collective bargaining 
disputes, conducts elections to determine the choice of 
employee bargaining representatives, and administers 
arbitration of employee grievances.
    The Committee remains concerned about oversight and 
reporting requirements included in the FAA Modernization and 
Reform Act of 2012 and accordingly includes a modest increase 
over the budget request.

            Occupational Safety and Health Review Commission


                         SALARIES AND EXPENSES

Appropriations, 2013\1\.................................     $11,644,000
Budget estimate, 2014...................................      12,634,000
Committee recommendation................................      12,300,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $12,300,000 for the Occupational 
Safety and Health Review Commission [OSHRC]. OSHRC serves as a 
court to resolve disputes between OSHA and employers charged 
with violations of health and safety standards enforced by 
OSHA.

                       Railroad Retirement Board

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

                     DUAL BENEFITS PAYMENTS ACCOUNT

Appropriations, 2013\1\.................................     $50,813,000
Budget estimate, 2014...................................      39,000,000
Committee recommendation................................      39,000,000

    The Committee recommends $39,000,000 for the Dual Benefits 
Payments Account. This amount includes an estimated $3,000,000 
derived from income taxes on vested dual benefits. This 
appropriation provides for vested dual benefit payments to 
beneficiaries covered under both the railroad retirement and 
Social Security systems.

          FEDERAL PAYMENTS TO THE RAILROAD RETIREMENT ACCOUNT

Appropriations, 2013\1\.................................        $150,000
Budget estimate, 2014...................................         150,000
Committee recommendation................................         150,000

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

                      LIMITATION ON ADMINISTRATION

Appropriations, 2013\1\.................................    $110,927,000
Budget estimate, 2014...................................     111,793,000
Committee recommendation................................     110,927,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $110,927,000 for RRB's costs 
associated with the administration of railroad retirement/
survivor and unemployment/sickness benefit programs. This 
account limits the amount of funds in the railroad retirement 
and railroad unemployment insurance trust funds that may be 
used by the Board for administrative expenses.
    The Committee includes new bill language giving RRB the 
authority to hire new attorneys in the excepted service. A 
recently identified contradiction between statutes has 
effectively left RRB unable to hire any new attorneys.

           LIMITATION ON THE OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2013\1\.................................      $8,138,000
Budget estimate, 2014...................................       8,877,000
Committee recommendation................................       8,638,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $8,638,000 for the RRB OIG. This 
Office conducts audits and investigations to protect the 
integrity of the RRB trust funds and provides comprehensive 
oversight of all RRB operations and programs.

                     Social Security Administration


                PAYMENTS TO SOCIAL SECURITY TRUST FUNDS

Appropriations, 2013....................................     $20,404,000
Budget estimate, 2014...................................      16,400,000
Committee recommendation................................      16,400,000

    The Committee recommends $16,400,000 in mandatory funds for 
payments to Social Security trust funds. This account 
reimburses the Old Age and Survivors Insurance [OASI] and 
Disability Insurance [DI] trust funds for special payments to 
certain uninsured persons, costs incurred administering pension 
reform activities, and the value of the interest for benefit 
checks issued but not negotiated. This appropriation restores 
the trust funds to the same financial position they would have 
been in had they not borne these costs and they were properly 
charged to general revenues.

                  SUPPLEMENTAL SECURITY INCOME PROGRAM

Appropriations, 2013.................................... $38,769,285,000
Budget estimate, 2014...................................  40,737,000,000
Committee recommendation................................  40,568,741,000

    The Committee recommends $40,568,741,000 in fiscal year 
2014 mandatory funds for the SSI program. In addition, the 
Committee recommends $19,700,000,000 in advance funding for the 
first quarter of fiscal year 2015. The SSI program guarantees a 
minimum level of income to individuals who are disabled, blind, 
or older than age 65, and meet certain income and resource 
limitations.

Federal Benefit Payments

    The Committee recommendation includes a fiscal year 2014 
program level of $55,579,000,000 for Federal benefit payments. 
This will support an average monthly benefit of approximately 
$556 for 8.2 million recipients.

Beneficiary Services

    The Committee recommendation includes $3,000,000 in new 
mandatory budget authority for beneficiary services. Carryover 
of prior year unobligated balances will be sufficient to fund a 
total estimated fiscal year 2014 program level of $48,000,000.
    These funds reimburse VR agencies for successfully 
rehabilitating disabled SSI recipients by helping them achieve 
and sustain productive, self-supporting work activity. Funds 
also support the Ticket to Work program that provides SSI 
recipients with a ticket to offer employment networks [ENs], 
including VR agencies, in exchange for employment and support 
services. Instead of reimbursing ENs for specific services, the 
Ticket to Work program pays ENs based on recipients achieving 
certain milestones and outcomes.

Research and Demonstration

    The Committee recommendation includes $54,000,000 in 
mandatory funds for research and demonstration projects 
conducted under sections 1110, 1115, and 1144 of the Social 
Security Act. 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 $2,500,000, the same amount as the budget 
request, for the PROMISE program. This demonstration program is 
an interagency effort between SSA and the Departments of 
Education, Labor, and HHS to test interventions that improve 
health, education, postsecondary, employment, and family 
outcomes for older children receiving SSI, and reduce their 
dependency on the program. In fiscal year 2013 the Department 
of Education will award competitive, multi-year grants to a 
small number of States that propose innovative strategies to 
improve such outcomes by enhancing coordination between 
existing programs and services for children ages 14-16 
receiving SSI. These funds at SSA will support evaluation 
activities, including providing technical assistance to State 
grantees.
    The Committee believes that promoting public understanding 
of Social Security programs is a critical task for SSA. 
Therefore, within the total for research and demonstration, the 
Committee recommendation includes $5,000,000 to test the impact 
of providing community outreach on Social Security programs and 
benefits, particularly to students, individuals just entering 
the workforce, and new parents.

Administrative Expenses

    The Committee recommendation includes $4,232,741,000 for 
SSI program administrative expenses. This appropriation funds 
the SSI program's share of administrative expenses incurred 
through the Limitation on Administrative Expenses [LAE] 
account.

                 LIMITATION ON ADMINISTRATIVE EXPENSES

Appropriations, 2013\1\\2\.............................. $11,431,895,000
Budget estimate, 2014...................................  11,069,846,000
Committee recommendation\2\.............................  11,965,473,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.
\2\Includes funding available under program integrity cap adjustment 
provided by Public Law 112-25.

    The Committee recommends $11,965,473,000 for SSA's LAE 
account. This account provides resources for SSA to administer 
the OASI, DI, and SSI programs, and to support CMS in 
administering the Medicare program. The LAE account is funded 
by the Social Security and Medicare trust funds for their share 
of administrative expenses, the general fund for the SSI 
program's share of administrative expenses, and applicable user 
fees. These funds support core administrative activities 
including processing retirement and disability claims, 
conducting hearings to review disability determination appeals, 
issuing Social Security numbers and cards, processing 
individuals' annual earnings information, and ensuring the 
integrity of Social Security programs through continuing 
disability reviews [CDR] and SSI redeterminations of non-
medical eligibility.
    The Committee remains concerned about the impact of 
persistently high workloads, coupled with recent budget 
constraints, on SSA's ability to provide quality services. 
After years of inadequate funding in the mid-2000s basic 
services began to suffer. By 2008 it took an average of 532 
days to process a disability hearing, and a substantial number 
of cases were pending for over 900 and even 1,000 days. 
Significant funding increases in fiscal years 2009 and 2010 
allowed SSA to work down this backlog while keeping pace with 
increases in disability claims, and reduce the average 
disability hearing processing time to 362 days in fiscal year 
2012. The Committee is deeply concerned that budget constraints 
are reversing these positive trends and impacting basic 
services to the American public, while an aging population will 
continue to put increased demands on the agency. Therefore, the 
Committee recommendation includes a $533,578,000 increase over 
the fiscal year 2013 level to keep pace with rising costs and 
consistently record-high workloads, and to increase program 
integrity efforts.
    Veterans Affairs [VA] Benefits.--The Committee commends the 
work SSA has done in recent years to improve coordination and 
data sharing with the VA to help improve the VA's disability 
claims process. The Committee directs SSA to continue to 
provide it with periodic updates on steps taken to continue to 
improve the process.
    Work Incentives Planning and Assistance [WIPA] and 
Protection and Advocacy for Beneficiaries of Social Security 
[PABSS].--The Committee recommendation includes $7,000,000 for 
WIPA and $23,000,000 for PABSS. These programs provide valuable 
services to help Social Security disability beneficiaries 
return to work.
    Representative Payee Oversight.--SSA assigns representative 
payees when beneficiaries are unable to financially manage 
their own benefit payments. The GAO and SSA's OIG have 
consistently identified management challenges and intensive 
administrative requirements with SSA's oversight of 
representative payees. The Committee strongly encourages SSA to 
continue to pursue efforts to improve representative payee 
oversight, including continuing to partner with outside 
organizations to identify, investigate, and prevent fraud and 
abuse.
    Social Security Annual Statements.--The Committee directs 
SSA to resume mailing annual Social Security account statements 
to all eligible individuals over age 25, consistent with 
section 1143(c)(2) of the Social Security Act. These annual 
statements provide valuable information to workers on their 
benefits under Social Security programs, including allowing 
workers to check their earning history and notify SSA of any 
errors in a timely fashion. Earnings discrepancies identified 
years later can be complicated and time-consuming to resolve. 
Due to budget constraints, SSA began limiting the mailing of 
annual Social Security account statements in 2011 and currently 
only mails it to workers near retirement over age 60 and once 
to younger workers when they turn age 25.
    Field Office Closings.--The Committee remains concerned 
that in recent years SSA has lacked a long-term strategic plan 
or comprehensive, transparent policies regarding field office 
closings. The Committee directs SSA to submit a report to the 
Committees on Appropriations of the Senate and House of 
Representatives by March 31, 2014, on its policies and 
procedures for closing and consolidating field offices. In 
addition, the Committee directs SSA to provide a readily 
available public notice of proposed field office closures to 
ensure that impacted communities are aware of proposed changes, 
and allow an opportunity for public input.
    Use of Predictive Analytics.--In recent years SSA has begun 
to utilize predictive analytics and other data analysis tools 
in a number of areas, including in its disability claims 
process, for example through its Quick Disability Determination 
and Compassionate Allowance initiatives, and program integrity 
activities. The Committee encourages SSA to continue to explore 
the expanded use of predictive analytic tools in these areas, 
as well as others, including in return-to-work initiatives and 
representative payee oversight.
    Social Security Advisory Board.--The Committee 
recommendation includes not less than $2,300,000 for the Social 
Security Advisory Board. This 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.

Program Integrity

    Within the total for LAE, the Committee recommendation 
includes $1,197,000,000 for program integrity activities. This 
includes $273,000,000 in base funding and $924,000,000 in cap 
adjustment funding allowed under the Budget Control Act of 
2011. These funds support program integrity activities such as 
CDRs and SSI redeterminations which save $9 and $5, 
respectively, for each $1 spent by reducing waste, fraud, 
abuse, and improper payments in Social Security, Medicare, and 
Medicaid programs. The Committee recommendation for Social 
Security program integrity activities is expected to save 
approximately $9,600,000,000 over 10 years to those programs.
    The budget request proposes funding the base amount out of 
discretionary budget authority in fiscal year 2014 but funding 
an additional $1,227,000,000 out of new mandatory budget 
authority, for a total of $1,500,000,000. Beginning in fiscal 
year 2015, the administration proposes funding the entire 
amount for program integrity with mandatory funding. The 
Committee recommends funding all program integrity expenses 
with discretionary budget authority, including utilizing the 
full cap adjustment allowed under the Budget Control Act.

User Fees

    Within the total for LAE, the Committee recommendation 
includes up to $174,000,000 for administrative activities 
funded from user fees. This includes $173,000,000 in fees 
collected from States that request SSA to administer State SSI 
supplementary payments and up to $1,000,000 from fees collected 
from non-attorney claimant representatives.

                    OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2013\1\.................................    $102,078,000
Budget estimate, 2014...................................     105,733,000
Committee recommendation................................     104,670,000

\1\Does not reflect the March 1, 2013, sequester of funds under Public 
Law 112-25 and excludes transfers and reprogrammings allowed under 
Public Law 113-6.

    The Committee recommends $104,670,000 for SSA's OIG. This 
includes $74,972,000 funded from the OASI and DI trust funds 
for those programs' share of OIG's expenses and $29,698,000 
funded from general revenues for the SSI program's share of 
expenses.

                                TITLE V

                           GENERAL PROVISIONS

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

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

    Paragraph 7 of rule XVI requires that Committee reports on 
general appropriations bills identify each Committee amendment 
to the House bill ``which proposes an item of appropriation 
which is not made to carry out the provisions of an existing 
law, a treaty stipulation, or an act or resolution previously 
passed by the Senate during that session.''
    The Committee is filing an original bill, which is not 
covered under this rule, but reports this information in the 
spirit of full disclosure.
    The Committee recommends funding for the following programs 
and activities which currently lack authorization: Elementary 
and Secondary Education Act; Institute of Education Sciences; 
parts C and D of the Individuals with Disabilities Education 
Act; Special Olympics Sport and Empowerment Act of 2004; 
Workforce Investment Act; Women in Apprenticeship and Non-
Traditional Occupations Act; Homeless Veterans Reintegration 
Program; Nurse Education Loan Repayment; Education and Training 
Related to Geriatrics; Mental and Behavioral Health Training; 
Children's Hospital Graduate Medical Education; Title XVII of 
the PHS Act; Ryan White CARE Act; Family Violence Prevention 
and Services Act; 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 
grants for Primary and Behavioral Healthcare Integration; Low 
Income Home Energy Assistance Program; Refugee and Entrant 
Assistance programs (except for Victims of Trafficking); Child 
Care and Development Block Grant; Head Start; Runaway and 
Homeless Youth programs; Adoption Incentives; Developmental 
Disabilities programs; Voting Access for Individuals with 
Disabilities; Native American Programs; Community Services 
Block Grant Act programs; National Institutes of Health; Assets 
for Independence; Alzheimer's Disease Demonstration Grants; 
Office of Disease Prevention and Health Promotion; 
Rehabilitation Services and Disability Research; Assistive 
Technology Act; Carl D. Perkins Career and Technical Education 
Improvement Act; Corporation for Public Broadcasting; National 
Council on Disability; Older Americans Act; Second Chance Act; 
Work Incentive Planning and Assistance; and Protection and 
Advocacy for Beneficiaries of Social Security.

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

    Pursuant to paragraph 7(c) of rule XXVI, on July 11, 2013, 
the Committee ordered favorably reported, en bloc, an original 
bill (S. 1284) making appropriations for the Departments of 
Labor, Health and Human Services, and Education, and related 
agencies for the year ending September 30, 2014, and for other 
purposes, and an original bill (S. 1283) making appropriations 
for the Legislative Branch for the fiscal year ending September 
30, 2014, and for other purposes provided, that each bill be 
subject to amendment and that each bill be consistent with the 
subcommittee funding guidance, by a recorded vote of 16-14, a 
quorum being present. The vote was as follows:
        Yeas                          Nays
Chairwoman Mikulski                 Mr. Shelby
Mr. Leahy                           Mr. Cochran
Mr. Harkin                          Mr. McConnell
Mrs. Murray                         Mr. Alexander
Mrs. Feinstein                      Ms. Collins
Mr. Durbin                          Ms. Murkowski
Mr. Johnson                         Mr. Graham
Ms. Landrieu                        Mr. Kirk
Mr. Reed                            Mr. Coats
Mr. Pryor                           Mr. Blunt
Mr. Tester                          Mr. Moran
Mr. Udall                           Mr. Hoeven
Mrs. Shaheen                        Mr. Johanns
Mr. Merkley                         Mr. Boozman
Mr. Begich
Mr. Coons

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

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

             TITLE 5--GOVERNMENT ORGANIZATION AND EMPLOYEES


                   CHAPTER 53--PAY RATES AND SYSTEMS


              SUBCHAPTER II--EXECUTIVE SCHEDULE PAY RATES


Sec. 5315. Positions at level IV

    Level IV of the Executive Schedule applies to the following 
positions, for which the annual rate of basic pay shall be the 
rate determined with respect to such level under chapter 11 of 
title 2, as adjusted by section 5318 of this title:

           *       *       *       *       *       *       *

          Assistant Secretaries of Agriculture (3).
          Assistant Secretaries of Commerce (11).
          Assistant Secretaries of Defense (16).
          Assistant Secretaries of the Air Force (4).
          Assistant Secretaries of the Army (5).
          Assistant Secretaries of the Navy (4).
          Assistant Secretaries of Health and Human Services 
        (6).
          Assistant Secretaries of the Interior (6).
          Assistant Attorneys General (11).
          Assistant Secretaries of Labor (10), one of whom 
        shall be the Assistant Secretary of Labor for Veterans' 
        Employment and Training.
          Administrator, Wage and Hour Division, Department of 
        Labor.
          Assistant Secretaries of State (24) and 4 other State 
        Department officials to be appointed by the President, 
        by and with the advice and consent of the Senate.
          Assistant Secretaries of the Treasury (10).

           *       *       *       *       *       *       *


Sec. 5316. Positions at level V

  Level V of the Executive Schedule applies to the following 
positions, for which the annual rate of basic pay shall be the 
rate determined with respect to such level under chapter 11 of 
title 2, as adjusted by section 5318 of this title:

           *       *       *       *       *       *       *

            Manpower Administrator, Department of Labor.
          Members, Renegotiation Board.
          Members, Subversive Activities Control Board.
          Assistant Administrator of General Services.
          Director, United States Travel Service, Department of 
        Commerce.
          [Administrator, Wage and Hour and Public Contracts 
        Division, Department of Labor.]
          Assistant Director (Program Planning, Analysis and 
        Research), Office of Economic Opportunity.
          Deputy Director, National Security Agency.
          Director, Bureau of Land Management, Department of 
        the Interior.
          Director, National Park Service, Department of the 
        Interior.
          National Export Expansion Coordinator, Department of 
        Commerce.
                                ------                                


                    TITLE 8--ALIENS AND NATIONALITY


                CHAPTER 12--IMMIGRATION AND NATIONALITY


                       SUBCHAPTER II--IMMIGRATION


    Part II--Admission Qualifications for Aliens; Travel Control of 
                          Citizens and Aliens


Sec. 1184. Admission of nonimmigrants

(a) Regulations

           *       *       *       *       *       *       *

(c) Petition of importing employer

    (1) The question of importing any alien as a nonimmigrant 
under subparagraph (H), (L), (O), or (P)(i) of section 
1101(a)(15) of this title (excluding nonimmigrants under 
section 1101(a)(15)(H)(i)(b1) of this title) in any specific 
case or specific cases shall be determined by the Attorney 
General, after consultation with appropriate agencies of the 
Government, upon petition of the importing employer. Such 
petition, shall be made and approved before the visa is 
granted. The petition shall be in such form and contain such 
information as the Attorney General shall prescribe. The 
approval of such a petition shall not, of itself, be construed 
as establishing that the alien is a nonimmigrant. For purposes 
of this subsection with respect to nonimmigrants described in 
section 1101(a)(15)(H)(ii)(a) of this title, the term 
``appropriate agencies of Government'' means the Department of 
Labor and includes the Department of Agriculture. The 
provisions of section 1188 of this title shall apply to the 
question of importing any alien as a nonimmigrant under section 
1101(a)(15)(H)(ii)(a) of this title. In this subsection, the 
term ``consultation'' includes, with respect to nonimmigrants 
described in section 101(a)(15)(H)(ii)(B), the authority of the 
Secretary of Labor to issue labor market determinations, 
including temporary labor certifications, and to establish 
regulations and policies for such issuance, including 
determining the appropriate prevailing wage rates for 
occupations in which such nonimmigrants will be employed.
    (14)(A) * * *

           *       *       *       *       *       *       *

    (B) The Secretary of Homeland Security may delegate to the 
Secretary of Labor, with the agreement of the Secretary of 
Labor, any of the authority given to the Secretary of Homeland 
Security under [subparagraph (A)(i)] subparagraph (A).
                                ------                                


                          TITLE 20--EDUCATION


               CHAPTER 44--CAREER AND TECHNICAL EDUCATION


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


                    Part A--Allotment and Allocation


Sec. 2324. National activities

(a) Program performance information

           *       *       *       *       *       *       *

(b) Miscellaneous provisions

        (1) Collection of information at reasonable cost

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

           *       *       *       *       *       *       *


                  CHAPTER 48--DEPARTMENT OF EDUCATION


             SUBCHAPTER II--ESTABLISHMENT OF THE DEPARTMENT


Sec. 3412. Principal officers

(a) Deputy Secretary of Education

           *       *       *       *       *       *       *

(b) Assistant Secretaries and General Counsel

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

           *       *       *       *       *       *       *

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

           *       *       *       *       *       *       *

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

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

           *       *       *       *       *       *       *


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

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


            TITLE 40--PUBLIC BUILDINGS, PROPERTY, AND WORKS


                            Part A--General


                          CHAPTER 31--GENERAL


                 SUBCHAPTER IV--WAGE RATE REQUIREMENTS


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

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

           *       *       *       *       *       *       *


          CHAPTER 37--CONTRACT WORK HOURS AND SAFETY STANDARDS


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

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

           *       *       *       *       *       *       *

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

           *       *       *       *       *       *       *

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


                TITLE 42--THE PUBLIC HEALTH AND WELFARE


               SUBCHAPTER V--HEALTH PROFESSIONS EDUCATION


                         Part A--Student Loans


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

Sec. 292o. Definitions

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

           *       *       *       *       *       *       *

            (5)(A) The term ``default rate'', in the case of an 
        eligible entity, means the percentage constituted by 
        the ratio of--
            (D) For purposes of subparagraph (A), a loan is 
        made with respect to an eligible entity if--
                    (i) in the case of an eligible institution, 
                the loan was made to students of the 
                institution;
                    (ii) in the case of an eligible lender, the 
                loan was made by the lender; and
                    (iii) in the case of a holder, the loan was 
                purchased by the holder.
            (6) The term ``Secretary'' means the Secretary of 
        Education.
                                ------                                


             TITLE 48--TERRITORIES AND INSULAR POSSESSIONS


          CHAPTER 18--MICRONESIA, MARSHALL ISLANDS, AND PALAU


             SUBCHAPTER I--MICRONESIA AND MARSHALL ISLANDS


        PART A--APPROVAL AND IMPLEMENTATION OF ORIGINAL COMPACT

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] 
                        2014, to the extent the government, 
                        institutions, and people of Palau were 
                        so eligible under such provisions in 
                        fiscal year 2003.
                                ------                                


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

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

                           TABLE OF CONTENTS


               TITLE II--ESTABLISHMENT OF THE DEPARTMENT

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

                        BUDGETARY IMPACT OF BILL


  PREPARED IN CONSULTATION WITH THE CONGRESSIONAL BUDGET OFFICE PURSUANT TO SEC. 308(a), PUBLIC LAW 93-344, AS
                                                     AMENDED
                                            [In millions of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                  Budget authority               Outlays
                                                            ----------------------------------------------------
                                                               Committee    Amount  in   Committee    Amount  in
                                                              guidance\1\      bill       guidance       bill
----------------------------------------------------------------------------------------------------------------
Comparison of amounts in the bill with Committee guidance
 to its subcommittees of amounts for 2014: Subcommittee on
 Labor, HHS, Education, and Related Agencies:
    Mandatory..............................................            NA      614,974           NA   \2\592,629
    Discretionary..........................................       164,330      165,583           NA   \2\162,281
        Security...........................................  ............  ...........           NA           NA
        Nonsecurity........................................       164,330      165,583           NA           NA
Projections of outlays associated with the recommendation:
    2014...................................................  ............  ...........  ...........   \3\666,735
    2015...................................................  ............  ...........  ...........       68,828
    2016...................................................  ............  ...........  ...........       17,534
    2017...................................................  ............  ...........  ...........        3,113
    2018 and future years..................................  ............  ...........  ...........          648
Financial assistance to State and local governments for                NA      342,199           NA      315,483
 2014......................................................

----------------------------------------------------------------------------------------------------------------
\1\There is no section 302(a) allocation to the Committee on Appropriations for fiscal year 2014.
\2\Includes outlays from prior-year budget authority.
\3\Excludes outlays from prior-year budget authority.

NA: Not applicable.


  COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2013 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL FOR FISCAL
                                                                        YEAR 2014
                                                                [In thousands of dollars]
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                        Senate Committee recommendation
                                                                                                                            compared with (+ or -)
                             Item                                     2013         Budget estimate      Committee    -----------------------------------
                                                                  appropriation                      recommendation         2013
                                                                                                                        appropriation    Budget estimate
--------------------------------------------------------------------------------------------------------------------------------------------------------
                TITLE I -- DEPARTMENT OF LABOR

            EMPLOYMENT AND TRAINING ADMINISTRATION

               TRAINING AND EMPLOYMENT SERVICES

Grants to States:
    Adult Training, current year..............................           57,269            79,644            79,644           +22,375   ................
        Advance from prior year...............................         (712,000)         (712,000)         (712,000)  ................  ................
        Fiscal year 2015......................................          712,000           712,000           712,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................          769,269           791,644           791,644           +22,375   ................

    Youth Training............................................          822,704           846,632           846,632           +23,928   ................
    Dislocated Worker Assistance, current year................          146,135           185,490           185,490           +39,355   ................
        Advance from prior year...............................         (860,000)         (860,000)         (860,000)  ................  ................
        Fiscal year 2015......................................          860,000           860,000           860,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................        1,006,135         1,045,490         1,045,490           +39,355   ................
                                                               =========================================================================================
          Subtotal, Grants to States..........................        2,598,108         2,683,766         2,683,766           +85,658   ................
              Current Year....................................       (1,026,108)       (1,111,766)       (1,111,766)         (+85,658)  ................
              Fiscal year 2015................................       (1,572,000)       (1,572,000)       (1,572,000)  ................  ................

Federally Administered Programs:
    Dislocated Worker Assistance National Reserve:
        Current year..........................................           24,066            20,859            20,859            -3,207   ................
        Disaster Relief PL 113-2 (Emergency)..................           25,000   ................  ................          -25,000   ................
        Advance from prior year...............................         (199,952)         (200,000)         (200,000)             (+48)  ................
        Fiscal year 2015......................................          200,000           200,000           200,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................          249,066           220,859           220,859           -28,207   ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Dislocated Worker Assistance..............        1,255,201         1,266,349         1,266,349           +11,148   ................

    Native Americans..........................................           47,467            47,562            47,467   ................              -95
    Migrant and Seasonal Farmworker programs..................           84,123            84,291            84,123   ................             -168
    Women in Apprenticeship...................................              994   ................              994   ................             +994
    YouthBuild activities.....................................           79,530            79,689            84,530            +5,000            +4,841
    Workforce Innovation Fund.................................           49,806           150,000            49,806   ................         -100,194
                                                               =========================================================================================
      Subtotal, Federally Administered Programs [FAP].........          510,986           582,401           487,779           -23,207           -94,622
          Current Year........................................         (285,986)         (382,401)         (287,779)          (+1,793)         (-94,622)
          Emergency Appropriations............................           25,000   ................  ................          -25,000   ................
          Fiscal year 2015....................................         (200,000)         (200,000)         (200,000)  ................  ................

    National Activities:
        Pilots, Demonstrations, and Research..................            6,590            25,000             6,590   ................          -18,410
        Reintegration of Ex-Offenders.........................           80,078            90,238            80,078   ................          -10,160
        Evaluation............................................            9,544   ................  ................           -9,544   ................
        Workforce Data Quality Initiative.....................            6,450             6,000             6,000              -450   ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................          102,662           121,238            92,668            -9,994           -28,570
                                                               =========================================================================================
          Total, Training and Employment Services [TES].......        3,211,756         3,387,405         3,264,213           +52,457          -123,192
              Current Year....................................       (1,414,756)       (1,615,405)       (1,492,213)         (+77,457)        (-123,192)
              Emergency appropriations........................           25,000   ................  ................          -25,000   ................
              Fiscal year 2015................................       (1,772,000)       (1,772,000)       (1,772,000)  ................  ................

                      OFFICE OF JOB CORPS

Administration................................................           29,019            30,147            30,147            +1,128   ................
Operations....................................................        1,565,940         1,586,776         1,586,776           +20,836   ................
Construction, Rehabilitation and Acquisition..................          104,582            75,000            90,000           -14,582           +15,000
                                                               -----------------------------------------------------------------------------------------
      Total, Office of Job Corps..............................        1,699,541         1,691,923         1,706,923            +7,382           +15,000
          Current Year........................................       (1,699,541)       (1,691,923)       (1,706,923)          (+7,382)         (+15,000)

COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS\1\...........          447,355           380,000           447,355   ................          +67,355
FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES..................          797,000           656,000           656,000          -141,000   ................

          STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT

                      SERVICE OPERATIONS

Unemployment Compensation [UI]:
    State Operations..........................................        3,158,717         2,881,575         2,931,575          -227,142           +50,000
    Demonstration grants......................................  ................           25,000            25,000           +25,000   ................
    National Activities.......................................           11,243            11,297            11,243   ................              -54
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Unemployment Compensation.....................        3,169,960         2,917,872         2,967,818          -202,142           +49,946

Employment Service [ES]:
    Allotments to States:
        Federal Funds.........................................           22,550            22,595            22,550   ................              -45
        Trust Funds...........................................          676,890           708,247           708,247           +31,357   ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................          699,440           730,842           730,797           +31,357               -45

    ES National Activities....................................           20,871            20,912            20,871   ................              -41
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Employment Service............................          720,311           751,754           751,668           +31,357               -86
          Federal Funds.......................................          (22,550)          (22,595)          (22,550)  ................             (-45)
          Trust Funds.........................................         (697,761)         (729,159)         (729,118)         (+31,357)             (-41)

Foreign Labor Certification:
    Federal Administration....................................           50,222            50,501            50,222   ................             -279
    Grants to States..........................................           15,040            15,099            15,040   ................              -59
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Foreign Labor Certification...................           65,262            65,600            65,262   ................             -338

One-Stop Career Centers/Labor Market Information..............           63,346            90,473            63,346   ................          -27,127
                                                               =========================================================================================
      Total, State UI and ES..................................        4,018,879         3,825,699         3,848,094          -170,785           +22,395
          Federal Funds.......................................          (85,896)         (113,068)          (85,896)  ................         (-27,172)
          Trust Funds.........................................       (3,932,983)       (3,712,631)       (3,762,198)        (-170,785)         (+49,567)

STATE PAID LEAVE FUND.........................................  ................            5,000             5,000            +5,000   ................
ADVANCES TO THE UI AND OTHER TRUST FUNDS\2\...................  ................          600,000           600,000          +600,000   ................

                    PROGRAM ADMINISTRATION

Adult Employment and Training.................................           46,583   ................  ................          -46,583   ................
    Trust Funds...............................................            8,503   ................  ................           -8,503   ................
Youth Employment and Training.................................           12,235   ................  ................          -12,235   ................
Training and Employment.......................................  ................           60,325            60,325           +60,325   ................
    Trust Funds...............................................  ................            8,639             8,639            +8,639   ................
Employment Security...........................................            3,469             3,522             3,522               +53   ................
    Trust Funds...............................................           39,264            39,856            39,856              +592   ................
Apprenticeship Services.......................................           27,620            28,015            30,000            +2,380            +1,985
Executive Direction...........................................            7,034             7,147             7,147              +113   ................
    Trust Funds...............................................            2,079             2,113             2,113               +34   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Program Administration...........................          146,787           149,617           151,602            +4,815            +1,985
          Federal Funds.......................................          (96,941)          (99,009)         (100,994)          (+4,053)          (+1,985)
          Trust Funds.........................................          (49,846)          (50,608)          (50,608)            (+762)  ................
                                                               =========================================================================================
      Total, Employment and Training Admin. [ETA].............       10,321,318        10,695,644        10,679,187          +357,869           -16,457
          Federal Funds.......................................        6,338,489         6,932,405         6,866,381          +527,892           -66,024
              Current Year....................................       (4,541,489)       (5,160,405)       (5,094,381)        (+552,892)         (-66,024)
              Emergency appropriations........................           25,000   ................  ................          -25,000   ................
              Fiscal year 2015................................       (1,772,000)       (1,772,000)       (1,772,000)  ................  ................
          Trust Funds.........................................        3,982,829         3,763,239         3,812,806          -170,023           +49,567
                                                               =========================================================================================
       EMPLOYEE BENEFITS SECURITY ADMINISTRATION [EBSA]

                     SALARIES AND EXPENSES

Enforcement and Participant Assistance........................          142,400           146,032           143,400            +1,000            -2,632
Policy and Compliance Assistance..............................           33,695            26,329            26,329            -7,366   ................
Executive Leadership, Program Oversight and Admin.............            6,692             6,743             6,743               +51   ................
                                                               -----------------------------------------------------------------------------------------
      Total, EBSA.............................................          182,787           179,104           176,472            -6,315            -2,632

          PENSION BENEFIT GUARANTY CORPORATION (PBGC)

Pension Insurance Activities..................................          (87,532)          (80,000)          (80,000)          (-7,532)  ................
Pension Plan Termination......................................         (238,128)         (268,230)         (268,230)         (+30,102)  ................
Operational Support...........................................         (151,241)         (157,211)         (157,211)          (+5,970)  ................
                                                               -----------------------------------------------------------------------------------------
      Total, PBGC (program level).............................         (476,901)         (505,441)         (505,441)         (+28,540)  ................

Enforcement of Wage & Hour Standards..........................          226,607           243,254           243,254           +16,647   ................
Office of Labor-Management Standards..........................           41,206            46,891            41,206   ................           -5,685
Federal Contractor EEO Standards Enforcement..................          104,976           108,467           106,000            +1,024            -2,467

          FEDERAL PROGRAMS FOR WORKERS' COMPENSATION

Salaries and Expenses.........................................          115,488           118,458           115,488   ................           -2,970
    Trust Funds...............................................            2,116             2,142             2,116   ................              -26
                                                               -----------------------------------------------------------------------------------------
      Total, Salaries and Expenses............................          117,604           120,600           117,604   ................           -2,996
          Federal Funds.......................................         (115,488)         (118,458)         (115,488)  ................          (-2,970)
          Trust Funds.........................................           (2,116)           (2,142)           (2,116)  ................             (-26)

                       SPECIAL BENEFITS

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

           SPECIAL BENEFITS FOR DISABLED COAL MINERS

Benefit Payments..............................................          177,000           128,000           128,000           -49,000   ................
Administration................................................            5,227             5,235             5,235                +8   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Fiscal year 2014 program level................          182,227           133,235           133,235           -48,992   ................
          Less funds advanced in prior year...................          -41,000           -35,000           -35,000            +6,000   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Current Year, Fiscal Year 2014...................          141,227            98,235            98,235           -42,992   ................
      New advances, 1st quarter fiscal year 2015..............           40,000            24,000            24,000           -16,000   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Special Benefits for Disabled Coal Miners........          181,227           122,235           122,235           -58,992   ................

             ENERGY EMPLOYEES OCCUPATIONAL ILLNESS

                       COMPENSATION FUND

Part B Administrative Expenses................................           52,147            55,176            55,176            +3,029   ................

               BLACK LUNG DISABILITY TRUST FUND

Benefit Payments and Interest on Advances.....................          242,200           257,478           257,478           +15,278   ................
Workers' Compensation Programs, Salaries and Expenses.........           32,906            33,033            33,033              +127   ................
Departmental Management, Salaries and Expenses................           25,217            25,365            25,365              +148   ................
Departmental Management, Inspector General....................              327               327               327   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Black Lung Disability.........................          300,650           316,203           316,203           +15,553   ................

Treasury Department Administrative Costs......................              356               356               356   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Black Lung Disability Trust Fund.................          301,006           316,559           316,559           +15,553   ................
                                                               =========================================================================================
      Total, Federal Programs for Workers' Compensation.......        1,001,984         1,010,570         1,007,574            +5,590            -2,996
          Federal Funds.......................................          999,868         1,008,428         1,005,458            +5,590            -2,970
              Current year....................................         (959,868)         (984,428)         (981,458)         (+21,590)          (-2,970)
              Fiscal year 2015................................          (40,000)          (24,000)          (24,000)         (-16,000)  ................
          Trust Funds.........................................            2,116             2,142             2,116   ................              -26

     OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION (OSHA)

                     SALARIES AND EXPENSES

Safety and Health Standards...................................           19,922            22,071            21,000            +1,078            -1,071
Federal Enforcement...........................................          207,337           207,785           207,785              +448   ................
Whistleblower enforcement.....................................           15,841            21,883            21,883            +6,042   ................
State Programs................................................          103,987           104,196           103,987   ................             -209
Technical Support.............................................           25,768            24,767            24,767            -1,001   ................

Compliance Assistance:
    Federal Assistance........................................           76,203            75,294            75,294              -909   ................
    State Consultation Grants.................................           57,775            57,890            57,775   ................             -115
    Training Grants...........................................           10,687            10,709            10,709               +22   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Compliance Assistance.........................          144,665           143,893           143,778              -887              -115

Safety and Health Statistics..................................           34,670            34,349            32,922            -1,748            -1,427
Executive Direction and Administration........................           11,468            11,575            10,890              -578              -685
                                                               =========================================================================================
      Total, OSHA.............................................          563,658           570,519           567,012            +3,354            -3,507

             MINE SAFETY AND HEALTH ADMINISTRATION

                     SALARIES AND EXPENSES

Coal Enforcement..............................................          163,572           168,871           168,871            +5,299   ................
Metal/Non-Metal Enforcement...................................           88,486            92,870            92,870            +4,384   ................
Standards Development.........................................            4,456             5,619             5,619            +1,163   ................
Assessments...................................................            7,088             8,358             8,358            +1,270   ................
Educational Policy and Development............................           38,249            29,230            29,230            -9,019   ................
Technical Support.............................................           33,546            34,113            34,113              +567   ................
Program Evaluation and Information Resources [PEIR]...........           18,120            20,268            20,268            +2,148   ................
Program Administration........................................           19,030            21,392            21,392            +2,362   ................
                                                               =========================================================================================
      Total, Mine Safety and Health Administration............          372,547           380,721           380,721            +8,174   ................
                                                               =========================================================================================
      Total, Worker Protection Agencies.......................        1,609,385         1,649,556         1,632,269           +22,884           -17,287
          Federal Funds.......................................       (1,607,269)       (1,647,414)       (1,630,153)         (+22,884)         (-17,261)
          Trust Funds.........................................           (2,116)           (2,142)           (2,116)  ................             (-26)

                  BUREAU OF LABOR STATISTICS

                     SALARIES AND EXPENSES

Employment and Unemployment Statistics........................          209,854           209,481           210,854            +1,000            +1,373
Labor Market Information......................................           67,041            67,176            67,041   ................             -135
Prices and Cost of Living.....................................          204,612           209,699           205,612            +1,000            -4,087
Compensation and Working Conditions...........................           80,105            82,128            80,105   ................           -2,023
Productivity and Technology...................................           12,031            10,313            12,031   ................           +1,718
Executive Direction and Staff Services........................           34,209            34,997            34,209   ................             -788
                                                               =========================================================================================
      Total, Bureau of Labor Statistics.......................          607,852           613,794           609,852            +2,000            -3,942
          Federal Funds.......................................          540,811           546,618           542,811            +2,000            -3,807
          Trust Funds.........................................           67,041            67,176            67,041   ................             -135

            OFFICE OF DISABILITY EMPLOYMENT POLICY

SALARIES AND EXPENSES.........................................           38,802            42,432            42,432            +3,630   ................

                    DEPARTMENTAL MANAGEMENT

                     SALARIES AND EXPENSES

Executive Direction...........................................           33,154            31,812            31,812            -1,342   ................
Departmental Program Evaluation...............................            8,467             9,000             8,467   ................             -533
Legal Services................................................          128,619           127,684           127,684              -935   ................
    Trust Funds...............................................              325               326               326                +1   ................
International Labor Affairs...................................           92,125            95,425            95,425            +3,300   ................
Administration and Management.................................           30,221            30,435            30,221   ................             -214
Adjudication..................................................           29,113            30,352            29,113   ................           -1,239
Women's Bureau................................................           11,536             9,214            11,536   ................           +2,322
Civil Rights Activities.......................................            6,772             8,268             6,772   ................           -1,496
Chief Financial Officer.......................................            5,329             5,440             5,329   ................             -111
                                                               -----------------------------------------------------------------------------------------
      Total, Salaries and expenses............................          345,661           347,956           346,685            +1,024            -1,271
          Federal Funds.......................................         (345,336)         (347,630)         (346,359)          (+1,023)          (-1,271)
          Trust Funds.........................................             (325)             (326)             (326)              (+1)  ................

               VETERANS EMPLOYMENT AND TRAINING

State Administration, Grants..................................          169,852           203,081           203,081           +33,229   ................
Transition Assistance Program.................................           14,242            14,000            14,000              -242   ................
Federal Administration........................................           38,245            41,838            41,838            +3,593   ................
National Veterans Training Institute..........................            3,459             3,414             3,414               -45   ................
Homeless Veterans Program.....................................           38,109            38,185            38,185               +76   ................
Veterans Workforce Investment Programs........................  ................  ................  ................  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Veterans Employment and Training.................          263,907           300,518           300,518           +36,611   ................
          Federal Funds.......................................           38,109            38,185            38,185               +76   ................
          Trust Funds.........................................          225,798           262,333           262,333           +36,535   ................

            INFRASTRUCTURE TECHNOLOGY MODERNIZATION

Departmental support systems..................................           11,806             4,898             4,898            -6,908   ................
Infrastructure technology modernization.......................            7,969            15,689            14,877            +6,908              -812
                                                               -----------------------------------------------------------------------------------------
      Total, IT Modernization.................................           19,775            20,587            19,775   ................             -812

                  OFFICE OF INSPECTOR GENERAL

Program Activities............................................           77,634            79,805            77,634   ................           -2,171
    Trust Funds...............................................            5,886             5,909             5,886   ................              -23
                                                               -----------------------------------------------------------------------------------------
      Total, Office of Inspector General......................           83,520            85,714            83,520   ................           -2,194
                                                               =========================================================================================
      Total, Departmental Management..........................          712,863           754,775           750,498           +37,635            -4,277
          Federal Funds.......................................          480,854           486,207           481,953            +1,099            -4,254
              Current Year....................................         (480,854)         (486,207)         (481,953)          (+1,099)          (-4,254)
          Trust Funds.........................................          232,009           268,568           268,545           +36,536               -23
                                                               =========================================================================================
            Total, Title I, Department of Labor...............       14,174,600        14,646,171        14,604,208          +429,608           -41,963

                Federal Funds.................................        9,890,605        10,545,046        10,453,700          +563,095           -91,346
                    Current Year..............................       (8,053,605)       (8,749,046)       (8,657,700)        (+604,095)         (-91,346)
                    Emergency appropriations..................           25,000   ................  ................          -25,000   ................
                    Fiscal year 2015..........................       (1,812,000)       (1,796,000)       (1,796,000)         (-16,000)  ................
                Trust Funds...................................        4,283,995         4,101,125         4,150,508          -133,487           +49,383

       TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES

      HEALTH RESOURCES AND SERVICES ADMINISTRATION [HRSA]

                 HEALTH RESOURCES AND SERVICES

                      Primary Health Care

Community Health Centers......................................        1,574,606         1,566,892         1,574,606   ................           +7,714
Free Clinics Medical Malpractice..............................               40                40                40   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Primary Health Care...........................        1,574,646         1,566,932         1,574,646   ................           +7,714

              Bureau of Health Professions [BHP]

                       Health Workforce

Health Professions, Training for Diversity:
    Centers of Excellence.....................................           22,863            22,909            22,863   ................              -46
    Health Careers Opportunity Program........................           14,942   ................           14,942   ................          +14,942
    Faculty Loan Repayment....................................            1,253             1,243             1,253   ................              +10
    Scholarships for Disadvantaged Students...................           47,357            47,452            47,357   ................              -95
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Training for Diversity........................           86,415            71,604            86,415   ................          +14,811

Training in Primary Care Medicine.............................           38,884            50,962            50,962           +12,078   ................
Pediatric Loan Repayment......................................  ................            5,000             5,000            +5,000   ................
Oral Health Training..........................................           32,654            32,392            32,654   ................             +262

Interdisciplinary Community-Based Linkages:
    Area Health Education Centers.............................           30,025   ................           30,025   ................          +30,025
    Geriatric Programs........................................           30,877            30,629            30,629              -248   ................
    Alzheimer's--Prevention and Public Health Fund\3\.........           (1,847)           (5,300)           (5,300)          (+3,453)  ................
    Mental and Behavorial Health..............................            2,916             2,892             3,916            +1,000            +1,024
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Interdisciplinary Community Linkages..........           63,818            33,521            64,570              +752           +31,049

          Evaluation Tap Funding..............................  ................  ................  ................  ................  ................
          Prevention and Public Health Fund\3\................            1,847             5,300             5,300            +3,453   ................
                                                               -----------------------------------------------------------------------------------------
            Total, Interdisciplinary Community Linkages.......           65,665            38,821            69,870            +4,205           +31,049

Workforce Information and Analysis............................            2,804             5,000             5,000            +2,196   ................

Public Health and Preventive Medicine programs................            8,177             3,226            10,177            +2,000            +6,951
    Prevention and Public Health Fund\3\......................  ................           (4,776)          (25,000)         (+25,000)         (+20,224)
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Public Health and Preventive Medicine.........            8,177             8,002            35,177           +27,000           +27,175

Nursing Programs:
    Advanced Education Nursing................................           63,797            83,469            83,469           +19,672   ................
    Nurse Education, Practice, and Retention..................           39,499            39,638            39,638              +139   ................
    Nursing Workforce Diversity...............................           15,947            15,819            15,819              -128   ................
    Loan Repayment and Scholarship Program....................           82,968            83,135            83,135              +167   ................
    Comprehensive Geriatric Education.........................            4,521             4,485             4,485               -36   ................
    Nursing Faculty Loan Program..............................           24,751            24,553            24,553              -198   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Nursing programs..............................          231,483           251,099           251,099           +19,616   ................

Children's Hospitals Graduate Medical Education...............          267,313            88,000           267,313   ................         +179,313
National Practitioner Data Bank...............................           28,016            28,016            28,016   ................  ................
    User Fees.................................................          -28,016           -28,016           -28,016   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Bureau of Health Professions..................          731,548           540,804           773,190           +41,642          +232,386
          Prevention and Public Health Fund...................           (1,847)          (10,076)          (30,300)         (+28,453)         (+20,224)
                                                               -----------------------------------------------------------------------------------------
      Total, Health Professions Program Level.................          733,395           550,880           803,490           +70,095          +252,610

                   Maternal and Child Health

Maternal and Child Health Block Grant.........................          643,807           638,646           643,807   ................           +5,161
Sickle Cell Anemia Demonstration Program......................            4,703             4,665             4,670               -33                +5
Traumatic Brain Injury........................................            9,840             9,760             9,760               -80   ................
Autism and Other Developmental Disorders......................           47,523            47,142            47,142              -381   ................
Heritable Disorders...........................................            9,913   ................            9,913   ................           +9,913
Heritable Disorders-Prevention and Public Health Fund.........  ................           (9,834)  ................  ................          (-9,834)
Healthy Start.................................................          104,369           103,532           103,532              -837   ................
Universal Newborn Hearing.....................................           18,811   ................           18,660              -151           +18,660
Universal Newborn Hearing--Prevention and Public Health Fund..  ................          (18,660)  ................  ................         (-18,660)
Emergency Medical Services for Children.......................           21,286            21,116            21,116              -170   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Maternal and Child Health.....................          860,252           824,861           858,600            -1,652           +33,739
          Prevention and Public Health Fund...................  ................          (28,494)  ................  ................         (-28,494)
                                                               -----------------------------------------------------------------------------------------
      Total, Maternal and Child Health Program Level..........          860,252           853,355           858,600            -1,652            +5,245

                  Ryan White HIV/AIDS Program

Ryan White AIDS Programs:
    Emergency Assistance......................................          669,915           666,071           669,915   ................           +3,844
    Comprehensive Care Programs...............................        1,317,999         1,370,827         1,369,327           +51,328            -1,500
        AIDS Drug Assistance Program [ADAP] (NA)..............         (896,502)         (943,299)         (943,299)         (+46,797)  ................
    Early Intervention Program................................          204,765           225,086           204,765   ................          -20,321
    Children, Youth, Women, and Families......................           77,013            77,167            77,013   ................             -154
    AIDS Dental Services......................................           13,458            13,485            13,458   ................              -27
    Education and Training Centers............................           34,473            34,542            34,473   ................              -69
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Ryan White AIDS programs......................        2,317,623         2,387,178         2,368,951           +51,328           -18,227
          Evaluation Tap Funding (NA).........................          (25,000)          (25,000)          (25,000)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Ryan White AIDs Program Level....................       (2,342,623)       (2,412,178)       (2,393,951)         (+51,328)         (-18,227)

                      Health Care Systems

Organ Transplantation.........................................           24,799            26,015            26,015            +1,216   ................
National Cord Blood Inventory.................................           11,864            11,887            11,864   ................              -23
Bone Marrow Program...........................................           23,283            23,330            23,283   ................              -47
Office of Pharmacy Affairs....................................            4,463             4,472             4,463   ................               -9
340B Drug Pricing User Fees...................................  ................            6,000             6,000            +6,000   ................
    User Fees.................................................  ................           -6,000            -6,000            -6,000   ................
Poison Control................................................           18,793   ................           19,793            +1,000           +19,793
Poison control-Prevention and Public Health Fund\3\...........  ................          (18,830)  ................  ................         (-18,830)
Hansen's Disease Services.....................................           16,013            16,045            16,013   ................              -32
Buildings and Facilities......................................              128               127               128   ................               +1
Payment to Hawaii, treatment of Hansen's......................            1,956             1,960             1,956   ................               -4
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Health Care Systems...........................          101,299            83,836           103,515            +2,216           +19,679
          Prevention and Public Health Fund...................  ................          (18,830)  ................  ................         (-18,830)
                                                               -----------------------------------------------------------------------------------------
      Total, Health Care Systems Program Level................          101,299           102,666           103,515            +2,216              +849

                         Rural Health

Rural Outreach Grants.........................................           55,442            55,553            55,442   ................             -111
Rural Health Research/Policy Development......................            9,847             9,866             9,847   ................              -19
Rural Hospital Flexibility Grants.............................           40,958            26,200            40,958   ................          +14,758
Rural and Community Access to Emergency Devices...............            2,490   ................            5,000            +2,510            +5,000
State Offices of Rural Health.................................           10,016            10,036            10,016   ................              -20
Black Lung Clinics............................................            7,125             7,140             7,125   ................              -15
Radiation Exposure Screening and Education Program............            1,931             1,935             1,931   ................               -4
Telehealth....................................................           11,479            11,502            11,479   ................              -23
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Rural Health..................................          139,288           122,232           141,798            +2,510           +19,566

Family Planning...............................................          296,244           327,402           327,402           +31,158   ................
Program Management............................................          161,186           161,794           161,794              +608   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Health resources & services appropriation........       (6,182,086)       (6,015,039)       (6,309,896)        (+127,810)        (+294,857)

       HEALTH EDUCATION ASSISTANCE LOANS PROGRAM ACCOUNT

HEAL Liquidating Account......................................           (1,000)           (1,000)           (1,000)  ................  ................
HEAL Program Management.......................................            2,830             2,807             2,807               -23   ................
                                                               -----------------------------------------------------------------------------------------
      Total, HEAL.............................................            2,830             2,807             2,807               -23   ................

        VACCINE INJURY COMPENSATION PROGRAM TRUST FUND

Post-Fiscal Year 1988 Claims..................................          235,000           235,000           235,000   ................  ................
HRSA Administration...........................................            6,464             6,477             6,464   ................              -13
                                                               -----------------------------------------------------------------------------------------
      Total, Vaccine Injury Compensation Trust Fund...........          241,464           241,477           241,464   ................              -13
                                                               =========================================================================================
      Total, Health Resources & Services Administration.......        6,426,380         6,259,323         6,554,167          +127,787          +294,844
          Evaluation tap funding..............................          (25,000)          (25,000)          (25,000)  ................  ................
          Prevention and Public Health Fund\3\................           (1,847)          (57,400)          (30,300)         (+28,453)         (-27,100)
                                                               -----------------------------------------------------------------------------------------
      Total, HRSA program level...............................       (6,453,227)       (6,341,723)       (6,609,467)        (+156,240)        (+267,744)

          CENTERS FOR DISEASE CONTROL AND PREVENTION

            DISEASE CONTROL, RESEARCH, AND TRAINING

Immunization and Respiratory Diseases.........................          575,095           668,696           575,095   ................          -93,601
    Evaluation Tap Funding....................................          (12,864)          (12,864)          (12,864)  ................  ................
    Pandemic Flu balances (Public Law 111-32).................          (11,829)  ................  ................         (-11,829)  ................
    Prevention and Public Health Fund\3\......................          (90,883)          (72,460)         (150,000)         (+59,117)         (+77,540)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (690,671)         (754,020)         (737,959)         (+47,288)         (-16,061)

HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.............        1,097,823         1,173,942         1,097,823   ................          -76,119
    Evaluation Tap Funding....................................  ................           (3,000)  ................  ................          (-3,000)
    Prevention and Public Health Fund\3\......................  ................  ................          (10,000)         (+10,000)         (+10,000)
                                                               -----------------------------------------------------------------------------------------
      Subtotal, HIV/AIDS, Viral Hepathitis, STD & TB..........        1,097,823         1,176,942         1,107,823           +10,000           -69,119

Emerging and Zoonotic Infectious Diseases.....................          252,043           380,664           283,237           +31,194           -97,427
    Prevention and Public Health Fund\3\......................          (44,174)          (51,750)          (52,000)          (+7,826)            (+250)
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Emerging and Zoonotic Infectious..............          296,217           432,414           335,237           +39,020           -97,177

Chronic Disease Prevention and Health Promotion...............          755,079           620,189           774,831           +19,752          +154,642
    Evaluation Tap Funding....................................  ................  ................  ................  ................  ................
    Prevention and Public Health Fund\3\......................         (233,033)         (415,904)         (485,700)        (+252,667)         (+69,796)
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Chronic Disiease Prevention...................         (988,112)       (1,036,093)       (1,260,531)        (+272,419)        (+224,438)

Birth Defects and Developmental Disabilities..................          137,051            67,148           123,483           -13,568           +56,335
    Prevention and Public Health Fund\3\......................  ................          (74,796)  ................  ................         (-74,796)
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Birth Defects.................................         (137,051)         (141,944)         (123,483)         (-13,568)         (-18,461)

Public Health Scientific Services.............................          143,726           144,416           143,726   ................             -690
    Evaluation Tap Funding....................................         (247,769)         (324,889)         (247,769)  ................         (-77,120)
    Prevention and Public Health Fund\3\......................          (51,501)          (70,000)          (58,100)          (+6,599)         (-11,900)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (442,996)         (539,305)         (449,595)          (+6,599)         (-89,710)

Environmental Health..........................................          104,819           126,126           113,827            +9,008           -12,299
    Prevention and Public Health Fund\3\......................          (20,740)          (29,000)          (39,200)         (+18,460)         (+10,200)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (125,559)         (155,126)         (153,027)         (+27,468)          (-2,099)

Injury Prevention and Control.................................          137,456           176,585           162,456           +25,000           -14,129
    Prevention and Public Health Fund\3\......................  ................  ................           (3,000)          (+3,000)          (+3,000)
    Evaluation Tap Funding....................................  ................           (5,000)  ................  ................          (-5,000)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (137,456)         (181,585)         (165,456)         (+28,000)         (-16,129)

National Institute for Occupational Safety & Health\3\........          181,551   ................          181,551   ................         +181,551
    Evaluation Tap Funding....................................         (110,724)         (271,911)         (110,724)  ................        (-161,187)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (292,275)         (271,911)         (292,275)  ................         (+20,364)

Energy Employees Occupational Illness Compensation Program....           55,358            55,358            55,358   ................  ................
Global Health.................................................          346,964           393,024           391,964           +45,000            -1,060
Public Health Preparedness and Response.......................        1,297,248         1,334,316         1,292,498            -4,750           -41,818
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................        1,297,248         1,334,316         1,292,498            -4,750           -41,818

CDC-Wide Activities...........................................          616,854           131,402           616,563              -291          +485,161
    Prevention and Public Health Fund\3\......................          (22,585)          (41,200)          (41,000)         (+18,415)            (-200)
                                                               -----------------------------------------------------------------------------------------
      Subtotal, CDC-Wide Activities...........................         (639,439)         (172,602)         (657,563)         (+18,124)        (+484,961)

      Total, Centers for Disease Control......................        5,701,067         5,271,866         5,812,412          +111,345          +540,546
          Discretionary.......................................        5,645,709         5,216,508         5,757,054          +111,345          +540,546
          Evaluation Tap Funding (NA).........................         (371,357)         (617,664)         (371,357)  ................        (-246,307)
          Pandemic Flu balances (Public Law 111-32)...........          (11,829)  ................  ................         (-11,829)  ................
                                                               -----------------------------------------------------------------------------------------
          Prevention and Public Health Fund\3\................         (462,916)         (755,110)         (839,000)        (+376,084)         (+83,890)
                                                               =========================================================================================
      Total, Centers for Disease Control Program Level........       (6,547,169)       (6,644,640)       (7,022,769)        (+475,600)        (+378,129)

                 NATIONAL INSTITUTES OF HEALTH

National Cancer Institute.....................................        5,062,039         5,125,951         5,091,885           +29,846           -34,066
National Heart, Lung, and Blood Institute.....................        3,072,863         3,098,508         3,077,916            +5,053           -20,592
National Institute of Dental & Craniofacial Research..........          409,889           411,515           409,947               +58            -1,568
National Institute of Diabetes and Digestive and Kidney               1,793,450         1,811,786         1,799,745            +6,295           -12,041
 Diseases [NIDDK].............................................
National Institute of Neurological Disorders & Stroke.........        1,623,113         1,642,619         1,631,703            +8,590           -10,916
National Institute of Allergy and Infectious Diseases.........        4,481,730         4,578,813         4,548,383           +66,653           -30,430
    Global HIV/AIDS Fund Transfer.............................  ................  ................  ................  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, NIAID program level...........................        4,481,730         4,578,813         4,548,383           +66,653           -30,430

National Institute of General Medical Sciences................        2,425,175         2,401,011         2,435,570           +10,395           +34,559
National Institute of Child Health & Human Development........        1,318,755         1,339,360         1,330,459           +11,704            -8,901
National Eye Institute........................................          701,307           699,216           701,407              +100            +2,191
National Institute of Environmental Health Sciences...........          684,200           691,348           686,753            +2,553            -4,595
National Institute on Aging...................................        1,101,234         1,193,370         1,185,439           +84,205            -7,931
National Institute of Arthritis and Musculoskeletal and Skin            534,715           540,993           537,398            +2,683            -3,595
 Diseases.....................................................
National Institute on Deafness and Other Communication                  415,440           422,936           420,125            +4,685            -2,811
 Disorders....................................................
National Institute of Nursing Research........................          144,479           146,244           145,272              +793              -972
National Institute on Alcohol Abuse and Alcoholism............          458,600           463,848           460,765            +2,165            -3,083
National Institute on Drug Abuse..............................        1,051,261         1,071,612         1,064,490           +13,229            -7,122
National Institute of Mental Health...........................        1,477,304         1,465,782         1,456,041           -21,263            -9,741
National Human Genome Research Institute......................          511,847           517,319           513,881            +2,034            -3,438
National Institute of Biomedical Imaging and Bioengineering...          337,681           338,892           337,728               +47            -1,164
National Center for Complementary and Alternative Medicine....          127,800           129,041           128,183              +383              -858
National Institute on Minority Health and Health Disparities..          275,887           283,299           281,416            +5,529            -1,883
John E. Fogarty International Center..........................           69,483            72,864            72,380            +2,897              -484
National Center for Advancing Translation Sciences............          574,216           665,688           661,264           +87,048            -4,424
National Library of Medicine (NLM)............................          336,963           382,252           379,712           +42,749            -2,540
    Evaluation Tap Funding....................................           (8,200)           (8,200)           (8,200)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          345,163           390,452           387,912           +42,749            -2,540

Office of the Director........................................        1,525,125         1,473,398         1,463,606           -61,519            -9,792
    Common fund...............................................         (544,870)         (572,948)         (568,151)         (+23,281)          (-4,797)
Buildings and Facilities......................................          125,093           126,111           125,308              +215              -803
                                                               =========================================================================================
      Total, National Institutes of Health (NIH)..............       30,639,649        31,093,776        30,946,776          +307,127          -147,000
          Evaluation Tap Funding..............................           (8,200)           (8,200)           (8,200)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, NIH Program Level................................      (30,647,849)      (31,101,976)      (30,954,976)        (+307,127)        (-147,000)

   SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION
                           [SAMHSA]

          SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES

Mental Health:
    Programs of Regional and National Significance............          275,205           333,277           357,191           +81,986           +23,914
    Prevention and Public Health Fund\3\......................  ................          (28,000)          (27,000)         (+27,000)          (-1,000)
                                                               -----------------------------------------------------------------------------------------
      Subtotal, PRNS..........................................         (275,205)         (361,277)         (384,191)        (+108,986)         (+22,914)

    Mental Health block grant.................................          437,840           438,717           462,705           +24,865           +23,988
        Evaluation Tap Funding................................          (21,039)          (21,039)          (21,039)  ................  ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal, MHBG Program level........................         (458,879)         (459,756)         (483,744)         (+24,865)         (+23,988)

    Children's Mental Health..................................          117,345           117,315           117,315               -30   ................
    Grants to States for the Homeless (PATH)..................           64,665            64,794            64,794              +129   ................
    Protection and Advocacy...................................           36,166            36,238            36,238               +72   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Mental Health.................................          931,221           990,341         1,038,243          +107,022           +47,902
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Mental health program level...................         (952,260)       (1,039,380)       (1,086,282)        (+134,022)         (+46,902)

Substance Abuse Treatment:
    Programs of Regional and National Significance............          398,048           304,794           306,451           -91,597            +1,657
    Prevention and Public Health Fund\3\......................  ................          (30,000)          (50,000)         (+50,000)         (+20,000)
        Evaluation Tap Funding................................           (2,000)  ................           (2,000)  ................          (+2,000)
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Program level.............................         (400,048)         (334,794)         (358,451)         (-41,597)         (+23,657)

    Substance Abuse block grant...............................        1,717,690         1,748,132         1,740,656           +22,966            -7,476
        Evaluation Tap Funding................................          (79,200)          (71,724)          (79,200)  ................          (+7,476)
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Program level.............................       (1,796,890)       (1,819,856)       (1,819,856)         (+22,966)  ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Substance Abuse Treatment.................        2,115,738         2,052,926         2,047,107           -68,631            -5,819
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Program level.............................       (2,196,938)       (2,154,650)       (2,178,307)         (-18,631)         (+23,657)

Substance Abuse Prevention:
    Programs of Regional and National Significance............          185,637           175,560           175,631           -10,006               +71
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Program Level.................................         (185,637)         (175,560)         (175,631)         (-10,006)             (+71)

Health Surveillance and Program Support:
    Health Surveillance, Crosscutting Issues and Support......          108,681           129,124           136,296           +27,615            +7,172
        Prevention and Public Health Fund.....................          (14,733)  ................          (15,000)            (+267)         (+15,000)
        Evaluation Tap Funding (NA)...........................          (27,428)          (71,995)          (30,428)          (+3,000)         (-41,567)
    Data Requests and Publications............................  ................            1,500             1,500            +1,500   ................
    User fees.................................................  ................           -1,500            -1,500            -1,500   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Health Surveillance Program Level................          150,842           201,119           181,724           +30,882           -19,395
                                                               =========================================================================================
      Total, SAMHSA...........................................        3,341,277         3,347,951         3,397,277           +56,000           +49,326

          Evaluation Tap Funding..............................         (129,667)         (164,758)         (132,667)          (+3,000)         (-32,091)
          Prevention and Public Health Fund\3\................          (14,733)          (58,000)          (92,000)         (+77,267)         (+34,000)
                                                               -----------------------------------------------------------------------------------------
      Total, SAMHSA Program Level.............................       (3,485,677)       (3,570,709)       (3,621,944)        (+136,267)         (+51,235)

       AGENCY FOR HEALTHCARE RESEARCH AND QUALITY [AHRQ]

                HEALTHCARE RESEARCH AND QUALITY

Research on Health Costs, Quality, and Outcomes:
    Evaluation Tap funding....................................         (235,768)         (201,073)         (231,384)          (-4,384)         (+30,311)
    Prevention and Public Health Fund\3\......................           (6,465)  ................           (7,000)            (+535)          (+7,000)
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Health Costs, Quality, and Outcomes...........         (242,233)         (201,073)         (238,384)          (-3,849)         (+37,311)

Medical Expenditures Panel Surveys:
    Evaluation Tap Funding (NA)...............................          (60,700)          (63,811)          (63,811)          (+3,111)  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Medical Expenditures Panel Surveys............          (60,700)          (63,811)          (63,811)          (+3,111)  ................

Program Support:
    Evaluation Tap Funding (NA)...............................          (72,585)          (68,813)          (68,813)          (-3,772)  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          (72,585)          (68,813)          (68,813)          (-3,772)  ................

          Evaluation Tap Funding (NA).........................         (369,053)         (333,697)         (364,008)          (-5,045)         (+30,311)
          AHRQ, Prevention and Public Health Fund\3\..........           (6,465)  ................           (7,000)            (+535)          (+7,000)
                                                               -----------------------------------------------------------------------------------------
      Total, AHRQ Program Level...............................         (375,518)         (333,697)         (371,008)          (-4,510)         (+37,311)
                                                               =========================================================================================
      Total, Public Health Service (PHS) appropriation........       46,108,373        45,972,916        46,710,632          +602,259          +737,716
      Total, Public Health Service Program Level..............      (47,510,440)      (47,993,745)      (48,581,164)      (+1,070,724)        (+587,419)

          CENTERS FOR MEDICARE AND MEDICAID SERVICES

                 GRANTS TO STATES FOR MEDICAID

Medicaid Current Law Benefits.................................      249,401,000       263,462,118       263,462,118       +14,061,118   ................
State and Local Administration................................       16,181,506        16,453,115        16,453,115          +271,609   ................
Vaccines for Children.........................................        3,607,256         4,293,383         4,293,383          +686,127   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Medicaid Program Level........................      269,189,762       284,208,616       284,208,616       +15,018,854   ................
          Less funds advanced in prior year...................      -90,614,082      -106,335,631      -106,335,631       -15,721,549   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Grants to States for Medicaid....................      178,575,680       177,872,985       177,872,985          -702,695   ................
          New advance, 1st quarter............................      106,335,631       103,472,323       103,472,323        -2,863,308   ................

              PAYMENTS TO HEALTH CARE TRUST FUNDS

Supplemental Medical Insurance................................      181,351,000       194,565,000       194,565,000       +13,214,000   ................
Federal Uninsured Payment.....................................          228,000           204,000           204,000           -24,000   ................
Program Management............................................          750,000         1,319,000         1,319,000          +569,000   ................
General Revenue for Part D Benefit............................       51,245,000        58,596,000        58,596,000        +7,351,000   ................
General Revenue for Part D Administration.....................          382,000           373,000           373,000            -9,000   ................
HCFAC Reimbursement...........................................          309,790           128,000           640,000          +330,210          +512,000
                                                               -----------------------------------------------------------------------------------------
      Total, Payments to Trust Funds, Program Level...........      234,265,790       255,185,000       255,697,000       +21,431,210          +512,000

Reduced Cost Sharing for Individuals in Qualified Plan........  ................        3,977,893   ................  ................       -3,977,893
    New Advance Fiscal Year 2015..............................  ................        1,420,000   ................  ................       -1,420,000

                      PROGRAM MANAGEMENT

Research, Demonstration, Evaluation...........................           21,118   ................  ................          -21,118   ................
Program operations............................................        2,653,582         4,011,200         4,011,200        +1,357,618   ................
Program Operations--PPHF\3\ (NA)..............................         (453,803)  ................  ................        (-453,803)  ................
State Survey and Certification................................          374,453           412,353           412,353           +37,900   ................
High Risk Insurance Pools.....................................           44,000            22,004            22,004           -21,996   ................
Federal Administration........................................          771,418           771,800           771,800              +382   ................
                                                               =========================================================================================
      Total, Program management, Limitation on new BA.........        3,864,571         5,217,357         5,217,357        +1,352,786   ................
      Total, Program management, Program level................        4,318,374         5,217,357         5,217,357          +898,983   ................

              HEALTH CARE FRAUD AND ABUSE CONTROL

CMS Activities................................................          249,942           251,420           429,846          +179,904          +178,426
HHS Office of Inspector General...............................           29,614            29,790           107,541           +77,927           +77,751
Department of Justice.........................................           29,614            29,790           102,613           +72,999           +72,823
                                                               -----------------------------------------------------------------------------------------
      Total, Health Care Fraud and Abuse Control..............          309,170           311,000           640,000          +330,830          +329,000
                                                               =========================================================================================
      Total, Centers for Medicare and Medicaid Services.......      523,350,842       547,456,558       542,899,665       +19,548,823        -4,556,893
          Federal funds.......................................      519,177,101       541,928,201       537,042,308       +17,865,207        -4,885,893
              Current year....................................     (412,841,470)     (437,035,878)     (433,569,985)     (+20,728,515)      (-3,465,893)
              New advance, Fiscal year 2015...................     (106,335,631)     (104,892,323)     (103,472,323)      (-2,863,308)      (-1,420,000)
          Trust Funds.........................................        4,173,741         5,528,357         5,857,357        +1,683,616          +329,000

           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............................        3,429,973         3,480,340         3,480,340           +50,367   ................
    Federal Incentive Payments................................          529,779           540,905           540,905           +11,126   ................
    Access and Visitation.....................................           10,000            10,000            10,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Child Support Enforcement.....................        3,969,752         4,031,245         4,031,245           +61,493   ................
                                                               =========================================================================================
      Total, Family Support Payments Program Level............        4,003,752         4,065,245         4,065,245           +61,493   ................

          Less funds advanced in previous years...............       -1,100,000        -1,100,000        -1,100,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Family Support Payments, current year............        2,903,752         2,965,245         2,965,245           +61,493   ................
          New advance, 1st quarter, Fiscal year 2015..........        1,100,000         1,250,000         1,250,000          +150,000   ................

          LOW-INCOME HOME ENERGY ASSISTANCE [LIHEAP]

Formula Grants................................................        3,464,729         2,820,000         3,614,729          +150,000          +794,729
Contingency Fund..............................................  ................          150,000   ................  ................         -150,000
Energy Reduction Burden Grants................................  ................           50,000   ................  ................          -50,000
                                                               -----------------------------------------------------------------------------------------
      Total, LIHEAP, Program Level............................        3,464,729         3,020,000         3,614,729          +150,000          +594,729

                REFUGEE AND ENTRANT ASSISTANCE

Transitional and Medical Services.............................          411,673           391,477           391,477           -20,196   ................
Victims of Trafficking........................................            9,755            19,775            15,775            +6,020            -4,000
Social Services...............................................          153,100           153,407           153,407              +307   ................
Preventive Health.............................................            4,814             4,730             4,730               -84   ................
Targeted Assistance...........................................           48,304            48,401            48,401               +97   ................
Unaccompanied Minors..........................................          375,088           494,597           494,597          +119,509   ................
Victims of Torture............................................           11,234            11,045            13,045            +1,811            +2,000
                                                               -----------------------------------------------------------------------------------------
      Total, Refugee and Entrant Assistance...................        1,013,968         1,123,432         1,121,432          +107,464            -2,000

  PAYMENTS TO STATES FOR THE CHILD CARE AND DEVELOPMENT BLOCK
                             GRANT

Child Care and Development Block Grant........................        2,323,656         2,478,313         2,500,000          +176,344           +21,687

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................................        7,986,040         9,621,070         9,621,070        +1,635,030   ................
    Consolidated Runaway, Homeless Youth Program..............           97,160           100,355            99,355            +2,195            -1,000
    Prevention Grants to Reduce Abuse of Runaway Youth........           17,865            17,901            17,865   ................              -36
    Child Abuse State Grants..................................           26,379            26,432            26,379   ................              -53
    Child Abuse Discretionary Activities......................           25,693            25,744            25,693   ................              -51
    Community Based Child Abuse Prevention....................           41,444            41,527            41,444   ................              -83
    Abandoned Infants Assistance..............................           11,530            11,553            11,530   ................              -23
    Child Welfare Services....................................          280,088           280,650           280,088   ................             -562
    Child Welfare Training/Innovative Approaches to Foster               26,039            26,092            26,039   ................              -53
     Care.....................................................
    Adoption Opportunities....................................           39,100            39,179            44,100            +5,000            +4,921
    Adoption Incentive........................................           39,268            39,346            39,268   ................              -78

Social Services and Income Maintenance Research...............  ................           44,000             9,000            +9,000           -35,000
    Evaluation Tap Funding....................................           (5,762)           (5,762)           (5,762)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Program Level.................................           (5,762)          (49,762)          (14,762)          (+9,000)         (-35,000)

Developmental Disabilities Programs:
    State Councils............................................           74,625   ................  ................          -74,625   ................
    Protection and Advocacy...................................           40,783   ................  ................          -40,783   ................
    Voting Access for Individuals with Disabilities...........            5,225   ................  ................           -5,225   ................
    Developmental Disabilities Projects of National                       8,301   ................  ................           -8,301   ................
     Significance.............................................
    University Centers for Excellence in Developmental                   38,714   ................  ................          -38,714   ................
     Disabilities.............................................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Developmental Disabilities Programs...........          167,648   ................  ................         -167,648   ................

Native American Programs......................................           48,486            48,583            48,486   ................              -97

Community Services:
    Community Services Block Grant Act programs:
        Grants to States for Community Services...............          676,003           350,000           676,003   ................         +326,003
        Economic Development..................................           29,883   ................           29,883   ................          +29,883
        Rural Community Facilities............................            4,971   ................            5,971            +1,000            +5,971
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................          710,857           350,000           711,857            +1,000          +361,857

        Individual Development Account Initiative.............           19,830            19,469            20,000              +170              +531
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Community Services........................          730,687           369,469           731,857            +1,170          +362,388

Domestic Violence Hotline.....................................            3,191             4,500             4,500            +1,309   ................
Family Violence/Battered Women's Shelters.....................          129,288           135,000           135,000            +5,712   ................
Independent Living Training Vouchers..........................           45,084            45,174            45,084   ................              -90
Faith-Based Center............................................            1,368             1,370             1,368   ................               -2
Disaster Human Services Case Management.......................            1,988             1,992             1,988   ................               -4
Program Direction.............................................          203,220           203,245           202,000            -1,220            -1,245
                                                               =========================================================================================
      Total, Children and Families Services Programs..........        9,921,566        11,083,182        11,412,114        +1,490,548          +328,932

          Current Year........................................       (9,921,566)      (11,083,182)      (11,412,114)      (+1,490,548)        (+328,932)
          Evaluation Tap Funding..............................           (5,762)           (5,762)           (5,762)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Program Level....................................       (9,927,328)      (11,088,944)      (11,417,876)      (+1,490,548)        (+328,932)

PROMOTING SAFE AND STABLE FAMILIES............................          345,000           345,000           345,000   ................  ................
    Discretionary Funds.......................................           62,938            63,065            63,065              +127   ................

            PAYMENTS FOR FOSTER CARE AND PERMANENCY

Foster Care...................................................        4,285,540         4,279,000         4,279,000            -6,540   ................
Adoption Assistance...........................................        2,368,680         2,463,000         2,463,000           +94,320   ................
Kinship Guardianship..........................................          123,000           124,000           124,000            +1,000   ................
Independent Living............................................          140,000           140,000           140,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
    Total, Payments to States.................................        6,917,220         7,006,000         7,006,000           +88,780   ................
        Less Advances from Prior Year.........................       -2,100,000        -2,200,000        -2,200,000          -100,000   ................
                                                               -----------------------------------------------------------------------------------------
            Total, payments, current year.....................        4,817,220         4,806,000         4,806,000           -11,220   ................
            New Advance, 1st quarter..........................        2,200,000         2,200,000         2,200,000   ................  ................
                                                               =========================================================================================
        Total, Administration for Children & Families.........       29,852,829        31,034,237        31,977,585        +2,124,756          +943,348
            Current year......................................      (26,552,829)      (27,584,237)      (28,527,585)      (+1,974,756)        (+943,348)
            Fiscal year 2015..................................       (3,300,000)       (3,450,000)       (3,450,000)        (+150,000)  ................
            Evaluation Tap Funding............................           (5,762)           (5,762)           (5,762)  ................  ................
                                                               -----------------------------------------------------------------------------------------
        Total, ACF Program Level..............................       29,858,591        31,039,999        31,983,347        +2,124,756          +943,348

              ADMINISTRATION FOR COMMUNITY LIVING

            AGING AND DISABILITY SERVICES PROGRAMS

Grants to States:
    Home and Community-based Supportive Services..............          366,182           366,916           366,916              +734   ................
    Preventive Health.........................................           20,902            20,944            20,944               +42   ................
    Protection of Vulnerable Older Americans--Title VII.......           21,754            21,797            21,797               +43   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          408,838           409,657           409,657              +819   ................

    Family Caregivers.........................................          153,314           153,621           153,621              +307   ................
    Native American Caregivers Support........................            6,351             6,364             6,364               +13   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Caregivers....................................          159,665           159,985           159,985              +320   ................

    Nutrition:
        Congregate Meals......................................          438,191           439,070           439,070              +879   ................
        Home Delivered Meals..................................          216,397           216,830           216,830              +433   ................
        Nutrition Services Incentive Program..................          160,069           160,389           160,389              +320   ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................          814,657           816,289           816,289            +1,632   ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Grants to States..........................        1,383,160         1,385,931         1,385,931            +2,771   ................

Grants for Native Americans...................................           27,546            27,601            27,601               +55   ................
Aging Network Support Activities..............................            7,857             7,873             7,873               +16   ................
Alzheimer's Disease Demonstrations............................            4,002             9,537             4,002   ................           -5,535
Alzheimer's Disease Initiative PPHF (NA)......................             (150)          (14,700)          (14,700)         (+14,550)  ................
Lifespan Respite Care.........................................            2,485             2,490             2,490                +5   ................
Chronic Disease Self-Management Program.......................  ................  ................  ................  ................  ................
    Prevention and Public Health Fund\3\......................           (7,086)          (10,000)          (10,000)          (+2,914)  ................
Elder Falls...................................................  ................  ................  ................  ................  ................
    Prevention and Public Health Fund\3\......................  ................  ................           (7,000)          (+7,000)          (+7,000)
Adult Protective Services Demonstration.......................  ................            8,000             8,000            +8,000   ................
Elder Justice--PPHF (NA)......................................           (2,000)  ................  ................          (-2,000)  ................
Senior Medicare Patrol Program................................            9,383             9,402             9,402               +19   ................
Elder Rights Support Activities...............................            4,080             4,088             4,088                +8   ................
Aging and Disability Resources................................            6,444   ................            6,444   ................           +6,444
State Health Insurance Program................................  ................           52,115            52,115           +52,115   ................
National Clearinghouse for Long-Term Care Information.........  ................            3,000             3,000            +3,000   ................
Paralysis Resource Center.....................................  ................            6,700             6,700            +6,700   ................

Developmental Disabilities Programs:
    State Councils............................................  ................           74,774            74,774           +74,774   ................
    Protection and Advocacy...................................  ................           40,865            40,865           +40,865   ................
    Voting Access for Individuals with Disabilities...........  ................            5,235             5,235            +5,235   ................
    Developmental Disabilities Projects of National             ................            8,317             9,317            +9,317            +1,000
     Significance.............................................
    University Centers of Excellence..........................  ................           38,792            38,792           +38,792   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................  ................          167,983           168,983          +168,983            +1,000

Program Administration........................................           23,017            30,035            30,035            +7,018   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Administration for Community Living..............        1,467,974         1,714,755         1,716,664          +248,690            +1,909
          Federal funds.......................................        1,467,974         1,662,640         1,664,549          +196,575            +1,909
          Trust Funds.........................................  ................          (52,115)          (52,115)         (+52,115)  ................
          Prevention and Public Health Fund...................           (9,236)          (24,700)          (31,700)         (+22,464)          (+7,000)
                                                               -----------------------------------------------------------------------------------------
      Total, ACL Program Level................................        1,477,210         1,739,455         1,748,364          +271,154            +8,909

                    OFFICE OF THE SECRETARY

                GENERAL DEPARTMENTAL MANAGEMENT

General Departmental Management:
    Federal Funds.............................................          219,159           234,067           219,159   ................          -14,908
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          219,159           234,067           219,159   ................          -14,908

Teen Pregnancy Prevention Community Grants....................          104,383   ................          104,790              +407          +104,790
    Prevention and Public Health Fund\3\......................  ................         (104,790)  ................  ................        (-104,790)
Teen Pregnancy Prevention approaches Evaluation Tap Funding...           (8,455)           (4,232)           (8,455)  ................          (+4,223)
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Pregnancy Grants..............................         (112,838)         (109,022)         (113,245)            (+407)          (+4,223)

Minority Health...............................................           55,670            40,560            42,560           -13,110            +2,000
Abstinence Education..........................................            4,981   ................  ................           -4,981   ................
Office of Women's Health......................................           33,615            26,808            26,808            -6,807   ................
Minority HIV/AIDS.............................................           53,574   ................           53,891              +317           +53,891
    Evaluation Tap Funding....................................  ................          (53,891)  ................  ................         (-53,891)
Embryo Adoption Awareness Campaign............................            1,992   ................  ................           -1,992   ................
Planning and Evaluation, Evaluation Tap Funding...............          (60,756)          (61,718)          (61,718)            (+962)  ................
                                                               -----------------------------------------------------------------------------------------
      Total, General Departmental Management..................          542,585           421,276           517,381           -25,204           +96,105
          Federal Funds.......................................         (473,374)         (301,435)         (447,208)         (-26,166)        (+145,773)
          Evaluation Tap Funding (NA).........................          (69,211)         (119,841)          (70,173)            (+962)         (-49,668)
          Prevention and Public Health Fund\3\................  ................         (104,790)  ................  ................        (-104,790)
                                                               -----------------------------------------------------------------------------------------
      Total, General Departmental Management Program..........          542,585           526,066           517,381           -25,204            -8,685

OFFICE OF MEDICARE HEARINGS AND APPEALS.......................           71,867            82,381            82,381           +10,514   ................

OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION                16,382            20,576            20,290            +3,908              -286
 TECHNOLOGY...................................................
    Evaluation Tap Funding....................................          (44,811)          (56,307)          (51,307)          (+6,496)          (-5,000)
    Certification and Standards...............................  ................            1,000             1,000            +1,000   ................
        User fees.............................................  ................           -1,000            -1,000            -1,000   ................
                                                               -----------------------------------------------------------------------------------------
          Total, Program Level................................          (61,193)          (76,883)          (71,597)         (+10,404)          (-5,286)

                  OFFICE OF INSPECTOR GENERAL

Inspector General Federal Funds...............................           49,983            68,879            59,879            +9,896            -9,000
    HIPAA/HCFAC funding (NA)..................................         (196,299)         (200,279)         (200,279)          (+3,980)  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Inspector General Program Level..................         (246,282)         (269,158)         (260,158)         (+13,876)          (-9,000)

OFFICE FOR CIVIL RIGHTS:
    Federal Funds.............................................           40,857            42,205            42,205            +1,348   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Office for Civil Rights..........................           40,857            42,205            42,205            +1,348   ................

 RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS

Retirement Payments...........................................          395,452           415,331           415,331           +19,879   ................
Survivors Benefits............................................           31,043            28,239            28,239            -2,804   ................
Dependents' Medical Care......................................          100,656           106,802           106,802            +6,146   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Medical Benefits for Commissioned Officers.......          527,151           550,372           550,372           +23,221   ................

       PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND

       Assistant Secretary for Preparedness and Response

Operations....................................................           32,925            33,213            33,213              +288   ................
Preparedness and Emergency Operations.........................           29,532            24,789            24,789            -4,743   ................
National Disaster Medical System..............................           52,645            52,502            52,502              -143   ................
Hospital Preparedness Cooperative Agreement Grants............          374,007           254,555           254,555          -119,452   ................
Emergency Systems for Advanced Registration of Volunteer                  4,981               505               505            -4,476   ................
 Health Professionals (ESAR-VHP)..............................
Biomedical Advanced Research and Development Authority [BARDA]          415,000           395,130           415,000   ................          +19,870
Medical Countermeasure Strategic Investment Corp..............  ................           20,000            15,000           +15,000            -5,000
Medical Countermeasure Dispensing.............................  ................            5,000             5,000            +5,000   ................
Policy and Planning...........................................           15,647            15,253            15,253              -394   ................
Project BioShield.............................................  ................          250,000           250,000          +250,000   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, AS for Preparedness and Response..............          924,737         1,050,947         1,065,817          +141,080           +14,870

            Assistant Secretary for Administration

Cybersecurity.................................................           39,845            41,125            41,125            +1,280   ................

                Assistant Secretary for Health

Medical Reserve Corps.........................................           11,224             8,979             8,979            -2,245   ................

                    Office of the Secretary

Pandemic Influenza Preparedness:
    Available until expended..................................  ................          108,000           108,000          +108,000   ................
    Annual....................................................  ................           32,009            32,009           +32,009   ................
                                                               -----------------------------------------------------------------------------------------
        Pandemic Influenza Program Level......................  ................          140,009           140,009          +140,009   ................

Office of Security and Strategic Information..................            6,435             7,470             7,470            +1,035   ................
HHS Lease Replacements........................................           16,966            41,000            41,000           +24,034   ................
Disaster Relief Public Law 113-2 (emergency appropriation)....          800,000   ................  ................         -800,000   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Office of the Secretary.......................          823,401           188,479           188,479          -634,922   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Non-pandemic flu/BARDA/BioShield/Parklawn.....        1,799,207         1,289,530         1,304,400          -494,807           +14,870
                                                               =========================================================================================
      Total, PHSSEF...........................................        1,799,207         1,289,530         1,304,400          -494,807           +14,870
                                                               =========================================================================================
      Total, Office of the Secretary..........................        2,978,821         2,355,378         2,506,735          -472,086          +151,357
          Federal Funds.......................................        2,106,954         2,272,997         2,424,354          +317,400          +151,357
          Federal Funds (emergency)...........................          800,000   ................  ................         -800,000   ................
          Trust Funds.........................................           71,867            82,381            82,381           +10,514   ................
          Evaluation Tap Funding (NA).........................         (114,022)         (176,148)         (121,480)          (+7,458)         (-54,668)
                                                               -----------------------------------------------------------------------------------------
            Total, Office of the Secretary Program Level......        2,292,843         2,636,316         2,628,215          +335,372            -8,101
                                                               =========================================================================================
            Total, Title II, Dept of Health & Human Services..      603,758,839       628,533,844       625,811,281       +22,052,442        -2,722,563

            Federal Funds.....................................      599,513,231       622,870,991       619,819,428       +20,306,197        -3,051,563
                Current year..................................     (489,077,600)     (514,528,668)     (512,897,105)     (+23,819,505)      (-1,631,563)
                Current Year (emergency)......................         (800,000)  ................  ................        (-800,000)  ................
                Fiscal year 2015..............................     (109,635,631)     (108,342,323)     (106,922,323)      (-2,713,308)      (-1,420,000)
            Trust Funds.......................................        4,245,608         5,662,853         5,991,853        +1,746,245          +329,000
            Pandemic Flu balances (Public Law 111-32).........          (11,829)  ................  ................         (-11,829)  ................


              TITLE III--DEPARTMENT OF EDUCATION

                EDUCATION FOR THE DISADVANTAGED

Grants to Local Educational Agencies [LEAs] Basic Grants:
    Advance from prior year...................................       (2,962,510)       (3,313,597)       (3,313,597)        (+351,087)  ................
    Forward funded............................................        3,599,514         2,834,559         3,767,248          +167,734          +932,689
    Current funded............................................  ................  ................            4,000            +4,000            +4,000
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Basic grants current year approp..............        3,599,514         2,834,559         3,771,248          +171,734          +936,689
      Subtotal, Basic grants total funds available............       (6,562,024)       (6,148,156)       (7,084,845)        (+522,821)        (+936,689)

    Basic Grants Fiscal Year 2015 Advance.....................        2,962,510         3,743,345         2,790,776          -171,734          -952,569
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Basic grants, program level...................        6,562,024         6,577,904         6,562,024   ................          -15,880

    Concentration Grants:
        Advance from prior year...............................       (1,362,301)       (1,293,919)       (1,293,919)         (-68,382)  ................
        Fiscal Year 2015 Advance..............................        1,362,301         1,362,301         1,362,301   ................  ................
    Targeted Grants:
        Forward funded........................................           23,367   ................  ................          -23,367   ................
        Advance from prior year...............................       (3,258,183)       (3,116,831)       (3,116,831)        (-141,352)  ................
        Fiscal Year 2015 Advance..............................        3,258,183         3,288,126         3,344,050           +85,867           +55,924
                                                               -----------------------------------------------------------------------------------------
          Subtotal (excluding emergencies)....................        3,281,550         3,288,126         3,344,050           +62,500           +55,924

    Education Finance Incentive Grants:
        Forward Funded........................................           23,367   ................  ................          -23,367   ................
        Advance from prior year...............................       (3,258,183)       (3,116,831)       (3,116,831)        (-141,352)  ................
        Fiscal Year 2015 Advance..............................        3,258,183         3,288,126         3,344,050           +85,867           +55,924
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................        3,281,550         3,288,126         3,344,050           +62,500           +55,924
                                                               =========================================================================================
          Subtotal, Grants to LEAs, program level.............       14,487,425        14,516,457        14,612,425          +125,000           +95,968
                                                               =========================================================================================
          Subtotal, Grants to LEAs, program level.............       14,487,425        14,516,457        14,612,425          +125,000           +95,968

School Improvement Grants.....................................          532,485           658,552           567,485           +35,000           -91,067
Striving Readers..............................................          159,378   ................          164,378            +5,000          +164,378

State Agency Programs:
    Migrant...................................................          392,450           393,236           392,450   ................             -786
    Neglected and Delinquent/High Risk Youth..................           50,130            50,231            50,130   ................             -101
                                                               -----------------------------------------------------------------------------------------
      Subtotal, State Agency programs.........................          442,580           443,467           442,580   ................             -887

Evaluation....................................................            3,188   ................            3,028              -160            +3,028
High School Graduation Initiative.............................           48,712   ................           48,809               +97           +48,809

Migrant Education:
    High School Equivalency Program...........................           36,453            36,526            36,526               +73   ................
                                                               =========================================================================================
      Total, Education for the disadvantaged..................       15,710,221        15,655,002        15,875,231          +165,010          +220,229
          Current Year........................................       (4,869,044)       (3,973,104)       (5,034,054)        (+165,010)      (+1,060,950)
          Fiscal year 2015....................................      (10,841,177)      (11,681,898)      (10,841,177)  ................        (-840,721)
      Subtotal, Forward Funded................................       (4,780,691)       (3,936,578)       (4,941,691)        (+161,000)      (+1,005,113)

PRESCHOOL DEVELOPMENT GRANTS..................................  ................          750,000           750,000          +750,000   ................

                          IMPACT AID

Basic Support Payments........................................        1,151,233         1,153,540         1,153,540            +2,307   ................
Payments for Children with Disabilities.......................           48,316            48,413            48,316   ................              -97
Facilities Maintenance (Sec. 8008)............................            4,835             4,845             4,835   ................              -10
Construction (Sec. 8007)......................................           17,406            17,441            17,441