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                                                      Calendar No. 509
114th Congress       }                                  {       Report
                                 SENATE
 2d Session          }                                  {      114-274

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




 
  DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND 
               RELATED AGENCIES APPROPRIATION BILL, 2017
                                _______
                                

                  June 9, 2016.--Ordered to be printed

                                _______
                                

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

                                 REPORT

                         [To accompany S. 3040]

    The Committee on Appropriations reports the bill (S. 3040) 
making appropriations for Departments of Labor, Health and 
Human Services, and Education, and related agencies for the 
fiscal year ending September 30, 2017, and for other purposes, 
reports favorably thereon without amendment and recommends that 
the bill do pass.



Amounts to new budget authority

Total of bill as reported to the Senate.................$932,211,568,000
Amount of 2016 appropriations........................... 888,428,751,000
Amount of 2017 budget estimate.......................... 933,107,118,000
Bill as recommended to Senate compared to:
    2016 appropriations................................. +43,782,817,000
    2017 budget estimate................................    -895,550,000















                                CONTENTS

                              ----------                              
                                                                   Page

List of Abbreviations............................................     4
Summary of Budget Estimates and Committee Recommendations........     8
    Overview.....................................................     8
    National Institutes of Health................................     9
    Combating Opioid Abuse.......................................    10
    Promoting College Affordability and Completion...............    11
    Improving Fiscal Accountability..............................    11
    Increasing the Efficiency and Cost Effectiveness of 
      Government.................................................    12
    Guidance Documents...........................................    14
    Other Highlights of the Bill.................................    14
Title I: Department of Labor:
    Employment and Training Administration.......................    17
    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.....................    29
    Occupational Safety and Health Administration................    32
    Mine Safety and Health Administration........................    34
    Bureau of Labor Statistics...................................    35
    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...................    59
    National Institutes of Health................................    81
    Substance Abuse and Mental Health Services Administration....   116
    Agency for Healthcare Research and Quality...................   124
    Centers for Medicare and Medicaid Services...................   126
    Administration for Children and Families.....................   135
    Administration for Community Living..........................   144
    Office of the Secretary......................................   151
    General Provisions...........................................   163
Title III: Department of Education:
    Education for the Disadvantaged..............................   165
    Impact Aid...................................................   168
    School Improvement Programs..................................   169
    Indian Education.............................................   173
    Innovation and Improvement...................................   174
    Safe Schools and Citizenship Education.......................   178
    English Language Acquisition.................................   179
    Special Education............................................   180
    Rehabilitation Services......................................   182
    Special Institutions for Persons With Disabilities:
        American Printing House for the Blind....................   183
        National Technical Institute for the Deaf................   184
        Gallaudet University.....................................   184
    Career, Technical, and Adult Education.......................   184
    Student Financial Assistance.................................   185
    Student Aid Administration...................................   187
    Higher Education.............................................   189
    Howard University............................................   194
    College Housing and Academic Facilities Loans Program........   194
    Historically Black College and University Capital Financing 
      Program Account............................................   194
    Institute of Education Sciences..............................   195
    Departmental Management:
        Program Administration...................................   197
        Office for Civil Rights..................................   199
        Office of the Inspector General..........................   199
    General Provisions...........................................   199
Title IV: Related Agencies:
    Committee for Purchase From People Who Are Blind or Severely 
      Disabled...................................................   201
    Corporation for National and Community Service...............   201
    Corporation for Public Broadcasting..........................   204
    Federal Mediation and Conciliation Service...................   205
    Federal Mine Safety and Health Review Commission.............   205
    Institute of Museum and Library Services.....................   206
    Medicaid and CHIP Payment and Access Commission..............   206
    Medicare Payment Advisory Commission.........................   207
    National Council on Disability...............................   207
    National Labor Relations Board...............................   207
    National Mediation Board.....................................   208
    Occupational Safety and Health Review Commission.............   208
    Railroad Retirement Board....................................   208
    Social Security Administration...............................   209
Title V: General Provisions......................................   215
Compliance With Paragraph 7, Rule XVI of the Standing Rules of 
  the Sen- ate...................................................   217
Compliance With Paragraph 7(c), Rule XXVI of the Standing Rules 
  of the Senate..................................................   217
Compliance With Paragraph 12, Rule XXVI of the Standing Rules of 
  the Senate.....................................................   218
Budgetary Impact of Bill.........................................   224
Comparative Statement of New Budget Authority....................   225

                         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
    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
    CJ--Congressional Justification of Estimates for 
Appropriations Committees
    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
    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
    NFP--Not-for-Profit
    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
    TIVAS--Title IV Additional Servicers
    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 2017, the Committee recommends total budget 
authority of $932,211,568,000 for the Departments of Labor, 
Health and Human Services, and Education, and Related Agencies. 
This amount includes $161,857,000,000 in current year 
discretionary funding subject to discretionary spending caps 
and $1,960,000,000 in cap adjustments for healthcare fraud and 
abuse control and for program integrity at the Social Security 
Administration, in accordance with the allocation for this 
bill.
    Fiscal year 2016 levels cited in this report reflect the 
enacted amounts in Public Law 114-113, the Consolidated 
Appropriations Act, 2016, adjusted for comparability.

                                OVERVIEW

    The Labor, Health and Human Services, and Education, and 
Related Agencies [Labor-HHS-Education] appropriations bill 
constitutes the largest share of non-defense discretionary 
spending, 31 percent of the total in fiscal year 2017. Total 
spending in this bill subject to discretionary spending caps is 
$270,000,000 below the comparable fiscal year 2016 level. This 
level has required the Committee to make difficult funding 
decisions and consider the appropriate role and jurisdiction of 
Federal programs.
    The Committee notes that the administration's budget 
requests for large programmatic increases, offset by reductions 
in core discretionary funding programs, continue to add 
financial pressure on existing programs and operations 
throughout the bill. This is especially true for the Department 
of Health and Human Services, whose budget request shifted 
nearly $3,000,000,000 in traditionally discretionary funded 
programs out of the annual appropriations process without 
knowing whether there is a path forward to fill those holes 
with new streams of mandatory funding. Had the Committee 
accepted the Department's budget request, it would have 
required a $1,000,000,000 cut to the National Institutes of 
Health [NIH], $150,000,000 cut to Community Health Centers, and 
the elimination of the Children's Hospital Graduate Medical 
Education program. Further, the administration requested 
increases for critical health activities, historically funded 
through discretionary appropriations, such as programs focused 
on fighting the growing opioid epidemic, mental health 
treatment, and critical medical research programs, such as 
advancing precision medicine, on the mandatory side of the 
ledger.
    The Committee recommendation prioritizes funding for 
programs adhering to the spirit and letter of the discretionary 
caps agreed to in the Bipartisan Budget Act of 2015. The 
priorities and considerations of the Committee in developing 
this bill are summarized in the section below:

                     NATIONAL INSTITUTES OF HEALTH

    The Committee recommendation includes $34,084,000,000 for 
the NIH, an increase of $2,000,000,000. The Committee strongly 
believes that in this difficult budget environment that the 
Labor-HHS-Education appropriations bill must continue to 
prioritize and recognize the essential role biomedical research 
plays in every American's life.
    The Committee rejects the administration's budget request 
to reduce discretionary funding for medical research at the NIH 
by $1,000,000,000. A continued commitment to NIH is essential 
to address our Nation's growing health concerns, spur medical 
innovation, sustain America's competitiveness, and reduce 
healthcare costs. After last year's historic increase of 
$2,000,000,000, the largest increase for the NIH in this bill 
in over a decade, the administration chose to take a step 
backwards by reducing discretionary funding for NIH. Instead of 
accepting this misguided budget request, the Committee 
increases funding by $2,000,000,000 above fiscal year 2016.
    The Committee recommendation allocates funding to areas 
holding the most extraordinary promise of scientific 
advancement, while allowing NIH to maintain flexibility to 
pursue unplanned scientific opportunities and address 
unforeseen public health needs. The Committee recommendation is 
estimated to support over 11,200 new and competing grants in 
fiscal year 2017, an increase of 4.2 percent above fiscal year 
2016.
    Alzheimer's Disease.--By 2050, the cost to treat and care 
for those suffering from Alzheimer's disease is expected to top 
$1,100,000,000,000 a year. To put that figure in perspective, 
it is twice what the Federal Government currently spends to 
defend the Nation. Without a medical breakthrough to prevent, 
slow, or stop the disease, Medicare and Medicaid-related costs 
could rise nearly five-fold. NIH-funded research offers the 
only hope for finding solutions to successfully manage this 
disease in the future. Therefore, the Committee recommendation 
includes an increase of $400,000,000 for Alzheimer's disease 
research, bringing the total available in fiscal year 2017 to 
approximately $1,391,000,000, a 40 percent increase above 
fiscal year 2016.
    Brain Research through Advancing Innovative 
Neurotechnologies [BRAIN].--The Committee continues to support 
the BRAIN Initiative and provides $250,000,000 in fiscal year 
2017. This is an increase of $100,000,000 above fiscal year 
2016 and $55,000,000 above the budget request. The BRAIN 
Initiative is developing a more complete understanding of brain 
function and has the possibility of helping millions of people 
who suffer from a wide variety of neurological and psychiatric 
disorders such as Parkinson's disease, schizophrenia, 
Alzheimer's disease, depression, and traumatic brain injury.
    Precision Medicine.--The Committee provides $300,000,000, 
an increase of $100,000,000 above fiscal year 2016, for the 
Precision Medicine Initiative. Instead of a one-size-fits-all 
approach, the Precision Medicine Initiative will allow 
physicians to individualize treatment.
    Combating Antibiotic Resistant Bacteria [CARB].--Given the 
threat posed by the spread of antibiotic resistant bacteria, 
the recommendation includes $463,000,000, an increase of 
$50,000,000 above fiscal year 2016, for efforts to develop new 
antibiotics and rapid diagnostic tests.

                         COMBATING OPIOID ABUSE

    It is estimated that 1.9 million American adults have an 
opioid use disorder related to prescription pain relievers, and 
586,000 have an opioid use disorder related to heroin. 
According to the Centers for Disease Control and Prevention 
[CDC], sales from prescription opioids nearly quadrupled 
between 1999 and 2014 and there was a corresponding increase in 
deaths from prescription opioids, claiming more than 165,000 
lives. Even more troubling, prescription opioids can act as a 
gateway drug to heroin use, another form of opioids. 
Approximately 3 out of 4 new heroin users abused prescription 
opioids before switching to heroin. To stop the spread of 
further opioid abuse, the bill provides $261,000,000, an 
increase of $126,000,000, or 93 percent, above fiscal year 
2016, in discretionary funding to fight both prescription 
opioid and heroin abuse:
    Abuse Prevention.--The Committee provides $98,000,000, a 
$28,000,000 increase above the fiscal year 2016 level, or 40 
percent, to CDC's Prescription Drug Overdose program to enhance 
State-level prevention efforts such as increasing adoption of 
safe opioid prescribing guidelines and improving data 
collection and collaboration among States.
    Drug Treatment, Prevention, and Awareness.--The Committee 
provides $60,000,000 to Substance Abuse and Mental Health 
Services Administration [SAMHSA] for grants to States to expand 
access to drug treatment services for those with a dependence 
on prescription opioids or heroin. This level is a $35,000,000, 
or 140 percent, increase above fiscal year 2016. Funds will be 
targeted to States that have experienced the greatest increase 
in treatment admissions for these drugs.
    Overdose Reversal.--The Committee includes $26,000,000 to 
prevent opioid overdose, a $14,000,000, or 117 percent, 
increase above fiscal year 2016. Funds will be used to help 
States purchase and train first responders on emergency devices 
that rapidly reverse the adverse effects of an opioid overdose 
and to increase awareness of the dangers of opioid use to the 
public. Of this amount, the Committee provides $8,000,000 to 
prevent opioid overdose-related deaths in rural areas. 
Americans living in rural communities are especially vulnerable 
and more likely to overdose on prescription pain killers than 
those in urban areas, according to CDC.
    Community Health Centers.--Within the funding provided to 
Community Health Centers, $50,000,000 is allocated for services 
relating to the treatment and prevention of opioid abuse. This 
investment will help health centers hire over 400 new providers 
and treat approximately 70,000 new patients nationwide. This is 
in addition to the $94,000,000 in funding that HRSA plans to 
provide Community Health Centers to improve and expand the 
delivery of substance abuse services in health centers for 
fiscal year 2017, with a specific focus on treatment of opioid 
use disorders in underserved populations.
    In total, the Department is expected to spend $356,000,000 
in discretionary and mandatory funding for targeted efforts to 
combat opioid abuse in fiscal year 2017. In addition, States 
have access to the Substance Abuse Prevention and Treatment 
Block Grant, funded at $1,858,079,000 in fiscal year 2017. 
Finally, the National Institute on Drug Abuse [NIDA] continues 
its efforts to understand addiction, fund research on 
medications to alleviate pain, support efforts to better 
understand the long-term effects of prescription opioid use, 
and research alternative ways to treat pain. NIDA receives an 
increase of $52,500,000 in this act.

             PROMOTING COLLEGE AFFORDABILITY AND COMPLETION

    The Committee recommendation restores and modifies a 
provision, eliminated in fiscal year 2011, allowing students to 
receive Pell grants year-round. This will allow a student who 
has exhausted their Pell grant award for the academic year to 
receive a Pell grant for an additional term, traditionally the 
summer.
    Currently, full-time students and some part-time students 
exhaust their full Pell grant after two semesters, or the 
equivalent. Students who wish to continue coursework for an 
additional term during the academic year must use other means 
to pay for it, such as student loans, or not take the 
additional classes and wait until the beginning of the next 
academic year. This expanded eligibility and flexibility in the 
Pell grant program will provide an incentive for students to 
take classes year-round and stay continuously enrolled, help 
them stay on track for graduation, accelerate completion of 
their program, enter or re-enter the workforce faster, and 
graduate with less student debt. This is expected to provide an 
estimated 1 million students an additional Pell grant, on 
average, of $1,650 for the 2017-2018 academic year.
    In addition, the Committee recommendation is more than 
sufficient to support the scheduled increase in the maximum 
Pell grant award from $5,815 for the 2016-17 school year to 
$5,935 for the 2017-18 school year.

                    IMPROVING FISCAL ACCOUNTABILITY

    The Committee has an obligation to promote fiscal 
accountability and the effective use of U.S. taxpayer funds. 
The annual appropriations process affords Congress the 
opportunity to continuously improve and refine how Government 
works. Appropriations bills provide oversight of every 
discretionary program, every year, which gives these bills the 
unique ability to react to changing needs and unintended 
consequences in the intervening years of an authorization bill.
    Taxpayer Transparency.--U.S. taxpayers have a right to know 
how the Federal Government is spending their hard-earned 
taxpayer dollars--especially when that money is being spent on 
advertising Federal programs. The Committee recommendation 
continues a provision to promote Government transparency and 
accountability by requiring Federal agencies funded in this act 
to include disclaimers when advertising materials are paid for 
with Federal funds. The Committee expects each agency to 
include in their fiscal year 2018 CJ information detailing how 
much funding was spent on advertising in fiscal year 2017.
    Federal Vehicle Fleet Management.--The General Services 
Administration [GSA] issues guidance on Federal fleet 
management, but the Federal vehicle fleet is decentralized, 
with each agency maintaining flexibility to manage vehicle 
utilization as appropriate. To provide greater transparency and 
accountability of funding for Federal vehicles, the Committee 
directs agencies funded in this bill to conduct an annual 
review of fleet utilization during the third quarter of each 
fiscal year. Agencies are directed to provide their Offices of 
Inspectors General [OIGs] with supporting documentation on the 
method used for determining optimal fleet inventories and 
justification for any deviation from GSA's Federal Property 
Management Regulations. OIGs shall be responsible for 
conducting annual audits of fleet management practices and 
making the subsequent results publicly available.
    Public Health Services Act [PHS] Evaluation Transfer.--The 
Committee recommendation continues to ensure that in fiscal 
year 2017, no funds will leave NIH via the transfer required by 
section 241 of the PHS Act.

     INCREASING THE EFFICIENCY AND COST EFFECTIVENESS OF GOVERNMENT

    The Committee provides funding for a variety of activities 
aimed at reducing fraud, waste, and abuse of taxpayer dollars. 
These program integrity initiatives have proven to be a wise 
Federal investment, resulting in billions of dollars of savings 
each year. In addition, the Committee recommendation provides 
direction to the Departments on opportunities to take action 
where Federal programs are fragmented or duplicative. The bill 
advances several initiatives to increase the efficiency and 
cost effectiveness of Government, including:
    Fighting Healthcare Fraud and Abuse.--The Committee 
includes $725,000,000 for the Health Care Fraud and Abuse 
Control program at CMS. The Committee notes that the latest 
data demonstrates for every $1 spent on fraud and abuse, $2 is 
recovered by the U.S. Treasury. By utilizing the cap adjustment 
provided in the Budget Control Act, the Committee 
recommendation will create over $10,200,000,000 in savings to 
the U.S. Treasury over 10 years.
    Inspectors General.--The Committee recommendation provides 
$672,574,000 for the Inspectors General funded in this act to 
conduct additional audits and investigations of possible waste 
and fraud in Government programs. The Committee appreciates the 
strong working relationships between the Inspectors General and 
the agencies they work with under this Committee's 
jurisdiction. The Committee reiterates the strong expectation 
that Inspectors General have timely and independent access to 
all records, reports, audits, reviews, documents, papers, 
recommendations, data and data systems, or other materials 
related to their responsibilities under this act and under the 
Inspector General Act of 1978. Further, the Committee also 
expects that all agencies funded by this act treat electronic 
data, records, and systems no differently than paper-based 
records and files with respect to access by OIGs unless 
particular electronic systems are clearly and explicitly 
protected from Inspectors General access by statute.
    Preventing Improper Social Security Payments.--The 
Committee recommendation includes $1,819,000,000, a 
$393,000,000 increase, for the Social Security Administration 
[SSA] to conduct continuing disability reviews and SSI program 
redeterminations of non-medical eligibility and for other 
program integrity efforts. Combined, these activities are 
estimated to save approximately $10,897,000,000 over 10 years 
in taxpayer dollars by reducing waste, fraud, abuse, and 
improper payments in the Social Security, Medicare, and 
Medicaid programs.
    Strengthening Oversight of Social Security Disability 
Benefits.--The Committee recommendation includes language 
strengthening oversight of Social Security disability programs. 
Specifically, the Committee encourages SSA to expedite efforts 
to update the medical vocational guidelines used as part of the 
initial disability determination process and to clarify how the 
medical improvement standard, and exceptions from it, should be 
applied during continuing disability reviews, as well as revise 
the treating physician rule to reflect changes in healthcare 
delivery. The Committee also supports the agency as it 
implements recommendations from GAO, as outlined in its annual 
duplication report, to reduce overpayments to individuals 
receiving concurrent Federal Workers Compensation Act [FECA] 
payments.
    Taxpayer Accountability.--In recent years, GAO has 
published reports that have exposed 200 areas of potential 
duplication and overlap. These reports have revealed more than 
1,100 potentially duplicative Federal programs that cost 
taxpayers billions of dollars every year and have identified 
opportunities to achieve greater efficiency and effectiveness 
that result in cost savings or enhanced revenue collection. 
While GAO has noted that the Nation has achieved significant 
savings based on these reports, many more efficiencies may be 
realized. The Committee directs each agency funded in this bill 
to report to the Committee, within 1 year of enactment of this 
act, on all efforts made to address the duplication identified 
by the annual GAO reports along with identifying substantive 
challenges and legal barriers to implementing GAO's 
recommendations, as well as suggested legislative 
recommendations that could help the agency to further reduce 
duplication. Given the current fiscal environment, it is 
imperative for Government agencies to increase efficiencies to 
maximize the effectiveness of agency programs.
    Unemployment Insurance Trust Fund Integrity.--The Committee 
provides $115,000,000 for Reemployment Services and Eligibility 
Assessments for fiscal year 2017. Recent data cited by the 
administration have shown that this program significantly 
reduces the time participating individuals receive unemployment 
compensation payments and reduces the total amount of benefits 
paid. Claimants are more successful in returning to work sooner 
in jobs with higher wages. The data show that $2.60 in savings 
is produced for every $1 in cost under this initiative. 
Enhanced, in-person assessments also play an impactful role in 
protecting the integrity of the Unemployment Insurance Trust 
Fund by reducing improper payments made to ineligible 
claimants.

                           GUIDANCE DOCUMENTS

    The Committee notes that executive branch agencies may, as 
authorized by the Administrative Procedures Act, issue a 
variety of types of interpretive guidance documents that are 
exempt from the public notice and comment process. However, 
some have raised concerns about the use of guidance documents 
because while such documents are not legally binding, regulated 
entities may interpret them as imposing new legally binding 
requirements. Further, the GAO has found that executive branch 
agencies could improve procedures for approving, disseminating, 
and periodically reviewing guidance documents. For example, 
after a sub-agency in the Department of Labor reviewed its 
guidance to determine if it was relevant and current, the sub-
agency was able to reduce its guidance by 85 percent.
    Consistent with GAO recommendations, the Committee believes 
Departments and agencies funded in this act need to make more 
progress in adhering to and implementing OMB's 2007 ``Final 
Bulletin for Agency Good Guidance Practices,'' which 
establishes policies and procedures for the development, 
issuance, and use of significant guidance documents by 
executive branch departments and agencies.
    The Committee recommends that guidance documents include a 
statement explaining why the agency believes it is appropriate 
to issue guidance about a matter instead of proposing a 
regulation and the specific statutory provisions or 
regulation(s) the guidance is interpreting. The Committee 
further recommends all guidance documents be posted in one 
place on its Web site as well as on the relevant sub-agency Web 
page. This information should be easily accessible for the 
public to comment on guidance. Finally, when appropriate, 
guidance should be sent to the Office of Management and Budget 
for review if it is significant.

                      OTHER HIGHLIGHTS OF THE BILL

    Access to Mental Health Care.--The Committee continues to 
prioritize mental health treatment and services and provides an 
increase of $80,000,000 to key mental health activities around 
the Nation. The Committee provides an increase of $30,000,000 
for the Mental Health Block Grant at SAMHSA as well as 
$50,000,000 to expand mental health services in Community 
Health Centers.
    Apprenticeship Grants.--The Committee recommendation 
includes $100,000,000, an increase of $10,000,000, for 
innovative, job-driven approaches that result in the expansion 
of Registered Apprenticeship programs to train workers with 
skills that meet employer and industry workforce needs.
    Charter Schools.--The Committee recommendation includes 
$343,172,000 for the Charter Schools Program, a $10,000,000 
increase, to promote school choice and accountability by 
developing and expanding high quality charter schools.
    Child Care.--The Committee recommendation includes 
$2,786,000,000 for the Child Care and Development Block Grant, 
a $25,000,000 increase. This builds on consistent increases in 
the program over the last several years to help States 
implement important reforms in the recent reauthorization of 
the program to strengthen child care health and safety 
standards, and improve the overall quality of child care 
programs.
    Children's Hospitals Graduate Medical Education [CHGME].--
The Committee recommendation includes $300,000,000 for CHGME, 
the full authorized level, an increase of $5,000,000 above 
fiscal year 2016. This funding supports freestanding children's 
teaching hospitals to provide Graduate Medical Education for 
physicians.
    Community Health Centers [CHC].--The Committee 
recommendation includes $1,491,522,000 for CHC's, level with 
fiscal year 2016. Combined with mandatory funding provided in 
Public Law 114-10, the fiscal year 2017 program level is 
$5,091,522,000. The Committee rejects the administration's 
proposal to reduce funding by $150,000,000. The Committee's 
recommendation is projected to support 27 million patients, an 
increase of approximately 4 million since 2014, and continues 
quality improvement activities for more than 1,300 health 
centers operating over 9,000 primary sites.
    Head Start.--The Committee recommendation includes 
$9,203,095,000, a $35,000,000 increase for Head Start. This 
will help all Head Start programs keep up with costs, recruit 
and retain highly qualified staff, maintain enrollment, and 
continue to provide high-quality early childhood care and 
education for children and families.
    International Labor Affairs.--The Committee recommendation 
includes $91,125,000, a $5,000,000 increase, to ensure that our 
trading partners around the world are respecting workers' 
rights. These funds will enable the Bureau of International 
Labor Affairs to increase its monitoring of labor provisions in 
our trade agreements, support additional grant assistance to 
address worker rights issues, and combat exploitative child 
labor.
    Job Corps.--Maintaining safe and productive learning 
environments for the participating youth and staff on the 
Nation's Job Corps campuses is a high priority. Recent 
increases in incidents of violence and other unsafe behaviors 
threaten both the well-being of people that depend on the 
program and the effectiveness and viability of the program 
itself. The largest discretionary increase in the bill within 
the Department of Labor is dedicated to addressing the safety 
and welfare of Job Corps students through physical security 
enhancements, mental health resources, and other specialized 
staffing.
    Medicare Appeals Process.--The number of cases appealed to 
the Office of Medicare Hearings and Appeals [OMHA] has 
increased 1,000 percent over the past 6 years. As of the end of 
2015, it takes OMHA nearly 700 days to close out an existing 
appeal. The Committee recommendation includes $112,381,000, a 
$5,000,000 increase, to OMHA to expand capacity to address the 
significant backlog of appeals.
    Occupational License Portability.--The Committee enhances 
an initiative started in 2016 to reduce barriers created by a 
lack of interstate reciprocity for occupational licenses. 
Additional funding is provided for consortia of States, with 
technical and other types of assistance from the Department of 
Labor, to evaluate and pursue cooperative approaches to enhance 
reciprocity or portability of occupational licenses across 
State lines. Such agreements would significantly ease barriers 
to opportunity and reemployment for thousands of Americans, 
especially for military spouses, dislocated workers from 
various industries, and transitioning servicemembers.
    Polio Eradication.--CDC has substantially contributed to 
the more than 99 percent decline in global polio cases from 
more than 350,000 cases reported in 1988. Currently, polio 
remains endemic in three countries, Nigeria, Afghanistan and 
Pakistan. The Committee includes $174,000,000, an increase of 
$5,000,000, for polio eradication.
    Supporting State and Local Flexibility in Elementary and 
Secondary Education.--The Committee recommendation supports the 
implementation of the Every Student Succeeds Act, the 
reauthorization of the Elementary and Secondary Education Act, 
that shifts significant responsibility, control, and 
accountability for schools back to States and local school 
districts. The Committee recommendation includes:
  --$15,409,802,000, a $500,000,000 increase for title I grants 
        to LEAs, including consolidated funding from the School 
        Improvement Grants program;
  --$1,315,603,000, a $10,000,000 increase, for Impact Aid;
  --$11,952,848,000, a $40,000,000 increase, for Individuals 
        with Disabilities Education Act State Grants.
    In addition, the Committee recommendation includes 
$300,000,000 for a new Student Support and Academic Enrichment 
formula block grant program. This represents a $22,239,000 
increase over the combined fiscal year 2016 funding level of 
the discrete programs consolidated to create this new formula 
block grant program.
    Telehealth.--The Committee commends the work that is being 
done in the area of Telehealth and the impact it is having on 
access to care for medically underserved and rural populations. 
In addition to a $1,000,000 increase for the Office for the 
Advancement of Telehealth [OAT] in fiscal year 2017, the 
Committee's recommendation includes several initiatives that 
focus on the success of Telehealth networks to increase access, 
prevent and treat opioid abuse, and expand continuing education 
to medical professionals in medically underserved areas.
    Training Assistance to Coal Workers.--The bill continues an 
initiative dedicating a portion of the Dislocated Worker 
National Reserve to ensure reemployment and training assistance 
are provided to workers dislocated from coal mines and closely 
related industries. As job losses mount in the coal industry, 
it is very important that dislocated workers are able to adapt 
existing skills and learn new skills demanded by other growing 
industries so they can return to work as soon as possible. The 
bill includes $19,000,000 for this initiative.
    Veterans Employment and Training Service.--The Committee 
recommendation includes $274,541,000, an increase of 
$3,431,000. This amount includes a program increase of 
$2,391,000 to enhance the Homeless Veteran's Reintegration 
Program which provides an array of specialized services to help 
homeless veterans, such as job training, social services, 
clothing, substance abuse treatment, transportation, and 
housing referrals.

                                TITLE I

                          DEPARTMENT OF LABOR

                 Employment and Training Administration

                    TRAINING AND EMPLOYMENT SERVICES

Appropriations, 2016....................................  $3,335,425,000
Budget estimate, 2017...................................   3,525,460,000
Committee recommendation................................   3,268,367,000

    The Training and Employment Services account provides 
funding primarily for activities under the Workforce Innovation 
and Opportunity Act [WIOA], and is a decentralized, integrated 
system of skill training and related services designed to 
enhance the employment and earnings of economically 
disadvantaged and dislocated workers. Funds provided for many 
training programs for fiscal year 2017 will support the program 
from July 1, 2017, through June 30, 2018. A portion of this 
account's funding, $1,772,000,000, is available on October 1, 
2017, for the 2017 program year.
    Any references 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 strongly encourages the Department to 
continue to work with other Federal agencies to align and 
streamline employment and training services. In cases where 
legislation would be required to achieve these goals, the 
President's budget request should include recommendations and 
specific proposals for consolidation of programs.
    The Committee urges the Department to continue and expand 
its efforts in preparing workers for in-demand occupations 
through a coordinated Federal, State, and local strategy. This 
strategy should include close engagement with employers by all 
levels of the workforce development system to ensure that 
provided training services align with the demands of those who 
would hire program participants.
    The Committee encourages the Employment and Training 
Administration [ETA] to expand its collaborative work with the 
Institute of Museum and Library Services to assist in the 
implementation of the WIOA to assist States and local boards in 
integrating the education, employment, and training services 
provided by public libraries into the workforce investment 
system. The Committee also encourages ETA to continue to invest 
in building and strengthening partnerships between the one-stop 
system and public libraries by encouraging applicants for 
competitive grant opportunities to collaborate with public 
libraries.
Grants to States
    The Committee recommends $2,636,000,000 for Training and 
Employment Services Grants to States.
    Under WIOA, a local board is given up to 100 percent 
transfer authority between Adult and Dislocated Worker 
activities upon approval of the Governor.
    The Committee recommendation is consistent with the WIOA 
authorization regarding the amount of WIOA State grant funding 
that may be reserved by Governors. Therefore, each Governor of 
a State shall reserve not more than 15 percent of the funds 
allotted to a State through the WIOA State grant programs for 
State-wide workforce investment activities. This increased 
flexibility will assist Governors in meeting unexpected needs, 
effectively targeting pockets of unemployment in their States 
and fulfilling their oversight and technical assistance 
responsibilities.
    Adult Employment and Training.--For adult employment and 
training activities, the Committee recommends $782,000,000.
    Formula funding is provided to States and further 
distributed to local workforce investment areas through one-
stop centers. The program provides employment and training 
services to disadvantaged, low-skilled, unemployed, and 
underemployed adults, including veterans.
    Funds are made available in this bill for adult employment 
and training activities in program year 2017, which occurs from 
July 1, 2017, through June 30, 2018. The bill provides that 
$70,000,000 is available for obligation on July 1, 2017, and 
that $712,000,000 is available on October 1, 2017. Both 
categories of funding are available for obligation through June 
30, 2018.
    Youth Training.--For youth training activities, the 
Committee recommends $838,000,000.
    The purpose of this program is to provide low-income youth 
facing barriers to employment with services that prepare them 
to succeed in the knowledge-based economy. The program provides 
assistance to youth 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 are made available for youth training activities in 
program year 2017, which occurs from April 1, 2017, through 
June 30, 2018.
    Dislocated Worker Assistance.--For dislocated worker 
assistance, the Committee recommends $1,016,000,000.
    This program is a State-operated effort that provides 
training services and support to help permanently separated 
workers return to productive unsubsidized employment. In 
addition, States must use State-wide 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 State-wide 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 2017, which occurs from July 1, 2017, through June 
30, 2018. The bill provides that $156,000,000 is available for 
obligation on July 1, 2017, and that $860,000,000 is available 
on October 1, 2017. Both categories of funding are available 
for obligation through June 30, 2018.
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 for the National Reserve in this bill 
support activities in program year 2017. The bill provides that 
$20,859,000 is available for obligation on July 1, 2017, and 
that $200,000,000 is available on October 1, 2017. Both 
categories of funding are available for obligation through 
September 30, 2018.
    The Committee bill continues a $19,000,000 program within 
the National Reserve initiated in fiscal year 2016 to focus 
dislocated worker training and support for the large numbers of 
people losing jobs in the coal mining and closely related 
industries. The Department is strongly urged to engage 
proactively with Workforce Development Boards and other 
appropriate entities at the State and local levels typically 
involved in applying for and administering National Dislocated 
Worker Grants to ensure that they are aware of the availability 
of the targeted funds so they will be sought and utilized 
promptly and effectively to assist coal workers in areas 
hardest hit by job loss in that industry.
    Indian and Native American Programs.--The Committee 
recommends $48,500,000 for Indian and Native American Programs. 
These programs are designed to improve the academic, 
occupational, and literacy skills of Native Americans, Alaskan 
Natives, and Native Hawaiians to aid the participants in 
securing permanent, unsubsidized employment. Allowable training 
services include adult basic education, GED attainment, 
literacy training, English language training, as well as the 
establishment of linkages with remedial education.
    The Committee directs the Department to obligate funding at 
the authorized levels for activities pursuant to section 166(k) 
of subtitle D of title I of the WIOA.
    Migrant and Seasonal Farmworker Programs.--The Committee 
recommends $81,896,000 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 farm work, 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 $75,885,000 be 
used for State service area grants. The Committee 
recommendation also includes bill language directing that 
$5,517,000 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 
$494,000 to be used for section 167 training, technical 
assistance, and related activities, including funds for migrant 
rest center activities.
    The Committee is concerned by continued labor shortages in 
the agricultural sector. The Committee directs the Department 
to ensure that agricultural worker training programs funded 
under Section 167 of WIOA prioritize the development of 
additional and enhanced skills specifically relevant to 
continued agricultural work.
    Women in Apprenticeship.--The Committee accepts the 
administration's request to eliminate the Women in 
Apprenticeship program. The Committee notes that the 
recommendation significantly expands funding for the new wide-
scale apprenticeship grant program, which includes an element 
designed to support apprenticeship opportunities for women, 
minorities, and other under-represented populations more 
holistically.
    YouthBuild.--The Committee strongly supports the YouthBuild 
program and recommends $84,534,000 to support its work to 
target at-risk high school dropouts and prepare them with the 
skills and knowledge they need to succeed in a knowledge-based 
economy. Since becoming a Federal program in 1992, YouthBuild 
has helped over 140,000 low-income young people learn valuable, 
marketable job skills by combining educational resources, a 
supportive environment, and real construction experience with 
the successful completion of more than 30,000 units of 
affordable housing for low-income communities and over 48 
million hours of community service. There are currently over 
260 YouthBuild programs across the country.
National Activities
    Reintegration of Ex-Offenders.--The Committee recommends 
$88,078,000 for the Reintegration of Ex-Offenders program. 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, 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. States 
are encouraged to continue to support reintegration efforts for 
ex-offenders with resources available through the comprehensive 
workforce development investment system. The Committee directs 
the Department to use funding to support efforts in high-crime, 
high-poverty areas and, in particular, communities that are 
seeking to address relevant impacts and root causes of civil 
unrest. The Committee directs the Department to require 
grantees to offer training and industry-recognized credentials 
that meet the needs of local, high-demand industries and to 
establish formal partnerships and job-placement services with 
industry employers.
    The Committee notes that the Federal YouthBuild program 
competed successfully to receive a Reintegration of Ex-
Offenders grant in 2011. According to the grant's final report, 
after 3 years of operation involving a total of over 500 young 
ex-offenders, the YouthBuild program demonstrated a recidivism 
rate of only 1 percent according to Department-established 
performance parameters. In fact, the DREAMS YouthBuild program 
in Brooklyn, which served over 200 ex-offenders alone, achieved 
a zero percent recidivism rate. These results compare very 
favorably with the average recidivism rate commonly ranging 
from 10 to 15 percent for the Reintegration of Ex-Offenders 
program according to the CJ. Success rates were high in part 
due to the program's strategy to engage heavily with youth and 
their parents pre-release. Due to YouthBuild's exemplary 
performance results, an existing national infrastructure 
including strong and mature community relationships, leveraged 
private support, and its status as a related Federal program, 
the Committee encourages ETA to consider establishing an 
ongoing, non-competitive, formal partnership between the 
Reintegration program and YouthBuild with an appropriate 
portion of the Reintegration activity funding. Such a 
partnership seems likely to bolster overall program success 
rates.
    Evaluation.--The bill continues to use a set-aside funding 
mechanism to support the evaluation of employment and training 
programs. Instead of directly providing funds for evaluation, 
the Committee recommendation supports evaluation activities 
through a 0.75 percent set-aside on all training and employment 
programs, including the WIOA formula programs, Job Corps, 
Community Service Employment for Older Americans, the 
Employment Service, and others. The set-aside approach ensures 
that sufficient funding is available to carry out comprehensive 
evaluation and applied research activities.
    ETA will continue to 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.
    Apprenticeship Grants.--The Committee recommendation 
includes $100,000,000 to support the ApprenticeshipUSA 
Initiative, an increase of $10,000,000 above fiscal year 2016. 
This funding will support innovative, job-driven approaches 
that expand apprenticeship programs to train workers with the 
21st century skills that meet employer and industry workforce 
needs. The Committee commends the Department for designing a 
national campaign to engage a broad range of stakeholders, 
including employers, labor, States, education and workforce 
partners, to expand and diversify apprenticeship opportunities 
across the country. The Committee directs the Department to use 
funding to support economic development strategies that 
generate new or leverage existing employer demand for 
apprenticeships. The Committee also directs the Department to 
build off of the success of the Women Apprentices in Non-
Traditional Occupations program by requiring States and 
organizations to engage, recruit, and serve under-represented 
populations, with a particular emphasis on increasing the 
representation of women in apprenticeship programs.

                               JOB CORPS

Appropriations, 2016....................................  $1,689,155,000
Budget estimate, 2017...................................   1,754,590,000
Committee recommendation................................   1,709,955,000

    The recommendation for operations of Job Corps centers is 
$1,591,625,000, an increase of $9,800,000 above fiscal year 
2016. The Committee directs that Job Corps dedicate significant 
operations funding in fiscal year 2017 to upgrading safety and 
security of Job Corps centers as requested. These investments 
will include improved training to detect security risks, 
increased security personnel staffing, additional mental health 
counseling, integrated behavior management approaches, and 
related activities to improve the safety environment at Job 
Corps centers. A portion of the increase may be dedicated to 
the modernization of curricula, upgrades of equipment to meet 
industry standards, and refinement of training to provide 
skills and credentials that are in high demand by employers.
    The Committee remains deeply concerned about the issue of 
student safety on Job Corps campuses across the country as well 
as findings by the Department's Office of Inspector General 
[OIG] regarding the enforcement of Job Corps' disciplinary 
policies, potentially exposing students to unsafe environments. 
The Committee recognizes the Department has taken important 
steps toward addressing these issues and strongly urges the 
Department to take fully corrective actions to ensure the 
safety of students and staff.
    The Committee recommendation for administrative costs is 
$32,330,000.
    The Committee also recommends a total of $86,000,000 in 
construction, renovation, and acquisition [CRA] funds, an 
increase of $11,000,000 above fiscal year 2016. This amount is 
available from July 1, 2017, to June 30, 2020. The Department 
is directed to utilize not less than $17,000,000 of the CRA 
funds to implement urgent targeted security measures at Job 
Corps centers, including improved access controls, perimeter 
fencing, security cameras, site lighting, and other appropriate 
measures. The CRA activity recommendation overall includes 
funds for building rehabilitation and replacement, to increase 
safety and security, to address conditions that threaten life 
or safety, to abate environmentally unsafe conditions, for 
engineering and contract support services, for center 
telecommunication upgrades, for contingency funds for emergency 
repairs, for minor repair and replacement, and for needed major 
equipment. The Committee continues bill language allowing the 
Secretary to transfer up to 15 percent of CRA funds, if 
necessary, to meet the operational needs of Job Corps centers 
or to achieve administrative efficiencies. The bill continues 
to require the Secretary to notify the House and Senate 
Committees on Appropriations at least 15 days in advance of any 
transfer. The Committee expects any notification to include a 
justification.
    The Committee supports the Department's goals to modernize 
curricula, upgrade equipment to meet industry standards, and 
refine training to provide skills and credentials that are in 
high demand by employers. To advance these goals, the Committee 
urges Job Corps to require strong, local employer partnerships 
and work-based learning opportunities for students as part of 
any Job Corps pilot initiative. Additionally, any external 
review of the Job Corps program should also include evaluation 
of the Job Corps management structure, the procurement process, 
and the procedures for determining or changing which academic 
and career training programs are offered at Job Corps centers.
    In addition, the Committee urges the Department to be 
cognizant of the competitiveness of Job Corps teacher and 
instructor salaries as well as staff retention and vacancy 
rates. Finally, funds should not be used to award a new 
contract for operation of a Job Corps center, unless the 
Assistant Secretary of ETA ensures that each of the factors 
listed in section 147(a)(3) of WIOA are applied to the 
procurement process to award a new contract to operate a Job 
Corps center as well as to any decision to restrict 
competition.
    Gulfport Job Corps Center.--The Committee is encouraged by 
recent progress made toward the rebuilding of the Gulfport Job 
Corps Center. The Committee expects the Department to have 
completed the section 106 process, finalized the design of the 
new center, and opened a request for contracts as quickly as 
possible. The Department should continue to remain committed to 
work to ensure that the center is rebuilt and able to return to 
serving the number of young people that it once served while, 
in the meantime, reserving sufficient funds for the restoration 
of the facility consistent with the expectations of the 
Committee. Given that Congress provided emergency 
appropriations for this purpose shortly after the damage caused 
by Hurricane Katrina, the Committee directs the Department to 
prioritize the Gulfport Job Corps Center among pending 
construction cases in the Construction, Rehabilitation and 
Acquisition Account. The Committee requests to be updated on a 
regular, continuing basis on the progress of the administrative 
steps to complete the design and rehabilitation of this 
facility.

            COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS

Appropriations, 2016....................................    $434,371,000
Budget estimate, 2017...................................     434,371,000
Committee recommendation................................     400,000,000

    Community Service Employment for Older Americans [CSEOA] 
provides part-time employment in community service activities 
for unemployed, low-income persons aged 55 and older. The 
Committee recommendation includes $400,000,000 for CSEOA.

              FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES

Appropriations, 2016....................................    $861,000,000
Budget estimate, 2017...................................     849,000,000
Committee recommendation................................     849,000,000

    The Committee recommendation includes mandatory funds for 
the Federal unemployment benefits and allowances program that 
assists trade-impacted workers with benefits and services to 
upgrade skills and retrain in new careers. These benefits and 
services are designed to help participants find a path back 
into middle-class jobs, improve earnings, and increase 
credential and education rates. The Committee recommendation 
provides for the full operation of the Trade Adjustment Act 
program in fiscal year 2017 consistent with current law.

     STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS

Appropriations, 2016....................................  $3,589,878,000
Budget estimate, 2017...................................   3,631,085,000
Committee recommendation................................   3,535,960,000

    The Committee recommendation includes $3,444,394,000 
authorized to be drawn from the Employment Security 
Administration account of the Unemployment Trust Fund and 
$91,566,000 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 recommends a total of $2,712,266,000 for UI 
activities. For UI State operations, the Committee recommends 
$2,697,019,000. Of these funds, the Committee includes 
$115,000,000 to help address and prevent long-term unemployment 
and reduce improper payments through the Reemployment Services 
and Eligibility Assessments [RESEA] initiative.
    The request also proposed $35,000,000 of the total be 
provided through a discretionary cap adjustment. The Committee 
recommendation does not include funding through the proposed 
cap adjustment.
    The Administration's request of $50,000,000 to fund State 
consortia to modernize their UI tax and benefit systems is also 
included in the recommendation. The Committee expects the full 
$50,000,000 to be applied to this purpose.
    The Committee recommendation includes $6,000,000 for the UI 
Integrity Center of Excellence, including $3,000,000 to support 
an integrated data hub and data analytics capacity to help 
States reduce fraud.
    The Committee recommendation provides no funding for an 
additional round of State incentive grants related to worker 
misclassification.
    The Committee recommendation provides for a contingency 
reserve amount should the unemployment workload exceed an 
average weekly insured claims volume of 2,453,000.
    The Committee recommends $15,247,000 for UI national 
activities, which will support activities that benefit the 
entire Federal-State UI system, including supporting the 
continuation of IT upgrades and technical assistance.
    For the Employment Service allotments to States, the 
Committee recommends $671,413,000. This amount includes 
$21,413,000 in general funds together with an authorization to 
spend $650,000,000 from the Employment Security Administration 
account of the Unemployment Trust Fund.
    The Committee also recommends $19,818,000 for Employment 
Service national activities. The administration of the work 
opportunity tax credit program accounts for $18,485,000 of the 
recommended amount; the remainder is for technical assistance 
and training to States.
    For carrying out the Department's responsibilities related 
to foreign labor certification activities, the Committee 
recommends $48,028,000. 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.
    The Committee is concerned about widespread reports of 
lengthy wage determination and application processing delays as 
well as allegations of instances of enforcement of regulations 
Congress specifically prohibited in the fiscal year 2016 
appropriations act. The H-2B program is a critical source of 
labor for highly seasonal industries including fishing, 
forestry, tourism, hospitality, recreation, and others. The 
program ensures a legal labor force to fill temporary jobs when 
an insufficient number of American workers are available. 
However, some requirements currently imposed by the Department 
make the program excessively burdensome and costly on employers 
seeking to legally obtain temporary employees which ultimately 
jeopardizes jobs for American workers dependent on these 
enterprises. General provisions are continued in the bill to 
address these concerns; however, persistent delays in 
processing applications remain. The delays noted in most of the 
guest worker programs have grown so severe that businesses have 
to forego part of their work seasons, resulting in missed or 
defaulted contracts, preventing growth, and ultimately 
jeopardizing the jobs of dependent American workers. The 
Committee directs the Department to administer and regulate the 
H-2B program in an efficient manner that is consistent with the 
law, allowing employers to legally seek temporary workers at 
fair and accurate prevailing wages.
    The Committee recommendation includes an amendment to a 
previously existing general provision to authorize ETA to 
utilize up to $20,000,000 of H-1B fee funds to augment staffing 
for H-2B and H-2A foreign labor certification processing, 
including wage determinations and associated tasks. The 
Department is directed to use no less of this authority than is 
necessary to eliminate all labor certification backlogs.
    In the determination of prevailing wage for the purposes of 
the H-2B program, the Secretary shall accept private wage 
surveys even in instances where Occupational Employment 
Statistics [OES] survey data are available unless the Secretary 
determines that the methodology and data in the provided survey 
are not statistically supported. The bill continues general 
provisions related to enforcement of H-2B regulations.
    Additionally, the Committee has been informed of instances 
in which certain job duties related to seafood processing have 
been categorized by the Department into OES wage rate 
categories that may not accurately reflect the work being 
performed by workers normally placed in that category. This 
type of worker misclassification is believed to have resulted 
in inaccurate prevailing wage determinations for many seafood 
workers. Therefore, the Committee strongly urges the Department 
to establish an OES wage rate category for seafood processing.
    For one-stop career centers and labor market information, 
the Committee recommends $70,153,000. The Committee includes 
$8,500,000 to support the initiative started in fiscal year 
2016 to establish occupational licensing grants for State 
consortia to identify, explore, and address areas where 
licensing requirements create an unnecessary barrier to labor 
market entry or labor mobility where interstate portability of 
licenses could improve economic opportunity, particularly for 
dislocated workers, transitioning servicemembers, veterans, and 
military spouses. The Committee also encourages the Department 
to urge participating States to consider ways to increase their 
recognition of military certifications for equivalent private 
sector skills and occupations to further ease the transition of 
former servicemembers to comparable civilian jobs. The 
Committee requests progress updates as this initiative 
proceeds.
    These funds also support system capacity building efforts 
which allow the American Job Center network to respond to the 
needs of the job seekers and businesses in the current economy, 
including the Disability Employment Initiative. When reviewing 
investment alternatives for the Disability Employment 
Initiative in fiscal year 2017, the Committee directs that the 
Department strongly consider needs in rural, underserved States 
especially in cases where meaningful applicant partnerships 
exist with institutions of higher learning and the workforce 
investment system.
    The recommendation also includes $1,500,000 to conduct a 
requested study and to begin to pilot approaches to modernize 
and streamline data collection for the O*NET and related tools. 
O*NET is a source of labor market information for the workforce 
development system.

        ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS

    The Committee bill continues language providing such sums 
as 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.

                         PROGRAM ADMINISTRATION

Appropriations, 2016....................................    $154,559,000
Budget estimate, 2017...................................     180,826,000
Committee recommendation................................     160,156,000

    The Committee recommendation of $160,156,000 for program 
administration includes $110,174,000 in general funds and 
$49,982,000 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 
WIOA, OAA, the Trade Act of 1974, and the National 
Apprenticeship Act. Trust funds provide for the Federal 
administration of employment security, training and employment, 
and executive direction functions.
    Of the funds provided above the fiscal year 2016 level, 
$3,200,000 is dedicated toward implementation of the integrated 
performance reporting system pursuant to WIOA and the grants 
management system, and $2,160,000 is for Office of 
Apprenticeship for the administration of the new apprenticeship 
grant program.

               Employee Benefits Security Administration


                         SALARIES AND EXPENSES

Appropriations, 2016....................................    $181,000,000
Budget estimate, 2017...................................     205,761,000
Committee recommendation................................     181,000,000

    The Committee recommends $181,000,000 for the Employee 
Benefits Security Administration [EBSA]. 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.
    Mental health disorders affected an estimated 43.8 million 
Americans last year. The Committee believes that the Mental 
Health Parity and Addiction Equity Act of 2008 [MHPAEA] made 
significant progress ensuring that individuals in need of 
mental health care have access to those services on the same 
basis as they would for other medical care. While MHPAEA has 
been a strong step towards parity, the Committee believes there 
is insufficient guidance on what constitutes parity under the 
law. Specific guidance for group health plans and health 
insurance issuers as well as for employers and employees 
covered by plans governed by the law is particularly needed. 
The Committee directs the Secretary to coordinate with the 
Secretary of Health and Human Services and prepare annual 
reports of parity compliance activities in each State. Reports 
shall include inquiries and complaints specific to the MHPAEA, 
and a transparent de-identified report of all enforcement 
actions. Reports also shall include a compliance guide that 
answers questions raised during the previous year and specific 
guidelines providing clear interpretations of the law and the 
final rule.

                  Pension Benefit Guaranty Corporation

    The Pension Benefit Guaranty Corporation's [PBGC's] 
estimated obligations for fiscal year 2017 include single-
employer benefit payments of $7,195,000,000, multi-employer 
financial assistance of $315,000,000, and administrative 
expenses of $519,506,000. Administrative expenses are comprised 
of three activities: pension insurance activities, pension plan 
termination expenses, and operational support. These 
expenditures are financed by permanent authority. For fiscal 
year 2016, the Committee accepted the PBGC's proposal to reform 
the previous administrative apportionment classifications from 
three budget activities to one budget activity to make 
operations more efficient and improve stewardship of resources. 
That consolidated approach for the three activities is 
continued, but PBGC is directed to continue providing detail 
every year on the three activities in its annual congressional 
budget justification.
    PBGC requested $98,500,000 for costs associated with the 
consolidation of three separate headquarters facilities into 
one upon the expiration of existing leases. The consolidation 
is intended to reduce the leased footprint of the agency, 
increase efficiencies associated with consolidated office 
space, and reduce overall lease costs. The Committee bill 
provides the requested funds, to be available for 5 years and 
only available for lease replacement costs. Unused funds for 
this purpose will be retained in the revolving fund.
    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 PBGC 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 and the bill continues 
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, 2018, for every 20,000 additional 
participants in terminated plans. 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.

                         Wage and Hour Division

                         SALARIES AND EXPENSES

Appropriations, 2016....................................    $227,500,000
Budget estimate, 2017...................................     276,599,000
Committee recommendation................................     227,500,000

    The Committee recommends $227,500,000 for the Wage and Hour 
Division [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.

                  Office of Labor-Management Standards

                         SALARIES AND EXPENSES

Appropriations, 2016....................................     $40,593,000
Budget estimate, 2017...................................      45,691,000
Committee recommendation................................      35,529,000

    The Committee recommends $35,529,000 for the Office of 
Labor-Management Standards [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, 2016....................................    $105,476,000
Budget estimate, 2017...................................     114,169,000
Committee recommendation................................     104,476,000

    The Committee recommends $104,476,000 for the Office of 
Federal Contract Compliance Programs [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.

                Office of Workers' Compensation Programs

                         SALARIES AND EXPENSES

Appropriations, 2016....................................    $115,501,000
Budget estimate, 2017...................................     126,159,000
Committee recommendation................................     117,601,000

    The Committee recommends $117,601,000 for the Office of 
Workers' Compensation [OWCP]. The bill provides authority to 
expend $2,177,000 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, 2016....................................    $210,000,000
Budget estimate, 2017...................................     220,000,000
Committee recommendation................................     220,000,000

    The Committee recommends $220,000,000 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 numbers by individuals filing claims under FECA or the 
Longshore and Harbor Workers' Compensation Act and its 
extensions.
    The Committee continues 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 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 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 maintains language consistent with 
long-standing interpretations and implementation of this 
appropriation stating that, along with the other compensation 
statutes already specifically enumerated, the appropriation is 
used to pay obligations that arise under the War Hazards 
Compensation Act, and the appropriation is deposited in the 
Employees' Compensation Fund and assumes its attributes, namely 
availability without time limit as provided by 5 U.S.C. section 
8147.

               SPECIAL BENEFITS FOR DISABLED COAL MINERS

Appropriations, 2016....................................     $69,302,000
Budget estimate, 2017...................................      61,319,000
Committee recommendation................................      61,319,000

    The Committee recommends a mandatory appropriation of 
$61,319,000 in fiscal year 2017 for special benefits for 
disabled coal miners. This is in addition to the $19,000,000 
appropriated last year as an advance for the first quarter of 
fiscal year 2017, for a total program level of $80,319,000 in 
fiscal year 2017. The decrease in this account below the fiscal 
year 2016 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 
$16,000,000 for the first quarter of fiscal year 2018. 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, 2016....................................     $58,552,000
Budget estimate, 2017...................................      59,846,000
Committee recommendation................................      59,846,000

    The Committee recommends $59,846,000 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 the Department of 
Energy [DOE], its contractors and subcontractors, or to certain 
survivors of such individuals. The mission also includes 
delivering benefits to certain beneficiaries of the Radiation 
Exposure Compensation Act. The Division is part of OWCP.
    In fiscal year 2017, the volume of incoming claims under 
part B of EEOICPA is estimated at about 5,300 from DOE 
employees or survivors, and private companies under contract 
with DOE, who suffer from a radiation-related cancer, 
beryllium-related disease, or chronic silicosis as a result of 
their work in producing or testing nuclear weapons.
    Under part E, approximately 4,350 new claims will be 
received during fiscal year 2017. 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, 2016....................................    $341,467,000
Budget estimate, 2017...................................     371,641,000
Committee recommendation................................     371,641,000

    The Committee bill provides an estimated $371,641,000 as 
requested for this mandatory appropriations account. This 
estimate is comprised of $69,526,000 for administrative 
expenses and an estimated $302,115,000 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 as requested: up to 
$38,246,000 for the part C costs of the Division of Coal Mine 
Workers' Compensation Programs; up to $30,594,000 for 
Departmental Management, Salaries and Expenses; and up to 
$330,000 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, 2016....................................    $552,787,000
Budget estimate, 2017...................................     595,023,000
Committee recommendation................................     552,787,000

    The Committee recommends $552,787,000 for the Occupational 
Safety and Health Administration [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 course tuition and fees for training institute courses 
used for occupational safety and health training and education 
activities in the private sector. The cap established by the 
bill is $499,000, the same as current law.
    The bill retains language that continues to 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 exemption of small farming operations from OSHA 
regulation has been in place since 1976. OSHA clarified the 
limits of its authority to conduct enforcement on small farms 
in July 2014, particularly regarding post-harvest activities of 
a farming operation. The continued exemption for small farms 
and recognition of limits of the OSHA regulatory authority are 
critical for family farms. It is also important the Department 
of Agriculture be consulted in any future attempts by OSHA to 
redefine or modify any aspect of the small farm exemption.
    The Committee recommends $100,850,000 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 OSHA's worker safety and health 
training and education programs 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 $10,537,000 for the OSHA Susan Harwood 
Training Grant Program and directs OSHA to dedicate no less 
than $3,500,000 per year for the purpose of administering the 
Voluntary Protection Program [VPP] in its Federal Compliance 
Assistance budget. OSHA shall not reduce funding levels or the 
number of employees administering the VPP, the Safety and 
Health Achievement Recognition Program [SHARP], or Federal 
Compliance Assistance, and shall not collect any monies from 
participants for the purpose of administering these programs.
    The Committee recognizes that fewer injuries mean safer, 
more productive workers and lower worker compensation and 
healthcare costs. Statistical evidence for VPP success is 
impressive. The average VPP worksite has a Days Away Restricted 
or Transferred [DART] case rate of 52 percent below the average 
for its industry. These sites typically do not start out with 
such low rates. Reductions in injuries and illnesses begin when 
the site commits to the VPP approach to safety and health 
management and the challenging VPP application process.
    The Committee repeats and emphasizes the concerns stated in 
the joint explanatory statement accompanying the Consolidated 
Appropriations Act, 2016 about OSHA's use of guidance documents 
to change longstanding OSHA policy. In June and July of 2015, 
OSHA issued three guidance documents related to Executive Order 
13650, ``Improving Chemical Facility Safety and Security.'' 
They are Process Safety Management of Highly Hazardous 
Chemicals and Covered Concentrations of Listed Appendix A 
Chemicals, RAGAGEP in Safety Process Management Enforcement, 
and PSM Retail Exemption Interim Enforcement Policy. These 
along with other OSHA ``letters of interpretation'' attempt to 
change prevailing agency policies without proposing regulatory 
changes, which would be governed by the requirements of the 
Administrative Procedures Act (5 U.S.C. 551 et. seq.). OSHA has 
issued letters of interpretation on substantive policy matters 
that leave the agency open to liability that can be avoided by 
going through the proper rulemaking process, including notice 
and period of public comment. OSHA is expected to implement 
agency policy changes through the formal regulatory process.
    Therefore, the revised enforcement policy relating to the 
exemption of retail facilities from coverage of the Process 
Safety Management of Highly Hazardous Chemicals standard (29 
CFR 191 0.119(a)(2)(i)) issued by the Occupational Safety and 
Health Administration on July 22, 2015, shall not be enforced 
nor deemed by the Department of Labor to be in effect until: 
the Bureau of the Census establishes a new North American 
Industry Classification System code under Sector 44-45 Retail 
Trade for Farm Supply Retailers; the Secretary of Labor, acting 
through the Assistant Secretary of Labor for Occupational 
Safety and Health, has carried out all notice and comment 
rulemaking procedures and invited meaningful public 
participation in the rulemaking; and the Secretary, acting 
through the Assistant Secretary of Labor for Occupational 
Safety and Health, arranges for an independent third-party to 
conduct a cost-benefit analysis of such proposed rule and the 
Secretary includes such analysis in the publication of the 
proposed rule.
    The Committee understands that, as a result of Executive 
Order 13650, Improving Chemical Facility Safety and Security, 
OSHA is considering options to ensure the safety of ammonium 
nitrate handling and storage. The Committee also understands 
that there is no record thus far of an accidental detonation of 
ammonium nitrate in a situation where a storage facility has 
been compliant with OSHA's existing regulations at 29 CFR 
1910.109(i). The existing regulations are based on standards of 
the National Fire Protection Association. Before any new 
regulations are proposed for the storage of solid ammonium 
nitrate, the Secretary shall submit a report to the Committees 
on Appropriations of the House Representatives and the Senate; 
the Senate Health, Education, Labor and Pensions Committee; and 
the House Committee on Education and the Workforce that 
identifies any provisions of OSHA's current 29 CFR 1910.109(i) 
regulations under consideration for update and that evaluates 
the costs and benefits of such changes.
    The Committee is concerned about OSHA's implementation of 
the Outreach Training Program and its use of Requests for 
Proposals [RFPs] to change longstanding OSHA policy. Since 
2008, OSHA has implemented and administered online Outreach 
Training Program courses via its OSHA Outreach Training 
Program--Online Training Guidance document. Instead of 
remaining consistent with its own Guidance document, OSHA has 
twice used the RFP process unsuccessfully to specifically limit 
online distribution of the Outreach Training Program. 
Therefore, the Committee urges OSHA to consider recognition of 
online training as an equivalent to classroom training with 
respect to the Outreach Training Program and improvement of 
worker safety and health. Further, OSHA is urged to seek the 
meaningful advance participation of policymakers and 
stakeholders through public meetings and pre-solicitation 
conferences prior to the issuance of any new or amended 
training RFP for this program. OSHA is directed to provide 
notification to the Committees on Appropriations of the House 
of Representatives and the Senate at least 10 days prior to 
issuance of any new or amended RFP specific to Outreach 
Training Programs.

                 Mine Safety and Health Administration

                         SALARIES AND EXPENSES

Appropriations, 2016....................................    $375,887,000
Budget estimate, 2017...................................     397,372,000
Committee recommendation................................     375,887,000

    The Committee recommendation includes $375,887,000 for the 
Mine Safety and Health Administration [MSHA].
    MSHA enforces the Federal Mine Safety and Health Act 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 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. To prepare properly for an actual emergency, the 
Committee also directs MSHA to continue to devote sufficient 
resources toward a competitive grant activity for effective 
emergency response and recovery training in various types of 
mine conditions.
    The Committee supports MSHA's ongoing work to improve mine 
rescue communications capabilities. To prepare properly for an 
actual mine rescue emergency, the Committee directs MSHA to 
continue to devote sufficient resources towards mine rescue 
technology and, to the extent possible, urges MSHA to expedite 
progress toward outfitting all five MSHA Mine Rescue teams with 
advanced mine rescue technology. The Committee has been 
informed that there is a discrepancy among States' 
interpretations of whether the purchase of mine rescue 
communications equipment is an eligible use of State Assistance 
Training funds. The Committee believes that such purchases, 
when used in part for training purposes which are the focus of 
these funds, are an allowable use and directs MSHA to clarify 
this issue for all training grant recipients.
    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.

                       Bureau of Labor Statistics

                         SALARIES AND EXPENSES

Appropriations, 2016....................................    $609,000,000
Budget estimate, 2017...................................     640,943,000
Committee recommendation................................     609,000,000

    The Committee recommends $609,000,000 for the Bureau of 
Labor Statistics [BLS]. This amount includes $65,000,000 from 
the Employment Security Administration account of the 
Unemployment Trust Fund and $544,000,000 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 
workforce statistics for Federal and non-Federal data users as 
provided by BLS.
    The Committee understands that BLS is preparing a report 
requested in last year's statement of managers that will 
discuss the efforts of BLS to account for and report on all 
forms of employment in the current economy. The Committee notes 
that the availability of data on trends in employment helps 
inform long-term economic policy-making and looks forward to 
receiving the report later this year.

                 Office of Disability Employment Policy

Appropriations, 2016....................................     $38,203,000
Budget estimate, 2017...................................      38,544,000
Committee recommendation................................      38,203,000

    The Committee recommends $38,203,000 for the Office of 
Disability Employment Policy 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 and 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.

                        Departmental Management

                         SALARIES AND EXPENSES

Appropriations, 2016....................................    $334,373,000
Budget estimate, 2017...................................     387,925,000
Committee recommendation................................     339,186,000

    The Committee recommendation includes $339,186,000 for the 
Departmental Management account. Of this amount, $338,878,000 
is available from general funds and $308,000 is available by 
transfer from the Employment Security account of the 
Unemployment Trust Fund. In addition, $30,594,000 is available 
by transfer from the Black Lung Disability Trust Fund.
    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 administration requested $2,620,000 and 15 full time 
equivalent staff to implement Executive Order 13673. This 
request is denied by the Committee. The Committee is concerned 
that the administration proposes to create additional layers of 
bureaucracy to duplicate existing functions of government. 
Violations of Federal labor law are a serious matter. Such 
violations are already illegal by definition, and enforcement 
mechanisms are already in place to adjudicate such cases and to 
levy punishment as appropriate, up to and including debarment.
    The Committee notes that some have raised concerns about 
the Department's use of guidance documents, including Dear 
Colleague letters, because such documents are not legally 
binding, but regulated entities may interpret them as such. 
Accordingly, the Committee recommendation includes new 
directives in the overview section of the Committee Report for 
each of the Departments and agencies included in this bill 
relating to the use of guidance documents.
    The Committee recommendation includes $91,125,000 for the 
Bureau of International Labor Affairs [ILAB], of which 
$61,825,000 is available for obligation through December 31, 
2017. 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 recognizes that the exploitation of children 
around the world remains a serious problem, including in 
settings where children should be safe and protected such as in 
homes and schools. Approximately 115 million children are 
engaged in hazardous work and 5.5 million children are in 
forced labor. The Committee notes ILAB's involvement in the 
United States Government Action Plan on Children in Adversity 
and requests that the amount of funding by objective for the 
Action Plan on Children in Adversity be reported as part of the 
fiscal year 2018 CJ.
    The Committee expects ILAB to enhance its current effort on 
programs to combat exploitative child labor. The Committee also 
expects that integrated child labor and worker rights projects 
supported by ILAB funds will have a significant and direct 
child labor component. The bill requires ILAB to spend not more 
than $54,825,000 for programs to combat exploitative child 
labor internationally and not less than $7,000,000 to implement 
model worker rights programs in countries with which the United 
States has trade preference programs or free trade agreements.
    The Committee understands ILAB's desire to place labor 
attaches in selected U.S. missions abroad and notes that 
Honduras has been established as a first priority. The 
Committee requests a report, not later than 180 days after 
enactment of this act, from the Departments of Labor and State 
which describes current labor-related staffing at U.S. missions 
overseas and the Departments' coordinated plan for future 
staffing and support for effective monitoring and enforcement 
of labor provisions related to free trade agreements and trade 
preference programs, particularly in priority countries.
    The Committee recommendation provides $8,040,000 for 
program evaluation and allows these funds to be available for 
obligation through September 30, 2018. 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 continues authority to use up to 
0.75 percent of certain Department appropriations for 
evaluation activities identified by the chief evaluation 
officer. The Committee expects to be notified of the planned 
uses of funds derived from this authority.
    The Committee directs the Chief Evaluation Officer, in 
conjunction with the Employee Benefits Security Administration 
and other relevant DOL offices, to submit a report to Congress 
within 6 months of enactment of this act that explains the 
Department's proposal for pilot programs to design, implement, 
and evaluate new and existing models and approaches for benefit 
portability and the ways in which such approaches would differ 
from currently available retirement plans that originate with 
employers which can be retained or rolled into other personal 
savings options.
    The recommendation includes $28,834,000 for the Office of 
the Assistant Secretary for Administration and Management. The 
increase of $421,000 above fiscal year 2016 is provided to 
cover requested inflationary and built-in costs.
    The recommendation includes $35,336,000 for the 
Adjudication activity, an increase of $3,336,000 above the 
fiscal year 2016 level. The Committee directs that the increase 
be used to reduce the projected increase in backlogged cases in 
the Office of Administrative Law Judges as requested and of 
which up to $896,000 may be used for built-in inflationary cost 
increases across the agencies within the Adjudication activity.
    The Committee recommendation provides $11,536,000 for the 
Women's Bureau. The Committee continues bill language allowing 
the Bureau to award grants. The requested program increase to 
support a Paid Leave Grant Program is not included.

                    VETERANS EMPLOYMENT AND TRAINING

Appropriations, 2016....................................    $271,110,000
Budget estimate, 2017...................................     285,520,000
Committee recommendation................................     274,541,000

    The Committee recommendation of $274,541,000 for the 
Veterans Employment and Training Service [VETS] includes 
$40,500,000 in general revenue funding and $234,041,000 to be 
expended from the Employment Security Administration account of 
the Unemployment Trust Fund.
    This account provides resources for VETS to maximize 
employment opportunities for veterans and transitioning service 
members, including protecting their employment rights. VETS 
carries out its mission through a combination of grants to 
States, competitive grants, and Federal enforcement and 
oversight.
    The Committee provides $175,000,000 for the Jobs for 
Veterans State Grants [JVSG] program. This funding will enable 
Disabled Veterans' Outreach Program specialists and Local 
Veterans' Employment Representatives to continue providing 
intensive employment services to veterans and eligible spouses; 
transitioning service members 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 maintains language 
providing authority for JVSG funding to be used for data 
systems and contract support to allow for the tracking of 
participant and performance information.
    The Committee provides $14,600,000 for the Transition 
Assistance Program [TAP]. This funding will support over 6,000 
employment workshops at military installations and in virtual 
classrooms worldwide for exiting service members and spouses.
    The Committee recommendation includes $41,027,000 for 
Federal administration costs. This funding level will support 
oversight and administration of the VETS grant programs, TAP 
employment workshops, and compliance and enforcement 
activities.
    The Committee recommends $40,500,000 for the Homeless 
Veterans' Reintegration Program [HVRP], an increase of 
$1,891,000, to help homeless veterans attain the skills they 
need to gain meaningful employment. This funding will allow DOL 
to provide HVRP services to as many as 17,000 homeless veterans 
nationwide, including homeless women veterans. The bill allows 
Incarcerated Veterans' Transition funds to be awarded through 
September 30, 2017, and to serve veterans who have recently 
been released from incarceration but are at-risk of 
homelessness.
    The Committee recommendation includes $3,414,000 for the 
National Veterans' Training Institute, which provides training 
to Federal staff and veteran service providers.

                  INFORMATION TECHNOLOGY MODERNIZATION

Appropriations, 2016....................................     $29,778,000
Budget estimate, 2017...................................      63,162,000
Committee recommendation................................      18,778,000

    The Committee recommends $18,778,000 for the IT 
Modernization account. Funds available in this account have 
been used for two primary activities. The first is departmental 
support systems, for which $4,898,000 is provided as requested. 
The second activity, IT Infrastructure Modernization, supports 
necessary activities associated with the Federal Data Center 
Consolidation Initiative.

                    OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2016....................................     $86,300,000
Budget estimate, 2017...................................      94,541,000
Committee recommendation................................      87,721,000

    The Committee recommends $87,721,000 for the DOL OIG. The 
bill includes $82,061,000 in general funds and authority to 
transfer $5,660,000 from the Employment Security Administration 
account of the Unemployment Trust Fund. In addition, an amount 
of $330,000 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 Innovation and Opportunity Act 
may only be used for competitive grants that train individuals 
over the age of 16 who are not enrolled in school, in 
occupations and industries for which employers are using H-1B 
visas to hire foreign workers. Authority is included to utilize 
H-1B fee receipts for the elimination of foreign labor 
certification processing backlogs.
    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 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 171 of the WIOA. In addition, authority is 
provided for program integrity-related activities as requested 
by the administration.
    Section 107. The bill continues a provision allowing up to 
0.75 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 108. The bill continues a provision regarding the 
application of the Fair Labor Standards Act after the 
occurrence of a major disaster.
    Section 109. The bill continues a provision that provides 
flexibility with respect to the crossing of H-2B nonimmigrants.
    Section 110. The bill continues a provision related to the 
wage methodology under the H-2B program.
    Section 111. The bill continues a provision regarding the 
three-fourths guarantee and definitions of corresponding 
employment and temporary need for purposes of the H-2B program.
    Section 112. The bill continues a provision related to 
enforcement of H-2B program regulations.

                                TITLE II

                DEPARTMENT OF HEALTH AND HUMAN SERVICES

    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, 2016....................................  $1,491,522,000
Budget estimate, 2017...................................   1,342,422,000
Committee recommendation................................   1,491,522,000

    The Committee recommendation for the activities of the 
Bureau of Primary Health Care is $1,491,522,000.
Community Health Centers
    The program level for Community Health Centers is 
$5,091,522,000, equal to the amount provided last year.
    The Committee provides $1,491,522,000 in this bill, which 
is combined with $3,600,000,000 in mandatory funding 
appropriated for fiscal year 2017.
    Programs supported by this funding include community health 
centers, migrant health centers, healthcare for the homeless, 
school-based, 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. Health centers play a vital role in ensuring 
access to primary care in underserved areas of the country, 
including urban, rural, and frontier areas.
    The Committee is supportive of ongoing efforts to expand 
the capacity of community health centers to offer a 
comprehensive, integrated range of services, through strategic 
investment in behavioral health, substance abuse, oral health, 
and other services and capacity. The Committee also recognizes 
the need for capital resources at community health centers to 
meet increased demand and upgrade facilities. The Committee 
supports administrative changes to the HRSA Loan Guarantee 
Program designed to improve its efficiency and better align the 
program with other successful Federal loan guarantees, and to 
increase utilization of this tool to leverage outside resources 
to meet health centers' capital needs.
    The Committee believes that enhanced funding for the 
technical assistance and networking functions available for 
health centers through national and State cooperative 
agreements and grants is critical to the successful operation 
and expansion of the Health Centers program. Funds are 
available within the amount provided to enhance technical 
assistance and training activities, further quality improvement 
initiatives, and continue the development of and support for 
health center-controlled networks so that new and existing 
centers can improve patient access to quality health services.
    Of the available funding for fiscal year 2017, bill 
language directs that not less than $50,000,000 shall be 
awarded for services related to the treatment, prevention, and 
awareness of opioid abuse. In addition, not less than 
$50,000,000 will be awarded for services related to mental 
health.
    In addition, within the amount provided, the Committee 
provides up to $99,893,000 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.
    Diabetic Retinopathy.--According to the National Eye 
Institute, diabetic retinopathy is highly treatable and even 
preventable for diabetic patients that receive early 
interventions. As one of the major side effects of diabetic 
patients, the rates of diabetic retinopathy diagnoses are 
increasing at the same rate as the spike in diabetes diagnoses, 
an unforeseen issue for urban medical institutions that should 
not be neglected. The Committee encourages HRSA to identify 
assistance to urban medical institutions that currently serve 
underserved populations for diabetic retinopathy.
    Native Hawaiian Health Care.--The Committee expects that no 
less than $14,400,000 be provided for the Native Hawaiian 
Health Care Program.
    Perinatal Transmission of Hepatitis B.--The Committee is 
pleased that HRSA funded an evaluation of intervention 
strategies to eliminate the perinatal transmission of Hepatitis 
B. The Committee recognizes that a full evaluation of 
intervention strategies will require the training of health 
care professionals, followed by service delivery, data 
collection, and evaluation. The Committee encourages HRSA to 
incorporate these recommended intervention strategies into the 
required activities and funding plans for health centers.
    Thalassemia.--The Committee supports the important work 
HRSA has funded to establish expert recommendations for patient 
care in three keys areas in thalassemia treatment and to aid 
the development of regional partnership networks related to 
thalassemia. The Committee looks forward to this work 
continuing and expanding to address more issues related to this 
patient population, which deals with a particularly challenging 
rare disorder.
    Tuberculosis [TB].--The Committee notes that the National 
Action Plan for Combating Drug Resistant Tuberculosis 
recommends the creation of healthcare liaisons between State 
and local health departments and institutions, including health 
centers that serve hard-to-reach groups who are at risk for TB. 
The Committee looks forward to an update on coordination 
between community health centers and State and local TB control 
programs to help ensure appropriate identification, treatment, 
and prevention of TB among vulnerable populations.
Free Clinics Medical Malpractice Coverage
    The Committee provides $1,000,000 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 to expand access to healthcare 
services to low-income individuals in medically underserved 
areas.

                      BUREAU OF HEALTH PROFESSIONS

Appropriations, 2016....................................    $836,895,000
Budget estimate, 2017...................................     536,745,000
Committee recommendation................................     826,806,000

    The Committee recommendation for the activities of the 
Bureau of Health Professions is $826,806,000.
    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.
    Health Professions Training.--Given that the Department of 
Health and Human Services recently celebrated the 30th year 
anniversary of the ``Report of the Secretary's Task Force on 
Black and Minority Health,'' commonly called the ``Heckler 
Report,'' HRSA is encouraged to work with the Office of 
Minority Health and the Office of Women's Health to submit a 
follow up report within 1 year after enactment of this act to 
the Committees on Appropriations of the House of 
Representatives and the Senate to the ``Heckler Report'' 
concerning advancements and future courses of action. The 
report should analyze HRSA's federally funded healthcare 
workforce programs, their funding, their impact, and ways to 
further increase diversity in the health professions, as well 
as increase the number of primary health care professionals.
    The Committee recommends that HRSA consider reinstating and 
funding the Student/Resident Experiences and Rotations in 
Community Health [SEARCH] program which provides opportunities 
for health professions students and residents to serve on 
multidisciplinary health care teams in underserved communities.
National Health Service Corps
    The Committee recommendation does not include discretionary 
funding for the National Health Service Corps [Corps], as 
proposed by the administration, due to funding constraints, and 
because funding was included in Public Law 114-10 for fiscal 
year 2017. The Committee strongly supports the Corps' long and 
successful record of supporting qualified healthcare providers 
that are dedicated to working in underserved areas with limited 
access to healthcare.
    Nearly 3-in-4 Corps members choose to stay in the area in 
which they serve upon completion of their service, and it is 
essential to ensure that the Committee is supporting the 
creation and development of health care professionals in rural 
areas.
    The Committee recognizes that the Corps is an essential 
tool for recruitment and retention of health professionals at 
community health centers, especially given recent expansions of 
the program. The Committee encourages HRSA to increase the 
proportion of clinicians serving at health centers to improve 
alignment between these two programs and to best leverage 
investments in Corps health professionals. The Committee 
recognizes that the Secretary retains the authority to include 
additional disciplines in the Corps. As such, the Committee 
urges the Secretary to include pharmacists and pediatric 
subspecialists as eligible recipients of scholarships and loan 
repayments through the program.
    The Committee continues to include section 206 of this act 
to modify the rules governing the Corps to allow every Corps 
member 60 days to cancel their contract.
Training for Diversity
            Centers of Excellence
    The Committee recommends $21,711,000 for the Centers of 
Excellence [COE] Program.
    The Committee recognizes that the COE Program increases the 
supply and competencies of underrepresented minorities [URM] in 
health professions. Funds support programs of excellence that 
enhance the academic performance of URM students, support URM 
faculty development, and facilitate research on minority health 
issues. Diversity among medical school students is associated 
with higher levels of cultural sensitivity of all students and 
greater willingness to serve diverse populations. There is 
evidence that suggests that minority health professionals are 
more likely to serve in areas with high rates of uninsured and 
areas of underrepresented racial and ethnic groups.
    The Committee commends those institutions with a historic 
commitment to educating under-represented minority students in 
the health professions. In addition to the ongoing efforts of 
COEs, the Committee encourages HRSA to survey current and 
former COEs for options on how to better address the low 
representation of under-represented minority males in COE's 
health professions disciplinary focus areas (medicine, 
dentistry, pharmacy, and behavioral health).
            Health Careers Opportunity Program
    The Committee eliminates the Health Careers Opportunity 
Program due to funding constraints. Funding to increase the 
diversity of the health professions workforce in this bill is 
prioritized by investing in programs that have a more immediate 
impact on the production of health professionals by supporting 
students who have committed to and are in training as 
healthcare professionals.
            Faculty Loan Repayment
    The Committee provides $1,190,000 for the Faculty Loan 
Repayment Program. This amount is the same as the fiscal year 
2016 enacted level and the budget request.
            Scholarships for Disadvantaged Students
    The Committee provides $49,070,000 for Scholarships for 
Disadvantaged Students, an increase of $3,100,000 above the 
fiscal year 2016 level. The Committee supports diversity among 
health professionals. This program provides grants to eligible 
health professions and nursing schools to award scholarships to 
students from disadvantaged backgrounds who have financial 
need.
    Increased funding will help to meet the demand for 
scholarship support to disadvantaged students who have unmet 
financial need in paying for their health professions 
education. It is essential that disadvantaged students, 
particularly those from rural or underserved health 
professional shortage areas, are given the tools to become 
effective health care professionals by using their knowledge of 
rural healthcare issues and are supported in pursing education 
and training.
            Primary Care Training and Enhancement
    The Committee provides $38,924,000 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 directs HRSA to 
prioritize programs that support underserved communities and 
applicants from disadvantaged backgrounds in any new grant 
competition in 2017.
Training in Oral Health Care
    The Committee provides $35,873,000 for Training in Oral 
Health Care programs, which includes not less than $10,000,000 
each for general and pediatric dentistry. 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 agency is directed to provide continuation funding for 
predoctoral and postdoctoral training grants initially awarded 
in fiscal year 2015, and for Section 748 Dental Faculty Loan 
Program grants initially awarded in fiscal year 2016.
    The Committee understands that since the Chief Dental 
Officer [CDO] was created at HRSA, the position has been 
downgraded to Senior Dental Advisor. The Committee strongly 
encourages HRSA to restore the position of Chief Dental Officer 
with executive level authority and resources to oversee and 
lead HRSA dental programs and initiatives. The CDO is also 
expected to serve as the agency representative on oral health 
issues to international, national, State, and/or local 
government agencies, universities, and oral health stakeholder 
organizations.
    The Committee continues long-standing bill language that 
prohibits funding for section 340G-1 of the PHS Act.
Interdisciplinary, Community-Based Linkages
            Area Health Education Centers
    The Committee provides $30,250,000 for Area Health 
Education Centers [AHECs], equal to the fiscal year 2016 level.
    The program links university health science centers with 
community health service delivery systems to provide training 
sites for students, faculty, and practitioners. The program 
supports three types of projects: core grants to plan and 
implement programs; special initiative funding for schools that 
have previously received AHEC grants; and model programs to 
extend AHEC programs with 50 percent Federal funding. The AHEC 
community training model provides a uniquely appropriate 
opportunity to bring the training of community health workers 
to scale. HRSA is encouraged to provide technical assistance on 
and disseminate best practices for training community health 
workers to existing AHECs. The Committee is pleased with AHEC's 
efforts to improve access to quality healthcare in America's 
rural and underserved areas by increasing the number of primary 
healthcare professionals who practice in those areas.
            Geriatric Programs
    The Committee provides $38,737,000 for Geriatric Programs.
    The Committee recognizes the importance of geriatric 
training programs incorporating culturally sensitive training 
programs and encourages HRSA to work to ensure training 
programs are collaborative, interdisciplinary, and culturally 
competent.
            Behavioral Health Workforce Education and Training Program
    The Committee provides $50,000,000 for Behavioral Health 
Workforce Education and Training Program [BHWET]. The BHWET 
Program is focused on developing and expanding the mental 
health and substance abuse workforce serving populations across 
the lifespan. As requested by the administration, the Committee 
transfers the program to HRSA from the Substance Abuse and 
Mental Health Services Administration [SAMHSA]. HRSA will 
continue to leverage SAMHSA's subject matter expertise in 
formatting new investments in fiscal year 2017.
    The Committee supports the broadened target populations of 
people to be served by the BHWET program. In light of the new 
competition that will be held in 2017, the Committee directs 
that eligible entities for this program shall include, but is 
not limited to, accredited programs that train masters and 
clinical doctoral level social workers, psychologists, 
counselors, marriage and family therapists, psychiatric mental 
health nurse practitioners; psychology interns; and behavioral 
health paraprofessionals. The Committee is concerned about the 
uneven distribution of funds among specialties resulting from 
the initial grant competition in 2014 and therefore directs 
HRSA to ensure that funding is distributed proportionately 
among the participating health professions and to consider 
strategies such as issuing separate funding opportunity 
announcements for each participating health profession.
            Mental and Behavioral Health Education Training Programs
    The Committee provides $9,916,000 for Mental and Behavioral 
Health Education Training Programs. The programs provide grants 
to higher education institutions and accredited training 
programs to recruit and train professionals and faculty in the 
fields of social work, psychology, psychiatry, marriage and 
family therapy, substance abuse prevention and treatment, and 
other areas of mental and behavioral health.
    Graduate Psychology Education Program [GPE].--The Committee 
recognizes the growing need for highly trained behavioral 
health professionals to deliver evidence-based services to 
vulnerable populations, including the elderly, returning 
military veterans, and those suffering from trauma. The GPE 
program is the main Federal initiative dedicated to the 
education and training of psychologists. The Committee urges 
HRSA to explore evidence-based approaches to leverage workforce 
capacity through this program, to invest in geropsychology 
training programs, and to help integrate health service 
psychology trainees at Federally Qualified Health Centers.
    When awarding GPE grants, the Committee directs HRSA to 
give priority to Historically Black Colleges and Universities 
and other Minority Serving Institutions that propose GPE 
projects in underserved and rural areas with significant health 
disparities, large minority patient populations, and/or 
shortages of behavioral health providers.
Health Professions Workforce Information and Analysis
    The Committee provides $4,663,000 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 $17,000,000 for Public Health 
Workforce Development. 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.
    The Committee recommendation includes funding for Public 
Health Training Centers and the Preventative Medicine Residency 
with Integrative Health Care program, as requested by the 
administration.
Nursing Workforce Development Programs
    The Committee provides $229,472,000 for Nursing Workforce 
Development programs. The program provides funding to address 
all aspects of nursing workforce demand, including education, 
practice, recruitment, and retention.
    The Committee encourages HRSA to expand the Nurse Corps 
Loan Repayment program by naming free and charitable clinics as 
accepted sites for nurses to work and take advantage of the 
Nurse Corps Loan Repayment program. The Committee supports 
efforts to ensure that affordable medication can be obtained by 
the neediest patients and urges the inclusion of free and 
charitable clinics as designated sites to provide access to 
free or low cost prescription drugs.
Children's Hospitals Graduate Medical Education
    The Committee provides $300,000,000, an increase of 
$5,000,000, for the Children's Hospitals Graduate Medical 
Education [CHGME] program. The Committee strongly supports the 
CHGME program which provides support for graduate medical 
education training programs in both ambulatory and in-patient 
settings within freestanding children's teaching hospitals. 
CHGME payments are determined by a per-resident formula that 
includes an amount for direct training costs added to a payment 
for indirect costs. Payments support training of resident 
physicians as defined by Medicare in both ambulatory and 
inpatient settings.
    The Committee recognizes changes made to the program that 
have increased the number of children's teaching hospitals 
eligible to apply for funding. The Committee notes the 
Secretary's use of the authority provided under the current 
authorization to make funding available for hospitals 
previously ineligible for the program, and urges the Secretary 
to continue to make such funding available in future CHGME 
application and funding cycles. The Committee encourages HRSA 
to continue its work with the Children's Hospitals on the 
development and collection of enhanced program performance 
measures.
National Practitioner Data Bank
    The Committee provides $18,814,000 for the National 
Practitioner Data Bank. As mandated by the Health Care Quality 
Improvement Act, the National Practitioner Data Bank does not 
receive appropriated funds, but instead is financed by the 
collection of user fees.
    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

Appropriations, 2016....................................    $845,117,000
Budget estimate, 2017...................................     845,117,000
Committee recommendation................................     846,617,000

    The Committee recommendation for the Maternal and Child 
Health [MCH] Bureau is $846,617,000. The mission of the Bureau 
is to improve the physical and mental health, safety, and well-
being of the Nation's women, infants, children, adolescents, 
and their families. This population includes fathers and 
children with special healthcare needs.
Maternal and Child Health Block Grant
    The Committee provides $641,700,000 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 supports programs that provide early, 
continuous, intensive, and comprehensive child development and 
family support services using evidence-based home visiting 
models with the goal of providing parents with child 
development knowledge and parenting support, provide early 
detection of developmental delays and health issues, prevent 
child abuse and neglect, and increase children's school 
readiness.
    The Committee encourages HRSA to utilize demonstration 
projects to support the implementation of integrating oral 
health and primary care practice. The projects should model the 
core clinical oral health competencies for non-dental providers 
that HRSA published and initially tested in its 2014 report, 
``Integration of Oral Health and Primary Care Practice.''
    Children's Health and Development.--Evidence shows that 
experiences in early childhood have long-term health 
consequences over the course of a person's life. These 
experiences are critical for a child's educational, social, 
physical, and economic well-being. Children living in States 
with persistently high child poverty rates experience more 
negative health outcomes than their peers elsewhere. Therefore, 
the Committee provides an additional $3,500,000 within the 
Special Projects of Regional and National Significance program 
and directs HRSA to fund a study focused on systemic change 
that would positively impact the policy of child-health-related 
institutions and systems in States with the highest levels of 
childhood poverty. A successful program would consider inter- 
and intra-cultural dynamics to yield best practices for areas 
across the nation with diverse populations, persistent poverty, 
and child health outcomes in need of improvement. The end goal 
of the program should be to yield a model for other States to 
utilize in improving child health and development outcomes.
    Vision Health.--The Committee is concerned that vision 
disorders are the leading cause of impaired health in 
childhood. One in four school-aged children has a vision 
problem significant enough to affect learning. The Committee 
recognizes that early detection can help prevent vision loss 
and blindness and understands many serious ocular conditions in 
children are treatable if diagnosed at an early stage. 
Therefore, the Committee commends and supports the work of the 
National Center for Children's Vision and Eye Health, which 
through partnerships, sound science, and targeted policy 
initiatives, advances the development of public health 
infrastructure to support a comprehensive, multi-tiered 
continuum of vision care for young children.
Sickle Cell Anemia
    The Committee provides $4,455,000 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.
Autism and Other Developmental Disorders
    The Committee provides $47,099,000 for the Autism and Other 
Developmental Disorders program. 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.
    Leadership Education in Neurodevelopmental and Related 
Disabilities [LEND] Programs.--The Committee provides 
$28,990,000 for the LEND program to maintain capacity and 
expand the number of sites to train professionals to diagnose, 
treat, and provide interventions to individuals with autism 
spectrum disorder authorized by the Combating Autism Act. This 
funding will help these programs initiate or expand their work 
in the area of interdisciplinary leadership training to meet 
the needs of children with Autism Spectrum Disorders and 
related developmental disabilities.
Newborn Screening for Heritable Disorders
    The Committee provides $11,883,000 for the Newborn 
Heritable Disorders Screening program, as described in section 
1109 of the Newborn Screening Saves Lives Act of 2008. 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 $103,500,000 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.
    Fetal Infant Mortality Review [FIMR].--The FIMR program is 
an important component of many Healthy Start and local health 
department initiatives that provide evidence-based 
interventions crucial to improving infant health in high risk 
communities. HRSA is encouraged to continue to support the FIMR 
program with Healthy Start funding while educating Healthy 
Start Programs on the successes of FIMR.
            Universal Newborn Hearing Screening and Early Intervention
    The Committee provides $17,818,000 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 $20,162,000 for the Emergency 
Medical Services for Children 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.

                            HIV/AIDS BUREAU

Appropriations, 2016....................................  $2,322,781,000
Budget estimate, 2017...................................   2,331,781,000
Committee recommendation................................   2,293,781,000

    The Committee recommendation includes $2,293,781,000 for 
the HIV/AIDS Bureau.
    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.
Emergency Assistance
    The Committee provides $655,876,000 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.
Comprehensive Care Programs
    The Committee provides $1,315,005,000 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 
[ADAP].
    The Committee provides $900,313,000 for AIDS medications in 
ADAP.
Early Intervention Services
    The Committee provides $201,079,000 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 $75,088,000 for grants for 
coordinated services to women, infants, children, and youth. 
The President's request did not include funding for this 
program. The Committee once again rejects the President's 
proposal to consolidate this program with the Early 
Intervention Services program.
    Funds are awarded to a variety of providers, including 
community health centers, 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 $13,122,000 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.
    The Ryan White Part F program provides for the Dental 
Reimbursement Program [DRP] which covers the unreimbursed costs 
of providing dental care to persons living with HIV/AIDS. 
Programs qualifying for reimbursement are dental schools, 
hospitals with postdoctoral dental education programs, and 
colleges with dental hygiene programs.
AIDS Education and Training Centers
    The Committee provides $33,611,000 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.
Special Projects of National Significance
    Due to budget constraints, the Committee does not include 
funding for Special Projects of National Significance. However, 
the Committee continues to preserve the core HIV/AIDS Bureau 
programs that provide treatment, care, and direct services to 
patients.

                          HEALTH CARE SYSTEMS

Appropriations, 2016....................................    $103,193,000
Budget estimate, 2017...................................     110,193,000
Committee recommendation................................     103,193,000

    The Committee recommendation for the Health Care Systems 
Bureau is $103,193,000.
    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 $23,549,000 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 clearinghouse 
and technical assistance functions.
National Cord Blood Inventory
    The Committee provides $11,266,000 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 $22,109,000 for the C.W. Bill Young 
Cell Transplantation Program.
    The Committee continues to 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 $10,238,000 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 includes a statutory provision to allow a 
nominal cost recovery fee to fund the program integrity 
provisions recommended by the inspector general. The fee will 
be set at 0.1 percent for covered entities and is expected to 
generate $9,000,000 in fiscal year 2018. The Committee expects 
HRSA to report the estimated and actual amounts generated by 
the fee in HRSA's annual CJ.
    The 340B statute requires HRSA to make 340B ceiling prices 
available to covered entities through a secure Web site. The 
Committee urges OPA to complete the development of a 
transparent system to verify the accuracy of the 340B discount 
or ceiling prices.
    The Committee recognizes that OPA recently published the 
first, comprehensive program guidance. The Committee urges OPA 
to consider carefully the comments received from all 
stakeholders.
Poison Control Centers
    The Committee provides $18,846,000 for poison control 
activities. The Poison Control Centers program currently 
supports a mix of grantees. Most serve States; a few serve 
multi-State regions; and, in a handful of cases, more than one 
grantee serves a single State.
    The Committee recognizes the critical role of Poison 
Control Centers and the value of its highly effective public-
private/local-State-Federal partnership in helping the country 
address the opioid epidemic, as well as contributing 
significantly to Congressional goals of achieving the most 
efficient delivery of healthcare services to all citizens.
    The Committee commends HRSA for successfully recognizing 
the first accreditation of a Poison Control Center through an 
approved State accrediting body in 2015. This accreditation, 
executed pursuant to the Poison Center Network Act, 
demonstrates the viability of the State-based accrediting 
process and makes clear that this designation confers the full 
approval of HRSA on centers successfully utilizing this 
pathway. The Committee urges HRSA to offer assistance to any 
Poison Control Center seeking State-based accreditation and to 
approve those deemed to meet standards sufficient to protect 
public safety.
National Hansen's Disease Program
    The Committee includes $15,206,000 for the National 
Hansen's Disease program. The program consists of inpatient, 
outpatient, long-term care as well as 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 $122,000 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 $1,857,000 to Hawaii for Hansen's 
Disease treatment. 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, 2016....................................    $149,571,000
Budget estimate, 2017...................................     144,162,000
Committee recommendation................................     152,571,000

    The Committee recommendation for Rural Health programs is 
$152,571,000, an increase of $3,000,000 above the fiscal year 
2016 level.
    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 the more than 42 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.
    Reliable Energy Supply for Rural Health Facilities.--The 
Committee recognizes that rural health facilities, including 
dialysis centers, are often dependent on inconsistent energy 
supply that can be interrupted for days or weeks following 
severe weather events. The lack of consistent power may require 
that patients travel long distances, often in less than safe 
conditions, for simple, life-saving procedures. This problem 
can be solved with alternative power generation capacity 
located at health facilities. The Committee encourages HRSA to 
design a competitive grant program that would support energy 
reliability and power generation capacity for qualified health 
and dialysis facilities located outside Metropolitan 
Statistical Areas or in a Rural Urban Commuting Areas.
Rural Health Outreach
    The Committee provides $65,500,000 for the Rural Health 
Outreach program, $2,000,000 above the fiscal year 2016 level.
    This program supports projects that demonstrate new and 
innovative modes of outreach in rural areas, such as 
integration and coordination of health services. The Committee 
recommendation provides not more than $12,514,000 for Outreach 
Service Grants; not more than $19,412,000 for Rural Network 
Development Grants; not less than $12,000,000 for Delta States 
Network Grant Program; not more than $2,400,000 for Network 
Planning Grants; and not less than $4,148,000 for Small 
Healthcare Provider Quality Improvement Grants.
    Delta States Rural Development Network Grant Program.--The 
Committee encourages HRSA to consult with the Delta Regional 
Authority [DRA] on the awarding and administration of grants 
under the Delta States Network Grant Program in fiscal year 
2017. Further, the Committee encourages HRSA to solicit input 
from DRA on the implementation, administration, and monitoring 
of Delta States Network Grant Program in fiscal year 2017. The 
Committee encourages HRSA to align its awards as closely as 
possible with the DRA's strategic plan and with DRA economic 
and community development plans. In addition, of the funds 
provided, the Committee provides $2,000,000 to support HRSA's 
collaboration with the DRA to develop a pilot program to help 
underserved rural communities identify and better address their 
health care needs and to help small rural hospitals improve 
their financial and operational performance. Finally, the 
Committee encourages HRSA to participate and collaborate on 
DRA's next health strategic plan for the Delta Region. The 
Committee believes that the information the DRA collects in the 
development of that plan will be of substantial value to HRSA, 
and encourages HRSA to provide support to DRA for the provision 
of that information.
Rural Health Research
    The Committee provides $9,351,000 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 $41,609,000 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 continues to reject the administration's 
proposal to eliminate the Small Hospital Improvement Program.
    The Committee recognizes the continuing need to provide 
support for hospitals located in rural and underserved 
communities. The Rural Hospital Flexibility Grant Program has 
improved access for the millions of Americans who reside 
outside of a reasonable scope of a critical access hospital.
State Offices of Rural Health
    The Committee provides $9,511,000 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 $6,766,000 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.
    The Committee is deeply concerned about changes HRSA has 
made to the Black Lung Clinic Grants Program in fiscal year 
2014, including the adoption of a three-tiered funding system 
and an overall per-applicant cap. These changes to the program 
have unnecessarily increased the administrative burden on 
applicants and may result in reductions in funding for States 
and communities most in-need of the essential health care 
services provided by this program. The fiscal year 2014 policy 
violates HRSA regulations which require the Secretary to give 
preference to State agencies, account for the number of miners 
to be served and their needs, and evaluate the quality and 
breadth of services to be provided by a prospective grantee. 
The Secretary is directed to evaluate funding levels for 
applicants based on the needs of the populations those 
applicants will serve and the ability of those applicants to 
provide health care services to miners with respiratory 
illnesses, with preference given to State agency applications 
over other applicants in that State, without regard to the 
funding tiers and overall per-applicant funding cap established 
by the Secretary in fiscal year 2014.
Radiation and Exposure Screening and Education Program
    The Committee provides $1,834,000 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 $18,000,000, an increase of 
$1,000,000 above the fiscal year 2016 level, 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 strongly supports OAT and their mission to 
expand high quality medical care to rural communities that do 
not have adequate access to medical providers including many 
medical specialties.
    Extension for Community Health Outcomes [ECHO].--Project 
ECHO is an innovative continuing medical education model that 
uses interactive videoconferencing to link specialist teams 
with primary care providers in rural and underserved areas. The 
Committee is encouraged by early implementations of the ECHO 
model in rural communities and requests a report from the 
Government Accountability Office regarding opportunities for 
increased adoption of such models, efficiencies, and potential 
cost savings, as well as ways to improve health care through 
such models, and field recommendations to advance the use of 
such models.
    Telehealth Center of Excellence.--The Committee recognizes 
the growing importance of telehealth in delivering high-quality 
healthcare to medically underserved communities in both rural 
and urban areas. The Federal Government's need for telehealth 
research and cross-agency coordination has grown as more 
Federal agencies, including HHS, USDA, DOD, VA, and FCC, have 
developed telehealth programs. Therefore, the Committee directs 
HRSA to develop a plan to create a telehealth center of 
excellence [COE] to test the efficacy of telehealth services in 
both urban and rural geographic locations. The COE would 
operate varied sites of service, including patients' homes; 
examine the benefits to student health of school-based 
telehealth; establish standards and best practices for various 
telehealth modes of delivery, including real-time audio-visual, 
audio-only, store-and-forward, and remote patient monitoring; 
pilot new health care delivery models as they emerge; test 
innovative payment models to examine potential cost savings to 
Federal health care spending from telehealth; facilitate inter-
agency coordination on telehealth issues; and perform any other 
telehealth-related research that is needed. To lead this COE, 
HHS should consider a public academic medical center with 
demonstrated success, a high volume of annual telehealth 
visits, and established programs that provide telehealth 
services in medically underserved areas with high chronic 
disease prevalence and high poverty rates. The selected site 
should also have established a reimbursement structure that 
allows telehealth services to be financially self-sustaining. 
The Committee requests a written report outlining HRSA's plans 
for a telehealth COE within 120 days of enactment of this act.
    Telehealth for the Prevention of Opioid Abuse.--The 
Committee encourages the Office of Rural Health Policy to 
explore how telehealth networks can improve access to, 
coordination of, and quality of prevention and treatment of the 
opioid epidemic, especially in rural areas. Increased use of 
telehealth networks will help ensure those struggling with a 
substance use disorder have access to the care they need, 
provide continuing education to rural clinicians and emergency 
medical providers on emerging treatment options, and will help 
patients who are prescribed opioids for pain management use 
them effectively and appropriately.
    Telehealth Resource Centers Grant Program.--The Committee 
recognizes the vital role of existing Telehealth Resource 
Centers across the United States to provide support to 
healthcare organizations, providers, and networks. In addition, 
these current centers are an important part of the telehealth 
infrastructure; helping to improve access to healthcare and 
ultimately improve outcomes for underserved populations. The 
Committee recommends that part of OAT funding should be used to 
support increased outreach to providers and communities 
regarding the benefits of telehealth and the availability of 
technical assistance to support its further adoption. The 
Committee supports continued funding of the current 12 regional 
centers and two National centers in fiscal year 2017.
Rural Opioid Overdose Reversal Program
    The Committee does not provide funding for this program 
under HRSA, but has provided funds to combat the opioid 
epidemic in rural communities through the Centers for Substance 
Abuse within SAMHSA.

                            FAMILY PLANNING

Appropriations, 2016....................................    $286,479,000
Budget estimate, 2017...................................     300,000,000
Committee recommendation................................     286,479,000

    The Committee provides $286,479,000 for the title X Family 
Planning program. This program supports preventive and primary 
healthcare services at clinics nationwide.

                           PROGRAM MANAGEMENT

Appropriations, 2016....................................    $154,000,000
Budget estimate, 2017...................................     157,061,000
Committee recommendation................................     154,000,000

    The Committee provides $154,000,000 for program management 
activities.
    The Committee does not include bill language requested by 
the administration to provide additional transfer authority to 
the Administrator beyond that which is already provided to the 
Secretary.

             VACCINE INJURY COMPENSATION PROGRAM TRUST FUND

Appropriations, 2016....................................    $244,500,000
Budget estimate, 2017...................................     249,200,000
Committee recommendation................................     247,500,000

    The Committee provides that $247,500,000 be released from 
the Vaccine Injury Compensation Trust Fund in fiscal year 2017. 
Of that amount, $7,500,000 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 a program level of 
$7,115,106,000 in this bill for the Centers for Disease Control 
and Prevention [CDC], which includes $55,358,000 in mandatory 
funds under the terms of the Energy Employees Occupational 
Illness Compensation Program Act [EEOICPA], $891,300,000 in 
transfers from the Prevention and Public Health [PPH] Fund, and 
$15,000,000 in Public Health and Social Services Emergency Fund 
[PHSSEF] unobligated balances from pandemic influenza 
supplemental appropriations.
    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; 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.

                 IMMUNIZATION AND RESPIRATORY DISEASES

Appropriations, 2016....................................    $798,405,000
Budget estimate, 2017...................................     748,066,000
Committee recommendation................................     798,405,000

    The Committee recommendation for the activities of the 
National Center for Immunization and Respiratory Diseases is 
$798,405,000, which includes $324,350,000 in transfers from the 
PPH Fund and $15,000,000 in transfers from PHSSEF unobligated 
balances.
    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 2016  Fiscal year 2017      Committee
                      Budget activity                         appropriation        request       recommendation
----------------------------------------------------------------------------------------------------------------
Section 317 Immunization Program..........................           610,847           560,508           610,847
    National Immunization Survey (non-add)................            12,864            12,864            12,864
Influenza Planning and Response...........................           187,558           187,558           187,558
----------------------------------------------------------------------------------------------------------------

    Cost Estimates.--The Committee is pleased with CDC's report 
on estimated funding needs of the Section 317 Immunization 
Program and requests that the report be updated and submitted 
not later than February 1, 2017, to reflect fiscal year 2018 
cost estimates. The updated report should also include an 
estimate of optimum State and local operations funding, as well 
as a discussion of the evolving role of the 317 program as 
expanded coverage for vaccination becomes available from 
private and public sources over the next several years.
    Influenza.--The Committee provides the same level of budget 
authority as in fiscal year 2016 and directs the Department to 
use $15,000,000 in pandemic influenza supplemental balances to 
support CDC's global influenza activity. The Committee expects 
in the future that CDC and the Department will clearly identify 
in budget documents when and how supplemental appropriations 
are used. In particular, the Committee expects to be notified 
if any additional balances are used by CDC in fiscal year 2017.
    Immunizations.--The Committee rejects the reduction to the 
Section 317 Immunization Program proposed by the Administration 
and provides funding at last year's level to enhance core 
activities including the infrastructure for the Vaccines for 
Children program. The Committee believes a strong public health 
immunization infrastructure is critical for ensuring high 
vaccination coverage levels, preventing vaccine-preventable 
diseases, and responding to outbreaks. During the 2015 measles 
outbreak, funds from this program supported State and local 
health departments in rapid response, public health 
communication, data gathering, and diagnostics.

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

Appropriations, 2016....................................  $1,122,278,000
Budget estimate, 2017...................................   1,127,278,000
Committee recommendation................................   1,112,278,000

    The Committee recommendation for the activities of the 
National Center for HIV, Viral Hepatitis, Sexually Transmitted 
Diseases [STDs], and TB Prevention is $1,112,278,000.
    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 2016  Fiscal year 2017      Committee
                      Budget activity                         appropriation        request       recommendation
----------------------------------------------------------------------------------------------------------------
Domestic HIV/AIDS Prevention and Research.................           788,712           788,712           788,712
    HIV Prevention by Health Department...................           397,161           397,161           397,161
    HIV Surveillance......................................           119,861           119,861           119,861
    Activities to Improve Program Effectiveness...........           103,208           103,208           103,208
    National, Regional, Local, Community & Other                     135,401           135,401           135,401
     Organizations........................................
    School Health.........................................            33,081            33,081            33,081
Viral Hepatitis...........................................            34,000            39,000            34,000
Sexually Transmitted Infections...........................           157,310           157,310           152,310
Tuberculosis..............................................           142,256           142,256           137,256
----------------------------------------------------------------------------------------------------------------

    Hepatitis B.--The Committee is concerned that even with a 
Hepatitis B vaccine that is 95 percent effective, CDC estimates 
that there are up to 2 million Americans infected with 
Hepatitis B, with over 19,500 new infections occurring each 
year and more than 10 deaths each day as a direct result of 
Hepatitis B. The Committee encourages CDC to prioritize the 
acceleration of Hepatitis B interventions within its Viral 
Hepatitis program.
    HIV Screening.--The Committee continues to support CDC 
grant programs that work to reduce the rate of undiagnosed 
persons among those infected with HIV, increase linkage to 
care, and increase viral suppression. The Committee 
acknowledges geographic disparities in rates of undiagnosed 
persons among those infected, viral suppression, and death 
rates based on the findings in the 2015 CDC HIV State 
Prevention Progress Report. The Committee requests that CDC 
partner closely with States to improve diagnosis rates among 
the undiagnosed and improve viral suppression rates, focusing 
specifically on States with the lowest scores on these outcome 
measures and with States who need to improve collection of 
complete laboratory data to measure viral suppression.
    Tuberculosis [TB].--The Committee applauds CDC for its 
leadership role in the President's National Action Plan for 
Combating Multi Drug Resistant TB. The Committee encourages the 
Director to prioritize implementation of the action plan, 
including the plan's objective to explore the development of a 
national stockpile of TB drugs and diagnostics and ensure that 
State and local TB control programs have adequate resources to 
pursue the plan's goals.
    Viral Hepatitis Prevention Coordinators.--The Committee 
recognizes the importance of the Viral Hepatitis Prevention 
Coordinator [VHPC] program as the only source of Federal 
expertise on hepatitis prevention for States. The Committee 
encourages the Division of Viral Hepatitis to expand efforts 
within current resources in jurisdictions not currently funded, 
including U.S. territories, to build the Federal response for 
all impacted areas by providing technical assistance to VHPCs 
for the provision of core prevention services such as 
screening, testing, linking to care, education, and 
surveillance.
    Viral Hepatitis Screening.--The Committee continues to 
support hepatitis screening activities and encourages CDC to 
prioritize screening programs in medically underserved and 
minority communities. Point-of-care testing allows for 
utilization of effective and innovative screening technology in 
a variety of health care settings.

               EMERGING AND ZOONOTIC INFECTIOUS DISEASES

Appropriations, 2016....................................    $579,885,000
Budget estimate, 2017...................................     629,485,000
Committee recommendation................................     578,885,000

    The Committee recommendation for the activities of the 
National Center for Emerging and Zoonotic Diseases is 
$578,885,000, which includes $52,000,000 in transfers from PPH 
Fund.
    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 2016  Fiscal year 2017      Committee
                      Budget activity                         appropriation        request       recommendation
----------------------------------------------------------------------------------------------------------------
Core Infectious Diseases..................................           393,313           427,913           396,313
    Antibiotic Resistance Initiative......................           160,000           200,000           163,000
    Lab Safety and Quality................................             8,000             8,000             8,000
    Vector-borne Diseases.................................            26,410            26,410            26,410
    Lyme Disease..........................................            10,663            10,663            10,663
    Prion Disease.........................................             6,000             6,000             6,000
    Chronic Fatigue Syndrome..............................             5,400  ................             5,400
    Emerging Infectious Diseases..........................           147,000           147,000           147,000
    All Other Infectious Diseases.........................            29,840            29,840            29,840
Food Safety...............................................            52,000            52,000            48,000
National HealthCare Safety Network........................            21,000            21,000            21,000
Quarantine................................................            31,572            46,572            31,572
Advanced Molecular Detection..............................            30,000            30,000            30,000
Epidemiology and Lab Capacity Program.....................            40,000            40,000            40,000
Healthcare-Associated Infections..........................            12,000            12,000            12,000
----------------------------------------------------------------------------------------------------------------

    Antibiotic Stewardship.--The Committee commends CDC on its 
efforts to improve antibiotic use, specifically its work to 
align the complementary work of antibiotic stewardship and 
early sepsis recognition. The Committee directs CDC to continue 
this dual approach for improving antibiotic use.
    Combating Antibiotic Resistant Bacteria [CARB].--The 
Committee continues to support the CARB initiative and provides 
$163,000,000 for this effort. The Committee recognizes the 
importance of addressing antibiotic-resistant bacteria through 
a ``One Health'' approach, simultaneously combating antibiotic 
resistance in human, animal, and environmental settings. The 
Committee directs CDC to competitively award research 
activities that address aspects of antibiotic resistance 
related to ``One Health'' among entities, including public 
academic medical centers, veterinary schools with agricultural 
extension services, and State public health departments whose 
proposals are in line with CDC's strategy for addressing 
antibiotic resistant bacteria. CDC shall provide an updated 
spend plan to the Committee within 30 days after enactment of 
this act and include an update on these efforts in the fiscal 
year 2018 CJ.
    The Committee encourages CDC to develop a national capacity 
to identify and catalog microbial genome sequences, paying 
attention to antibiotic-resistant microbes. The CDC should 
continue to pursue research opportunities in the area of 
antimicrobial stewardship in diverse healthcare settings and 
encourage regional collaborations to study the most effective 
strategies to improve antibiotic prescribing and stewardship.
    Emerging and Zoonotic Infections Diseases.--The Committee 
encourages CDC to continue improving a comprehensive outbreak 
response, including leveraging existing Federal and State 
investments to work with research universities with expertise 
in disease detection, surveillance, containment, and early 
vaccine development response capabilities.
    National Healthcare Safety Network.--The Committee notes 
that each year, hospital acquired catheter associated urinary 
tract infections [CAUTIs] results in the death of 15,000 
patients. The Committee urges the CDC to examine existing 
evidence regarding the use of stents to address CAUTIs and 
issue appropriate communications to hospitals, including an 
update to its 2009 guidelines to prevent CAUTIs if necessary. 
The Committee also notes that treatment gaps in healthcare 
associated infections persist across non-hospital health care 
settings. The Committee recognizes that the National Healthcare 
Safety Network started collecting data from ambulatory surgical 
centers and encourages CDC to continue to expand its data 
collection efforts to additional providers in non-hospital 
settings.
    Prion Diseases.--The Committee commends the work of the 
National Prion Disease Pathology Surveillance Center and 
supports its work developing better diagnostic tools. Prion 
diseases are a group of fatal neurodegenerative disorders 
causing dementia. Creutzfeldt-Jakob disease is one of the more 
devastating types of prion disease that can be transmitted from 
disease carriers by tissue transplants or from ingesting beef 
contaminated with Bovine Spongiform Encephalopathy, more 
commonly known as ``mad cow'' disease. The Center monitors all 
human and animal prion diseases, identifies the origin, and 
together with CDC develops more efficient diagnostic methods to 
prevent spreading into the human population.
    Responding to Emerging Threats.--The Epidemiology and 
Laboratory Capacity for Infectious Diseases Program [ELC] 
strengthens the epidemiologic and laboratory capacity in 50 
States, six local health departments, and eight territories. 
This funding provides critical support to epidemiologists and 
laboratory scientists who are instrumental in discovering and 
responding to various food and vector-borne outbreaks. The 
Committee provides funding for ELC grants to sustain core 
surveillance capacity and ensure that State and local 
epidemiologists are equipped to respond rapidly to emerging 
threats including antimicrobial resistant superbugs and the 
Zika virus.
    Sepsis.--The Committee is pleased that the CDC addressed 
sepsis as a priority within the CARB initiative in its fiscal 
year 2017 CJ. The Committee supports the CDC's goals to scale 
up the evaluation of sepsis surveillance to help track national 
sepsis rates, assess the impact of prevention and treatment 
initiatives, and enable comparisons between health care 
facilities to identify problem areas. The Committee requests a 
breakdown of funding used for sepsis awareness, prevention, and 
treatment across CDC programs in the fiscal year 2018 CJ.
    Vector Borne Diseases.--The Committee notes the importance 
of the Epidemiology and Lab Capacity program to help protect 
the nation from Zika, West Nile, Lyme disease, and other 
bacterial and viral diseases caused by mosquitos, ticks, and 
other arthropods. CDC is encouraged to allocate the maximum 
amount possible to support evidence-based efforts at the 
Federal, State, and local public health agencies and labs for 
arbovirus control, testing, and reporting. In particular, the 
Committee encourages CDC to focus research on tick borne 
illnesses, including Lyme disease and Rocky Mountain Spotted 
Fever, which have increased significantly in the past decade.

            CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION

Appropriations, 2016....................................  $1,177,096,000
Budget estimate, 2017...................................   1,117,145,000
Committee recommendation................................   1,064,646,000

    The Committee recommendation for the activities of the 
National Center for Chronic Disease Prevention and Health 
Promotion is $1,064,646,000, which includes $337,950,000 in 
transfers from the PPH Fund.
    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 2016  Fiscal year 2017      Committee
                      Budget activity                         appropriation        request       recommendation
----------------------------------------------------------------------------------------------------------------
Tobacco...................................................           210,000           210,000           210,000
Nutrition, Physical Activity and Obesity..................            49,920            49,920            49,920
    High Obesity Rate Counties (non-add)..................            10,000            10,000            10,000
School Health.............................................            15,400            15,400            15,400
Health Promotion..........................................            14,025            14,025            14,025
    Community Health Promotion............................  ................  ................  ................
    Glaucoma..............................................             3,300             3,300             3,300
    Visual Screening Education............................               525               525               525
    Alzheimer's Disease...................................             3,500             3,500             3,500
    Inflammatory Bowel Disease............................               750               750               750
    Interstitial Cystitis.................................               850               850               850
    Excessive Alcohol Use.................................             3,000             3,000             3,000
    Chronic Kidney Disease................................             2,100             2,100             2,100
Prevention Research Centers...............................            25,461            25,461            25,461
Heart Disease and Stroke..................................           160,037           160,037           130,037
Diabetes..................................................           170,129           170,129           140,129
National Diabetes Prevention Program......................            20,000            20,000            20,000
Cancer Prevention and Control.............................           356,174           302,173           356,174
    Breast and Cervical Cancer............................           210,000           169,204           210,000
        WISEWOMAN (non-add)...............................            21,120            21,120            21,120
    Breast Cancer Awareness for Young Women...............             4,960             4,960             4,960
    Cancer Registries.....................................            49,440            49,440            49,440
    Colorectal Cancer.....................................            43,294            39,515            43,294
    Comprehensive Cancer..................................            19,675            19,675            19,675
    Johanna's Law.........................................             5,500             5,500             5,500
    Ovarian Cancer........................................             7,500             7,500             7,500
    Prostate Cancer.......................................            13,205  ................            13,205
    Skin Cancer...........................................             2,125             2,125             2,125
    Cancer Survivorship Resource Center...................               475               475               475
    Other.................................................  ................             3,779  ................
Oral Health...............................................            18,000            18,000            16,000
Safe Motherhood/Infant Health.............................            46,000            46,000            46,000
Arthritis.................................................            11,000            11,000            11,000
Epilepsy..................................................             8,000             8,000             8,500
National Lupus Registry...................................             6,000             6,000             6,000
Racial and Ethnic Approach to Community Health............            50,950            30,000  ................
Partnerships to Improve Community Health..................  ................  ................  ................
Million Hearts............................................             4,000             4,000             4,000
Workplace Wellness........................................  ................  ................  ................
National Early Child Care Collaboratives..................             4,000             4,000             4,000
Hospitals Promoting Breastfeeding.........................             8,000             8,000             8,000
Good Health and Wellness in Indian Country................  ................            15,000  ................
----------------------------------------------------------------------------------------------------------------

    Alzheimer's and Healthy Aging.--The Committee commends the 
Healthy Brain Initiative for its leadership in bringing 
attention to the public health crisis of Alzheimer's disease. 
The Committee encourages CDC to continue implementing the 
action steps listed in the updated Road Map, including working 
towards a consensus on the mortality burden of the disease.
    Asthma.--The Committee applauds CDC's 618 
Initiative and its recognition that asthma is one of the most 
common and costly health conditions in the United States. 
Twenty-four million Americans have asthma, including 6.3 
million children. The annual direct healthcare costs and lost 
productivity attributed to asthma total $56,000,000,000. The 
Committee understands that better coordination of public health 
and health systems interventions are necessary to reduce the 
disease burden of asthma, and encourages increased 
collaboration with payers.
    Atopic Dermatitis [AD].--The Committee understands that AD 
is the most severe and long-lasting form of eczema impacting as 
many as one out of every four children and 7-8 million adults 
in the United States. The Committee recognizes that AD is a 
potentially debilitating condition which can severely 
compromise a person's quality of life, and yet, there is a lack 
of understanding into what causes AD and how it can be managed, 
treated, and, ultimately, prevented. The Committee recognizes 
that there are continued gaps in data on eczema and atopic 
dermatitis in adults, particularly regarding prevalence rates 
and linkages between comorbidities including asthma and food 
allergies. 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 obtain better data and begin 
to fill these gaps.
    Breast and Cervical Cancer Early Detection Program.--The 
Committee again rejects the administration's proposed funding 
reduction to the Breast and Cervical Cancer early detection 
program and provides funding at the fiscal year 2016 level. The 
Committee notes that, in 2017, roughly 2.6 million women aged 
40-64 will remain uninsured and eligible for breast cancer 
screening services under this program. Similarly, 5.7 million 
women aged 21-64 will remain uninsured in 2017 and eligible for 
cervical cancer screening through the Breast and Cervical 
Cancer Early Detection Program. This program remains critical 
for women across the country and has shown strong success in 
specifically providing low-income, uninsured, and underinsured 
women with the lifesaving preventive services they need.
    Cancer Screening in Minority Populations.--The Committee 
remains concerned about the disparity in cancer screening and 
treatment in minority and medically underserved populations. 
CDC is encouraged to employ novel partnerships with both cancer 
providers and community leaders in community-based outreach 
efforts, such as those in faith-based organizations, clinics, 
and recreational centers, designed to improve early detection 
and prevention in regions of the country that have high numbers 
of economically disadvantaged minorities.
    Cancer Survivor Resource Center.--Recognizing there are 
more than 14,500,000 cancer survivors in the United States, the 
Committee encourages the CDC to invest in evidence-based 
physical activity and wellness programs for cancer survivors. 
Evidence-based physical activity programs have been shown to 
improve survivors' overall quality of life, increase 
cardiovascular endurance, decrease cancer-related fatigue, and 
help them meet or exceed recommended amounts of physical 
activity.
    Children in Adversity.--The Committee recognizes that CDC 
is a key implementing partner of the United States Government 
Action Plan on Children in Adversity's three principle 
objectives. The Committee fully supports the use of funds 
provided to the CDC through this act for activities that the 
agency has identified as being necessary to link representative 
data to effective, sustainable, and scalable action, and thus 
ensure that: (1) the percentage of children achieving age-
appropriate growth and developmental milestones are increased; 
(2) the percentage of children living outside of family care is 
reduced; and (3) the percentage of children experiencing 
violence, exploitation, abuse, and neglect is reduced. The 
Committee directs the CDC to collaborate with USAID, PEPFAR, 
and the Department of Labor to ensure monitoring and evaluation 
is aligned for all of the Action Plan's objectives. The 
Committee asks that the annual Public Law 109-95 report to 
Congress display the amount of funding by objective to the 
Action Plan on Children in Adversity.
    Chronic Fatigue Syndrome.--The Committee applauds the CDC's 
efforts to collaborate with disease experts in its multi-site 
study. The Committee is pleased that the National Academy of 
Medicine [NAM] has clarified the disease definition and that 
the NAM and the CFS Advisory Committee have made 
recommendations to educate the medical community. The Committee 
encourages CDC to leverage those recommendations to provide new 
clinical guidelines and to execute a broad-based medical 
education campaign. To address the critical lack of access to 
clinical care, the Committee encourages CDC to work with the 
NIH and other agencies within the Department to find creative 
ways to support a clinical care component to regional Centers 
of Excellence.
    Chronic Pain.--The Committee commends CDC for including 
chronic pain in the Healthy People 2020 initiative. The 
Committee encourages CDC to analyze data collected from the 
chronic pain questions included in the 2016 National Health 
Interview Survey, make this information available to the 
public, and expand the topic area on chronic pain in the 
Healthy People 2030 initiative. The Committee further 
encourages the CDC to address the public health epidemic of 
chronic pain by making information and current statistics on 
chronic pain publicly available through the CDC Vital Signs 
reports.
    Colorectal Cancer.--The Committee rejects the 
administration's proposed funding reduction to this program and 
emphasizes the importance of continuing to provide screenings 
for low-income, uninsured, and underinsured adults who may not 
have benefited from the ACA.
    Community Grants.--The Committee eliminated the 
Partnerships to Improve Community Health [PICH] in the fiscal 
year 2016 agreement. To lessen the disruption during PICH close 
out, last year the agreement directed CDC to shift fiscal year 
2016 continuation costs to two chronic disease budget lines, 
$30,000,000 to Heart Disease and Stroke and $30,000,000 to 
Diabetes. In fiscal year 2017, PICH close out will be 
completed. Therefore, the Committee has removed funds from 
these two chronic disease budget lines and directs that no 
funds shall be used for continuing PICH activities. Within 120 
days of enactment of this act, the Division of Community Health 
shall provide a report to the Committee on evaluation plans for 
PICH following the final year of funding in fiscal year 2016.
    Community Prevention.--The Committee requests that, within 
120 days of enactment of this act, CDC shall provide the 
Committee any evaluation data or analysis related to previous 
investments in community prevention and health promotion, 
including Communities Putting Prevention to Work and the 
Community Transformation Grant programs. This report shall 
summarize previous funding histories, list projects and 
activities funded, and provide specific evidence-based data on 
how these projects advanced public health.
    Diabetes Prevention Program.--The Committee recommendation 
includes $20,000,000, the same as fiscal year 2016, for the 
Diabetes Prevention Program. This program promoting lifestyle 
interventions has proven to reduce the risk of developing 
diabetes by 58 percent in individuals at high risk.
    Division of Diabetes Translation [DDT].--The Committee 
recognizes the work of CDC's DDT to address the diabetes 
epidemic and encourages CDC to continue to ensure that the 
prevention needs of those Americans with, and at risk for, 
diabetes and prediabetes are met. The Committee believes these 
activities must include clear outcomes and ensure transparency 
and accountability that demonstrate how funding was used to 
support diabetes prevention and specifically how diabetes 
funding reached State and local communities. Additionally, the 
Committee encourages CDC to support the translation of research 
into better prevention and care, as well as the National 
Diabetes Education Program, the expansion of diabetes 
surveillance, and other DDT activities.
    Early Child Care Collaboratives.--The Committee recognizes 
that the early care and education setting is an important one 
for promoting healthy habits in young children. The Committee 
provides $4,000,000 to the National Early Child Care 
Collaboratives to enable training of early care and education 
providers in implementation of healthy eating and physical 
activity best practices, including strategies for engaging 
families. Funds will also support technical assistance for 
integration of healthy eating and physical activity best 
practices into existing State and local professional 
development systems Early Care and Education settings and 
health initiatives.
    Electronic Cigarettes.--The Committee notes a rise in usage 
of electronic cigarettes, or e-cigarettes, by U.S. middle and 
high school students. The Committee is aware of an ongoing NAM 
study on the health effects from e-cigarettes and 
recommendations for future federally funded research. The 
Committee looks forward to the results and recommendations from 
the study.
    Epilepsy in Rural Areas.--Over 2,000,000 individuals in the 
United States have epilepsy and, while new cases are most 
common among young children, the onset of epilepsy can occur at 
any age. The Committee has included an increase of $500,000 
from last year's level for CDC to expand telehealth and 
educational training programs for rural and underserved areas 
that reach school nurses, child care personnel, first 
responders, and care providers for seniors, to recognize and 
respond appropriately to seizures caused by epilepsy or result 
from trauma and other acute chronic illness. Given the link 
between epilepsy and Tuberous Sclerosis Complex, the Committee 
also supports efforts to increase awareness of Tuberous 
Sclerosis Complex clinical trials and effective therapeutics, 
and encourages the CDC to update the study of all-cause 
mortality of persons diagnosed with TSC.
    Heart Disease and Stroke Prevention.--The Committee 
supports the Division for Heart Disease and Stroke Prevention's 
efforts against cardiovascular disease and supports the Paul 
Coverdell National Acute Stroke Registry and the projects 
within State and Local Public Health Actions to Prevent 
Obesity, Diabetes, and Heart Disease, and Stroke.
    Heart Valve Disease.--The Committee understands that heart 
valve disease can be debilitating and if not treated properly 
can result in heart failure, sudden cardiac arrest, and death. 
The Committee encourages CDC to include information on valve 
disease on its Web site and to help bring public awareness to 
this disease. The Committee encourages CDC to engage with 
patient and research organizations to explore collaborative 
ways to integrate information about the warning signs, 
symptoms, and risk factors of valve disease into CDC's existing 
programs.
    High Obesity Rate Counties.--The Committee remains 
concerned about the growing body of evidence suggesting that 
obesity is one of the most significant challenges facing the 
public health system. If this epidemic continues unabated, 
obesity and the many complications it causes will increase the 
disease burden among Americans, particularly youth. The 
Committee continues to include $10,000,000 to support the rural 
extension and outreach services grants for rural counties with 
an obesity prevalence of over 40 percent. The Committee expects 
CDC to work with State and local public health departments to 
support measurable outcomes through evidenced-based obesity 
research, intervention, and prevention programs. Grants should 
combine basic, clinical, and population research to better 
understand and treat the metabolic, medical, surgical, 
environmental, and societal implications of obesity in 
cooperation with partners that have existing outreach capacity 
to develop and implement educational and intervention programs. 
CDC should focus its efforts in areas of the country with the 
highest burden of obesity and with the comorbidities of 
hypertension, cardiac disease, and diabetes from county level 
data in the Behavioral Risk Factor Surveillance System. The 
Committee encourages CDC to only support activities that are 
supported by scientific evidence.
    Inflammatory Bowel Disease [IBD].--The Committee commends 
CDC for exploring the burden of IBD and communicating these 
results to the public. Little is known about the impact of IBD 
on minority and underserved populations, and the Committee 
encourages CDC to complement its existing epidemiological study 
with a focus on these populations.
    Interstitial Cystitis [IC].--The Committee recommendation 
for interstitial cystitis activities provides support for the 
ongoing epidemiology study, as well as education, outreach, and 
public awareness activities.
    Johanna's Law.--The Committee is pleased by the agency's 
recent launch of ``Know: BRCA'' to help increase the public's 
awareness of hereditary breast and ovarian cancers and improve 
understanding the individual risk of having a BRCA mutation. 
The Committee urges CDC to take steps to integrate components 
of the ``Inside Knowledge campaign'' and ``Know: BRCA'' to the 
extent possible, to ensure coordination of public health 
messages related to ovarian cancer, leveraging of resources, 
and maximizing economies of scale.
    Lupus Registry.--The Committee continues to support 
research efforts under the National Lupus Patient Registry 
program, but acknowledges that challenges still remain. Burden 
of illness studies are needed to better understand and evaluate 
issues such as the disease impact on quality of life, 
productivity, frequency of clinical events, natural history, 
and the direct and indirect costs associated with lupus. The 
Committee encourages CDC to support the lupus cohort and burden 
of illness studies.
    Marfan Syndrome.--The Committee remains concerned that 
structural cardiovascular disorders, such as Marfan syndrome, 
continue to claim the lives of high school athletes across the 
country who received a sports physical prior to competition. 
CDC is encouraged to work with patient and professional 
stakeholders to develop minimum screening guidelines that 
ensure all young athletes are appropriately screened for 
potentially life-threatening structural cardiovascular 
disorders.
    Million Hearts.--The Committee supports the Million Hearts 
program, a public-private initiative setting goals for our 
Nation in preventing heart attacks and strokes. These funds 
support enhanced ways to implement the ABCS: aspirin when 
appropriate, blood pressure control, cholesterol management, 
and smoking cessation, as well as activities to increase the 
use of cardiac rehabilitation, as appropriate.
    Mississippi Delta Health Collaborative [MDHC].--The 
Committee commends CDC's efforts supporting the Mississippi 
Delta Health Collaborative in implementing a successful, 
evidenced-based strategy to reduce the burden of heart disease 
and stroke. These advancements were made possible with chronic 
disease prevention interventions through partnerships at the 
local level, and team-based approaches designed to link 
communities with clinical care, such as education and 
counseling, medication therapy management, comprehensive 
medication management, and utilizing health information 
technology to change health outcomes. Taking these lessons 
learned, the Committee wants to build upon the investments and 
see whether this success can be replicated in other high-risk 
and underserved areas in the future. Therefore, the Committee 
encourages CDC, working with the Collaborative and relevant 
stakeholders, to reach populations at high risk in the Delta 
with effective interventions while maintaining the current 
strategy. CDC shall consider using lifestyle change 
intervention models like the Diabetes Prevention Program; 
utilizing local pharmacy schools with existing community-based 
research programs that could focus on screenings, medication 
reviews, medication therapy management, comprehensive 
medication management, and disseminating prevention strategies; 
and working with communities to establish health networks to 
better coordinate and manage community based health 
initiatives. To reach the target population, the Committee 
encourages CDC to take advantage of rapidly evolving healthcare 
technology by leveraging the resources of States with 
recognized leadership in areas of electronic medical records, 
telehealth, and innovative delivery of education tools. CDC 
shall provide an update on these activities in the fiscal year 
2018 CJ.
    Ovarian Cancer.--The Committee commends the CDC for its 
work to evaluate existing risk assessment tools, which can be 
used to help identify patients with a genetic predisposition to 
ovarian and other cancers, and identify which of these existing 
tools are valid, reliable, and the most user-friendly for 
providers and patients. The Committee requests that the CDC 
present the findings of this review and provide recommendations 
with respect to how CDC can support the deployment of the tools 
found to have the greatest value and utility in the fiscal year 
2018 CJ.
    Pulmonary Hypertension [PH].--The Committee understands 
that PH causes heart failure and death. CDC is encouraged to 
support education, outreach, and awareness activates that 
promote early and accurate diagnosis of PH.
    Racial and Ethnic Approach to Community Health [REACH].--
The Committee eliminates the REACH program due to funding 
constraints. Funding continues to be provided to other programs 
that conduct outreach to reduce ethnic disparities in health 
status.
    Safe Motherhood Initiative.--Preterm birth affects more 
than 500,000 babies each year in the United States and is the 
leading cause of neonatal mortality. The Committee commends CDC 
for funding State-based Perinatal Collaboratives that focus on 
improving birth outcomes using known preventative strategies 
such as reducing early elective deliveries.
    Sleep Surveillance.--The Committee is pleased by CDC's work 
on a national public health awareness campaign for sleep. The 
Committee urges CDC to ensure that funding for surveillance 
activities on sleep disorders and sleep health is maintained in 
addition to these awareness efforts.
    WISEWOMAN.--The Committee lauds the WISEWOMAN program that 
helps uninsured and under-insured low-income women ages 40 to 
64 decrease, prevent, or control heart disease and stroke by 
providing preventive health services, referrals to local health 
care providers, lifestyle programs and health counseling 
services tailored to identified risk factors to promote 
lasting, healthy behavior change. From 2008 through 2014, 
WISEWOMAN served more than 165,000 women and over 90 percent 
had at least one heart disease and stroke risk factor. More 
than 118,000 evidenced-based behavior change services were 
provided to help reduce heart disease and stroke.

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

Appropriations, 2016....................................    $135,610,000
Budget estimate, 2017...................................     135,610,000
Committee recommendation................................     137,560,000

    The Committee recommendation for the activities of the 
National Center on Birth Defects and Developmental Disabilities 
[NCBDDD] is $137,560,000.
    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 2016  Fiscal year 2017      Committee
                      Budget activity                         appropriation        request       recommendation
----------------------------------------------------------------------------------------------------------------
Child Health and Development..............................            65,800            65,800            65,800
    Other Birth Defects...................................            19,000            19,000            19,000
    Fetal Death...........................................               900               900               900
    Fetal Alcohol Syndrome................................            11,000            11,000            11,000
    Folic Acid............................................             3,150             3,150             3,150
    Infant Health.........................................             8,650             8,650             8,650
    Autism................................................            23,100            23,100            23,100
Health and Development with Disabilities..................            54,710            54,710            56,660
    Disability and Health.................................            22,050            22,050            24,000
    Tourette Syndrome.....................................             2,000             2,000             2,000
    Early Hearing Detection and Intervention..............            10,760            10,760            10,760
    Muscular Dystrophy....................................             6,000             6,000             6,000
    Attention Deficit Hyperactivity Disorder..............             1,900             1,900             1,900
    Fragile X.............................................             2,000             2,000             2,000
    Spina Bifida..........................................             6,000             6,000             6,000
    Congenital Heart Defects..............................             4,000             4,000             4,000
Public Health Approach to Blood Disorders.................             4,500             4,500             4,500
Hemophilia CDC Activities.................................             3,500             3,500             3,500
Hemophilia Treatment Centers..............................             5,000             5,000             5,000
Thalassemia...............................................             2,100             2,100             2,100
----------------------------------------------------------------------------------------------------------------

    Cerebral Palsy.--The Committee encourages CDC to build on 
established surveillance and research methods to support 
research infrastructure focused on Cerebral Palsy across 
various geographic U.S. regions.
    Congenital Heart Disease [CHD].--CHD is the number one 
cause of birth defects in the United States and a leading cause 
of birth defect-related infant mortality. The Committee notes 
that children and adults with CHD require ongoing, specialized 
cardiac care, and there remain gaps in the epidemiological data 
as children and adolescents transition to adult care. The 
Committee commends the National Center for Birth Defects and 
Developmental Disabilities for its leadership in addressing CHD 
and adult CHD surveillance efforts, including on the estimated 
number of individuals in the United States living with CHD, 
epidemiology of CHD across the lifespan, age-specific 
prevalence, and factors associated with those patients who may 
have dropped out of appropriate specialty care.
    Fetal Alcohol Spectrum Disorders [FASD].--The Committee 
encourages the CDC to collaborate with State substance abuse 
agencies to establish a State-Federal partnership on FASD 
issues. This collaboration would involve dissemination of FASD 
best practices, providing technical assistance, and creating 
State-to-State sharing opportunities.
    Fragile X and Associated Disorders.--The Committee commends 
CDC's efforts to identify and define the population impacted by 
FX and FXD with the goal of understanding the public health 
impact of these conditions. The Committee acknowledges 
significant progress made by the NCBDDD Fragile X Clinical and 
Research Consortium in growing its FORWARD Database and its 
Patient Registry. The CDC is encouraged to continue this 
effort. The Committee also supports the public-private 
partnership which resulted in the ``Future of Fragile X: 
Setting the Public Health Research Agenda'' meeting in 2014 and 
the resulting Funding Opportunity Announcement which seeks to 
use longitudinal data to characterize the natural history of 
Fragile X to improve services and outcomes. The Committee 
encourages the NCBDDD to continue data driven public health 
research to reduce the public health burden of both FX and 
autism.
    Health and Development for Those With Disabilities.--The 
Committee supports the work of the National Center on Health, 
Physical Activity and Disability [NCHPAD] and its goal of 
promoting better health for adults and children with 
disabilities. By mobilizing national networks to provide 
technical assistance, provide community leaders and community 
organizations with health promotion training, and by 
disseminating effective strategies and tools for disability 
service providers, NCHPAD plays an important role in 
encouraging a healthier lifestyle for Americans with 
disabilities.
    Hemophilia.--The Committee has included sufficient funding 
to maintain the Center's hemophilia programs, which provide 
critical information to better understand risk factors for 
complications and identify high-risk populations for prevention 
measures. The Committee recognizes the importance of CDC's 
research on inhibitors and the recommendation that people with 
hemophilia be tested for inhibitors at least annually. The 
Committee encourages CDC, working with stakeholders and the 
network of hemophilia treatment centers, to implement inhibitor 
testing across the United States and support further research 
to better understand inhibitors and how they can be prevented.
    Improving the Health of People With Intellectual 
Disabilities.--People with disabilities have a high risk of 
poor health outcomes such as obesity, hypertension, and mood 
disorders such as depression. Therefore, the Committee includes 
$6,700,000 for the Healthy Athletes program.
    Muscular Dystrophy Surveillance.--The Committee is aware of 
the CDC's established surveillance efforts through the Muscular 
Dystrophy Surveillance, Tracking, and Research Network [MD 
STARnet] and supports the development of a plan to enhance the 
quality and quantity of the data being collected through MD 
STARnet. Additionally, the Committee is interested in the 
agency's plans to disseminate and implement the updated care 
standards, including for adults with Duchenne and for other 
forms of muscular dystrophy, and requests a report on this 
activity 180 days after the enactment of this act. The 
Committee also supports CDC's engagement of multiple Divisions 
and Centers in the development of a Duchenne newborn screening 
program.
    Spina Bifida.--While spina bifida and related neural tube 
defects are highly preventable through education and adequate 
daily folic acid consumption, it is the most common permanently 
disabling birth defect in the United States. The Committee 
supports the continuation of the Spina Bifida Clinical Care 
Monitoring and Tracking program and commends the National Spina 
Bifida Program in serving as a model for programs assisting 
other individuals living with similar complex conditions. The 
Committee encourages CDC to continue the dissemination of 
information to clinicians, parents, and families living with 
spina bifida.
    Thalassemia.--The Committee commends CDC's thalassemia 
program and encourages CDC to coordinate the efforts of the 
treatment centers and the nonprofit patient advocacy community 
to enhance public and provider awareness about thalassemia 
prevention and treatment.
    Tuberous Sclerosis Complex [TSC].--The Committee encourages 
CDC to take into consideration all the major manifestations of 
TSC in its surveillance network.

                   PUBLIC HEALTH SCIENTIFIC SERVICES

Appropriations, 2016....................................    $491,597,000
Budget estimate, 2017...................................     500,631,000
Committee recommendation................................     485,000,000

    The Committee recommendation for Public Health Scientific 
Services is $485,000,000.
    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 2016  Fiscal year 2017      Committee
                      Budget activity                         appropriation        request       recommendation
----------------------------------------------------------------------------------------------------------------
Health Statistics.........................................           160,397           160,397           156,000
Surveillance, Epidemiology, and PH Informatics............           279,000           283,008           279,000
Public Health Workforce...................................            52,200            57,226            50,000
----------------------------------------------------------------------------------------------------------------

    Alzheimer's Disease and Dementia.--The Committee is aware 
of recent peer-reviewed studies suggesting that more than 
500,000 U.S. deaths each year are attributable to Alzheimer's 
disease and dementia, far in excess of the deaths reported by 
the Center each year. Such statistics would elevate Alzheimer's 
disease from the sixth leading cause of death to the third 
leading cause of death. The Committee directs the CDC to make 
recommendations on ways to ensure the accuracy and completeness 
of measurements of the Alzheimer's disease and dementia death 
rate and to develop a consensus on the mortality burden of the 
disease.
     Community Preventive Services Task Force.--The Committee 
notes that the Task Force recommendations provide information 
about evidence-based options that decision makers and 
stakeholders can consider when determining what best meets the 
specific needs, preferences, available resources, and 
constraints of their jurisdictions and constituents. These 
recommendations and the reviews of the evidence on which they 
are based are compiled in the Guide to Community Preventive 
Services. The Committee recognizes CDC's continuing efforts to 
support the Task Force and to conduct dissemination activities 
that provide information to help communities make informed 
decisions.
    Modernizing Vital Statistics Collection.--While most States 
now or will soon have operational electronic birth and death 
registration systems, many do not have the resources to 
maximize electronic death reporting or to modernize their 
systems to keep pace with new technology. The Committee 
encourages CDC to support States in upgrading antiquated 
systems and improving the quality and accuracy of vital 
statistics reporting.

                          ENVIRONMENTAL HEALTH

Appropriations, 2016....................................    $182,303,000
Budget estimate, 2017...................................     182,303,000
Committee recommendation................................     182,303,000

    The Committee recommendation for the National Center for 
Environmental Health is $182,303,000. The Committee 
recommendation includes $17,000,000 in transfers from the PPH 
Fund.
    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 found in people and to what degree. The 
Center also determines whether and at what level of exposure 
these substances are harmful to humans.
    The Committee recommendation includes funding for the 
following activities:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                            Fiscal year 2016  Fiscal year 2017      Committee
                      Budget activity                         appropriation        request       recommendation
----------------------------------------------------------------------------------------------------------------
Environmental Health Laboratory...........................            56,000            56,000            56,000
    Newborn Screening Quality Assurance Program...........             8,300             8,300             8,300
    Newborn Screening for SCID............................             1,200             1,200             1,200
    Other Environmental Health............................            46,500            46,500            46,500
Environmental Health Activities...........................            46,303            46,303            46,303
    Safe Water............................................             8,600             8,600             8,600
    Amyotrophic Lateral Sclerosis Registry................            10,000            10,000            10,000
    Built Environment & Health Initiative.................  ................  ................  ................
    Climate Change........................................            10,000            10,000            10,000
    All Other Environmental Health........................            17,703            17,703            17,703
Environmental and Health Outcome Tracking Network.........            34,000            24,000            34,000
Asthma....................................................            29,000            29,000            29,000
Childhood Lead Poisoning..................................            17,000            17,000            17,000
Hearing Loss..............................................  ................            10,000  ................
----------------------------------------------------------------------------------------------------------------

     Amyotrophic Lateral Sclerosis [ALS] Registry.--The 
Committee commends CDC and the Agency for Toxic Substances and 
Disease Registry [ATSDR] for its continued efforts to maintain 
and strengthen the National ALS Registry and to ensure that the 
registry supports and advances research into the causes and 
treatment of ALS and the care of ALS patients. The Committee 
encourages ATSDR to identify and support additional ways the 
registry can advance ALS treatment development including as a 
tool to identify cohorts for research studies; assess benefit-
risk and patient preferences; assist in conducting natural 
history studies; collect patient and caregiver reported 
outcomes and post-marketing data; and identify geographic 
locations for trial sites based on proximity of larger patient 
populations that meet enrollment criteria. The Committee also 
encourages ATSDR to continue to consult with ALS organizations, 
patients, researchers, the pharmaceutical industry and Federal 
agencies, including NIH, VA, and the FDA, to coordinate efforts 
and ensure the registry continues to be a resource for 
stakeholders.
    Environmental Health Activities.--The Committee is aware 
that local health departments are involved in a wide array of 
environmental health activities including groundwater 
protection, protection of the food supply, pollution 
prevention, and hazardous waste disposal. CDC is urged to 
ensure that funds are available to State and local health 
departments in communities to address local level threats.
    Healthy Housing.--The Committee recognizes the important 
role that healthy housing can play in reducing the risk of 
numerous conditions, including asthma and lead poisoning. CDC 
is encouraged to continue to support healthy housing 
activities.
    Lead Poisoning.--The Committee notes that the National 
Advisory Committee on Childhood Lead Poisoning Prevention was 
disbanded in 2013. The lead poisoning crisis in Flint, 
Michigan, demonstrates that this committee is greatly needed by 
providing a forum for convening lead poisoning experts and 
providing these experts with an official conduit for 
recommendations to CDC to address emerging lead poisoning 
problems quickly. CDC is encouraged to re-establish this 
Committee. CDC is also encouraged to prioritize the geocoding 
and mapping of lead poisoning surveillance data, which is 
inexpensive and makes the data much more accessible to local 
jurisdictions and agencies serving lead-poisoned children.

                     INJURY PREVENTION AND CONTROL

Appropriations, 2016....................................    $236,059,000
Budget estimate, 2017...................................     268,629,000
Committee recommendation................................     264,059,000

    The Committee recommendation for the National Center for 
Injury Prevention and Control is $264,059,000.
    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 2016  Fiscal year 2017      Committee
                      Budget activity                         appropriation        request       recommendation
----------------------------------------------------------------------------------------------------------------
Intentional Injury........................................            97,730           107,730            97,730
    Domestic Violence and Sexual Violence.................            32,700            32,700            32,700
        Child Maltreatment................................             7,250             7,250             7,250
    Youth Violence Prevention.............................            15,100            15,100            15,100
    Domestic Violence Community Projects..................             5,500             5,500             5,500
    Rape Prevention.......................................            44,430            44,430            44,430
    Gun Violence Prevention Research......................  ................            10,000  ................
National Violent Death Reporting System...................            16,000            23,570            16,000
Unintentional Injury......................................             8,800             8,800             8,800
    Traumatic Brain Injury................................             6,750             6,750             6,750
    Elderly Falls.........................................             2,050             2,050             2,050
Injury Prevention Activities..............................            28,950            28,950            28,950
Prescription Drug Overdose................................            70,000            80,000            98,000
Illicit Opioid Use Risk Factors...........................             5,579             5,579             5,579
Concussion Surveillance...................................  ................             5,000  ................
Injury Control Research Centers...........................             9,000             9,000             9,000
----------------------------------------------------------------------------------------------------------------

    Children's Exposure to Violence.--The Committee believes 
that understanding children's exposure to violence and its 
potential impacts on a child's health and well-being is of 
critical importance. The Committee encourages CDC to continue 
its collaboration with the Office of Juvenile Justice and 
Delinquency Prevention at the Department of Justice on the 
National Survey of Children's Exposure to Violence.
    Combating Opioid Abuse.--The Committee includes 
$98,000,000, an increase of $28,000,000 above fiscal year 2016, 
for the Prescription Drug Overdose [PDO] Prevention for States 
program. CDC shall use this increase, which is $18,000,000 
above the administration's request, to expand its competitive 
cooperative agreement program that funds States with the 
greatest burden of opioid overdoses and readiness to implement 
prevention activities and improve interventions that monitor 
prescribing and dispensing practices, inform clinical practice, 
and protect high risk patients. The Committee notes the strong 
connection between abuse of prescription opioids and use of 
other types of opioids like heroin. Activities targeting one 
area will have a significant impact on the other. Therefore, 
funding will support activities such as implementing guidelines 
to improve prescribing behaviors and collecting real-time and 
more accurate data for heroin-related opioid deaths. The 
Committee urges CDC to require applicants applying for the PDO 
Prevention for States Program to collaborate with the State 
substance abuse agency or those agencies managing the State's 
PDMP to ensure linkages to clinically appropriate substance use 
disorder services.
    Concussion Surveillance.--The 2013 NAS study ``Sports-
Related Concussions in Youth: Improving the Science, Changing 
the Culture'' recommended that CDC establish and oversee a 
national surveillance system to accurately determine the 
incidence of sports-related concussions, including youth ages 5 
to 21. The Committee is aware of the promising progress CDC has 
made in creating a comprehensive survey instrument which the 
agency will be piloting in the coming months to prepare for a 
national survey in the future. The Committee supports CDC's 
work in this area and urges the agency to increase its efforts.
    Opioid Prescribing Guidelines.--The Committee applauds 
CDC's Guidelines for Prescribing Opioids for Chronic Pain and 
directs the agency to translate the guidelines into succinct, 
usable formats and toolkits accessible to providers across the 
country. CDC is also directed to broadly disseminate the 
guidelines and toolkits to promote use among as many providers 
as possible. The Committee expects CDC to offer technical 
assistance to States and expand training modules available for 
continuing medical education credit and maintenance of 
certification to spur uptake of guidelines by professional 
societies and health systems. CDC is urged to coordinate with 
the Office of the National Coordinator for Health Information 
Technology to develop and disseminate clinical decision support 
tools derived from the opioid prescribing guidelines. CDC is 
also urged to work with the VA and the DOD on implementing 
these guidelines to ensure consistent, high-quality care 
standards across the Federal Government.

                     OCCUPATIONAL SAFETY AND HEALTH

Appropriations, 2016....................................    $339,121,000
Budget estimate, 2017...................................     285,621,000
Committee recommendation................................     334,121,000

    The Committee recommendation for National Institute for 
Occupational Safety and Health [NIOSH] programs is 
$334,121,000.
    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.
    Total Worker Health.--The Committee commends CDC's Total 
Worker Health Program, which aims to promote and protect the 
health and productivity of the American workforce through 
research and dissemination of innovative and cost-effective 
tools and interventions for American businesses. The Committee 
commends CDC's work in this area and encourages CDC to continue 
dissemination of these tools.
    The Committee recommendation includes funding for the 
following activities at the following amounts:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                            Fiscal year 2016  Fiscal year 2017      Committee
                      Budget activity                         appropriation        request       recommendation
----------------------------------------------------------------------------------------------------------------
National Occupational Research Agenda.....................           115,500            90,500           115,500
    Agriculture, Forestry, Fishing (non-add)..............            25,000  ................            25,000
Education and Research Centers............................            28,500  ................            28,500
Personal Protective Technology............................            20,000            20,000            20,000
Healthier Workforce Center................................  ................  ................  ................
Mining Research...........................................            61,300            61,300            61,300
National Mesothelioma Registry and Tissue Bank............             1,100             1,100             1,100
Other Occupational Safety and Health Research.............           112,721           112,721           107,721
----------------------------------------------------------------------------------------------------------------

         ENERGY EMPLOYEES OCCUPATIONAL INJURY COMPENSATION ACT

Appropriations, 2016....................................     $55,358,000
Budget estimate, 2017...................................      55,358,000
Committee recommendation................................      55,358,000

    The Committee recommendation for the Energy Employees 
Occupational Illness Compensation Program Act [EEOICPA] is 
$55,358,000. This mandatory funding supports NIOSH scientists 
who reconstruct radiation dose levels to inform compensation 
decisions.

                             GLOBAL HEALTH

Appropriations, 2016....................................    $427,121,000
Budget estimate, 2017...................................     442,121,000
Committee recommendation................................     432,121,000

    The Committee recommends $432,121,000 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 2016  Fiscal year 2017      Committee
                      Budget activity                         appropriation        request       recommendation
----------------------------------------------------------------------------------------------------------------
Global HIV/AIDS Program...................................           128,421           128,421           128,421
Global Immunization Program...............................           219,000           224,000           224,000
    Polio Eradication.....................................           169,000           174,000           174,000
    Measles and Other Vaccine Preventable Diseases........            50,000            50,000            50,000
Parasitic Diseases and Malaria............................            24,500            24,500            24,500
Global Health Security....................................  ................             5,000  ................
Global Disease Detection and Emergency Response...........            45,400            50,400            45,400
Global Public Health Capacity Development.................             9,800             9,800             9,800
----------------------------------------------------------------------------------------------------------------

    Antimicrobial Resistance [AMR].--As a result of the 
increased global availability and over-prescription of 
antimicrobial medicines to humans and animals, a number of 
disease-causing microbes have developed resistance to drugs 
previously used to treat them. Yet U.S. efforts to combat AMR 
may be insufficient, since most resistance emerges in other 
regions of the world where antimicrobial use in people and food 
animals is rampant and poorly regulated. The Committee urges 
CDC to consider partnering with a coalition of hospitals, State 
public health departments, global health non-governmental 
organizations, and biotech companies, among others, with the 
goal of linking global patterns of emerging resistance to their 
impact in U.S. hospitals and clinical settings. Such a 
coalition would attempt to identify the most important factors 
that contribute to the emergence and the spread of AMR 
infections worldwide, and how they are spread to the United 
States.
    Malaria and Parasitic Diseases.--The Committee recognizes 
the important role the Center for Global Health plays in the 
fight against malaria and parasitic diseases. CDC's crucial 
monitoring and surveillance of transmission, evaluation of 
interventions for effectiveness and impact, and testing of 
tools in a real world setting are critical to understanding how 
to scale up global health programs and ensure that our global 
health investments are smarter, better, and not wasteful. The 
Committee therefore encourages CDC to continue to research, 
monitor, and evaluate efforts for malaria and parasitic disease 
in collaboration with other divisions and agencies.
    Polio.--CDC is the lead U.S. agency in the global effort to 
eradicate polio and currently works with various organizations 
by providing expertise in training, vaccines, epidemiology, 
laboratory capacity, and surveillance. Currently, polio is 
endemic in only three countries, Nigeria, Afghanistan, and 
Pakistan. However, Nigeria has not reported a case since August 
of 2014 and will be declared polio free if no cases are 
reported by August of 2017. The Committee commends these 
efforts and includes a $5,000,000 increase above the fiscal 
year 2016 level to help eradicate this disease.
    Tropical Disease.--The Committee recognizes the critical 
role the Center and its Vector Borne Disease program play in 
ongoing efforts to prepare for and fight tropical diseases 
emerging on U.S. soil, such as Dengue, Chikungunya and now 
Zika. The groundwork laid in the Center's efforts on Dengue and 
Chikungunya will be critical for fighting Zika. The Committee 
recognizes that without a robust Vector Borne Disease program, 
the United States will be ill equipped to monitor and prepare 
for Zika and new vector-borne infectious disease threats.

                PUBLIC HEALTH PREPAREDNESS AND RESPONSE

Appropriations, 2016....................................  $1,405,000,000
Budget estimate, 2017...................................   1,402,166,000
Committee recommendation................................   1,396,800,000

    The Committee recommendation for the Office of Public 
Health Preparedness and Response [PHPR] is $1,396,800,000.
    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 2016  Fiscal year 2017      Committee
                      Budget activity                         appropriation        request       recommendation
----------------------------------------------------------------------------------------------------------------
Public Health Emergency Preparedness Cooperative Agreement           660,000           660,000           660,000
Academic Centers for Public Health Preparedness...........             8,200  ................  ................
All Other State & Local...................................  ................  ................  ................
BioSense..................................................            23,000            23,000            23,000
All Other CDC Preparedness................................           138,800           144,166           138,800
Strategic National Stockpile..............................           575,000           575,000           575,000
----------------------------------------------------------------------------------------------------------------

    Emergency Preparedness.--The Committee continues to request 
detailed information on how State Public Health Emergency 
Preparedness [PHEP] funding is distributed at the local level 
by States. CDC is encouraged to provide in the fiscal year 2018 
CJ an update on how much of the Federal PHEP funding is being 
allocated to local health departments and what basis or formula 
each State is using to make such allocations.
    State and Local Preparedness and Response.--The Committee 
eliminates the Academic Centers for Public Health Preparedness 
as requested by the administration. CDC will continue to 
support research and training through its Office of Public 
Health Preparedness and Response.
    Strategic National Stockpile [SNS].--The Committee 
encourages CDC to evaluate the latest approved advances in 
influenza prevention and antiviral treatment for inclusion in 
the SNS in preparation for pandemic influenza. Moreover, CDC 
should consider a comprehensive approach to preparedness 
through vaccines, diagnostics, and antiviral therapeutics.
    U.S. Public Health Capacity and Needs.--The Committee 
directs GAO to issue a report within 180 days of the enactment 
of this act that reviews the U.S. public health system's 
current capacity to respond to infectious disease outbreaks, 
including Federal emergency response. The GAO report shall 
identify response best practices based on a review of the 
responses to recent major global infectious disease outbreaks, 
and provide recommendations about how to ensure that every 
State public health department has the capacity to provide for 
a minimum necessary level of public health services. During the 
course of their review and preparation of recommendations, GAO 
shall review the 2012 Institute of Medicine report entitled 
``For the Public's Health: Investing in a Healthier Future.''

                          CDC-WIDE ACTIVITIES

Appropriations, 2016....................................    $283,570,000
Budget estimate, 2017...................................     144,791,000
Committee recommendation................................     273,570,000

    The Committee provides $113,570,000 for public health 
leadership and support activities at CDC.
    CDC is encouraged to work with the Department to use the 
Nonrecurring Expenses Fund for capital projects and National 
Repair and Improvement activities at CDC.
    The recommendation includes $160,000,000 in transfers from 
the PPH Fund.
    The Committee recommendation includes funding for the 
following activities in the following amounts:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                            Fiscal year 2016  Fiscal year 2017      Committee
                      Budget activity                         appropriation        request       recommendation
----------------------------------------------------------------------------------------------------------------
Preventive Health and Health Services Block Grant.........           160,000  ................           160,000
Public Health Leadership and Support......................           113,570           113,570           113,570
----------------------------------------------------------------------------------------------------------------

    Preventative Health and Health Services Block Grant.--The 
Committee continues to reject the administration's proposal to 
eliminate this program and provides $160,000,000, the same 
level as in fiscal year 2016. These grants are crucial for 
States because they provide enough flexibility necessary to 
resolve any emerging health issues at the local level while 
tailoring those activities to best address the diverse, 
complex, and constantly changing local community.
    Underground Mine Safety.--The Committee appreciates the 
requested timeline submitted by CDC and continues to support a 
replacement facility for the Lake Lynn Experimental Mine and 
Laboratory. The Committee directs CDC to utilize prior-year 
funding for the planning and design, land acquisition, 
construction, and equipping of the replacement facility. No 
later than 180 days after enactment, the CDC shall submit a 
detailed update of its activities to date to replace the Lake 
Lynn facility and accompanying plan to complete the timely 
acquisition of a replacement facility to the Committees on 
Appropriations of the House of Representatives and the Senate.
    The Committee does not include bill language requested by 
the administration to provide additional transfer authority to 
the Director beyond that which is already provided to the 
Secretary.

                     National Institutes of Health

    The National Institutes of Health [NIH] is the global 
leader in medical research. The Committee provides 
$34,084,000,000 for NIH activities within the jurisdiction of 
this bill, an increase of $2,000,000,000, or 6.3 percent, above 
fiscal year 2016. This includes $857,000,000 in transfers 
available under section 241 of the PHS Act. The Committee 
continues a reform to section 241 allocations such that no NIH 
funding will be removed from NIH under this authority. This 
reform ensures that section 241 transfers are a benefit to NIH 
rather than a liability. In addition, it improves the 
transparency of NIH's budget, so that the enacted total is 
truly the amount the Committee expects to be used for 
biomedical research.
    The Committee recommendation provides $300,000,000 in 
fiscal year 2017 from the Department's Nonrecurring Expenses 
Fund [NEF]. Bill language is included to repurpose this portion 
of the NEF, created in fiscal year 2008, for biomedical 
research activities at the NIH.
    The Committee continues its commitment to funding research 
on Alzheimer's disease and increases funding by $400,000,000 to 
a total of approximately $1,391,000,000 in fiscal year 2017; 
increases funding for the Precision Medicine Initiative by 
$100,000,000; increases funding for antibiotic resistance 
research by $50,000,000; and increases funding for the BRAIN 
Initiative by $100,000,000. In addition, funding is provided to 
ensure that every Institute and Center receives an increase 
above fiscal year 2016 to continue investments in innovative 
research that will advance the fundamental knowledge and speed 
the development of new therapies, diagnostics, and preventive 
measures to improve the health of all Americans. Revolutionary 
discoveries often come from unexpected, untargeted research. 
The Committee continues to support these basic advances as well 
as the clinical and translational research that moves basic 
discoveries from ``bench-to-bedside.''

                       NATIONAL CANCER INSTITUTE

Appropriations, 2016....................................  $5,213,509,000
Budget estimate, 2017...................................   5,097,287,000
Committee recommendation................................   5,429,769,000

    The Committee recommendation includes $5,429,769,000 for 
the National Cancer Institute [NCI]. Of this amount, 
$50,000,000 is available for repairs and improvements to the 
NCI facility in Frederick, Maryland.
    Biospecimen Resource Locator.--The Committee appreciates 
that the NCI has developed and supports the Specimen Resource 
Locator, a searchable database of biospecimen collections. The 
Committee also appreciates that pediatric cancer biospecimen 
resources are included within the Specimen Resource Locator, 
and requests an update from NCI on pediatric cancer biospecimen 
collections in the fiscal year 2018 CJ.
    Breast Cancer.--Recent advances in breast cancer screening 
include the introduction of digital mammography [DM] and 
magnetic resonance imaging [MRI] for women at high risk for 
breast cancer. A new technology available for breast cancer 
screening, tomosynthesis [TM], is FDA-approved and being 
adopted as the ``standard of care'' in some markets. Limited 
trial results to date show a strong reduction in false 
positives and a trend toward more cancers diagnosed with TM 
than with DM. The Committee recommends NCI continue its vital 
research to help provide breast cancer patients and their 
physicians with a clear, informed picture of the role of breast 
cancer imaging. The Committee encourages NCI to conduct a 5-
year, large cohort study exploring the validity and merits of 
TM and how it compares to other forms of imaging.
    Cancer Kinome and Ovarian Cancer.--The Committee is aware 
that research into the role of kinases-enzymes in the human 
genome that regulate an immense variety of cellular function-
holds the promise to drive the development of new treatments 
and cures for a variety of cancers, including ovarian cancer. 
NCI is encouraged to support research in this area.
    Cancer and Mitochondria.--The Committee commends NCI for 
its work in establishing a Mitochondrial Model Organisms and 
Cellular Systems Working Group and for its work to identify 
needs, barriers, and opportunities pertaining to mitochondrial 
biology relevant to addressing mechanistic questions in cancer. 
The Committee encourages NCI to continue to support research 
studies that examine the mechanisms by which cancer cells 
utilize oxidative stress in stromal cells to fuel their growth.
    Colorectal Cancer and Inflammatory Bowel Diseases.--The 
Committee recognizes that left untreated, inflammatory bowel 
diseases can advance to colorectal cancer. The Committee 
encourages additional research on the developmental pathway of 
colorectal cancer among patients with IBD.
    Deadliest Cancers.--While overall cancer incidence and 
death rates are declining, the Committee is concerned that 
there are a group of cancers, defined in statute as 
recalcitrant cancers, whose 5-year survival rates remains below 
50 percent. The Committee applauds the NCI for launching its 
Molecular Analysis for Therapy Choice [MATCH] study, a 
potentially ground-breaking trial that analyzes patients' 
tumors to determine whether they contain genetic abnormalities 
for which a targeted drug exists and assigns treatment based on 
the abnormality. The Committee was pleased to learn that a goal 
of MATCH is to ensure patients with rare cancers represent at 
least 25 percent of the enrollees in the trial. Given the 
growing toll recalcitrant cancers take on society, and the 
enormous potential MATCH offers for our Nation's deadliest 
cancers, the Committee strongly urges NCI to continue to 
prioritize rare cancers within the MATCH trial.
    Cancer and Hereditary Hemorrhagic Telangiectasia [HHT].--
HHT is a genetic disorder of the blood vessels, and one 
variation of the disorder, HHT1, is characterized by deficiency 
in endoglin, an angiogenic protein. Recent research has 
indicated improved survival outcomes for cancer patients who 
also have HHT1. The Committee encourages NCI to support 
research investigating whether reduced systemic endoglin 
levels, expected in patients diagnosed with HHT1, impacts 
clinical outcomes for cancer. The Committee requests an update 
in the fiscal year 2018 CJ on the status of research related to 
this topic.
    Early Detection.--The Committee is pleased to support the 
NCI's goal of increasing early detection research. Early 
detection is an important means to saving lives and reducing 
the need for systemic treatments which have long-term side 
effects for many patients.
    Immunotherapy.--Recent NCI research demonstrates that new 
cancer immunotherapy approaches that specifically attack tumor 
cells with characteristics unique to a certain cancer could be 
effective against a wide range of cancers. The Committee 
encourages NCI to further explore new interventions, such as 
immunotherapy, as a promising new treatment strategy for 
children with cancer.
    Liver Cancer.--The Committee notes that the number of liver 
cancer cases has more than tripled since 1980 and the death 
rate for this cancer has continued to increase. The Committee 
continues to be concerned with the increasing incidence of 
liver cancer and its low 5-year survival rate. Therefore, the 
Committee encourages NCI to continue to support liver cancer 
research across its portfolio, including research focused on 
the development of biomarkers to serve as early detection 
markers of cancer to offer the prospect of improved outcomes.
    Melanoma.--Melanoma is the most responsive tumor type to 
the new generation of immune therapies. As many phase 3 trials-
the essential platform to provide high quality annotated 
biospecimens for biomarker discovery-are launched under the 
aegis of the NCI, and industry has specimens that have not been 
fully analyzed, the Committee urges a coordinated effort to 
analyze biospecimens across NCI and industry trials and 
treatment type with the most advanced technologies. The current 
Exceptional Responders Initiative has been focused primarily on 
chemotherapy which has been proven to be ineffective in 
improving outcomes for the majority of patients with melanoma. 
This initiative could be extended to exceptional responders to 
targeted therapies and/or immunotherapies. The Committee 
continues to encourage efforts to use advances in genomic, 
proteomic, and digital imaging technologies for early 
detection, research to understand genetic changes that occur in 
melanogenesis and mechanisms that underlie clinical dormancy to 
provide effective means of preventing recurrence. The Committee 
requests an update on these requests in the fiscal year 2018 
CJ.
    Metastatic Brain Tumor Research.--The incidence of 
metastatic brain tumors has been increasing, largely due to the 
fact that more Americans are surviving and living longer after 
treatment for other cancer diagnoses. While the increased 
incidence is a significant cause of concern, brain metastases 
are often treatable if diagnosed in a timely manner. The 
Committee encourages NCI to continue to involve stakeholders in 
the brain tumor community in its research efforts to develop 
strategies that improve our understanding of the molecular 
basis for cancer metastasis to the brain, detection through 
enhanced imaging, early intervention, and treatment.
    Military Hospitals and Cancer Centers Collaboration.--The 
Committee is aware that formal alliances between American 
military hospitals and NCI-designated cancer centers would 
provide an ideal context to facilitate research on the causes, 
prevention, and treatment of cancer in military personnel and 
their families. The Committee encourages NCI to explore 
opportunities for collaborative clinical research efforts 
between American military hospitals and NCI-designated cancer 
centers. The Committee urges NCI to focus on populations with 
significant health disparities, including multiethnic 
populations.
    Ovarian Cancer.--The Committee notes that despite 
scientific advancements, ovarian cancer remains the fifth most 
prevalent disease for women with 5-year survival rates still 
below 50 percent. The Committee encourages NCI to continue to 
support clinical trials with emerging genomics-driven 
immunotherapies applied to human ovarian cancer, with 
particular emphasis on treatments that target the molecular 
characteristics of each tumor. The Committee requests an update 
in the fiscal year 2018 CJ.
    Pancreatic Cancer.--The Scientific Framework for Pancreatic 
Ductal Adenocarcinoma [PDAC] made four important 
recommendations for expanding pancreatic cancer research: 
understanding the biological relationship between PDAC and 
diabetes mellitus; evaluating longitudinal screening protocols 
for biomarkers for early detection of PDAC and its precursors; 
studying new therapeutic strategies in immunotherapy; and 
developing new treatment approaches that interfere with RAS 
oncogene-dependent signaling pathways. The Committee looks 
forward to receiving the fiscal year 2018 CJ to learn how the 
specific recommendations included in the report are being 
implemented.
    Pediatric Cancer.--The Committee remains concerned that 
pediatric cancers remain the leading cause of death by disease 
past infancy among children in the United States, and that the 
majority of childhood cancer survivors suffer from late effects 
of cancer treatment. The Committee strongly encourages NCI to 
bolster pediatric cancer research and clinical trials. The 
Committee urges NCI to continue key investments in pediatric 
oncology research, including clinical studies for children with 
brain tumors, development of the novel pediatric MATCH study, 
and the important pediatric preclinical testing program 
evaluating new agents for treating pediatric malignancies. 
Further, the NCI Director is urged to conduct research related 
to the needs, outcomes, health disparities, and barriers of 
pediatric cancer survivors, with an emphasis on minority or 
other medically underserved populations. The Committee requests 
an update 90 days after enactment of this act on specific 
pediatric cancer initiatives as well as how general cancer 
research will benefit pediatric cancer activities. In addition, 
the Committee expects a further update to be included in the 
fiscal year 2018 CJ on how the NCI is focusing on the unique 
needs of children.
    Precision Medicine.--The Committee continues to strongly 
support NCI's PMI, and provides $70,000,000 to continue its 
efforts to develop effective patient-specific treatments that 
target the disease's genetic and molecular abnormalities. NCI 
has made significant progress in changing the way we understand 
cancer, advances that have and are producing massive amounts of 
new data. To make the fullest use of all of this information, 
NCI has committed resources to launch the Genomic Data Commons 
to stimulate sharing of information among researchers, and is 
evaluating the expansion of existing databases and other 
approaches to data sharing with the NCI cloud pilots. NCI and 
the broader research community recognize that the need for data 
integration and manipulation to make full use of these massive 
cancer datasets not only entails investment in open data 
hosting, but requires significant investments in scalable, 
interactive data management that combines imaging, clinical, 
and molecular datasets. It also requires further data standards 
development to enable discovery, increase accessibility, 
improve interoperability, and promote data reuse and 
reproducibility, as well as resolve uncertainty in technical 
variation that can arise from different approaches in sample 
storage, acquiring biomaterial, and choices in computational 
pipelines. It is hoped that open sharing on this scale, 
accessible for research, clinical decision making, and drug 
development, will accelerate understanding--and more effective 
treatments--for many cancers. The Committee directs NCI to 
provide a plan, developed in collaboration with its external 
partners, to the Committee 6 months after enactment of this act 
outlining its efforts to address these questions to effectively 
build a cancer genomics data ecosystem that enables and 
promotes data sharing, including schedule and cost estimates. 
Finally, the Committee notes the importance of NCI clinical 
trials in the area of immuno-oncology. The Committee encourages 
NCI to engage leaders in this emerging field to utilize the 
network of existing comprehensive cancer centers and the 
National Clinical Trials Network to aggressively develop new 
therapies through clinical trials using engineered T-cells, 
coordinated research strategies, and training initiatives for 
broad application. Of particular interest is the use of 
precision medicine to develop therapies for late stage and 
other cancers where conventional treatments have proved largely 
ineffective.
    Prostate Cancer.--The Committee is aware of NCI's ongoing 
investment in prostate cancer research, and encourages further 
efforts into treatments for men with advanced disease as well 
as diagnostic and imaging methodologies common in other 
hormone-driven cancers with similar disease burden. The 
Committee encourages NCI to coordinate its response to these 
needs with other Federal agencies, and collaborators as 
appropriate, including the Department of Defense, as well as 
private research foundations and advocacy groups.
    Psycho-Social Distress Complications.--According to the 
Institute of Medicine, nearly 50 percent of all cancer patients 
experience distress. Further, studies suggest that distress in 
cancer patients leads to higher healthcare costs, less 
compliance with treatment pathways, and poorer health outcomes. 
While significant advancements have been made in biomedical 
treatments in cancer care, the Committee is concerned that the 
unaddressed psycho-social needs of patients are adversely 
impacting the effectiveness and cost of care, as well as the 
individuals' overall well-being. The Committee encourages NCI 
to implement distress screenings in the NIH Clinical Center and 
in NCI-funded clinical trials as appropriate.
    Radiation Oncology.--It is increasingly evident that 
combination therapy-involving radiation therapy, surgery, 
chemotherapy, immunotherapy and/or precision therapy-provides 
the best treatment options for many cancer patients. The 
Committee applauds the recent funding announcement for 
Cooperative Agreements to Develop Targeted Agents for Use with 
Systemic Agents Plus Radiotherapy and supports the NCI's 
prioritization of breaking down the existing silos, fostering a 
collaboration of the best scientists in far-reaching fields.
    Sleep Health and Cancer.--The Committee understands the 
complex intersection between sleep health and cancer 
development, cancer progression, and remission. The Committee 
encourages NCI to explore the role of sleep in cancer 
development and progression.

               NATIONAL HEART, LUNG, AND BLOOD INSTITUTE

Appropriations, 2016....................................  $3,115,538,000
Budget estimate, 2017...................................   3,069,901,000
Committee recommendation................................   3,242,685,000

    The Committee recommendation includes $3,242,685,000 for 
the National Heart, Lung, and Blood Institute [NHLBI].
    Asthma.--The Committee applauds NHLBI for its efforts to 
develop better treatments to manage severe asthma as part of 
the Precision Medicine Initiative, and urges the NHLBI to 
expand these efforts.
    Cardiovascular Disease [CVD].--The Committee is aware that 
for certain disease areas, like CVD, rural States and their 
respective patient populations have disproportionately high 
incidence. In the case of cardiovascular disease, high rates of 
obesity, diabetes, and smoking among rural populations create 
much higher risks for acute cardiovascular disease. While the 
NHLBI has the primary lead for research in CVD, other 
Institutes that include emphasis on children or bioengineering 
have important secondary roles in helping to generate positive 
research outcomes to combat this disease area. For this reason, 
the Committee urges the NIH to consider convening a cross 
disciplinary, multi-Institute effort to identify ways to 
include rural populations in research and to work with 
institutions located in heavily rural States.
    Chronic Obstructive Pulmonary Disease [COPD].--The 
Committee notes NHLBI's collaboration with the CDC in the 
development of a COPD action plan and is pleased with the 
stakeholder town hall meeting held recently on the NIH campus 
to advance its completion. The Committee expects CDC and NIH to 
work together to complete the action plan on a timely basis and 
report bi-annually on the implementation of the plan's 
recommendations. Further, the Committee remains aware and 
concerned that Alpha 1 Antitrypsin Deficiency [Alpha 1] is a 
major genetic risk factor for developing COPD. The Committee, 
therefore, encourages NHLBI to continue to advance Alpha 1 
research as part of the overall plan.
    Congenital Heart Disease [CHD].--The Committee commends the 
NHLBI for its continued work to better understand causation and 
appropriate treatment needs for those with the most life 
threatening congenital heart defects through its biomedical 
research program 'Bench to Bassinet' and the critical multi-
centered infrastructure of the Pediatric Heart Network. The 
Committee urges NHLBI to continue its work with other Federal 
agencies and professional and patient organizations to expand 
collaborative research initiatives and other related activities 
targeted toward prevention and treatment of the diverse 
lifelong needs of children and adults living with CHD.
    Cystic Fibrosis [CF].--The Committee encourages advancement 
of cell-based tools to advance new therapies to patients based 
on an individual's specific CF-causing mutation. These tools 
may be used to develop new personalized approaches to CF 
therapeutics, including new means to identify and characterize 
the efficacy of multidrug therapies that address the mutant 
CFTR protein, which is the underlying cause of CF in the 
majority of those with the disease. In particular, the 
Committee supports research into nonsense mutations for CF, 
which truncate the creation of CFTR protein in about 10 percent 
of the CF population and contribute to thousands of other 
genetic diseases. In addition, the Committee urges further 
research into live cell imaging modalities that are able to 
characterize mucus and monitor mucociliary clearance, the 
defense mechanisms at the heart of CF, and many other 
respiratory diseases. The Committee encourages funding for new 
technologies aimed at the genetic repair of cystic fibrosis. 
This includes technologies for gene editing, lung stem cell 
biology and nucleic acid delivery. Such technologies are 
critical for developing therapies to reach all CF patients, 
especially those with mutations that are not amenable to 
protein manipulation with CFTR modulating therapies.
    Fibrotic Diseases.--The Committee encourages NIH to 
continue to vigorously support research into fibrotic diseases 
affecting different organs, including the lung, liver, kidney, 
heart, and skin, and to ensure enhanced coordination between 
its Institutes as they conduct necessary, expanded single organ 
or cross-organ fibrotic disease research to save lives and 
reduce healthcare expenses in future budget years. Furthermore, 
the Committee encourages NIH to explore the creation of a 
trans-NIH fibrotic disease working group, which would bring 
together key stakeholders at the NIH and elsewhere, to evaluate 
current research efforts and develop strategic paths forward to 
maximize efforts in fibrotic disease research. The Committee 
also directs NIH to include an update in its fiscal year 2018 
CJ on its work relating to idiopathic pulmonary fibrosis 
following the November 2012 NHLBI workshop, ``Strategic 
Planning for Idiopathic Pulmonary Fibrosis.''
    Heart Disease.--The Committee is aware of the enormous and 
growing burden heart disease inflicts on our Nation's 
population and economy, particularly as the population ages, 
and strongly encourages NIH to increase its heart research 
investment commensurate with the impact on public health and 
scientific opportunities. The Committee looks forward to 
receiving details on the Institute's strategic vision for heart 
research.
    Hemophilia.--The Committee encourages NHLBI to include rare 
diseases such as hemophilia in its work through the Precision 
Medicine Initiative. For patients with hemophilia, there is 
wide variation in disease severity and therapeutic outcomes not 
readily explained by the disease-causing gene mutations. 
Genome-wide studies would yield new insights into the 
pathogenesis of hemophilia and patient responses to therapies, 
benefiting patients with bleeding disorders and broader patient 
communities.
    Lung Disease.--The Committee applauds NHLBI's efforts on 
primary lung disease prevention, from prenatal lung development 
through the aging process. The Committee requests that NHLBI 
report on its efforts to prevent lung disease, which is now the 
third leading cause of death in the United States, in the 
fiscal year 2018 CJ.
    Lymphangioleiomyomatosis [LAM].--The Committee remains very 
interested in efforts to find a cure for LAM, a progressive and 
often fatal lung disease in women. The Committee supports both 
intramural and extramural means of expanding research on LAM 
and urges NHLBI to use all available mechanisms as appropriate 
to stimulate a broad range of clinical and basic research. The 
Committee commends NIH for supporting multi-center LAM trials 
and encourages additional support of such trials.
    Pulmonary Hypertension [PH].--The Committee applauds NHLBI 
for leading research efforts that have helped prolong life for 
individuals affected by PH. NHLBI is encouraged to further 
study the underlying mechanisms of PH, particularly idiopathic 
pulmonary arterial hypertension, so that additional gains can 
be made that benefit patient health and wellness.
    Sickle Cell Disease [SCD].--The Committee encourages NHLBI 
to devote more research to the study of SCD. Academic medical 
centers located in States with significant populations of 
sickle cell patients have made progress in treating the disease 
through NIH-sponsored clinical trials and through blood and 
marrow transplantation, which is currently the only therapy 
that can cure the disease. However, more focused research is 
needed to augment the limited treatment options available. The 
Committee notes recent advances in treatment of SCD and urges 
the Institute to support clinical trials for prenatal and 
postnatal treatment of SCD, which includes multiple promising 
approaches to eradicate the disease, save lives, and reduce 
dramatically the substantial health care costs associated with 
SCD for children and adults.
    Sleep Phenotypes.--The health consequences of sleep 
disorders such as obstructive sleep apnea and insomnia include 
increased risk of hypertension, cardiovascular disease and 
obesity. The Committee is encouraged by NHLBI's efforts to 
improve our understanding of sleep disorders and urges NHLBI to 
partner with other NIH Institutes to continue advancing 
research for sleep phenotypes and biomarkers that further 
explore health disparities and the intersection between chronic 
diseases and sleep.
    Thoracic Aortic Disease.--The Committee is concerned by 
sudden, preventable death caused by thoracic aortic aneurysm 
and dissection attributed to structural cardiovascular 
disorders, such as Marfan syndrome, and encourages NHLBI to 
further study the mechanisms of disease and opportunities to 
improve patient health.

         NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH

Appropriations, 2016....................................    $413,396,000
Budget estimate, 2017...................................     404,560,000
Committee recommendation................................     430,544,000

    The Committee recommendation includes $430,544,000 for the 
National Institute of Dental and Craniofacial Research [NIDCR].
    Dental Materials.--Biomaterials is an important section of 
biomedical research for practicing dentists. The Committee 
urges NIDCR to continue to invest in the development and 
innovation of dental materials.
    Overlapping Pain Conditions.--The Committee commends the 
NIDCR for its ongoing support for the Orofacial Pain 
Prospective Evaluation and Risk Assessment program, which is 
yielding valuable information on many physiological aspects of 
temporomandibular disorders and overlapping pain conditions. 
The Committee encourages continued research on overlapping pain 
conditions and increased collaboration across NIH Institutes on 
epidemiological, basic, clinical and translational research 
related to pain conditions.

    NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES

Appropriations, 2016....................................  $1,816,310,000
Budget estimate, 2017...................................   1,786,086,000
Committee recommendation................................   1,891,652,000

    The Committee recommendation includes $1,891,652,000 for 
the National Institute of Diabetes and Digestive and Kidney 
Diseases [NIDDK].
    Asian Americans and Diabetes.--The Committee supports 
targeted research to examine the physiological differences 
between Asian Americans and other populations affected by 
diabetes with the goal of establishing appropriate indices for 
risk and disease detection, including a specific Body Mass 
Index cut point to identify Asian Americans with, or at risk 
for, future diabetes.
    Autism.--The Committee urges NIDDK to study the 
relationship between GI diseases and Autism Spectrum Disorders.
    Biomarkers.--The Committee encourages NIDDK to accelerate 
the discovery and validation of biomarkers to aid in designing 
and conducting clinical trials to prevent, treat, and cure type 
1 diabetes. The Committee also encourages NIDDK to work with 
NIAID to develop biomarkers specifically related to immune 
interventions for multiple autoimmune diseases, including type 
1 diabetes.
    Celiac Disease and Type 1 Diabetes.--The Committee is 
encouraged by the TEDDY study which has led to discoveries in 
the risk for pediatric celiac disease and the development of 
type 1 diabetes. The Committee urges the Institute to explore 
the intersection of type 1 diabetes with celiac disease 
prevention.
    Diabetes.--The Committee recognizes the important work of 
NIDDK, the lead Federal agency conducting research to find a 
cure for diabetes and improve diabetes care. The Committee 
recognizes the success of NIDDK-supported research in the 
development of essential tools to manage diabetes, including 
insulin pumps and blood glucose monitors, ongoing development 
of artificial pancreas technologies, and new and better 
medications to treat diabetes. The Committee urges NIDDK to 
commit resources commensurate with the severity and escalating 
costs of the epidemic to further diabetes research that will 
build upon these past successes, improve prevention and 
treatment, and bring the Nation closer to a cure.
    Gestational Diabetes.--The Committee recognizes the 
importance of research funded by the NIDDK related to 
gestational diabetes, a disease affecting up to 9.2 percent of 
all pregnant women. Given that both women with gestational 
diabetes and their babies face long-term health consequences as 
a result of the disease, such as increased risk of developing 
type 2 diabetes, the Committee urges NIDDK to explore 
additional opportunities for research on gestational diabetes.
    Inflammatory Bowel Disease Genetics Consortium.--The 
Committee is pleased by NIDDK's work on the Inflammatory Bowel 
Disease Genetics Consortium and supports this ongoing 
initiative. The Committee also urges NIDDK to expand its 
portfolio on pediatric IBD research through existing and new 
initiatives.
    Interstitial Cystitis.--The Committee is pleased that the 
Multidisciplinary Approach to the Study of Chronic Pelvic Pain 
Research Network is leading to novel and multidisciplinary 
efforts to study interstitial cystitis and has the potential to 
have a particularly positive impact on women's health.
    Irritable Bowel Syndrome [IBS].--The Committee is 
encouraged by the work of NIDDK to explore symptoms of IBS 
among various patient populations and urges NIDDK to further 
explore the etiology of IBS and the efficacy of treatments for 
IBS symptoms.
    Liver Disease.--The Committee continues to be concerned by 
the morbidity and mortality of Hepatitis C-related liver 
disease and the development of cirrhosis, liver failure, and 
liver cancer in chronically infected persons with viral 
hepatitis. The Committee urges NIDDK to enhance multi-Institute 
collaborations on liver research to understand these diseases. 
The Committee encourages NIDDK and NIAID to collaborate 
research efforts in this area.
    Medical Foods.--The Committee is encouraged by the opening 
of a new Office of Nutrition Research. The Committee requests 
the Office develop research initiatives that explore the impact 
of medical foods on nutrition and digestive disease management.
    Pancreatitis and Pancreatic Cancer.--The Committee is 
encouraged by NIDDK's consortium for the Study of Chronic 
Pancreatitis Diabetes and Pancreatic Cancer in collaboration 
with NCI. The Committee urges additional efforts to utilize the 
diverse data of patients within the consortium in precision 
medicine to inform targeted treatment and prevention.
    Pediatric Kidney Disease.--The Committee is encouraged by 
NIDDK's plans to conduct pilot studies of candidate therapies 
for Pediatric Chronic Kidney Disease. These studies will 
further optimize study designs for larger trials of new 
pediatric chronic kidney disease treatments. Further, the 
Committee continues to support NIDDK efforts to work 
collaboratively with other NIH Institutes, including the NICHD 
and NHLBI, to encourage multi-disciplinary research for 
children and young adults with kidney disease. Such 
collaborative efforts will aid in identifying childhood 
antecedents of chronic kidney disease, including modifiable 
risk factors that could be critical to developing interventions 
for pediatric kidney disease.
    Psychosocial Issues and Chronic Disease Management.--People 
with chronic diseases have an elevated risk of psychosocial 
issues such as depression, anxiety, and eating disorders. These 
issues correlate with an increase in negative outcomes for 
disease management. The Committee urges NIDDK to devote 
resources toward investigating the psychosocial burdens related 
to chronic diseases, particularly as it relates to type 1 
diabetes, and identify steps that can be taken to help improve 
disease management.

        NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

Appropriations, 2016....................................  $1,695,180,000
Budget estimate, 2017...................................   1,659,416,000
Committee recommendation................................   1,803,306,000

    The Committee recommendation includes $1,803,306,000 for 
the National Institute of Neurological Disorders and Stroke 
[NINDS].
    Amyotrophic Lateral Sclerosis [ALS].--The Committee 
strongly supports NIH's research in ALS and encourages NIH to 
continue to support promising ALS research related to IPS 
cells, whole genome sequencing, biomarkers, precision medicine, 
natural history studies, and translational research that could 
help identify new treatments for the disease. NIH is encouraged 
to partner with ALS organizations and other Federal agencies 
and programs, including the ALS Research Program at DOD, the 
VA, and the National ALS Registry at CDC/ATSDR. The Committee 
further encourages NIH to work with FDA, industry, and other 
stakeholders to identify opportunities to inform and advance 
the development of treatments for ALS, particularly how the NIH 
can support Phase II and Phase III clinical trials in ALS.
    Cerebral Cavernous Angioma.--The Committee urges HHS 
agencies [NIH, FDA, and CDC] to work together with the research 
and advocacy community to increase the efficiency and 
effectiveness of the research and clinical drug trials effort.
    Cerebral Palsy [CP].--Over 800,000 Americans are impacted 
by CP and currently there are no identified best practices at 
diagnosis or through the lifespan, organized standards of care, 
CP Registry, or proven therapy protocols. The Committee 
commends NINDS for working with scientists and stakeholders to 
develop a 5-year, research-focused strategic plan for CP 
prevention, treatment, and cure through the lifespan. The 
Committee urges NINDS, working with other relevant NIH ICs, to 
strengthen research efforts in support of the strategic plan to 
advance basic and translational research for CP, as well as 
clinical efforts to improve outcomes of diverse impairments and 
health issues on functioning, participation and well-being 
across the lifespan.
    Duchenne Muscular Dystrophy.--The Committee recommends 
NINDS consider strategies that could lead to the development of 
combinatorial therapies for Duchenne Muscular Dystrophy. The 
Committee supports facilitating clinical trial readiness and 
establishing research infrastructure needed to conduct high-
quality, efficient trials in Duchenne alongside efforts to 
improve performance of clinical trial endpoints and develop and 
validate biomarkers of the disease. The Committee also 
recognizes that there have been significant scientific advances 
in exon skipping technology since the 2010 NIH/FDA meeting and 
urges the NIH, in coordination with the FDA and other agencies, 
to conduct a Duchenne follow-on meeting to examine the current 
state of the science of exon skipping and targeted 
therapeutics.
    Lyme Disease.--With over 300,000 individuals suffering from 
Lyme disease, especially in rural States across the United 
States, an improved understanding of the disease is essential 
to the health and wellbeing of Americans. In patients who 
suffer from long-term complications associated with Lyme 
disease, clear treatment pathways are often missed as a result 
of inaccurate and incomplete testing. The Committee urges the 
NINDS, in coordination with CDC, to study the long-term effects 
of Lyme disease. Specifically, the Committee urges NINDS to 
evaluate the effectiveness of laboratory tests associated with 
the detection of Borrellia burgdori to diagnose the disease 
early, which can improve the effectiveness of treatment.
    Parkinson's Disease.--The Committee commends NINDS for 
taking critical steps in identifying priority research 
recommendations to advance research on Parkinson's disease, 
which impacts between 500,000 and 1,500,000 Americans and is 
the second most prevalent neurodegenerative disease in the 
United States. The Committee recognizes that NINDS is 
prioritizing public health concerns with severe gaps in unmet 
medical needs and supports the research recommendations set 
forth by the NINDS planning strategy to bring us closer to 
better treatments and a cure for Parkinson's disease. The 
Committee also encourages NINDS to submit an update of its 
progress on implementing these recommendations in the fiscal 
year 2018 CJ.
    Peripheral Neuropathies.--The Committee notes the lack of 
ongoing research into Guillain-Barre syndrome, chronic 
inflammatory demyelinating polyneuropathy, and related 
conditions, and encourages NINDS to work with stakeholders to 
identify research needs and develop strategies for supporting 
critical projects.
    Stroke.--The Committee recognizes the immense burden stroke 
places on our Nation's population and economy, and strongly 
support NINDS increase its stroke research efforts. NINDS is 
also encouraged to continue to implement top priorities 
identified in the 2012 planning initiative for stroke 
prevention, treatment, and recovery research, particularly 
augmentation of the Stroke Clinical Trials Network, including 
early stroke recovery.

         NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES

Appropriations, 2016....................................  $4,715,697,000
Budget estimate, 2017...................................   4,700,548,000
Committee recommendation................................   4,961,305,000

    The Committee recommendation includes $4,961,305,000 for 
the National Institute of Allergy and Infectious Diseases 
[NIAID].
    Autoimmune Neuropathies.--The Committee encourages NIAID to 
work with NINDS and other ICs to support efforts to gauge the 
state-of-the-science of autoimmune neuropathies research into 
conditions like Guillain-Barre syndrome and chronic 
inflammatory demyelinating polyneuropathy, and to establish a 
cross-cutting research plan for this portfolio.
    Combating Antibiotic Resistant Bacteria [CARB].--With the 
identification of the first case of CRE in the United States 
last month, the Committee remains deeply concerned by the 
threat posed by the rise of antibiotic resistant bacteria. The 
Committee continues to strongly support NIAID's work related to 
CARB and includes approximately $463,000,000, an increase of 
$50,000,000, for NIAID to expand efforts to develop new 
antibiotics and rapid diagnostic tests, and build a national 
genome sequence database on all reported resistant human 
infections. Critical to the success of these efforts is 
developing a comprehensive understanding of the biological 
mechanisms that cause or contribute to antibiotic resistance, 
both in terms of resistance due to human activity or by 
inherent natural processes. This fundamental knowledge will 
enhance efforts to responsibly steward existing antibiotics, 
develop new antibiotics, and repurpose current antibiotics in 
new ways or combinations. The Committee encourages NIH and FDA 
to convene industry and other stakeholders to develop 
strategies to augment and enhance the infrastructure supporting 
clinical trials of new antibiotics. The Committee also 
encourages NIH to continue and expand its collaboration with 
USDA and CDC to develop a research strategy to promote a 
fundamental understanding of antibiotic resistance and 
improving the responsible use of antibiotics in agriculture. 
The Committee requests an update on these activities in the 
fiscal year 2018 CJ.
    Healthcare-Associated Infections [HAIs].--HAIs are 
estimated to occur in 5 percent of all hospitalizations in the 
United States, resulting in more than 1,700,000 illnesses and 
99,000 deaths annually. While HHS has been leading efforts to 
develop and encourage hospitals to implement improved infection 
control strategies, potential solutions are complicated by the 
difficulty of removing dangerous pathogens, including 
multidrug-resistant organisms, from the clinical environment by 
disinfection protocols alone. The Committee has been encouraged 
by the progress made in reducing central line-associated 
bloodstream infections and methicillin-resistant Staphylococcus 
aureus bacteremia, but there has been little or no improvement 
since 2009 in, for example, the rates of catheter-associated 
urinary tract infections and colon surgery surgical site 
infections [SSI]. Clearly, more action is needed at every level 
of health care to eliminate infections that commonly threaten 
hospital patients. As efforts to develop a systems approach to 
decontamination increase, one of most promising areas of 
research is related to technologies that can provide surfaces 
with self-disinfection capability. Advancements in this area 
could be greatly beneficial to health outcomes, reduce 
healthcare expenses, and improve patient life-quality. The 
Committee encourages NIAID to support efforts to accelerate the 
development of self-disinfecting medical devices, disinfecting 
strategies to alleviate SSIs, as well as materials engineering 
approaches to minimize or prevent the transmission of pathogens 
from surfaces within clinical care environments.
    Hepatitis B.--The Committee is aware that it is now 
possible to study the entire Hepatitis B virus life cycle, and, 
therefore, a research program to identify life cycle 
vulnerabilities. The Committee encourages NIAID to collaborate 
with NIDDK to advance innovative research to discover and 
develop new therapies and treatments to interrupt the life 
cycle of the Hepatitis B virus to eliminate the infection and 
to help cure this deadly disease.
    Hereditary Angioedema [HAE].--The Committee applauds NIAID 
for co-hosting the Expanding Boundaries of our HAE Knowledge 
Conference and supports its focus on continuing HAE research 
activities moving forward.
    HIV/AIDS.--The Committee appreciates that NIAID has made 
reducing the incidence of HIV/AIDS, including the development 
of safe and effective vaccines, a high priority. The Committee 
is aware of several promising HIV vaccine candidates, including 
candidates that use novel immunogens and vaccine platforms, 
such as cytomegalovirus [CMV]. The Committee supports NIAID 
efforts to advance such innovative and promising vaccine 
candidates into early clinical testing.
    Tuberculosis [TB].--The Committee encourages NIAID to 
continue prioritizing and implementing the National Action Plan 
for Combating Multi-drug Resistant Tuberculosis, including 
addressing the Plan's objectives, and coordinating with other 
TB research agency partners including USAID and CDC.

             NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES

Appropriations, 2016....................................  $2,512,437,000
Budget estimate, 2017...................................   2,434,144,000
Committee recommendation................................   2,633,755,000

    The Committee recommendation includes $2,633,755,000 for 
the National Institute of General Medical Sciences [NIGMS], 
which includes $857,000,000 in transfers available under 
section 241 of the PHS Act.
    Institutional Development Award [IDeA].--The Committee 
provides $333,361,000 for the IDeA program, an increase of 
$13,277,000. The IDeA program continues to support high-quality 
research throughout the country and enhances the 
competitiveness of investigators at institutions located in 
States in which the aggregate success rate for NIH grants has 
been historically low. Discoveries and medical breakthroughs 
can come from anywhere, and the Committee continues to strongly 
support the IDeA program, particularly its focus on serving 
rural and medically underserved communities in IDeA States. In 
particular, the Committee is concerned that many institutions 
eligible for funding under the National Science Foundation's 
Experimental Program to Stimulate Competitive Research [EPSCoR] 
are ineligible to participate in the IDeA program. The 
Committee directs NIGMS to report to the Committee no later 
than 120 days after enactment of this act with updated IDeA 
eligibility criteria that would incorporate EPSCoR States into 
the IDeA program.
    Science Education Partnership Awards [SEPA].--SEPA fosters 
important connections between biomedical researchers and K-12 
teachers and their students. These connections establish an 
education pipeline to careers in biomedical sciences, which is 
one of the most important areas of workforce development for 
the U.S. economy. Therefore, NIH is directed to continue 
funding the SEPA program at no less than $17,100,000, the 
fiscal year 2016 level. Further, because of the central role 
NIGMS plays in managing programs that support the development 
of the biomedical research workforce, the Committee transfers 
the SEPA program from OD to NIGMS.
    Small Business Research Funding.--The Committee supports 
the initiative to direct small business research funding to 
IDeA States to foster the development of products to advance 
public health. The Committee asks NIGMS to consider allocating 
funding for one shared innovation incubator in each of the four 
IDeA regions that would be competitively bid among IDeA States 
and would serve IDeA States. NIH shall not use funding from its 
IDeA allocation for these grants.

  EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN 
                              DEVELOPMENT

Appropriations, 2016....................................  $1,338,348,000
Budget estimate, 2017...................................   1,316,607,000
Committee recommendation................................   1,395,811,000

    The Committee recommendation includes $1,395,811,000 for 
the Eunice Kennedy Shriver National Institute of Child Health 
and Human Development [NICHD].
    Demographic Research.--The NICHD Population Dynamics Branch 
fosters scientific understanding of changes in human health and 
development at the population level by supporting research and 
research training in demography--the scientific study of human 
populations--and reproductive health. The Committee urges NICHD 
to sustain this research by making a strong investment in its 
Population Dynamics Centers Research Infrastructure Program. 
Further, the Committee supports NICHD's efforts to make wise 
investments in large-scale longitudinal scientific surveys and 
prioritize data sharing as a condition of award. Making these 
survey data widely available efficiently promotes and supports 
broad-based scientific research activities on health and 
development.
    Fragile X.--The Committee commends NICHD for leading the 
effort to map the molecular, physiological, biological, and 
genetic connections between fragile X [FX], and the fragile X 
protein, and autism spectrum disorder. The fragile X gene and 
its protein continue to present important insight into 
discovering the root cause of autism and disease modifying 
treatments for FX and autism. The Committee urges the NICHD to 
explore ways to utilize funding for FX and autism in tandem to 
accelerate the pace of research toward identification of the 
commonality between the two conditions and the development of 
disease modifying treatments that will reduce health burdens.
    Intellectual and Developmental Disabilities Research 
Centers [IDDRC].--The Committee recognizes the outstanding 
contributions of the IDDRCs toward understanding why child 
development goes awry, discovering ways to prevent 
developmental disabilities, and discovering treatments and 
interventions to improve the lives of people with developmental 
disabilities and their families. The Committee urges NICHD to 
continue to support the IDDRCs to conduct basic and 
translational research to develop effective prevention, 
treatment, and intervention strategies for children and adults 
with developmental disabilities.
    Preterm Birth.--The Committee applauds NICHD's work with 
leading global health organizations to develop a research 
agenda aimed at reducing preterm birth. Public and privately 
funded research that, taken together, spans the range of 
discovery, development, and delivery science is needed to 
identify the causes of premature birth. The Committee urges 
NICHD to enhance investments in biomedical and clinical 
research related to the prevention of preterm birth and the 
care and treatment of preterm infants.

                         NATIONAL EYE INSTITUTE

Appropriations, 2016....................................    $707,998,000
Budget estimate, 2017...................................     687,249,000
Committee recommendation................................     740,826,000

    The Committee recommendation includes $740,826,000 for the 
National Eye Institute [NEI].
    Age-Related Macular Degeneration [AMD].--The Committee 
recognizes NEI's leadership in identifying more than 500 genes 
associated with both common and rare eye diseases. NEI's 
International AMD Genomics Consortium has now discovered a 
total of 52 genetic variants that are associated with AMD, 
located among 34 regions of the human genome called loci, 16 of 
which had not been previously associated with AMD. With past 
NEI-funded research solidifying a link between AMD and genes 
encoding the complement system, a set of proteins that plays a 
central part in immune responses and inflammation, the 
Committee anticipates additional findings from initial research 
that suggest that a class of medications used to treat HIV, 
called nucleoside reverse transcriptase inhibitors [NRTIs], 
shows promise to treat AMD, and may be repurposed to treat 
other inflammatory disorders.
    Audacious Goals Initiative [AG].--The Committee commends 
NEI's leadership through its Audacious Goals Initiative, which 
aims to restore vision within the next decade through 
regeneration of the retina by replacing cells that have been 
damaged by disease and injury and restoring their visual 
connections to the brain. The Committee is pleased that NEI has 
awarded the first set of grants associated with novel imaging 
technologies to help clinicians observe the function of 
individual neurons in human patients and follow them over time 
as they test new therapies, and will proceed with a second 
round of awards associated with identifying new factors that 
control regeneration and comparing the regenerative process 
among model organisms, rodents, and non-human primates.
    Cataract.--The Committee recognizes that clouding of the 
eye's lens in cataracts is the leading cause of blindness 
worldwide. It commends recent NEI-funded research that reported 
on the use of the fiber optic-based dynamic light scattering 
technology, developed by NASA, to estimate the level of the 
structural protein alpha-crystalline in the lens every 6 months 
in patients at risk for cataracts over the course of 3 years. 
This effort confirmed the correlation of the loss of protein 
with the rate of nuclear cataract progression, enabling 
clinicians to determine cataract progression and a potential 
time to intervene to prevent their formation. The Committee is 
also pleased that a recent NEI study has identified molecules 
that restore transparency to the lens in animal models, which 
could lead to therapies being delivered by eye drops, thereby 
eliminating surgery.
    Diabetic Retinopathy Clinical Research Network.--The 
Committee commends NEI for the collaborative efforts of the 
Diabetic Retinopathy Clinical Research Network. The Committee 
acknowledges the importance of clinical trial networks and 
hopes the NEI will maintain the Diabetic Retinopathy Clinical 
Research Network's commitment to facilitating clinical research 
on diabetic retinopathy. The Committee strongly encourages the 
NEI to build on the success of the Diabetic Retinopathy 
Clinical Research Network to expand and extend the scope of the 
network to include other retinal diseases.
    Glaucoma.--The Committee recognizes the identification of 
three new genes by the NEI Glaucoma Human Genetics 
Collaboration Heritable Overall Operational Database Consortium 
that are strongly associated with primary open-angle glaucoma, 
the most common form of the disease. The finding that variants 
of these genes may alter the protection of the optic nerve from 
degeneration due to oxidative stress increases the total number 
of genes associated with primary open angle glaucoma to 15, 
demonstrating that the underlying mechanisms of the disease may 
involve the interaction of many genes with environmental 
influences.
    Usher Syndrome.--The Committee continues to urge the 
prioritization of Usher syndrome research at NEI. The Committee 
requests an update on NEI and NIDCD basic, clinical, and 
translational research that will lead to additional treatment 
options and improved patient outcomes for individuals with 
Usher syndrome. The update should include a description of the 
criteria used by NIH to evaluate grant submissions to ensure 
the prioritization of those that accelerate human treatment 
options that would benefit individuals with Usher syndrome.

          NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES

Appropriations, 2016....................................    $693,533,000
Budget estimate, 2017...................................     681,613,000
Committee recommendation................................     722,301,000

    The Committee recommendation includes $722,301,000 for the 
National Institute of Environmental Health Sciences [NIEHS].
    Autism.--The Committee urges the NIEHS, as the lead agency 
on environmental health research and a member agency of the 
Interagency Autism Coordinating Committee [IACC], to ask the 
IACC to consider research on environmental factors related to 
autism, including onset patterns, in the upcoming revision to 
the IACC Strategic Plan for Autism Research. In addition, as 
the lead NIH Institute on Autism Spectrum Disorders research, 
the Committee suggests that NIMH work in coordination with 
NIEHS to assure that research on environmental factors 
continues to be supported.
    Healthy Housing.--The Committee encourages NIEHS to further 
study the impact healthy housing has on reducing environmental 
exposures that lead to health risks such as asthma and lead 
poisoning.

                      NATIONAL INSTITUTE ON AGING

Appropriations, 2016....................................  $1,598,246,000
Budget estimate, 2017...................................   1,265,133,000
Committee recommendation................................   2,067,138,000

    The Committee recommendation includes $2,067,138,000 for 
the National Institute on Aging [NIA].
    Alzheimer's Disease.--The bill includes approximately 
$1,391,000,000, an increase of $400,000,000 above fiscal year 
2016, for high-quality research on Alzheimer's disease, subject 
to the scientific opportunity presented in the peer review 
process. NIA is encouraged 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 in 2015. Further, the Committee 
recognizes the importance of well-characterized, longitudinal, 
population-based cohort studies in providing new insights into 
risk factors related to dementia, with special focus on 
minority populations where disease burden is greatest. As the 
participants in these studies have aged, much has been learned 
about cognitive decline and the role of mid-life risk factors, 
but key challenges remain, particularly in the identification 
of biomarkers and in understanding the role of environmental 
versus genetic factors. The Committee directs NIH to support 
research involving the subsequent generations of such cohorts, 
as studying the adult children of these extensively 
characterized cohort members may provide new insights into risk 
identification and accelerated prevention efforts. In 
particular, NIA is encouraged to fund a pilot program to test 
community-based clinical trials for the prevention of cognitive 
decline. Such a longitudinal study should include an ethnically 
representative sample, incorporate genomic and environmental 
Alzheimer's disease risk factors and monitor cognitive and 
motor function, disability, and morbidity over time. The 
Committee notes that poor sleep health and sleep disorders 
progress diseases that impair cognitive functioning, such as 
Alzheimer's disease. The Committee encourages support for 
research that explores the linkages between sleep cycle, 
cardiovascular system, and Alzheimer's disease, in an effort to 
inform prevention. Priority consideration should be given to 
applicants with a NIA designated Alzheimer's Disease Center, 
Alzheimer's Disease Accelerating Medicines Partnership award, 
and at least one Patient-Centered Outcomes Research Institute 
grant. Finally, the Committee is particularly interested in 
NIH's plans to place additional emphasis on high-risk, high-
reward projects using a DARPA-like approach to goal-oriented 
and milestone-driven research. The Committee believes such an 
approach can be particularly valuable in addressing major 
scientific gaps and encourages NIH to establish clear 
priorities, including Alzheimer's disease and dementia and 
other high-cost diseases of aging, particularly given our 
national goal of preventing and effectively treating 
Alzheimer's disease by 2025.
    Demographic Research.--The Committee is greatly concerned 
by the health and financial threats that dementia-related 
disorders, including Alzheimer's disease, pose as the U.S. 
population ages. NIA is urged to respond by investing in the 
full spectrum of scientific research, including population 
research, to address the complex nature of dementia-related 
disorders and its devastating effects on patients, families, 
and caregivers. This effort should include sustained investment 
in large-scale longitudinal studies, such as the Health and 
Retirement Study. The Committee encourages NIA to support 
research and data collection on the causes of widening 
disparities in health and longevity at older ages, and the role 
of social factors, such as education and income, in the health 
and well-being of older people.

 NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES

Appropriations, 2016....................................    $541,662,000
Budget estimate, 2017...................................     532,753,000
Committee recommendation................................     564,131,000

    The Committee recommendation includes $564,131,000 for the 
National Institute of Arthritis and Musculoskeletal and Skin 
Diseases [NIAMS].
     Arthritis Disparities.--Research from CDC notes that 
minority groups, including African American and Latino/Hispanic 
populations, experience higher rates of arthritis-attributable 
activity and work limitations than other populations. The 
Committee encourages NIAMS to support research to understand 
these disparities, in collaboration with NIMHD.
    Epidermolysis Bullosa [EB].--The Committee recognizes the 
promising scientific gains made in pursuit of treatments for EB 
and supports the private partners working to advance research 
towards practical EB treatments. Further research in this area 
holds great promise for both EB and for other skin and 
connective-tissue disorders treatments. The Committee 
encourages the NIH to continue to support meritorious research 
and collaboration activities related to EB.

    NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS

Appropriations, 2016....................................    $422,936,000
Budget estimate, 2017...................................     416,146,000
Committee recommendation................................     441,778,000

    The Committee recommendation includes $441,778,000 for the 
National Institute on Deafness and Other Communication 
Disorders [NIDCD].
    Otolaryngology.--The Committee is concerned that research 
in the study of human temporal bone tissues may be jeopardized 
by the loss of technical and pathological expertise in this 
field. Active temporal bone laboratories are largely 
responsible for the pathologic characterizations of many of the 
diseases that are treated on a frequent basis, including 
otosclerosis, Meniere's disease and chronic otitis media. 
However, there are other disorders for which the pathology has 
not been well characterized and the need remains for the active 
participation of multiple laboratories to develop new 
techniques to allow for molecular investigations that have not 
been possible in the past. The Committee urges NIDCD to work 
with the otolaryngology community to facilitate new and 
innovative therapies that examine the pathology of the ear and 
to ensure that hypothesis driven research is retained in 
pathology centers.
    Usher Syndrome.--The Committee continues to encourage the 
NIDCD to prioritize Usher syndrome research. The Committee 
requests an update on NEI and NIDCD basic, clinical, and 
translational research that will lead to additional treatment 
options and improved patient outcomes for individuals with 
Usher syndrome. The update should include a description of the 
criteria used by NIH to evaluate grant submissions to ensure 
that prioritization of those that accelerate human treatment 
options that would benefit individuals with Usher syndrome.

                 NATIONAL INSTITUTE OF NURSING RESEARCH

Appropriations, 2016....................................    $145,912,000
Budget estimate, 2017...................................     143,942,000
Committee recommendation................................     151,965,000

    The Committee recommendation includes $151,965,000 for the 
National Institute of Nursing Research [NINR].
    Nursing Research.--The Committee supports NINR's Strategic 
Plan, Bringing Science to Life, as well as its efforts to 
bolster the new NIH-Wide Strategic Plan. The Committee applauds 
NINR's aim to enhance health promotion and disease prevention. 
The Committee supports NINR's commitment to improving quality-
of-life by managing symptoms of acute and chronic illness; 
improving palliative and end-of-life care; enhancing innovation 
in science and practice; and developing the next generation of 
nurse scientists. The Committee remains particularly interested 
in NINR's efforts to invest in young nurse scientists who will 
produce the evidence to improve quality of care nationally and 
globally.

           NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM

Appropriations, 2016....................................    $467,445,000
Budget estimate, 2017...................................     459,578,000
Committee recommendation................................     488,782,000

    The Committee recommendation includes $488,782,000 for the 
National Institute on Alcohol Abuse and Alcoholism [NIAAA].
    Genomic Research and Alcohol Dependence.--The Committee 
remains concerned about the negative impact of alcohol abuse 
both to individuals struggling with alcoholism and to the 
budgets of Federal health programs. Research has implicated 
several gene variants that confer risk for Alcohol Use Disorder 
[AUD] and posttraumatic stress, suggesting that there may be 
shared genetic vulnerabilities for these disorders. The 
Committee encourages the NIAAA to capitalize on advances in 
genetic tools and available datasets to gain additional insight 
into the genetics of co-occurring AUD and posttraumatic stress 
to inform prevention and treatment for affected individuals. 
NIAAA shall provide a report to the Committee within 180 days 
after enactment of this act that provides a detailed plan on 
how to move large-scale genetic screening initiatives forward 
to focus on high-risk populations, including those who exhibit 
alcohol dependency after suffering from post-traumatic stress.

                    NATIONAL INSTITUTE ON DRUG ABUSE

Appropriations, 2016....................................  $1,050,550,000
Budget estimate, 2017...................................   1,020,459,000
Committee recommendation................................   1,103,032,000

    The Committee recommendation includes $1,103,032,000 for 
the National Institute on Drug Abuse [NIDA].
    Adolescent Brain Development.--The Committee recognizes and 
supports the Adolescent Brain and Cognitive Development [ABCD] 
Study, which will continue to study the dramatic brain 
development that takes place during adolescence and how the 
various experiences children are exposed to during this time 
interact with each other and a child's brain development. As 
the largest longitudinal brain-imaging study of youth, the ABCD 
study will follow approximately 10,000 U.S. children from ages 
9-10 into early adulthood, and will yield critical insights 
into the foundational aspects of adolescence that shape life 
trajectories. The Committee requests an update on the ABCD 
study in the fiscal year 2018 CJ.
    Drug Treatment in Justice System Settings.--The Committee 
understands that providing evidence-based treatment for 
substance use disorders offers a strong alternative for 
interrupting the drug use/criminal justice cycle for offenders 
with drug problems. NIDA's Juvenile Justice Translational 
Research on Interventions for Adolescents in the Legal System 
[JJ-TRIALS] program identifies and tests strategies for 
improving the delivery of evidence-based substance abuse and 
HIV prevention and treatment services for justice-involved 
youth. The JJ-TRIALS initiative will provide insight into the 
process by which juvenile justice and other service settings 
can successfully adopt and adapt existing evidence-based 
programs and strategies to improve treatment for at-risk youth. 
The Committee requests an update on the JJ-TRIALS in the fiscal 
year 2018 CJ.
    Expansion of Research on Opioid Alternatives.--The 
Committee remains concerned about the growing epidemic of 
opioid overdoses. The widespread availability of opioid 
painkillers has contributed to the millions of Americans who 
suffer from addiction disorders. Although NIDA has studied the 
effectiveness and risks associated with long-term opioid use 
for chronic pain, little research has been done to investigate 
new and alternative treatment options for treating pain, both 
acute and chronic. The Committee strongly encourages NIDA to 
expand scientific activities related to research on medications 
used to treat and reduce chronic pain. In doing this, NIDA 
should coordinate with CDC, HHS, VA, FDA, DOD, DEA, industry, 
experts in the field of pain research and addiction, and the 
medical research community at large, to identify gaps in 
scientific research related to opioid abuse and addiction, and 
the treatment of acute and chronic pain. In addition, NIDA 
should continue to sponsor research to better understand the 
effects of long-term prescription opioid use, especially as it 
relates to the prevention and treatment of opioid abuse and 
addiction.
    Medications Development.--The Committee recognizes that new 
technologies are required for the development of next-
generation pharmaceuticals. The Committee is encouraged by 
NIDA's current approaches to develop viable immunotherapeutic 
or biologic methods for treating addiction. The goal of this 
research is the development of safe and effective vaccines or 
antibodies that target specific addictive drugs. The Committee 
is encouraged by this approach; if successful, immunotherapies, 
alone or in combination with other medications, behavioral 
treatments, or enzymatic approaches, stand to revolutionize how 
we treat, and ultimately prevent addiction.
    Opioid Misuse and Addiction.--The Committee appreciates the 
important role that research plays in the various Federal 
initiatives aimed at addressing the opioid crisis. The 
Committee urges NIDA to continue to fund research on 
medications to alleviate pain, including the development of 
those with reduced abuse liability, and continue to work with 
industry to fund innovative research into such medications. The 
Committee requests an update in the fiscal year 2018 CJ on 
these initiatives.
    Raising Awareness of Drug Abuse and Addiction Prevention 
and Treatment.--Education is a critical component of any effort 
to curb drug use and addiction, and it must target every 
segment of society, including healthcare providers, patients, 
and families. Through its NIDAMeD initiative, NIDA is advancing 
addiction awareness, prevention, and treatment in primary care 
practices through seven Centers of Excellence for Physician 
Information. Intended to serve as national models, these 
centers target physicians-in-training, including medical 
students and resident physicians in primary care specialties. 
NIDA also developed, in partnership with the Office of National 
Drug Control Policy, two online continuing medical education 
courses on safe prescribing for pain and managing patients who 
abuse prescription opioids. The Committee is pleased with 
NIDAMed, and urges NIDA to continue its focus on activities to 
provide physicians and other medical professionals with the 
tools and skills needed to incorporate drug abuse screening and 
treatment into their clinical practices.

                  NATIONAL INSTITUTE OF MENTAL HEALTH

Appropriations, 2016....................................  $1,518,673,000
Budget estimate, 2017...................................   1,459,700,000
Committee recommendation................................   1,619,537,000

    The Committee recommendation includes $1,619,537,000 for 
the National Institute of Mental Health [NIMH].
    Autism.--As the lead agency on Autism Spectrum Disorders 
policy, the Committee urges the NIMH to include research on 
environmental factors related to autism, especially regressive 
autism, in the upcoming revision to the Strategic Plan for 
Autism Research.

                NATIONAL HUMAN GENOME RESEARCH INSTITUTE

Appropriations, 2016....................................    $513,227,000
Budget estimate, 2017...................................     509,762,000
Committee recommendation................................     534,516,000

    The Committee recommendation includes $534,516,000 for the 
National Human Genome Research Institute [NHGRI].

      NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING

Appropriations, 2016....................................    $343,506,000
Budget estimate, 2017...................................     334,025,000
Committee recommendation................................     361,062,000

    The Committee recommendation includes $361,062,000 for the 
National Institute of Biomedical Imaging and Bioengineering 
[NIBIB].
    Healthcare-Associated Infections [HAIs].--HAIs are 
estimated to occur in 5 percent of all hospitalizations in the 
United States, resulting in more than 1.7 million illnesses and 
99,000 deaths annually. While HHS has been leading efforts to 
develop and encourage hospitals to implement improved infection 
control strategies, potential solutions are complicated by the 
difficulty of removing dangerous pathogens, including 
multidrug-resistant organisms, from the clinical environment by 
disinfection protocols alone. The Committee has been encouraged 
by the progress made in reducing central line-associated 
bloodstream infections and methicillin-resistant Staphylococcus 
aureus bacteremia, but there has been little or no improvement 
since 2009 in, for example, the rates of catheter-associated 
urinary tract infections and colon surgery surgical site 
infections [SSI]. Clearly, more action is needed at every level 
of health care to eliminate infections that commonly threaten 
hospital patients. As efforts to develop a systems approach to 
decontamination increase, one of most promising areas of 
research is related to technologies that can provide surfaces 
with self-disinfection capability. Advancements in this area 
could be greatly beneficial to health outcomes, reduce 
healthcare expenses, and improve patient life-quality. The 
Committee encourages NIBIB to support efforts to accelerate the 
development of self-disinfecting medical devices, disinfecting 
strategies to alleviate SSIs, as well as materials engineering 
approaches to minimize or prevent the transmission of pathogens 
from surfaces within clinical care environments.

        NATIONAL CENTER FOR COMPLEMENTARY AND INTEGRATIVE HEALTH

Appropriations, 2016....................................    $129,941,000
Budget estimate, 2017...................................     126,673,000
Committee recommendation................................     136,195,000

    The Committee recommendation includes $136,195,000 for the 
National Center for Complementary and Integrative Health 
[NCCIH].
    Pain Management.--The Committee is encouraged by the 
ongoing collaboration between NCCIH, VA, DOD, and other NIH 
Institutes to develop and test efficacious non-pharmacological 
approaches to pain management and comorbidities-including 
opioid misuse, abuse, and disorder-in military personnel, 
veterans, and their families. As opioid prescribing rates have 
increased at the VA in recent years, and opioid abuse has risen 
among young veterans, the Committee believes it is critical to 
support research on non-pharmacological treatments to ensure 
the best quality of care for our Nation's veterans and 
servicemembers, and urges the NIH, VA, and DOD to continue this 
vital research.

      NATIONAL INSTITUTE ON MINORITY HEALTH AND HEALTH DISPARITIES

Appropriations, 2016....................................    $280,680,000
Budget estimate, 2017...................................     279,680,000
Committee recommendation................................     292,323,000

    The Committee recommendation includes $292,323,000 for the 
National Institute on Minority Health and Health Disparities 
[NIMHD].
    Cohort Studies.--The Committee is aware of novel efforts 
underway to recruit individuals from racially and ethnically 
diverse backgrounds for participation in the PMI Cohort 
Program. Information from the cohort will be a broad, powerful 
resource for researchers working on a variety of important 
health questions. The Committee applauds NIH's efforts to 
partner with HRSA to begin partnerships with several Federally 
Qualified Health Centers to develop, pilot, and refine 
approaches for bringing underserved individuals, families, and 
communities into the PMI Cohort Program. The Committee believes 
that the NIMHD can and should help support these efforts to 
ensure participation of racially and ethnically diverse 
individuals.
    Research Centers in Minority Institutions.--The Committee 
continues to recognize the critical role played by minority-
serving institutions in addressing minority health and health 
disparities, while also providing training for a diverse health 
workforce. 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, with each $1 invested being leveraged to 
generate an additional $5 to $6 in competitive research 
funding. 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 non-
minority researchers. The Committee remains concerned NIMHD may 
be considering changing RCMI's configuration and funding 
structure without adequate congressional or stakeholder input. 
Therefore, the Committee directs NIH to maintain the existing 
vital infrastructure support provided through the RCMI program 
and make available not less than last year's level for the RCMI 
program. Further, NIMHD is directed to provide an update to the 
Committee no later than 90 days after enactment of this act on 
any proposed changes to the program and prior to any changes 
being implemented.

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

Appropriations, 2016....................................     $70,117,000
Budget estimate, 2017...................................      69,175,000
Committee recommendation................................      73,026,000

    The Committee recommendation includes $73,026,000 for the 
Fogarty International Center [FIC].
    Global Health Research.--Recent disease outbreaks such as 
Ebola and the flu have shown the importance of the Center's 
essential role in global infectious disease health research 
training and health system strengthening. These efforts help 
developing countries to eventually advance their own research 
and health solutions and tools. FIC also has developed 
partnerships in countries 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 of building relationships with scientists 
abroad to foster a stronger and more effective science 
workforce and health capacity on the ground, and improving the 
image of the United States through health diplomacy in their 
countries.

                      NATIONAL LIBRARY OF MEDICINE

Appropriations, 2016....................................    $395,684,000
Budget estimate, 2017...................................     395,110,000
Committee recommendation................................     412,097,000

    The Committee recommends $412,097,000 for the National 
Library of Medicine [NLM]. Of the funds provided, $4,000,000 is 
for the improvement of information systems, to remain available 
until September 30, 2018.

          NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES

Appropriations, 2016....................................    $685,417,000
Budget estimate, 2017...................................     660,131,000
Committee recommendation................................     713,849,000

    The Committee recommendation includes $713,849,000 for the 
National Center for Advancing Translational Sciences [NCATS]. 
The Committee includes bill language allowing up to $25,835,000 
of this amount, the same as the budget request and fiscal year 
2016, to be used for the Cures Acceleration Network [CAN].
    Clinical and Translational Science Awards [CTSA] Program.--
The Committee includes $520,740,000, an increase of 
$20,740,000, for the CTSA Program. The Committee applauds the 
success of the CTSA Program and recognizes recent NCATS efforts 
to update the program following the recommendations of the 
Institute of Medicine. NCATS is encouraged to further integrate 
the CTSA Program into the full spectrum of medical research 
activities at NIH, including collaboration with other ICs, and 
greater support for the CTSA hubs and network.

                         OFFICE OF THE DIRECTOR

Appropriations, 2016....................................  $1,558,600,000
Budget estimate, 2017...................................   1,432,859,000
Committee recommendation................................   1,731,152,000

    The Committee recommendation includes $1,731,152,000 for 
the Office of the Director [OD]. Within this total, 
$790,542,000 is provided for the Common Fund, which includes 
$230,000,000 for the Precision Medicine Initiative, an increase 
of $100,000,000 above fiscal year 2016.
    Academic Research Enhancement Award [AREA] Program.--The 
Committee believes that biomedical discoveries can occur 
anywhere, and continues to support programs that foster 
biomedical research and opportunities for students at 
institutions who may not receive significant NIH funding. In 
particular, the Committee continues its long-standing support 
of the IDeA program. However, the Committee notes that many 
institutions that may benefit from the IDeA program are 
ineligible because they reside in States that are EPSCoR 
States, but not IDeA States. The Committee encourages NIH to 
enhance support for the AREA program by holding regional 
workshops to provide guidance on writing and submitting R15/
AREA applications and on developing institutional capacities 
for undergraduate research. Further, NIH is urged to develop 
ways to improve ties between institutions that receive 
significant NIH funding and AREA-eligible institutions.
    Amyloidosis.--The Committee recommends that NIH continue 
its research efforts into amyloidosis, a group of rare diseases 
characterized by abnormally folded protein deposits in tissues. 
Amyloidosis is often fatal and there is no known cure. Current 
methods of treatment are risky and unsuitable for many 
patients. The Committee requests NIH to update the Committee on 
the steps taken to increase the understanding of the causes of 
amyloidosis and the efforts to improve the diagnosis and 
treatment of this devastating group of diseases.
    Angiogenesis.--The Committee commends the NIH for posting 
the Trans-NIH Angiogenesis Workshop findings. The Committee 
urges NIH to address the needs outlined in the comments 
including, the establishment of cross-disciplinary 
collaborations across therapeutic fields by NCI, NHLBI, NIDDK, 
NEI and other institutes, and the creation of a trans-NIH 
Program Project Grant. The Committee further encourages NIH to 
examine angiogenesis modifying interventions across populations 
using data to identify differences in response and benefit 
across age, gender, ethnicity/race/ancestral categories, 
socioeconomic strata, chronic disease States, and genetic 
background. Specifically, NIH is encouraged to study: 
angiogenesis and metabolism; biomarkers that reflect normal and 
abnormal angiogenesis; epigenetic changes of angiogenesis 
induced by natural stimuli such as diet, physical activity, and 
lifestyle, as well as medications; the effect of angiogenesis 
regulation on health and disease outcomes; the functional 
connections between angiogenesis and other health defense 
systems in the body (inflammation, regeneration, anti-aging, 
and immunity).
    Big Data Infrastructure Plan.--Biomedical research has 
become increasingly reliant on growing amounts of digital data, 
a development with tremendous--and potentially disruptive--
promise if this data can be used effectively by the research 
community to enable major scientific breakthroughs. Figuring 
out how to make this possible is one of the biggest issues 
facing NIH as it pursues ambitious initiatives related to 
cancer, the human brain, Alzheimer's disease, and other 
challenges. In 2012, NIH began an extramural program to provide 
a framework of pilot programs, centers of excellence, and grant 
opportunities to advance thinking in how to organize, share, 
and use big data. The Committee believes that NIH now needs to 
build on this progress by developing a strategic plan to 
realize the full potential of these efforts for NIH's 
Institutes and Centers. The Committee directs NIH to provide 
such a plan to the Committee within 1 year of enactment of this 
act. This plan should describe how NIH intends to make big data 
sustainable, interoperable, accessible and usable, and include 
a roadmap to achieve these objectives. The plan should be 
developed with the input of external partners and stakeholders, 
and include milestones and estimates of the resources that will 
be necessary to achieve its goals.
    Brain Health.--The Committee supports brain health 
research, education, and care that can be advanced through 
collaborative and interdisciplinary efforts that seek to study 
issues of cognition across the age spectrum with a goal to 
improve overall community health. The Director is strongly 
encouraged to recognize brain health as a top research priority 
with a special emphasis for initiatives that cross the age 
continuum and include autism, PTSD/TBI, and Alzheimer's 
Disease.
    Brain Research through Application of Innovative Neuro-
technologies [BRAIN] Initiative.--The Committee continues to 
strongly support the BRAIN initiative. The bill provides 
$250,000,000, an increase of $100,000,000 above fiscal year 
2016, to expand the initiative consistent with the BRAIN 2025 
report issued in 2014. The Committee is encouraged by the rapid 
progress the initiative has made in dramatically changing the 
ways we gather data about the brain, generating advances in 
tools for measuring brain structure and activity that have the 
potential to produce massive amounts of new data. To prepare 
for the management of all this information, BRAIN has dedicated 
some of its existing budget to stimulate the development of 
centers for data warehousing, analysis and visualization for 
each of its defined research areas. However, the Committee 
believes the need for data integration and manipulation that 
would make full use of these large cross-disciplinary datasets 
not only entails a large investment in open data hosting, but 
also requires significant investments in interactive data 
management that combines neurophysiological, imaging, clinical, 
and molecular datasets in both human and model organisms. The 
Committee encourages NIH to work with its Federal, academic and 
private partners, as well as leaders in the technology sector, 
to jointly develop integrated, user friendly, scalable data 
analysis hubs for BRAIN data as well as methods for tool 
dissemination. The goal of such an effort would be a network 
that has at its core an interconnected open platform of 
imaging, neurophysiological, behavioral, clinical, and 
molecular data along with the metadata essential for its 
interpretation. This collaborative effort would guide 
development and sharing of best practices in data acquisition, 
analysis, and choices in computational pipelines. Open sharing 
on this scale would enable data analysis and visualization 
across institutional boundaries to accelerate understanding of 
brain function and dysfunction. The Committee directs NIH to 
provide a plan, developed in collaboration with its partners, 
to the Committee 6 months after enactment of this act to create 
such a network, including schedule and cost estimates.
    Building Infrastructure Leading to Diversity [BUILD].--The 
Committee supports the NIH Director's efforts to reverse the 
trend of underrepresentation of researchers from ethnically 
diverse backgrounds and continues to be pleased with the 
commitment to increase the number of minority investigators. 
The Committee encourages NIH to ensure that graduate 
institutions with a historic mission of educating minorities in 
the health professions and biomedical sciences can participate 
in the program.
    Burden of Disease.-- The Committee expects NIH to consider 
the burden of a disease when setting priorities and developing 
strategic plans across its Institutes and Centers. Diseases 
such as Alzheimer's, diabetes, heart disease, and cancer affect 
a large portion of the population, especially the aging 
population. The impact of these diseases on patients and their 
families are substantial and costly. Targeting biomedical 
research funding toward these diseases is an important strategy 
to finding better treatments and cures. Further, the Committee 
commends the NIH on the inclusion of burden of disease as part 
of its NIH-Wide Strategic Plan for Fiscal Years 2016-2020. The 
Plan calls for the relative burdens of individual diseases and 
medical disorders to be regarded as crucial considerations in 
balancing the priorities of the Federal research portfolio. The 
Committee supports a focus on conditions in need of further 
funding such as chronic pain, including migraine and other 
treatment alternatives for chronic pain.
    Chimpanzees.--The Committee supports NIH in its decision to 
make chimpanzees eligible for retirement from NIH-supported 
biomedical research and reaffirm its commitment to the care of 
the federally owned and supported chimpanzee population. 
Consistent with that policy, the Committee directs NIH to 
report its estimated timeline for moving chimpanzees to 
accredited sanctuaries within 30 days after enactment of this 
act. In addition, the Committee recognizes the need to provide 
greater financial support for the lifelong care of federally 
owned and supported chimpanzees, including sanctuary facility 
capital and care costs.
    Chronic Fatigue Syndrome [CFS].--The Committee is pleased 
to see the 2015 reports from the Institute of Medicine and the 
NIH's Pathways to Prevention Workshop, along with the recent 
advances in science and renewed interests of researchers, 
relating to CFS. The Committee urges the NIH to collaborate 
with disease researchers, clinicians, patients, and their 
advocates to address the historical lack of research and to 
capitalize on these opportunities to make progress on this 
poorly understood disease. Specifically, the Committee 
encourages NIH to use funding to jumpstart the field through a 
set of intramural and extramural investments that could include 
Funding Opportunity Announcements for biomarkers and treatment 
trials; other investigator-initiated studies, including for 
early-stage research; and support for research to develop 
consensus on a case definition and research standards.
    Chronic Overlapping Pain Conditions.--The Committee notes 
the strong scientific evidence substantiating common disease 
mechanisms underlying Chronic Overlapping Pain Conditions. 
However, evidence needed to inform practice guidelines is 
insufficient, sometimes resulting in the misdiagnosis and 
ineffective and harmful treatment of patients with these 
disorders. A coordinated effort on chronic overlapping pain 
conditions is urgently needed to maximize the Federal research 
investment and inform clinical practice. Research 
recommendations from the 2012 NIH Workshop on Chronic 
Overlapping Pain Conditions and September 2014 scientific 
meeting, co-sponsored by various NIH ICs and the TMJ 
Association, should continue to guide the relevant ICs in 
advancing research that spans the basic, translational and 
clinical research continuum to advance scientific understanding 
of chronic overlapping pain conditions, as well as the 
development and discovery of safe and effective treatments.
    Chronic Pain Research.--The 2011 Institute of Medicine 
report, ``Relieving Pain in America,'' revealed the devastating 
public health crisis of chronic pain, demonstrating that 4-in-
10 American adults report chronic pain at a cost of 
$1,600,000,000 per day. The Committee strongly urges NIH to 
intensify and expand its basic, translational, and clinical 
research effort on chronic pain to elucidate underlying 
mechanisms of disease, as well as to discover and develop safe, 
effective, non-habit forming drug and non-drug therapies. The 
Committee encourages the Director to include chronic pain in 
ongoing NIH initiatives that have potential for yielding 
significant advancements in this area, such as the Precision 
Medicine Initiative, the NIH Common Fund, Advanced Medicines 
Partnership, BRAIN Initiative, and public-private partnerships 
within NCATS.
    Clinical Center Reorganization.--The Committee notes NIH's 
recently announced plans to restructure its Clinical Center 
[CC] to ensure patient safety and care are always its foremost 
priorities. The restructuring follows the advice of a blue 
ribbon panel tasked with assessing the CC and NIH intramural 
clinical research following a highly critical FDA inspection of 
the CC Pharmacy in May 2015. The Committee commends NIH for its 
efforts to look beyond the serious problems in the Pharmacy to 
assess other aspects of its operations. It is understandable 
that the decentralized nature of NIH would lead to fragmented 
accountability and governance at the CC, and the decision to 
adopt a centralized management structure modeled on the best 
practices in the Nation's top hospitals makes sense. The 
Committee directs NIH to continue to provide timely updates as 
these efforts move forward, including providing an update in 
the fiscal year 2018 CJ, including the status of recruitment of 
the CC's new management team, the activities of the Hospital 
Board and Office of Research Support and Compliance, and 
adoption of other industry best practices by the CC.
    Duchenne Muscular Dystrophy.--The Committee is aware of the 
updated MD Action Plan released in the winter of 2015, and 
supports the Plan's recommendation to expand Duchenne research 
into bone health, endocrine functioning, and cardio-pulmonary 
functioning. Further, the Committee is encouraged that NIH 
support for earlier stage research in Duchenne muscular 
dystrophy has successfully resulted in a substantial pipeline 
of new potential therapeutics. To provide a smooth transition 
for these projects into clinical development and to increase 
the potential for success, the Committee urges NIH to increase 
support for late stage preclinical and early stage clinical 
projects; and to consider partnering with outside entities, 
including patient organizations and industry, to facilitate 
research focused on the rapid identification and qualification 
of new biomarkers for Duchenne.
    Environmental Influences on Child Health Outcomes Program/
National Children's Study Alternative [ECHO].--The Committee 
continues its support of the ECHO program and the goal to 
understand the effects of environmental exposures on child 
health and development. Sufficient funding, level with fiscal 
year 2016, is provided to the OD to continue this program. In 
particular, the Committee notes its support for the IDeA States 
Pediatric Clinical Trials Network in ECHO which will leverage 
the infrastructure at existing IDeA State centers by embedding 
clinical trials experts at IDeA State locations. This structure 
will facilitate their partnership with other academic 
institutions and help address access gaps for rural and 
medically underserved children.
    Fragile X [FX].--The Committee commends NIH for the NICHD-
led effort that resulted in significant progress in mapping the 
molecular, physiological, biological, and genetic connections 
among FX, the FX protein, and autism spectrum disorder. 
Increased focus on basic science is needed to identify 
additional targetable mechanisms of the disease. The Committee 
urges the Director to support expanded natural history studies 
to supplement the CDC's efforts, and to focus on validating 
outcome measures and identifying biomarkers. Given the 
inextricable connection between the FX protein and autism, the 
Committee urges the Director and IC Directors with Fragile X 
and autism portfolios to explore ways to create greater 
efficiency and synergy among these two research tracks to 
accelerate translational research toward a better understanding 
of both conditions and to shorten the time to bring effective 
treatments to market. Finally, the Committee commends the NIH 
for its previous work to create and update the Research Plan on 
Fragile X Syndrome and Associated Disorders and urges the NICHD 
to reconvene this group before the end of fiscal year 2017 to 
discuss updates to the research plan.
    Gabriella Miller Kids First Research Act.--The Committee 
provides the full budget request of $12,600,000. The Committee 
requests that NIH provide information on how it has disbursed 
the fiscal year 2016 funding for the Gabriella Miller Kids 
First Research Act, including any personnel that are 
responsible for overseeing the allocation of designated 
research dollars, the criteria that NIH employed to ensure 
awards will advance the objectives of the act, and a 
description of the research projects that were funded at the 
end of fiscal year 2016. This report should also describe the 
criteria and process for grant awards the NIH intends to use 
for fiscal year 2017 and subsequent years of funding under the 
act.
    Government-Wide Collaborations.--NIH, VA, and DOD 
collaborate frequently and successfully on various research 
activities. The Committee looks forward to the report in the 
fiscal year 2018 CJ focusing on the cooperative and strategic 
approach the agencies take in areas of biomedical research that 
overlap to maximize the potential of the research.
    Gut Microbiome.--The Committee commends the Office of the 
Director for its work to partner with NIDDK on the Human 
Microbiome project, which has led to valuable scientific 
discoveries in therapeutic and genetic research on inflammatory 
bowel diseases. The Committee urges expanded research on 
predictors and modifiable factors that can improve early 
interventions and treatments, particularly among pediatric and 
young adult populations.
    Hereditary Hemorrhagic Telangiectasia [HHT].--The Committee 
supports the formation of an HHT coordinating committee of 
multiple ICs, including NINDS, NHLBI, NICHD, NHGRI, NIDDK, 
NIBIB, and NCATS. The Committee urges the coordinating 
committee to initiate a workshop to explore collaborative 
research opportunities into the diagnosis and treatment of HHT, 
including efforts to foster translational research in the 
development of new therapeutics for vascular anomalies, the 
identification of potential targets for interrupting pathways 
to prevent HHT progression, and new imaging methods to enable 
more precise detection of vascular malformations. The Committee 
requests an update in the fiscal year 2018 CJ on the status of 
research related to this topic.
    Human Trisome.--The Committee looks forward to the results 
of NIH's feasibility report on a multi-year study to examine 
the molecular, cellular, and physiological mechanisms that 
predestine individuals born with a third copy of human 
chromosome 21 to either live with--or be protected from--a 
range of diseases that cause nearly 60 percent of U.S. deaths. 
The Committee encourages NIH to focus on whether aspects of the 
project, from accrual of children and adults with T21, to 
analysis of biological samples at the genetic, epigenetic, 
biochemical, and cellular levels, to advanced bioinformatics 
analysis of large genomics datasets, fit within the priorities 
set in the NIH research plan published in 2014.
    Imaging.--The Committee notes that imaging research occurs 
in multiple ICs throughout the NIH and is an integral component 
of the BRAIN Initiative. The Committee requests NIH provide an 
overview of imaging research throughout all NIH activities, 
including collaborations with other HHS and non-HHS agencies. 
The Committee requests this information be included in the 
fiscal year 2018 CJ.
    Inclusion of Children.--The Committee appreciates the 
commitment made by the NIH in its fiscal year 2017 budget 
request to pursue plans to collect age-related inclusion 
information for research studies to support enhanced analyses 
and reporting on inclusion by age. Reporting study 
participation by age will assist the Committee, researchers, 
and other stakeholders in understanding whether children as a 
whole, or particular pediatric subpopulations, are 
underrepresented in federally funded biomedical research. The 
Committee believes that the implementation challenges cited by 
the NIH, including determining the appropriate format for 
collecting age-related data and establishing meaningful age-
based categories, are addressable with appropriate expertise 
and stakeholder input. The Committee directs the NIH to develop 
a detailed plan to collect data and report publicly on the 
actual numbers of children and age distribution that are 
enrolled in its clinical studies.
    Infrastructure.--The Committee understands that Federal 
agencies such as NIH need to maintain and upgrade parts of 
their physical infrastructure every year. The NIH facilities 
budget has been relatively flat since 2009. Over time, only the 
most essential maintenance and repairs for health and safety 
have been addressed, leaving an increasing backlog of projects 
requiring attention. To ensure the Committee is informed of 
NIH's critical facility needs and inform future infrastructure 
budgets, the Committee has included up to $1,000,000 for NIH to 
enter into a contract with the National Research Council, 
Division of Engineering and Physical Sciences, to prepare a 
report that assesses the capital needs of NIH's main campus. 
The report should identify facilities in greatest need of 
repair, describe the work needed to bring them up to current 
standards, and include cost estimates for each project. The 
Committee directs NIH to provide the report with its 
recommendations to the House and Senate Committees on 
Appropriations no later than 1 year from the date of the 
contract agreement on the statement of work between NIH and the 
National Research Council.
    Interagency Pain Research.--The Committee encourages the 
Director to intensify and coordinate fundamental, 
translational, and clinical research with respect to the 
understanding of pain, the discovery and development of 
therapies for chronic pain, and the development of alternatives 
to opioids for effective pain treatments. In doing so, the 
Committee urges the NIH to consider recommendations made by the 
Federal Pain Research Strategy, an ongoing effort coordinated 
by the Interagency Pain Research Coordinating Committee and the 
NIHDemographic.
    Lymphatic Research and Lymphatic Disease.--The Committee 
commends the trans-NIH Coordinating Committee for Lymphatic 
Research, which sponsored a historic Lymphatic Symposium in 
2015. The Committee supports building on this momentum by 
growing the cadre of lymphatic researchers through the 
establishment of extramural interdisciplinary research training 
programs relevant to the lymphatic system in health and disease 
and by incorporating greater reviewer expertise in lymphatic 
biology/disease in the pertinent standing study sections within 
the Center for Scientific Review. This research will be 
instrumental in understanding the pivotal role of the lymphatic 
system in the pathogenesis and/or treatment of cancer 
metastasis, AIDS, auto-immune diseases, obesity, cardiovascular 
disease, and organ transplantation as well as those affected by 
lymphatic conditions after cancer or those with congenital 
conditions.
    Mitochondrial Disease Research.--The Committee appreciates 
the NIH's support of the trans-NIH Mitochondrial Disorders 
Working Group, the North American Mitochondrial Disease 
Consortium, the Mitochondrial Disease Sequence Data Resource 
Consortium, and its support for investigator initiated 
intramural and extramural studies. The Committee looks forward 
to the pending publication of a report in follow up to the 
December 2014 workshop on Nutritional Interventions in Primary 
Mitochondrial Disease that will identify a research agenda for 
evidence-based nutritional interventions for mitochondrial 
disorders. With the growing recognition mitochondrial disease 
provides a window into understanding and treating many 
conditions that afflict large segments of the population, the 
Committee strongly encourages the Director to urge an 
aggressive research effort around primary mitochondrial disease 
as well as mitochondrial function and dysfunction.
    National Pediatric Research Network [NPRN].--The Committee 
is aware that the National Pediatric Research Network 
authorizes an innovative model to accelerate research through 
infrastructure consortia across the Nation's pediatric research 
institutions. The Committee has provided sufficient funding to 
explore how to carry out provisions of the act, as feasible, 
and requests that NIH update the Committee on how it is 
implementing the goals of the act within 60 days of enactment 
of this act.
    Natural Products Collections.--The Committee continues to 
urge NIH to increase access to comprehensive and professionally 
organized natural products libraries.
    Neurofibromatosis [NF].--The Committee supports NIH's 
commitment to NF research and treatment at multiple ICs, 
including NCI, NINDS, NIDCD, NHLBI, NICHD, NIMH, NCATS, and 
NEI. The Committee encourages NCI to continue to support its NF 
research portfolio in fundamental basic science, translational 
research and clinical trials focused on NF. The Committee also 
encourages the NCI to support NF preclinical mouse models and 
associated tumor sequencing efforts. Because NF causes brain 
and nerve tumors and is associated with cognitive and 
behavioral problems, the Committee urges NINDS to continue to 
support fundamental basic science research on NF relevant to 
nerve damage and repair. Based on emerging findings from 
numerous researchers worldwide demonstrating that children with 
NF are at significant risk for autism, learning disabilities, 
motor delays, and attention deficits, the Committee encourages 
NINDS, NIMH and NICHD to continue to support laboratory-based 
and clinical investigations in these areas. Since NF2 accounts 
for approximately 5 percent of genetic forms of deafness, the 
Committee encourages NIDCD to continue its investment in NF2 
basic and clinical research. NF1 can cause vision loss due to 
optic gliomas; the Committee encourages NEI to continue its 
investment in NF1 basic and clinical research.
    Neurogenic Bladder and Kidney Disease.--The Committee 
encourages NIH to study the causes and care of the neurogenic 
bladder and kidney disease to improve the quality of life of 
children and adults with Spina Bifida; to support research to 
address issues related to the treatment and management of Spina 
Bifida and associated secondary conditions, such as 
hydrocephalus; and to support research to understand the myriad 
co-morbid conditions experienced by individuals with Spina 
Bifida, including those associated with both paralysis and 
developmental delay.
    Nonrecurring Expenses Fund [NEF].--Created in fiscal year 
2008, the NEF permits HHS to transfer unobligated balances of 
expired discretionary funds into the NEF account for capital 
acquisitions. For fiscal year 2017, the Committee transfers 
$300,000,000 from the NEF to OD for carrying out activities 
associated with biomedical research. The OD shall provide 
actual expenditures based on activity in the fiscal year 2018 
CJ.
    Phelan-McDermid Syndrome.--Phelan-McDermid Syndrome is a 
genetic disorder caused by a partial deletion of chromosome 22 
and a loss of the SHANK3 gene. The Committee encourages NIH to 
continue its multi-Institute approach to research into the 
Syndrome and related ``shankopathies.'' Some topics of 
interest, if feasible, include the correlation of the syndrome 
with mental health disorders, including autism, schizophrenia, 
catatonia, and bipolar disorder; the study of SHANK3 as a 
target for better understanding risk factors for mental health 
problems that occur in adolescence; phenotype studies of the 
syndrome as a model for studying prodromes as indicators of 
later manifestations in disorders; and gastro-intestinal 
complications associated with Phelan-McDermid Syndrome and 
related disorders. The Committee requests an update in the 
fiscal year 2018 CJ on the status of research related to this 
topic.
    Physician-Scientist Workforce.--The Committee is concerned 
about the impact of the decrease in the number of physician-
scientists who can accelerate the translation of science to the 
treatment of widespread chronic, and currently incurable 
diseases such as diabetes and other diseases. The Committee 
applauds NIH for the actions it has already taken to address 
barriers that are preventing physician-scientists from entering 
the biomedical research workforce and looks forward to 
continuing progress on this front. The Committee expects a 
report in the fiscal year 2018 CJ on the specific steps NIH has 
taken and their effect, as well as the path forward to 
implement the recommendations of the Physician-Scientist 
Workforce Working Group.
    Precision Medicine Initiative [PMI].--The Committee 
recommendation continues its strong support for PMI by 
providing $230,000,000 to develop a national research cohort of 
1 million or more U.S. volunteers. This level of funding is 
$100,000,000 above fiscal year 2016, and is in addition to 
$70,000,000 included in the bill for NCI-led PMI for oncology. 
The Committee is aware that the Advisory Committee to the 
Director in its final report supported the inclusion of 
children in the PMI Cohort Program and recommended that NIH 
consider how to best incorporate necessary safeguards to ensure 
appropriate enrollment, retention and protections for children. 
Since much of adult health is rooted in the earliest years, 
there is great value to including children in the PMI-Cohort 
Program. The Committee encourages NIH to ensure that through 
the process of awarding funds for the PMI-Cohort Program, that 
pediatric populations are appropriately included in the study. 
The Committee also encourages NIH to use in vitro clinical 
trials and broader phenotypic data analysis to test how a 
particular cancer or other disease conditions may react to a 
specific therapy or combination of therapies. Finally, the 
Committee directs NIH to provide a report within 6 months of 
enactment of this act assessing PMI plans to safeguard 
participants' personal data.
    Research Facilities.--Much of the Nation's biomedical 
research infrastructure, including laboratories and research 
facilities at academic institutions and nonprofit research 
organizations, is outdated or insufficient. For taxpayers to 
receive full value from their considerable investments in 
biomedical research, scientists must have access to appropriate 
research facilities. Therefore, $25,000,000 is provided for 
grants or contracts to public, nonprofit, and not-for-profit 
entities to expand, remodel, renovate, or alter existing 
research facilities or construct new research facilities as 
authorized under 42 U.S.C. section 283k. The Committee urges 
NIH to consider recommendations made by the NIH Working Group 
on Construction of Research Facilities, including making awards 
that are large enough to underwrite the cost of a significant 
portion of newly constructed or renovated facilities.
    Severe Acute Shock and Multi-Organ Failure.--There are an 
estimated 1,300,000 cases in the United States each year of 
severe, acute shock, which can trigger multi-organ failure, 
often resulting in death. Despite the number of Americans 
affected by this condition and the lack of a proven treatment 
for shock, the Committee notes that there is no dedicated 
Federal research focused on addressing these challenges. The 
Committee encourages NIH to support research to develop 
treatments for severe, acute shock, including septic shock, 
cardiogenic shock, hypovolemic shock, and hemorrhagic shock.
    Temporomandibular Disorders [TMD].--The Committee 
understands that NIH-funded research has demonstrated that TMD 
is primarily a multisystem disorder with overlapping co-morbid 
conditions influenced by multiple biological and environmental 
factors rather than solely an orofacial pain condition. 
However, diagnosis and care of patients have not changed to 
reflect this major paradigm shift. Therefore, the Committee 
strongly supports research to examine the safety and efficacy 
of current clinical treatments of TMD, the burden and costs 
associated with TMD, and the development of future scientific 
and clinical, professional and policy directions for TMD. 
Further, the Committee encourages NIH ICs with pertinent 
expertise on the temporomandibular joint to collaborate and 
implement the recommendations from the Temporomandibular Joint 
in Health and Disease Round Table held in 2013. Research to 
develop safe and effective techniques for joint repair and 
regeneration is essential. An analysis of problems associated 
with current joint replacements should provide guidance in 
these efforts.
    Transfer Authority.--The Committee does not include bill 
language requested by the administration to provide additional 
transfer authority to the Director beyond that which is already 
provided to the Secretary.
    Translational Science and Clinical Trials.--The Committee 
commends NIH's continued focus on clinical and translational 
science, but is concerned with the need to expand this work to 
geographic regions with the highest burdens of chronic disease, 
limited access to health care providers, and minority 
populations. By providing support for the necessary 
infrastructure for translational science across the spectrum 
from drug and natural product discovery to clinical trial 
implementation to community and population health, citizens 
with significant needs in these underserved regions will 
benefit. Therefore, NIH is directed to support efforts to build 
and sustain integrated clinical and translational science 
infrastructure to optimize the movement of drug and natural 
product discoveries across the translational spectrum in States 
where funding has not previously been provided, but where there 
is significant disease burden.
    Tuberous Sclerosis Complex [TSC].--The Committee is 
encouraged by progress on updating NIH's 2003 TSC Research 
Plan, including a March 2015 workshop sponsored by NINDS and 
the Tuberous Sclerosis Alliance that assessed progress and 
prioritized new opportunities for research in TSC. Building on 
this progress, the Committee encourages the Director to 
coordinate the participation of multiple ICs on a research 
strategy aimed at addressing the numerous medical and 
neuropsychological burdens associated with TSC while 
deciphering the biology underlying phenotypic heterogeneity. 
Manifestations of TSC are highly variable among affected 
individuals, and TSC can be a model condition for developing 
precision medicine approaches to treat each individual's 
symptoms to maximize the benefit-risk ratio. NIH should 
encourage research opportunities in the five key areas 
prioritized by workshop participants: understanding phenotypic 
heterogeneity in TSC, gaining a deeper knowledge of TSC 
signaling pathways and the cellular consequences of TSC 
deficiency, improving TSC disease models, developing clinical 
biomarkers for TSC, and facilitating therapeutics and clinical 
trials research.

                        BUILDINGS AND FACILITIES

Appropriations, 2016....................................    $128,863,000
Budget estimate, 2017...................................     128,863,000
Committee recommendation................................     128,863,000

    The Committee recommendation includes $128,863,000 for NIH 
buildings and facilities. This funding will remain available 
for obligation for 5 years. The Committee does not include the 
request by the administration to make funding available until 
expended.

       Substance Abuse and Mental Health Services Administration

    The Committee recommends $3,738,077,000 for the Substance 
Abuse and Mental Health Services Administration [SAMHSA]. The 
recommendation includes $134,667,000 in transfers available 
under section 241 of the PHS Act and $12,000,000 in transfers 
from the PPH Fund.
    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 continues bill language that 
instructs the Administrator of SAMHSA and the Secretary to 
exempt the Mental Health Block Grant [MHBG] and the Substance 
Abuse Prevention and Treatment [SAPT] Block Grant from being 
used as a source for the PHS evaluation set-aside in fiscal 
year 2017.

                             MENTAL HEALTH

Appropriations, 2016....................................  $1,166,987,000
Budget estimate, 2017...................................   1,158,766,000
Committee recommendation................................   1,170,037,000

    The Committee recommends $1,170,037,000 for mental health 
services. The recommendation includes $21,039,000 in transfers 
available under section 241 of the PHS Act and $12,000,000 in 
transfers from the PPH Fund. Included in the recommendation is 
funding for programs of regional and national significance 
[PRNS], the MHBG, children's mental health services, Projects 
for Assistance in Transition from Homelessness [PATH], and 
Protection and Advocacy for Individuals with Mental Illness 
[PAIMI].
Programs of Regional and National Significance
    The Committee recommends $387,659,000 for PRNS within the 
Center for Mental Health Services [CMHS]. The Committee 
recommendation includes $12,000,000 in transfers to PRNS from 
the PPH Fund. These programs address priority mental health 
needs by 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 2016  Fiscal year 2017      Committee
                      Budget activity                         appropriation        request       recommendation
----------------------------------------------------------------------------------------------------------------
CAPACITY:
    Seclusion & Restraint.................................             1,147             1,147             1,147
    Youth Violence Prevention.............................            23,099  ................  ................
    Project AWARE State Grants............................            49,902            57,001            57,001
    Mental Health First Aid...............................            14,963            14,963            14,963
    Healthy Transitions...................................            19,951            19,951            19,951
    National Traumatic Stress Network.....................            46,887            46,887            46,887
    Children and Family Programs..........................             6,458             6,458             6,458
    Consumer and Family Network Grants....................             4,954             4,954             4,954
    MH System Transformation and Health Reform............             3,779             3,779             3,779
    Project LAUNCH........................................            34,555            34,555            23,605
    Primary and Behavioral Health Care Integration........            49,877            26,004            49,877
    National Strategy for Suicide Prevention..............             2,000            30,000             2,000
    Suicide Lifeline......................................             7,198             7,198             7,198
    GLS--Youth Suicide Prevention--States.................            35,427            35,427            35,427
    GLS--Youth Suicide Prevention--Campus.................             6,488             6,488             6,488
    AI/AN Suicide Prevention Initiative...................             2,931             2,931             2,931
    Homelessness Prevention Programs......................            30,696            30,696            30,696
    Tribal Behavioral Grants..............................            15,000            15,000            15,000
    Minority AIDS.........................................             9,224            15,935             9,224
    Crisis Systems........................................  ................             5,000  ................
    Criminal and Juvenile Justice Programs................             4,269             4,269             4,269
    Assisted Outpatient Treatment.........................            15,000            15,000            15,000
 
SCIENCE AND SERVICE:
    GLS--Suicide Prevention Resource Center...............             5,988             5,988             5,988
    Practice Improvement and Training.....................             7,828             7,828             7,828
    Primary and Behavioral Health Care Integration TA.....             1,991             1,991             1,991
    Consumer & Consumer Support TA Centers................             1,918             1,918             1,918
    Minority Fellowship Program...........................             8,059             8,059             8,059
    Disaster Response.....................................             1,953             1,953             1,953
    Homelessness..........................................             2,296             2,296             2,296
    HIV/AIDS Education....................................               771               771               771
----------------------------------------------------------------------------------------------------------------

    Primary and Behavioral Healthcare Integration.--The 
Committee directs SAMHSA to require grantees of the Primary and 
Behavioral Health Care Integration program to include in their 
biannual National Outcome Measures report a summary of the 
policies that serve as barriers to the provision of integrated 
care and the specific steps the grantee has taken or will take 
to address such barriers.
    Project Aware.--The Committee strongly supports Project 
AWARE which increases awareness of mental health issues and 
connects young people that have behavioral health issues and 
their families with needed services. The Committee 
recommendation reflects the administration's proposal to 
reallocate funding from Youth Violence Prevention to Project 
AWARE. This shift will allow SAMHSA to avoid program 
duplication. The increase provided will support a new cohort of 
Project AWARE State Education Agency awards. Of the amount 
provided for Project AWARE, the Committee directs SAMHSA to use 
$10,000,000 for discretionary grants to support efforts in 
high-crime, high-poverty areas and, in particular, communities 
that are seeking to address relevant impacts and root causes of 
civil unrest. These grants should maintain the same focus as 
fiscal year 2016 grants and continue to be coordinated with the 
Department of Education grants. The Committee requests a report 
on progress of fiscal year 2016 grantees 180 days after the 
enactment of this act.
    Project Linking Actions for Unmet Needs in Children's 
Health [LAUNCH].--The Committee continues to support Project 
LAUNCH activities which promote the wellness of young children 
from birth to age 8 by addressing the physical, social, and 
emotional, cognitive, and behavioral aspects of their 
development. The Committee provides continuation funding for 
all existing grant activities.
Community Mental Health Services Block Grant
    The Committee recommends $562,571,000 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 recommendation continues bill language 
requiring that at least 10 percent of the funds for the MHBG 
program be set-aside for evidence-based programs that address 
the needs of individuals with early serious mental illness, 
including psychotic disorders. The Committee commends SAMHSA 
for its collaboration with NIMH on the implementation of this 
set-aside. The Committee notes that it usually takes 17 years 
to translate research findings into practice and hopes that 
this joint effort between NIMH and SAMHSA may be a model for 
how to reduce this timeframe. The Committee directs SAMHSA to 
continue its collaboration with NIMH to ensure that funds from 
this set-aside are only used for programs showing strong 
evidence of effectiveness and that target the first episode of 
psychosis. SAMHSA shall not expand the use of the set-aside to 
programs outside of the first episode psychosis. The Committee 
directs SAMHSA to include in the fiscal year 2018 CJ a detailed 
table showing at a minimum each State's allotment, name of the 
program being implemented, and a short description of the 
program.
Children's Mental Health Services
    The Committee recommends $119,026,000 for the Children's 
Mental Health Services program. This program provides grants 
and technical assistance to support comprehensive, community-
based systems of care for children and adolescents with serious 
emotional, behavioral, or mental disorders. Grantees must 
provide matching funds and services must be coordinated with 
the educational, juvenile justice, child welfare, and primary 
healthcare systems. The Committee has not included bill 
language requested by the administration to set aside up to 10 
percent of these funds to carry out early interventions for 
young people at high risk of developing psychosis. While the 
Committee applauds SAMHSA's focus on this population, it 
believes further evidence of effectiveness is needed before 
these interventions are widely adopted.
Projects for Assistance in Transition From Homelessness
    The Committee recommends $64,635,000 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 $36,146,000 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.

                       SUBSTANCE ABUSE TREATMENT

Appropriations, 2016....................................  $2,195,424,000
Budget estimate, 2017...................................   2,186,348,000
Committee recommendation................................   2,194,563,000

    The Committee recommends $2,194,563,000 for substance abuse 
treatment programs, including PRNS 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.
Programs of Regional and National Significance
    The Committee recommends $336,484,000 for PRNS within the 
Center for Substance Abuse Treatment [CSAT]. The recommendation 
includes $2,000,000 in transfers available under section 241 of 
the PHS Act.
    PRNS 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 2016  Fiscal year 2017      Committee
                      Budget activity                         appropriation        request       recommendation
----------------------------------------------------------------------------------------------------------------
CAPACITY:
    Opioid Treatment Programs/Regulatory Activities.......             8,724             8,724             8,724
    Screening, Brief Intervention, Referral, & Treatment..            46,889            30,000            32,000
    Target Capacity Expansion.............................            36,303            61,303            71,303
        Medicated Assisted Treatment for Prescription Drug            25,000            50,080            60,000
         and Opioid Addiction (non-add)...................
    Buprenorphine Prescribing Authority Demo..............  ................            10,000  ................
    Pregnant & Postpartum Women...........................            15,931            15,931            15,931
    Strengthening Treatment Access and Retention..........  ................  ................  ................
    Recovery Community Services Program...................             2,434             2,434             2,434
    Children and Families.................................            29,605            29,605            29,605
    Treatment Systems for Homeless........................            41,304            36,386            36,386
    Minority AIDS.........................................            65,570            58,859            65,570
    Criminal Justice Activities...........................            78,000            61,946            61,946
    Crisis Systems........................................  ................             5,000  ................
 
SCIENCE AND SERVICE:
    Addiction Technology Transfer Centers.................             9,046             8,081             9,046
    Minority Fellowship Program...........................             3,539             3,539             3,539
    Special Initiatives/Outreach..........................  ................  ................  ................
----------------------------------------------------------------------------------------------------------------

    Addiction Technology Transfer Centers [ATTCs].--The 
Committee again rejects the administration's proposal to reduce 
funding for the ATTCs and instead provides the same funding 
level as fiscal year 2016. The Committee directs SAMHSA to 
ensure that ATTCs maintain a primary focus on addiction 
treatment and recovery services.
    Combating Opioid Abuse.--Of the amount provided for 
Targeted Capacity Expansion, the Committee includes $60,000,000 
for discretionary grants to States for the purpose of expanding 
treatment services to those with heroin or opioid dependence. 
The Committee directs CSAT to ensure that these grants include 
as an allowable use the support of medication assisted 
treatment and other clinically appropriate services. These 
grants should target States with the highest age adjusted rates 
of admissions and that have demonstrated a dramatic age 
adjusted increase in admissions for the treatment of opioid use 
disorders.
    Complex Trauma.--Child traumatic stress occurs when 
children and adolescents are exposed to traumatic events or 
situations that overwhelm their ability to cope and affects 
tens of thousands of children each year. The Committee supports 
SAMHSA's current efforts in this area and encourages SAMHSA to 
explore opportunities to address the causes of complex trauma 
throughout the lifespan.
    Drug Courts.--SAMHSA is directed to ensure that all Drug 
Treatment Court funding is allocated to serve people diagnosed 
with a substance use disorder as their primary condition. 
SAMHSA is further directed to ensure that all drug treatment 
court grant recipients work directly with the corresponding 
State substance abuse agency in the planning, implementation, 
and evaluation of the grant. SAMHSA should expand training and 
technical assistance to drug treatment court grant recipients 
to ensure evidence-based practices are fully implemented.
    Medication-Assisted Therapy.--The Committee encourages 
SAMHSA to finalize regulations on prescribing buprenorphine to 
treat opioid dependence while supporting strategies to 
eliminate diversion as expeditiously as possible.
    Opioids State Targeted Response/State Targeted Response 
Cooperative Agreements.--The Committee recognizes the valuable 
work conducted by Sheriff's Departments across the country that 
have undertaken a collective effort to enhance the continuum of 
care for incarcerated individuals with substance use disorders. 
These efforts by Sheriff's Departments that have jail-operation 
powers and corrections duties serve as a critical component as 
it relates to a variety of treatment and recovery support 
services. As SAMHSA works to allocate resources for States 
grappling with the opioid crisis, the Committee encourages 
SAMHSA to consider these efforts for the Opioids State Targeted 
Response grants.
    Oral Fluid Guidelines.--The Committee is pleased with 
SAMHSA's recommendation of oral fluid as an alternative 
specimen for drug testing and commends SAMSHA for the progress 
made on issuing oral fluid guidelines for the Federal Workplace 
Drug Testing Programs. The Committee urges SAMSHA to publish 
the guidelines expeditiously and to implement the guidelines in 
partnership with stakeholders and other agencies.
    Pregnant and Postpartum Women [PPW].--The Committee 
recommendation provides the same level of funding for the PPW 
program, which supports comprehensive, family-based residential 
substance use disorder services for pregnant and parenting 
women, their minor children, and other family members. The 
Committee has not included language requested by the 
administration to support non-residential family-based services 
through innovation grants. The Committee notes that this issue 
is addressed in reauthorization legislation that is pending in 
both the House of Representatives and Senate.
    Screening, Brief Intervention, and Referral to Treatment 
[SBIRT].--The Committee is pleased that SAMHSA recently 
included language in the SBIRT Request for Proposal to allow 
grantees to focus 20 percent of the funding on individuals 
between the ages of 12 and 18 who are seeking medical services. 
This will expand opportunities for health care and youth 
service practitioners to engage young people in preventative 
conversations about substance use, as well as identify and 
address risky use before it progresses to addiction. The 
Committee expects SAMHSA to continue to encourage applicants to 
take advantage of this allowable use of funds for 12- to 18-
year-olds.
    Viral Hepatitis Screening.--The Committee applauds SAMHSA 
for encouraging grantees to screen for viral hepatitis, 
including the use of innovative strategies like rapid testing 
and urges SAMHSA to continue these efforts. The Committee notes 
the disproportionate impact of viral hepatitis among minority 
populations and the co-infection rate among individuals with 
HIV/AIDS. The Committee urges SAMHSA to work with minority AIDS 
grantees to incorporate hepatitis screening into programmatic 
activities.
Substance Abuse Prevention and Treatment Block Grant
    The Committee recommends $1,858,079,000 for the Substance 
Abuse Prevention and Treatment Block Grant [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.

                       SUBSTANCE ABUSE PREVENTION

Appropriations, 2016....................................    $211,219,000
Budget estimate, 2017...................................     211,148,000
Committee recommendation................................     225,219,000

    The Committee recommends $225,219,000 for the Center for 
Substance Abuse Prevention [CSAP], the sole Federal 
organization with responsibility for improving accessibility 
and quality of substance abuse prevention services.
    The Committee notes that youth drug use continues to be a 
major issue and that perceptions of harm are significantly 
waning. Therefore, 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 activities and 
not for any other purpose.
Programs of Regional and National Significance
    The Committee provides $225,219,000 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 2016  Fiscal year 2017      Committee
                      Budget activity                         appropriation        request       recommendation
----------------------------------------------------------------------------------------------------------------
CAPACITY:
    Strategic Prevention Framework/Partnership for Success           109,484           109,484           109,484
    Strategic Prevention Framework Rx.....................            10,000            10,000            10,000
    Grants to Prevent Prescription Drug/Opioid Overdose...            12,000            12,000            26,000
    Mandatory Drug Testing................................             4,894             4,894             4,894
    Minority AIDS.........................................            41,205            41,205            41,205
    Sober Truth on Preventing Underage Drinking (STOP Act)             7,000             7,000             7,000
        National Adult-Oriented Media Public Service                   1,000             1,000             1,000
         Campaign.........................................
        Community-based Coalition Enhancement Grants......             5,000             5,000             5,000
        ICCPUD............................................             1,000             1,000             1,000
    Tribal Behavioral Health Grants.......................            15,000            15,000            15,000
 
SCIENCE AND SERVICE:
    Fetal Alcohol Spectrum Disorder.......................  ................  ................  ................
    Center for the Application of Prevention Technologies.             7,493             7,493             7,493
    Science and Service Program Coordination..............             4,072             4,072             4,072
    Minority Fellowship Program...........................                71                71                71
----------------------------------------------------------------------------------------------------------------

    Combating Opioid Abuse.--The Committee provides $26,000,000 
for grants to prevent opioid overdose related deaths. Part of 
the initiative to Combat Opioid Abuse, this program will help 
States equip and train first responders and other community 
partners with the use of devices that rapidly reverse the 
effects of opioids. Of this amount, the Committee provides 
$8,000,000 to prevent opioid overdose-related deaths in rural 
areas. People in rural communities are especially vulnerable 
and more likely to overdose on prescription pain killers than 
people in urban areas, according to the CDC. The Committee 
encourages SAMHSA to work with HRSA in the administration of 
these resources to rural areas. The Committee directs SAMHSA to 
ensure applicants outline how proposed activities in the grant 
would work with treatment and recovery communities in addition 
to first responders. Furthermore, the Committee provides 
$10,000,000 for the Strategic Prevention Framework Rx program 
to increase awareness of opioid abuse and misuse in 
communities.
    Strategic Prevention Framework State Incentive Grant and 
Partnerships for Success.--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.
    STOP Act.--The Committee directs that all funds 
appropriated for STOP Act community-based coalition enhancement 
grants shall be used for making grants to eligible communities 
and not for any other purposes or activities.

                HEALTH SURVEILLANCE AND PROGRAM SUPPORT

Appropriations, 2016....................................    $156,306,000
Budget estimate, 2017...................................     173,886,000
Committee recommendation................................     148,258,000

    The Committee recommends $148,258,000 for Health 
Surveillance and Program Support activities. The recommendation 
includes $32,428,000 in transfers available under section 241 
of the PHS Act.
    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.
    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 2016  Fiscal year 2017      Committee
                      Budget activity                         appropriation        request       recommendation
----------------------------------------------------------------------------------------------------------------
Health Surveillance.......................................            47,258            47,258            47,258
Program Management........................................            79,559            77,559            77,000
Performance & Quality Information Systems.................            12,918            12,918            10,000
Public Awareness and Support..............................            15,571            13,482            13,000
Peer Professional Workforce Development...................  ................            10,000  ................
Minority Fellowship Program...............................  ................  ................  ................
Behavioral Health Workforce Data..........................             1,000             1,000             1,000
----------------------------------------------------------------------------------------------------------------

    Behavioral Health Workforce Education and Training.--The 
Committee transfers this program to HRSA as requested by the 
administration.
    Minority Fellowship Program.--The Committee maintains the 
separate accounts for the Minority Fellowship Programs at the 
Center for Mental Health Services, Center for Substance Abuse 
Prevention, and the Center for Substance Abuse Treatment like 
in previous fiscal years and does not consolidate them as 
proposed by SAMHSA. Therefore, funding for these programs is 
reflected in the tables for each of the centers.
    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.

               Agency for Healthcare Research and Quality

Appropriations, 2016....................................    $334,000,000
Budget estimate, 2017...................................     363,698,000
Committee recommendation................................     324,000,000

    The Committee provides $324,000,000 for the Agency for 
Healthcare Research and Quality [AHRQ]. 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.

                  HEALTH COSTS, QUALITY, AND OUTCOMES

    The Committee provides $184,279,000 for research on health 
costs, quality, and outcomes [HCQO]. 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 2016  Fiscal year 2017      Committee
                      Budget activity                         appropriation        request       recommendation
----------------------------------------------------------------------------------------------------------------
Research on Health Costs, Quality, and Outcomes:
    Prevention/Care Management............................            11,649            11,649            11,649
    Health Information Technology.........................            21,500            22,877            16,500
    Patient Safety Research...............................            74,253            75,977            74,253
    Health Services Research, Data and Dissemination......            89,398           113,474            81,877
----------------------------------------------------------------------------------------------------------------

    Antimicrobial Stewardship.--The Committee supports AHRQ's 
efforts to develop, improve, and disseminate antimicrobial 
stewardship interventions to combat the ongoing and serious 
threat of antimicrobial resistance. AHRQ is directed to work 
closely with CDC, NIH, and other Federal agencies to coordinate 
efforts to improve the use of antibiotics in humans across 
hospital and community settings.
    Consumer Assessment of Healthcare Providers and Systems 
[CAHPS].--The Committee notes that CAHPS surveys are important 
tools for patients to make more informed decisions about their 
medical care and for providers and insurers to inform quality 
improvement initiatives and incentives. Patient experience data 
in maternity care is currently not regularly and systematically 
collected. Therefore, the Committee urges AHRQ to expand its 
current set of surveys and develop a CAHPS survey for maternity 
care.
    Effective Healthcare Program.--The Committee is aware of 
AHRQ's interest in expanding the areas of focus for the Horizon 
Scanning System. The Committee believes it is equally important 
for AHRQ to improve the utility of the system by streamlining 
the processes by which it collects information and improving 
the manner and timeliness that this information is made 
available to the public. Therefore, the Committee requests a 
report from AHRQ within 90 days of enactment regarding how it 
can better accomplish these objectives.
    Health IT Safety.--The Committee recommendation includes 
$16,500,000 for AHRQ's work on safe health IT practices 
specifically related to the design, implementation, usability, 
and safe use of health IT systems. The Committee believes this 
investment will generate new evidence regarding safe health IT 
practices that will ultimately be used by ONC, FDA, CMS, and 
others to inform policy interventions.
    Healthcare-Associated Infections.--Within the Patient 
Safety portfolio, the Committee provides $37,253,000, the same 
level as in fiscal year 2016, for healthcare-associated 
infection activities. Within this funding level, the Committee 
includes $10,000,000 for activities as part of the CARB 
initiative. These funds will support the development and 
expansion of antibiotic stewardship programs specifically 
focused on ambulatory and long-term care settings. In addition, 
the Committee directs AHRQ to collaborate with NIH, BARDA, CDC, 
FDA, VA, DOD, and USDA to leverage existing resources to 
increase capacities for research aimed at developing 
therapeutic treatments, reducing antibiotic use and resistance 
in animals and humans, and implementing effective infection 
control policies.
    Healthcare Delivery Systems.--Within the Patient Safety 
portfolio, the Committee includes $10,000,000 for Healthcare 
Delivery Systems grants, or ``patient safety learning labs.'' 
The purpose of these grants is to test new ways of addressing 
entrenched patient safety issues by using a systems engineering 
approach.
    U.S. Preventative Task Force [USPSTF].--The Committee 
strongly urges the Secretary to ensure greater transparency and 
inclusion of appropriate physician experts in the development 
of USPSTF recommendations. The Committee is concerned about the 
lack of communication with relevant stakeholders and 
inconsistency with recommendations by other Federal agencies or 
organizations. Therefore, the Committee emphasizes the need for 
the USPSTF to conduct outreach to relevant stakeholders, 
including provider groups, practicing specialists that treat 
the specific disease or condition under review, and relevant 
patient and disease advocacy organization before voting on a 
draft recommendation statement. To promote greater 
transparency, the Committee urges that any final recommendation 
statement include a description of comments received on the 
draft recommendation statement and relevant recommendations of 
other Federal agencies and organizations.

                   MEDICAL EXPENDITURES PANEL SURVEYS

    The Committee provides $68,877,000 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 $70,844,000 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, 2016

                                                        $243,545,410,000

Budget estimate, 2017

                                                         262,003,967,000
Committee recommendation
                                                         262,003,967,000

    The Committee recommends $262,003,967,000 in mandatory 
funding for Grants to States for Medicaid.
    The fiscal year 2017 recommendation excludes 
$115,582,502,000 in fiscal year 2016 advance appropriations for 
fiscal year 2017. As requested by the administration, 
$125,219,452,000 is provided for the first quarter of fiscal 
year 2018.
    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, 2016

                                                        $283,171,800,000

Budget estimate, 2017

                                                         299,187,700,000
Committee recommendation
                                                         299,187,700,000

    The Committee recommends $299,187,700,000 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 $214,944,000,000 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 $82,512,000,000 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 $405,000,000 to 
be transferred to the Supplementary Insurance Trust Fund as the 
general fund share of Part D administrative expenses. The 
Committee recommendation includes $299,000,000 in 
reimbursements to the Health Care Fraud and Abuse Control 
[HCFAC] fund, which reflects the portion of the HCFAC spending 
to be reimbursed by the General Fund.

                           PROGRAM MANAGEMENT

Appropriations, 2016....................................  $3,669,744,000
Budget estimate, 2017...................................   4,109,549,000
Committee recommendation................................   3,669,744,000

    The Committee recommends $3,669,744,000 for CMS program 
management, which includes funding for research, program 
operations, survey and certification programs, and Federal 
administration.
    Research, Demonstrations and Evaluations.--The Committee 
recommends $20,054,000 for research, demonstrations, and 
evaluation activities.
Program Operations
    The Committee recommends $2,519,823,000 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.
    ACA Notifications.--The Committee continues bill language 
requiring the administration to provide detailed enrollment 
figures to the Committees on Appropriations of the House of 
Representatives and the Senate not less than two full business 
days before any public release of the information.
    Access to Mental Health Care.--The Committee continues to 
prioritize mental health treatment and services and provides an 
increase within the bill for these programs. The Committee 
provides an increase of $30,000,000 for the Mental Health Block 
Grant at SAMHSA as well as $50,000,000 to expand mental health 
services in Community Health Centers around the Nation. While 
these programs remain fundamental components of the mental and 
behavioral health system, the Committee notes that without 
access to these services, many Americans suffering from mental 
or behavioral health issues will continue to go untreated. The 
Committee strongly urges CMS to pursue initiatives that expand 
access to quality care and increase parity for mental health 
services.
    Adult Immunization Quality Measures.--The Committee is 
aware that CMS is working to close gaps in quality measures to 
improve care delivery and patient outcomes, including reducing 
racial and ethnic health disparities. Adult immunization 
quality measures are one area where more work is needed as 
noted in the August 2014, the National Quality Forum [NQF] 
report entitled ``Priority Setting for Healthcare Performance 
Measurement: Addressing Performance Measure Gaps for Adult 
Immunization''. The Committee recommends CMS partner with the 
Core Measures Collaborative and NQF's Measure Application 
Partnership to address the current gaps in adult immunization 
measures and ensure the reflect current best practices. The 
Committee requests a report from CMS no later than 18 months 
following enactment on the steps the agency has taken to expand 
and improve quality measures applicable to adult immunization 
under Medicare and Medicaid, including an action plan to 
disseminate measures to enable widespread adoption.
    Air Ambulance Services and Payment Structures.--The 
Committee directs the GAO to submit a report to the Committees 
on Appropriations of the House of Representatives and the 
Senate no later than 12 months after the enactment of this act 
on air ambulance services and payment structures. The report 
should include analysis of the following costs: maintenance of 
aircrafts; medical supplies; fuel; employee expenses; recurring 
training relating to aviation, maintenance, communication, and 
clinical; rent and utilities; communications; travel; hull and 
aviation liability insurance, life insurance, and professional 
malpractice insurance; marketing; supplies; overhead support; 
aircraft ownership expenses; safety enhancement capital costs; 
and safety enhancement recurring costs, as well as the amounts 
charged to individuals who utilize these services. The report 
should reflect regional, State, demographic, and urban/rural/
super rural differences; coverage maps for rotor and fixed 
winged services; number of providers vs. number of transports 
over the last decade broken out by year and by region; health 
plans accepted, including Medicare, Medicaid, and stand-alone 
air medical transport insurance, and type and amount of 
coverage; number of air ambulance providers that accept 
Medicare reimbursement, number of carriers that in network 
agreements with health insurance providers, and out of network 
carriers; whether health insurance, including Medicare and 
Medicaid, reimbursements cover costs and which air ambulance 
providers balance bill those receiving services; differences in 
rates, costs, and frequency for transports from accident sites 
in comparison to rates, costs, and frequency for facility-to-
facility transports; differences in emergency rates, costs, and 
frequency in comparison to non-emergency, or chartered, rates, 
costs, and frequency; evaluate costs/reimbursement rates 
relative to quality of aircraft and services provided; and 
startup costs and fixed and variable costs. Finally, the report 
should also include analysis of the disproportionate share of 
super-rural air ambulance utilization as a ratio of all super-
rural ambulance usage in comparison to rural air ambulance 
utilization as a ratio of all rural ambulance usage, including 
the factors leading to an increased super-rural proportion of 
use of air ambulance services and whether the increased use is 
justified.
    Ambulance Moratorium.--The Committee supports CMS' efforts 
to extend home health and ambulance moratoriums to curb and 
prevent waste, fraud, and abuse. The Committee encourages CMS 
to continue to ensure patients have appropriate access to care 
while weighing additional extensions.
    American Board of Interventional Pain Physicians [ABIPP].--
The ABIPP has extensive training requirements and a 
credentialing process that requires primary board certification 
from the American Board of Medical Specialties [ABMS]. The 
Committee encourages CMS to consider ABIPP specialty 
certification as equivalent to certifications recognized by 
ABMS, including, but not limited to accreditation, licensing, 
participation in Managed Care Organizations and Accountable 
Care Organizations and privileges to practice interventional 
pain management.
    Appropriate Use Criteria [AUC] for Certain Imaging 
Services.-- In section 218(b) of Public Law 113-93, Congress 
instructed CMS to promote the use of AUC for certain imaging 
services in the Medicare program. This language was intended to 
support the study and adoption of clinical decision support 
systems, which can be integrated into electronic health 
records. In seeking to implement section 218(b), the Committee 
encourages CMS to focus on consultation with clinical 
guidelines when ordering advanced imaging tests before 
instituting prior authorization. The Committee encourages CMS 
to continue to support the use of AUC by closing knowledge gaps 
with health care professionals on how to apply AUC when 
choosing an imaging text.
    Assistive Technology Act Programs Reutilization Program.--
The Committee is encouraged that several State Medicaid 
Programs have developed assistive technology and durable 
medical equipment reuse programs. These programs retrieve and 
refurbish devices that were purchased with Medicaid funds, but 
are no longer being used by Medicaid recipients or other 
sources. Refurbished equipment may be reassigned to Medicaid 
members as a priority or to other eligible individuals who are 
disabled or elderly. CMS should encourage State Medicaid 
programs to partner with State Assistive Technology Act 
Programs to develop and implement reutilization programs with a 
goal of containing Medicaid costs.
    Cancer Screening Technologies.--The Committee believes it 
is critical for Medicare beneficiaries to have access to high-
quality preventive services, including innovative cancer 
screening tests. To help maintain robust access to quality 
preventive cancer care, the Committee requests that CMS, when 
considering Medicare quality measurements, work with 
stakeholders, as appropriate, to ensure that cancer screening 
technologies are reviewed in a timely manner.
    Caregiver Counseling and Supportive Services.--The 
Committee is aware of a body of evidence that suggests defined 
counseling and supportive services delivered to family (non-
paid) caregivers of Medicare beneficiaries with Alzheimer's 
disease and dementia can substantially delay beneficiary 
placement in an institutional care setting and reduce Federal 
expenditures associated with such care. The Committee is 
concerned about the current and anticipated Medicare and 
Medicaid costs associated with Alzheimer's disease and 
recommends that CMS, in consultation with ACL, consider a pilot 
or demonstration program to evaluate the impact of such 
evidence-based Alzheimer's caregiver support models could have 
on the Medicare and Medicaid programs.
    Complex Rehabilitation Technology.--The Committee 
encourages CMS to ensure that individuals with severe 
disabilities, including those with cerebral palsy, muscular 
dystrophy, multiple sclerosis, and spinal cord injuries, who 
are entitled to Medicare benefits have adequate information on 
how to access complex rehabilitation technology that 
appropriately addresses their unique needs.
    Critical Access Hospitals [CAH].--The Committee is 
disappointed that the administration continues to propose 
eliminating CAH status from facilities located less than 10 
miles from another hospital and reducing the reimbursement rate 
from 101 percent to 100 percent of reasonable cost. A recent 
Health Affairs study reviewed the impact of similar minimum 
distance requirements and found that currently 37.6 percent of 
CAHs had a negative operating margin, and if such a distance 
requirement went into effect, it would rise to 75.6 percent. If 
a CAH lost its designation, it would be forced under the 
applicable prospective payment systems which are designed for 
larger facilities, not small, low volume rural hospitals. The 
results of the study underscore the importance of factoring 
clinical expertise, physician distribution, availability of 
telehealth, sufficient volume to maintain key services, and the 
needs of underserved populations. Coupled with over regulation, 
decreased reimbursements, and workforce shortages, CAHs would 
be forced to close without their designation, causing patients 
to travel farther, forego preventative care, and ultimately 
cost more in CMS healthcare expenditures.
    CT Colongraphy.--Due to the proven life and cost-savings of 
preventative screening for colorectal cancer, the Committee 
encourages CMS to consider covering CT Colonography as a 
Medicare-covered colorectal cancer screening test under section 
1861(pp)(1) of the Social Security Act.
    Diabetes Technologies.--Diabetes technologies known as 
continuous glucose monitors [CGM] have been shown in clinical 
trials to improve health care outcomes of people with type 1 
diabetes and reduce the risk of low blood sugar emergencies 
which can lead to hospitalizations. These technologies are 
recommended by national diabetes guidelines and covered by 95 
percent of private health plans. Medicare, however, does not 
cover CGM technologies, leaving seniors vulnerable. The 
Committee encourages Medicare to modernize its policies to 
cover CGM technologies to ensure access for those with type 1 
diabetes or those entering Medicare who have benefitted from 
the technology under their prior health plan.
     Electrodiagnostic Tests.--The Committee requests an update 
from CMS submitted to the Committees on Appropriations of the 
House of Representatives and the Senate on the three 
recommendations proposed by the 2014 OIG Report: ``Questionable 
Billing for Medicare Electrodiagnostic Tests''.
    Evaluation and Management Research.--The Committee 
recognizes that both traditional and innovative payment models 
rely on traditional fee-for-service as a foundation for 
physician payment. The existing outpatient evaluation and 
management service codes do not adequately capture the range of 
outpatient evaluation and management work performed by 
cognitive physicians. The Committee encourages CMS to 
commission the research necessary to understand, on the basis 
of newly collected data, what occurs during and following an 
outpatient evaluation and management service. Once complete, 
CMS should use these findings to develop new outpatient service 
codes and the associated documentation requirements. This 
research model can then be used to revise the other evaluation 
and management code families. The Committee expects a report 
submitted to the Committees on Appropriations of the House of 
Representatives and the Senate on the status of this research 
in the fiscal year 2018 CJ.
    Graduate Medical Education [GME].--Communities throughout 
the country, particularly those in rural areas, struggle with 
physician shortages, particularly with access to primary care 
and mental health care. GME serves as the final step in a 
physician's training, and Medicare provides the majority of 
public financing for GME. The Committee is concerned that 
current public financing for GME does not adequately address 
the needs of all communities or the changing demands of the 
health care system. The Committee directs CMS to submit a 
report to Congress, no later than 180 days after the enactment 
of this act, on what steps can be taken under current law to 
address physician shortages.
    Health Insurance Exchange Transparency.--The Committee 
continues bill language that requires CMS to provide cost 
information for the following categories: Federal Payroll and 
Other Administrative Costs; Exchange related Information 
Technology [IT]; Non-IT Program Costs, including Health Plan 
Benefit and Rate Review, Exchange Oversight, Payment and 
Financial Management, Eligibility and Enrollment; Consumer 
Information and Outreach, including the Call Center, Navigator 
Grants and Consumer Education and Outreach; Exchange Quality 
Review; Small Business Health Options Program [SHOP] and 
Employer Activities; and Other Exchange Activities. Cost 
Information should be provided for each fiscal year since the 
enactment of the Patient Protection and Affordable Care Act 
(Public Law 111-148). CMS is also required to include the 
estimated costs for fiscal year 2018.
    Home Dialysis.--The Committee encourages CMS to review, 
streamline, and update the Medicare Administrative Contractor 
waiver requirements to incorporate a fair and transparent 
process to granting waivers for use of remote monitoring and 
management technologies. The Committee requests a report on the 
status of the review and update process within 180 days of the 
enactment of this act.
    Intrathecal Pain Pumps.--The Committee is concerned that 
recent changes to Medicare billing practice may restrict 
patient access to intrathecal pain pumps as an option for pain 
management in States where the boards of pharmacy prohibit sale 
of compounded solutions from a pharmacist to a physician. 
Therefore, the Committee directs the Secretary, in consultation 
with relevant stakeholders, to conduct a study of the effect of 
this billing practice change on patient access in these States. 
The Secretary shall submit the report within 6 months after 
enactment of this act to the Committees on Appropriations of 
the House of Representatives and the Senate with 
recommendations rectifying any identified limits to patient 
access to intrathecal pain pump medication.
    Medicare Advantage.-- The Committee is concerned that the 
formula to determine Medicare Advantage reimbursement rates is 
calculated based on the per capita cost of coverage to 
beneficiaries enrolled in Medicare Part A and/or Part B. 
However, where there is high enrollment in Medicare Advantage, 
a relatively large proportion of Medicare beneficiaries without 
Part B coverage, and relatively lower fee-for-service costs, 
Medicare Advantage reimbursement rates may be better based on 
the per capita cost of coverage to beneficiaries enrolled in 
both Medicare Parts A and B. The Committee encourages CMS to 
consider more accurate adjustments for fiscal year 2018.
    Out of Network Emergency Care.--The Committee believes that 
beneficiary protections are important to reduce the financial 
exposure of patients who receive emergency care outside of 
their insurance network. The Committee is concerned that the 
Center for Consumer Information and Insurance Oversight [CCIIO] 
has not provided sufficient clarity on how to determine the 
``Usual, Customary & Reasonable'' [UCR] amount and encourages 
that CCIIO publish clarifying guidance.
    Part D Billing of Vaccines.--The Committee is aware that 
Medicare Part B covers vaccines for several serious vaccine-
preventable diseases, including influenza, pneumonia, and 
Hepatitis B for at-risk patients. However, a growing number of 
other vaccines are only covered under Medicare's pharmacy 
benefit, which can be challenging and burdensome for Part B 
providers to bill. This can impede beneficiary access to the 
full complement of vaccines recommended by the Advisory 
Committee on Immunization Practices. The Committee encourages 
CMS to prioritize the establishment and deployment of a Web-
based system to facilitate access to information regarding Part 
D coverage criteria for vaccines and streamline billing for 
Part D vaccines. Such a system should reduce administrative 
burdens by enabling physicians to search plan coverage and 
allow electronic submission claims for vaccines and vaccine 
administration directly to Part D plans. The Committee requests 
a report within 1 year of enactment submitted to the Committee 
detailing implementation, including health care professional 
education efforts among health care professionals and 
utilization rates of recommended Part D vaccines among Medicare 
beneficiaries.
    Pre-Dispute Arbitration SNF.--The Committee is aware that 
CMS has proposed regulations that would restrict or prohibit 
pre-dispute arbitration agreements in skilled nursing 
facilities. The Committee urges CMS to more thoroughly study 
the impact of restricting pre-dispute arbitration agreements 
before taking further action.
    Prosthetic Coverage.--The Committee recognizes that 
Medicare payments for all prosthetics, and especially the newer 
advanced technologies, have declined over each of the years 
2010-2014. The Committee encourages CMS to consult broadly with 
clinicians, patient groups, and the prosthetics field regarding 
revisions to the draft Local Coverage Determination, prior to 
publishing an updated draft policy for public comment.
    Recovery Audit Contractors [RAC].--The Committee directs 
the Medicare appeals intra-agency working group to provide 
quarterly updates to the Committees on Appropriations of the 
House of Representatives and the Senate reflecting the total 
number of appeals filed, appeals pending, and appeals disposed 
of for all four levels of the appeals process. The quarterly 
updates should include a breakout of RAC and non-RAC claims, an 
update on RAC contracting and how new RAC requirements have 
affected the rate of appeals.
    Relative Values Under the Medicare Physician Fee 
Schedule.--The Committee encourages the Secretary to increase 
the representation of actively practicing board certified 
primary care physicians on any advisory board, working group, 
task force or panel that is charged with formulating 
recommendations to any annual updates involving physician work 
standards.
    Risk Corridor Program.--The agreement continues bill 
language to prevent the CMS Program Management appropriation 
account from being used to support risk corridor payments. The 
agreement directs CMS to provide a report starting with plan 
year 2014 and continuing through the duration of the program to 
the Committees on Appropriations of the House of 
Representatives and the Senate detailing the receipts and 
transfer of payments for the Risk Corridor Program.
    Robotic Stereotactic Radiosurgery.--The Committee was 
encouraged by CMS' decision to reverse the National Correct 
Coding Initiative [NCCI] procedure edit regarding the provision 
of robotic radiosurgery. With this decision, CMS recognizes the 
safety and value of dosimetry calculations in radiation 
oncology. However, the Committee remains concerned that the 
cuts to robotic stereotactic radiosurgery threatens its 
viability in both the hospital and freestanding center setting. 
The Committee encourages CMS not to make further changes to 
these services in the freestanding center as CMS complies with 
Public Law 114-115.
    Rural Health.--While nearly a quarter of the U.S. 
population lives in rural areas, access to CAHs continues to be 
a challenge for many residents as these hospitals face 
significant financial challenges. The majority of rural 
residents are older, poorer, and less likely to have employer 
sponsored health plans. As a result, if a rural hospital 
closes, many patients end up driving long distances to see a 
doctor, forgo seeking medical care, or even worse, wait until 
it is too late to seek proper medical attention. These patients 
spend more money out of pocket to travel and miss out on 
routine preventative care which will end up increasing 
healthcare costs in the long run. The Committee continues to 
direct CMS to work with HRSA's Office of Rural Health and 
provide an update in the fiscal year 2018 CJ on actions taken 
to alleviate the disproportionate impact of regulations, 
reimbursement cuts, and workforce issues on rural hospitals.
    Smart Medicare Card.--The Committee encourages CMS to 
continue to explore smart card technology for Medicare 
beneficiaries and providers to increase quality of care, reduce 
identity theft, and increase the accuracy of Medicare billing.
    Third Party Premium Assistance.--The Committee remains 
concerned that CMS guidance on qualified health plan third 
party payment remains unclear and is being interpreted as 
prohibiting premium assistance by nonprofit organizations. CMS 
is encouraged to continue to clarify language and consider 
outlining specific instances when third-party payment premium 
assistance should be accepted.
    Use of Opioid Drugs to Manage Chronic Pain.--The Committee 
understands that opioid pain medications are used and are often 
essential in the appropriate management of acute and chronic 
pain. Given the national problem of misuse and abuse of 
prescription opioid pain medications, the Committee encourages 
CMS to increase awareness of alternative pain management 
strategies to opioids to reduce opioid monotherapy in 
appropriate cases.
    Use of Social Security Numbers on Medicare Beneficiaries' 
Cards.--Under Public Law 114-10, Congress prohibits the use of 
Social Security numbers on Medicare beneficiary cards. The 
Committee urges CMS to work expeditiously to remove Social 
Security numbers from Medicare cards as directed in Public Law 
114-10. The Committee directs CMS to provide an update on the 
progress of this initiative in their fiscal year 2018 CJ.
    Vial Size.--Within 90 days of enactment of this act, CMS 
shall enter into an agreement with the Health and Medicine 
Division of the National Academies of Sciences, Engineering, 
and Medicine [the Academies] to conduct a study on the Federal 
healthcare costs, safety, and quality concerns associated with 
discarded drugs that results from weight-based dosing of 
medicines contained in single-dose vials. As part of this 
study, the Academies should assess factors such as patient 
safety; storage/shipping issues; FDA guidance; CDC guidelines 
to biopharmaceutical manufacturers; and the Federal cost of 
discarded drugs. Stakeholders, including CMS, FDA, CDC, DOD, 
IHS, VA, specialty physicians [including rural practitioners], 
specialty clinics [including rural clinics], patient groups, 
biopharmaceutical manufacturers, health insurance companies, 
and healthcare distributors/wholesalers shall be consulted. The 
Committee directs this report, which shall include 
recommendations to Congress, to be submitted to the Committees 
on Appropriations of the House of Representatives and the 
Senate no later than 12 months after the contract date.
State Survey and Certification
    The Committee recommends $397,334,000 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.
    The Committee continues to support CMS collecting and 
analyzing the findings from this surveillance tool to inform 
the agency's education and surveillance efforts moving forward.
Federal Administration
    The Committee recommends $732,533,000 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, 2016....................................    $681,000,000
Budget estimate, 2017...................................     725,000,000
Committee recommendation................................     725,000,000

    The Committee recommends $725,000,000, to be transferred 
from the Medicare trust funds, for Health Care Fraud and Abuse 
Control [HCFAC] activities. The latest data demonstrate for 
every $1.00 spent on fraud and abuse, $2 is recovered by the 
Treasury. By utilizing the cap adjustment provided in the 
Budget Control Act, the Committee recommendation will create 
over $10,200,000,000 in savings to the U.S. Treasury over 10 
years.
    The Committee recommendation includes a base amount of 
$311,000,000 and an additional $414,000,000 through a budget 
cap adjustment authorized by section 251(b) of the Balanced 
Budget and Emergency Deficit Control Act of 1985.
    Senior Medicare Patrol Program.--The bill includes language 
to fully fund the Senior Medicare Patrol Program administered 
through the Administration for Community Living from the level 
provided in this account.

                Administration for Children and Families


  PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY SUPPORT 
                                PROGRAMS

Appropriations, 2016....................................  $2,944,906,000
Budget estimate, 2017...................................   3,010,631,000
Committee recommendation................................   3,010,631,000

    The Committee recommendation includes $3,010,631,000 in 
fiscal year 2017 mandatory funds for Child Support Enforcement 
and Family Support programs. In addition, the Committee 
recommends $1,400,000,000 in advance funding for the first 
quarter of fiscal year 2018.
    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, 2016....................................  $3,390,304,000
Budget estimate, 2017...................................   3,000,304,000
Committee recommendation................................   3,390,304,000

    The Committee recommendation includes $3,390,304,000 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.

                     REFUGEE AND ENTRANT ASSISTANCE

Appropriations, 2016....................................  $1,674,691,000
Budget estimate, 2017...................................   2,249,860,000
Committee recommendation................................   1,674,691,000

    The Committee recommends $1,674,691,000 for Refugee and 
Entrant Assistance programs. These programs provide a variety 
of benefits and services to refugees, asylees, Cuban and 
Haitian entrants, immigrants arriving on Special Immigrant 
Visas, trafficking victims, and torture victims (collectively 
referred to below as ``refugees''). These programs also provide 
temporary care and services for unaccompanied children 
apprehended by the Department of Homeland Security or other law 
enforcement agencies, who have no lawful immigration status in 
the United States until they can be placed with a parent, 
guardian, or other sponsor while awaiting adjudication of their 
immigration status.
Transitional and Medical Services
    The Committee recommendation includes $490,000,000 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 arriving refugees, as 
well as foster care services to unaccompanied minors.
    The Committee notes that there is considerable uncertainty 
in the estimates of costs for this program, which depend 
heavily on the number of refugees admitted and entering the 
United States, as well as estimates of financial, medical, and 
foster care costs of arriving refugees. In addition, there are 
significant prior-year unobligated balances available within 
ORR that may be used for the TAMS program. Congress has 
provided extended availability for funds appropriated in this 
account specifically to account for uncertainties in this 
program. The Committee will consider future funding needs as 
more data becomes available.
Victims of Trafficking
    The Committee recommendation includes $18,755,000 for 
Victims of Trafficking programs. These programs support a 
national network of organizations that provide a variety of 
services--including case management, counseling, benefit 
coordination, and housing assistance--for victims of commercial 
sex and forced labor trafficking.
    Within the total, the Committee recommendation includes 
$13,000,000 for services for foreign national victims, and 
$5,755,000 to improve services available for U.S. citizens and 
legal permanent residents, the same as the fiscal year 2016 
funding levels. The Committee recommendation also includes 
continued funding for a national human trafficking resource 
center, and includes bill language clarifying that funds can 
continue to be used for these activities.
Social Services
    The Committee recommendation includes $155,000,000 for 
Social Services programs for refugees. These funds include both 
formula and discretionary grants to States and nonprofit 
organizations to provide a variety of employment and support 
services to recently arrived refugees.
    Preferred Communities.--The Committee is encouraged that 
ORR integrates long-term intensive case management services for 
vulnerable refugee populations and secondary migrants through 
the Preferred Communities Program. Extended case management 
services help to ensure refugees achieve self-sufficiency and 
integrate into their new communities.
Preventive Health
    The Committee recommendation includes $4,600,000 for 
Preventive Health services for refugees. This program funds 
competitive grants to States to provide newly arrived refugees 
health orientation and education services, referrals for 
medical and mental health services, and access to ongoing 
healthcare.
Targeted Assistance
    The Committee recommendation includes $47,601,000 for the 
Targeted Assistance program. This program provides additional 
funds to States and counties with the greatest number of 
refugee arrivals and high concentrations of refugees facing 
difficulties achieving self-sufficiency.
Unaccompanied Children
    The Committee recommendation includes $948,000,000 for the 
Unaccompanied Children [UC] program. The UC program provides 
temporary shelter and basic services to children who have no 
lawful immigration status in the United States and who have 
been apprehended in the United States by the Department of 
Homeland Security or other law enforcement agencies without a 
parent or guardian. HHS takes custody of the children until 
they can be placed with a parent or guardian living in the 
United States pending resolution of their immigration status, 
or until their immigration status otherwise changes.
    Similar to the TAMS program, there is considerable 
uncertainty in the estimates of costs for this program, which 
depend heavily on the number of unaccompanied children coming 
to the United States and referred to HHS. There are also 
significant prior-year unobligated balances available for use 
under this program that may be used in fiscal year 2016 and 
2017. The amount of unobligated balances available in fiscal 
year 2017, which will directly impact the amount of new budget 
authority needed for fiscal year 2017, will depend on costs in 
fiscal year 2016, for which there is also considerable 
uncertainty. The Committee will consider future funding needs 
for this program as more data becomes available.
    The Committee notes that HHS is responsible for providing 
post-release services, including home visits, for certain 
children it places with a sponsor pending adjudication of their 
immigration status. The Committee strongly encourages HHS to 
continue efforts to improve its process for providing post-
release services to ensure that children are placed in safe, 
appropriate environments.
Victims of Torture
    The Committee recommendation includes $10,735,000 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, 2016....................................  $2,761,000,000
Budget estimate, 2017...................................   2,961,672,000
Committee recommendation................................   2,786,000,000

    The Committee recommends $2,786,000,000 for the Child Care 
and Development Block Grant [CCDBG], a formula grant to States 
that provides financial assistance to families to help pay for 
child care, and otherwise improve the quality of child care 
programs.
    The CCBDG Act of 2014 included a new set-aside requiring 
States to reserve a specified percentage of funding for 
improving the quality of infant and toddler child care. This 
replaces a similar set-aside previously included in 
appropriations language. Accordingly, the Committee 
recommendation removes the set-aside previously included in 
appropriations language.

                      SOCIAL SERVICES BLOCK GRANT

Appropriations, 2016....................................  $1,700,000,000
Budget estimate, 2017...................................   1,700,000,000
Committee recommendation................................   1,700,000,000

    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.

                CHILDREN AND FAMILIES SERVICES PROGRAMS

Appropriations, 2016.................................... $11,234,268,000
Budget estimate, 2017...................................  11,725,057,000
Committee recommendation................................  11,214,935,000

    The Committee recommends $11,214,935,000 for Children and 
Family Services programs. These funds support a variety of 
programs for children, youth, and families; Native Americans; 
victims of child abuse, neglect, and domestic violence; and 
other vulnerable populations.
    The Committee directs the Department, in conjunction with 
the Department of Education, to conduct the review of all 
federally funded early childhood education programs required by 
section 9213 of the Every Student Succeeds Act, to develop a 
plan for the elimination of overlapping programs, determine if 
activities conducted by States using grant funds from Race to 
the Top and Preschool Development Grants have led to a better 
utilization of resources, and make recommendations to Congress 
for streamlining all such programs.
Head Start
    The Committee recommendation includes $9,203,095,000 for 
Head Start. Head Start provides grants directly to local 
organizations to provide comprehensive early childhood 
education services to children and their families, from before 
birth to age 5.
    The Committee recommendation includes a $35,000,000 
increase to support increases for all current Head Start 
programs which will help programs keep up with costs, recruit 
and support highly qualified staff, maintain enrollment levels, 
and continue to provide high-quality, comprehensive services 
for children and families.
    Within the total for Head Start, in addition to funds 
otherwise available for Early Head Start, the Committee 
recommendation includes $635,000,000, the same as the fiscal 
year 2016 level, to support the continuation of Early Head 
Start Expansion and Child Care Partnerships grants. The 
Committee continues to direct HHS to give equal priority to 
grantees providing more traditional Early Head Start services 
and those forming child care partnerships. The Committee 
continues to support this partnership model but such 
partnerships will not be viable in every community and in many 
places it may be more appropriate to simply provide traditional 
Early Head Start services.
    Within the total for Head Start, the Committee 
recommendation also includes up to $25,000,000, the same as the 
comparable fiscal year 2016 level and the budget request, for 
transition-related costs associated with the Head Start 
Designation Renewal System [DRS]. HHS is in the process of 
evaluating the DRS, including its validity, its sensitivity in 
differentiating lower performing programs from higher 
performing programs, and its role in improving the quality of 
Head Start programs. The Committee looks forward to the results 
of this evaluation. In addition, the Committee encourages HHS 
to continue to consider the unique challenges faced by Head 
Start grantees in remote and frontier areas when reviewing such 
grantees' compliance with health and dental screening 
requirements as part of the DRS.
    The Committee continues to support efforts to expand the 
duration of Head Start services. Research increasingly 
indicates that expanding the duration of services, including 
lengthening the school day and school year, is critical to 
increasing and sustaining the benefits of early childhood 
programs. However, the Committee directs HHS to ensure that as 
part of the effort to expand the duration of services, grantees 
continue to have flexibility to meet the needs of their local 
community, and to fund other quality improvement activities 
that may be necessary to improve the quality of programs prior 
to expanding the duration of services.
Preschool Development Grants
    The Committee recommendation includes $250,000,000 for 
Preschool Development Grants. The Every Student Succeeds Act 
moves this program from the Department of Education to HHS, and 
the Committee recommendation is consistent with that move. 
Funding for Preschool Development Grants in fiscal year 2016 is 
shown in HHS for comparability.
    The Preschool Development Grants program provides 
competitive grants to States to develop or expand preschool 
programs for 4-year olds from low- and moderate-income 
families. This fiscal year 2017 funding will support the 
continuation costs for the fourth and final year of existing 
State grants.
Consolidated Runaway and Homeless Youth Program
    The Committee recommendation includes $101,980,000 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.
Education and Prevention Grants To Reduce Sexual Abuse of Runaway Youth
    The Committee recommendation includes $17,141,000 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 $25,310,000 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 $33,000,000 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 $39,764,000 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.
Child Welfare Services
    The Committee recommendation includes $268,735,000 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 $17,984,000 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.
    National Survey of Child and Adolescent Well-Being.--The 
Committee recommendation includes funding within this program 
for HHS to continue the National Survey of Child and Adolescent 
Well-Being. This survey provides critical, nationally 
representative, longitudinal data on children who have been 
involved in State child protective services programs. This 
helps examine the current characteristics and needs of children 
and families involved with child protective services, and 
evaluate the impact of interventions to improve child and 
family well-being.
Adoption Opportunities
    The Committee recommends $39,100,000 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.
    The Committee encourages ACF to fund activities to improve 
hospital-based adoption support services for pregnant and 
expectant mothers, including training for hospital staff and 
doctors. Such activities would help ensure that mothers who 
wish to make an adoption have access to trained staff and 
comprehensive supports throughout the adoption process.
Adoption Incentives
    The Committee recommends $37,943,000 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 $6,512,000 for Social Services and 
Income Maintenance Research. 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.
Native American Programs
    The Committee recommends $50,000,000 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 Native 
American language nests and survival schools, as authorized by 
sections 803C(b)(7)(A)-(B) of the Native American Programs Act. 
The Committee directs HHS to give priority to programs with the 
most rigorous immersion programs.
Community Services Block Grant
    The Committee recommendation includes $715,000,000 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.
Community Economic Development
    The Committee recommendation does not include funding for 
the Community Economic Development [CED] program, as proposed 
by the administration. The President's budget proposed 
eliminating this program because it is similar or duplicative 
of programs administered by other agencies, including the 
Department of Treasury.
Rural Community Facilities
    The Committee recommendation does not include funding for 
the Rural Community Facilities program, as proposed by the 
administration. The President's budget proposed eliminating 
this program because it is similar or duplicative of programs 
administered by other agencies, including the Department of 
Agriculture and Environmental Protection Agency.
Assets for Independence
    The Committee recommendation does not include funding for 
the Assets for Independence program. This program was created 
in 1998 as a demonstration program to test the impact of 
individual development accounts on a range of outcomes for low-
income individuals and families.
National Domestic Violence Hotline
    The Committee recommendation includes $8,250,000 for the 
National Domestic Violence Hotline. This national, toll-free 
hotline provides critical emergency assistance and information 
to victims of domestic violence 24 hours a day.
Family Violence Prevention and Services
    The Committee recommendation includes $151,000,000 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.
Chafee Education and Training Vouchers
    The Committee recommendation includes $43,257,000 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 $1,864,000 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 to identify needed 
assistance, and providing ongoing support and monitoring 
through the recovery process.
Program Administration
    The Committee recommendation includes $205,000,000 for the 
Federal costs of administering ACF programs.

              CHILDREN'S RESEARCH AND TECHNICAL ASSISTANCE

Appropriations, 2016....................................................
Budget estimate, 2017...................................     $10,000,000
Committee recommendation................................................

    The Committee recommendation does not include new 
discretionary funding for Children's Research and Technical 
Assistance. This program receives dedicated mandatory funding 
to carry out authorized activities.

                   PROMOTING SAFE AND STABLE FAMILIES

Appropriations, 2016....................................    $404,765,000
Budget estimate, 2017...................................     424,765,000
Committee recommendation................................     384,765,000

    The Committee recommends $384,765,000 for the Promoting 
Safe and Stable Families program. The Committee recommendation 
includes $325,000,000 in mandatory funds authorized by the 
Social Security Act and $59,765,000 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.
    The Committee notes that the authorization for Promoting 
Safe and Stable Families expiries in fiscal year 2016. 
Mandatory funding for certain activities within this account 
are not assumed to continue in the CBO baseline. Accordingly, 
the Committee recommendation does not include funding for those 
activities.

                PAYMENTS FOR FOSTER CARE AND PERMANENCY

Appropriations, 2016....................................  $5,298,000,000
Budget estimate, 2017...................................   5,764,000,000
Committee recommendation................................   5,764,000,000

    The Committee recommends $5,764,000,000 in mandatory funds 
for Payments for Foster Care and Permanency. In addition, the 
Committee recommends $2,500,000,000 in advance mandatory 
funding for the first quarter of fiscal year 2018. These funds 
support programs that assist States with the costs of 
maintaining eligible children in foster care, prepare children 
for living on their own, assist relatives with legal 
guardianship of eligible children, and find and support 
adoptive homes for children with special needs.
    The Committee notes that older youth in the foster care 
system or aging out of the foster care system have extremely 
high rates of homelessness. There are many steps that State and 
local child welfare agencies can take to help prevent 
homelessness for these youth, and to help prevent child abuse 
and neglect, including extending foster care payments for youth 
up to age 21 and better coordinating with programs supported by 
the Department of Housing and Urban Development, the Department 
of Labor, and the Department of Education. The Committee 
strongly encourages HHS to provide States and localities with 
guidance and examples of best practices for using extended 
foster care payments to help maintain housing stability. The 
Committee further encourages HHS to develop, in coordination 
with the U.S. Interagency Council on Homelessness, 
comprehensive guidance on transition planning for youth exiting 
the foster care system including lessons from the Youth At Risk 
of Homelessness Planning Grants; best practices regarding 
seeking legal permanency and permanent connections to caring 
adults for youth nearing the end of eligibility for foster 
care; example transition plans; and guidance about the Federal 
funding sources available to assist with the transition process 
for youth exiting foster care including housing and supportive 
services such as tenancy supports, basic living skills 
development, behavioral health, and connections to education 
and employment. The Committee directs HHS to report to the 
House and Senate Committees on Appropriations within 120 days 
of enactment of this act on the actions it has taken, as well 
as future actions it will undertake, to implement these 
directives.
    Ensuring Timely Mental Health Screenings and Assessments 
for Children in Foster Care.--The Committee strongly encourages 
HHS to provide guidance to States to improve mental health 
screenings and services for children in foster care. 
Specifically, the Committee strongly encourages HHS to require, 
as part of the State plan required under section 422 of the 
Social Security Act, that a child receives an initial health 
screening within 30 days of entry into foster care and, if an 
initial mental health issue is identified, the child receives a 
comprehensive assessment in mental health within 60 days.

                  Administration for Community Living


                 AGING AND DISABILITY SERVICES PROGRAMS

Appropriations, 2016....................................  $1,992,550,000
Budget estimate, 2017...................................   2,020,994,000
Committee recommendation................................   1,935,435,000

    The Committee recommends an appropriation of $1,935,435,000 
for the Administration for Community Living [ACL]. The 
Committee recommendation also includes $27,700,000 to be 
transferred to ACL from the PPH Fund.
    ACL was created with the goal of increasing access to 
community support 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.
    The Committee understands that ACL has proposed to expand 
the administrative capacity of the formula grant programs by 
transferring up to 2 percent from the State grants to support 
new staff. The Committee recognizes that this additional 
capacity may enhance program oversight and performance. 
However, the Committee is concerned about the disproportionate 
impact the transfer may have on grantees in the smaller formula 
programs, particularly those authorized under the Development 
Disabilities Assistance and Bill of Rights Act. The Committee 
urges ACL to more thoughtfully examine the impact of the 
proposed transfer on the smaller programs before taking further 
action.
Home- and Community-Based Supportive Services
    The Committee recommends an appropriation of $347,724,000 
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. The Committee 
directs ACL to work with States to prioritize innovative 
service models, like naturally occurring retirement communities 
[NORCs], which help older Americans remain independent as they 
age. The Committee notes that NORCs, and similar settings, are 
a more cost-effective alternative to long-term care that 
enables older Americans to be more engaged in their communities 
while living at home.
Preventive Health Services
    The Committee recommends $19,848,000 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 $20,658,000 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.
National Family Caregiver Support Program
    The Committee recommends $150,586,000 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 $7,531,000 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 $448,342,000 
for congregate nutrition services and $226,342,000 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 $160,069,000 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 USDA.
Aging Grants to Indian Tribes and Native Hawaiian Organizations
    The Committee recommends $26,158,000 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 $9,961,000 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.
    Within funding for the Aging Network Support Activities, 
the Committee supports the continuation of the National 
Alzheimer's Call Center, which is available in all States, 24-
hours a day, 7 days a week, year-round, to provide expert 
advice, crisis counseling, care consultation and information 
referral services in at least 140 languages, for persons with 
Alzheimer's disease, their family members and informal 
caregivers.
    The Committee also includes $2,500,000 to help provide 
supportive services for aging Holocaust survivors in the United 
States.
Alzheimer's Disease Demonstration Grants to States
    The Committee recommendation includes $4,800,000 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 $3,360,000 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 $8,000,000 be transferred from the 
PPH Fund to ACL for the Chronic Disease Self-Management Program 
[CDSMP]. This program assists those with chronic disease manage 
their conditions and improve 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 $5,000,000 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.
Elder Rights Support Activities
    The Committee recommends $13,874,000, an increase of 
$2,000,000 above fiscal year 2016, for Elder Rights Support 
activities, including $10,000,000 for the Elder Justice 
Initiative. These activities support programs that provide 
information, training, and technical assistance to legal and 
aging services organizations in order to prevent and detect 
elder abuse and neglect.
    Elder Justice Initiative.--The Committee is aware of the 
work being carried out by the Elder Justice Coordinating 
Council [EJCC], where the Department is a permanent member, and 
remains supportive of efforts to help protect older adults from 
all forms of abuse, including through increasing public 
awareness to occurrences of elder abuse and the dissemination 
of information about how members of the public may obtain 
services. Through the work of the EJCC, the Committee 
encourages the Department of Justice to work with the Secretary 
of the HHS, and other relevant agencies, to develop a national 
elder justice awareness campaign.
Aging and Disability Resource Centers
    The Committee recommendation includes $6,119,000 for Aging 
and Disability Resource Centers [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
    Due to budget constraints, the Committee recommendation 
does not include funding for the State Health Insurance 
Assistance Program. The Committee expects ACL, in coordination 
with CMS and States, to continue to provide accurate and 
understandable health insurance information to Medicare 
beneficiaries and their families through existing HHS programs 
that support these activities.
Paralysis Resource Center
    The Committee recommendation includes $7,700,000 for the 
Paralysis Resource Center, which provides comprehensive 
information and referral services to people living with 
paralysis and their families. These resources and services 
focus on the promotion of independence and quality of life for 
the over 6,000,000 Americans living with paralysis.
Limb Loss
    The Committee provides $2,810,000 for the Limb Loss 
program, which supports programs and activities to improve the 
health of people with limb loss and promote their well-being, 
quality of life, prevent disease, and provide support to their 
families and caregivers.
Traumatic Brain Injury
    The Committee provides $9,321,000 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 not less than the fiscal year 2016 
funding level for protection and advocacy services, as 
authorized under section 1305 of Public Law 106-310.
Developmental Disabilities State Councils
    The Committee recommendation includes $73,000,000 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 $38,734,000 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 that 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 $4,963,000 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 $10,000,000 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.
    Technical Assistance.--The Committee provides $575,000 for 
technical assistance and training for the State Councils on 
Developmental Disabilities.
    Transportation.--The Committee includes $1,000,000 to fund 
transportation assistance activities for older adults and 
persons with disabilities. These activities should focus on the 
most cost-effective and sustainable strategies that can be 
replicated to other communities. The Committee is pleased with 
the Inclusive Community Transportation program's efforts to 
integrate rural transit systems for individuals with 
disabilities and older adults to access health care services, 
paratransit, multiple transportation providers, and other 
critical community based supports. These small community 
demonstration grants should be designed to include the 
perspectives of individuals with disabilities and older adults 
in the transportation system and service design.
University Centers for Excellence in Developmental Disabilities
    The Committee recommendation includes $38,619,000 for the 
University Centers for Excellence in Developmental Disabilities 
[UCEDDs], a network of 67 centers that are interdisciplinary 
education, research and public service units of a university 
system or public or nonprofit entities associated with 
universities. The funding will keep the national network of 
Centers strong and able to assist States to initiate 
collaborative research, education, training, and service 
efforts that help States to implement ESSA and WIOA, thereby 
ensuring that youth with disabilities successfully complete 
elementary school and transition from school to postsecondary 
education and/or integrated employment. The funding will also 
allow the Centers to continue to respond to emerging and 
emergent national issues such as assisting in ongoing 
developmental monitoring, especially for children exposed to 
lead and other environmental teratogens, and for infants 
exposed to the Zika virus with its resulting complications.
Independent Living
    The Committee recommendation includes $101,183,000 for the 
Independent Living Program. This program helps ensure that 
individuals with disabilities can live a productive and 
independent life in society. Funding supports States sustain, 
improve, and expand independent living services and establish 
and support a network of centers for independent living.
National Institute on Disability, Independent Living, and 
        Rehabilitation Research
    The Committee recommendation includes $103,970,000 for the 
National Institute on Disability, Independent Living, and 
Rehabilitation Research [NIDILRR]. The NIDILRR supports 
research and activities that help to maximize the full 
potential of individuals with disabilities in employment, 
independent living, and social activities.
    The Committee recognizes that there is a significant 
opportunity over the next decade for the Department to 
simultaneously lower healthcare costs and improve quality of 
life for the older adult and disabled population by embracing 
the rapidly growing shift to technology solutions for daily 
living. These solutions are poised to extend the ability to 
live independently into advanced age, and ``age in place'', 
helping to bridge the ``care gap'' so that older and disabled 
adults might avoid nursing homes and other institutionalized 
care as long as possible, while also remaining connected to 
their families and communities.
    The Committee encourages the NIDILRR to continue to support 
research and activities that help older or disabled adults, 
including those in rural and tribal communities, to increase, 
maintain, or improve their functional capabilities. To that 
end, the Committee supports increased investment in university 
research to harness technological advances that improve health, 
maximize community engagement, encourage productivity, and 
preserve independence among older individuals and their 
families. Special emphasis should be given to research projects 
that seek to develop technologies that allow for independent 
living, seek to address aging and disabled populations, and 
target rural, frontier, and tribal communities as they stand to 
benefit the most from home and community-delivered technologies 
that reduce isolation, increase safety and well-being, prevent 
falls and related injuries, and maximize mobility.
Assistive Technology
    The Committee recommendation includes $32,000,000 for 
Assistive Technology [AT]. AT provides States with funding to 
support individuals with disabilities of all ages to obtain 
devices and services that will increase, maintain, or improve 
their functional capabilities.
    The Committee also includes report language directing CMS 
to work with ACL to encourage Assistive Technology 
Reutilization programs at the State level.
Program Administration
    The Committee recommends $40,063,000 for program 
administration at ACL. These funds support salaries and related 
expenses for program management and oversight activities.
    Muscular Dystrophy.--The Committee is aware that the ACL is 
included in the Muscular Dystrophy Coordinating Committee under 
the Muscular Dystrophy CARE Act Amendments enacted in September 
2014. The Committee supports programs and initiatives focused 
on the transitions of persons with Duchenne into adulthood. The 
Committee requests a report within 180 days of enactment of 
this act on the administration's plans to conduct comprehensive 
studies focused on demonstrating the cost-effectiveness of 
independent living programs and supports for persons living 
with various forms of muscular dystrophy.

                        Office of the Secretary


                    GENERAL DEPARTMENTAL MANAGEMENT

Appropriations, 2016....................................    $520,837,000
Budget estimate, 2017...................................     544,890,000
Committee recommendation................................     509,747,000

    The Committee recommends $509,747,000 for General 
Departmental Management [GDM]. The recommendation includes 
$64,828,000 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.
    Alzheimer's Education Campaign.--Although many medical 
organizations recommend early documented diagnosis and prompt 
treatment of Alzheimer's to assure safety and provide timely 
advice to patients and their families, several studies have 
concluded that many physicians lack sufficient training and 
experience in assessing and treating Alzheimer's disease. The 
Committee directs the Secretary to plan and implement a 
comprehensive outreach and education campaign directed at 
physicians, practitioners, patients, and caregivers with a goal 
of increasing information going to patients who are members of 
racial and ethnic minority groups. The campaign shall include 
dissemination of the following information: (1) Early detection 
and diagnosis of Alzheimer's confers many benefits; (2) What 
the criteria and guidelines are for diagnosis of Alzheimer's 
disease; (3) Comprehensive care planning improves the quality 
of long term Alzheimer's outcomes and may slow or prevent 
cognitive impairment, improve management of accompanying 
chronic conditions, increase access to medical and non-medical 
treatment, provide access to support services, allow time for 
financial planning and building a care team, and increase 
treatment options such as enrollment in clinical trials; and 
(4) Any other information the Secretary determines appropriate.
    The information from the comprehensive Alzheimer's 
education initiative shall be posted on the Web sites of 
relevant Federal agencies, including OWH, OMH, and the Office 
of Rural Health Policy, and shared with providers and advocacy 
organizations. The campaign shall not specify, or be designed 
as a tool to limit the health care providers available to 
patients. In developing the information to be disseminated, the 
Secretary shall consult with appropriate medical societies and 
patient advocate organizations for Alzheimer's disease, and 
with patient advocate organizations representing racial and 
ethnic minority groups with a special emphasis on African 
American and Hispanic populations.
    The Committee directs the Secretary to submit to the 
Committees on Appropriations of the House of Representatives 
and Senate, the Committee on Finance of the Senate, and the 
Committee on Ways and Means and the Committee on Energy and 
Commerce of the House of Representatives an annual report 
describing the activities carried out under this section during 
the preceding fiscal year, and an evaluation of the extent to 
which such activities have been effective in improving the 
health and well-being of racial and ethnic minority groups.
    Antibiotic Resistance.--The Committee supports the CARB 
initiative that strengthens efforts to prevent, detect, and 
control illness and deaths related to infections caused by 
antibiotic resistant bacteria. The Committee directs the 
Department to continue to work with DOD, USDA, VA, and FDA to 
broaden and expand efforts to track and store both antibiotic 
resistant bacteria genes and the mobile genetic elements from 
antibiotic resistant bacteria along with metadata. The 
Committee also recognizes the importance of basic and applied 
research toward the development of new vaccines as a way to 
prevent future antibiotic resistance through infection 
prevention and control. The Committee urges the Secretary to 
prioritize this research as part of its strategy to combat 
antibiotic resistance. The Committee also urges the Secretary 
to consider the use of existing vaccines in antibiotic 
stewardship efforts to help mitigate new resistance 
development. The Department shall include in the fiscal year 
2018 CJ a detailed update on the progress being made to 
implement the CARB national strategy.
    Antimicrobial Usage, Risks, and Prevention.--The Committee 
is deeply concerned about the continued misuse of dangerous 
chemicals and unapproved animal drugs in aquaculture production 
in developing countries. Findings highlighted in a November 30, 
2008, report by the Food and Drug Administration [FDA] cited 
clear scientific evidence that the application of certain 
compounds during the various stages of production may result in 
carcinogenic, mutagenic and other negative effects to human 
health. The Secretary, in coordination with FDA, CDC, and other 
relevant Federal agencies, is directed to submit to the 
Committees on Appropriations within 180 days after enactment of 
this act a report on the current risks of unapproved substances 
used in foreign imported aquaculture and an updated assessment 
of the human health impacts associated with these risks.
    Breast Cancer Patient Education Campaign.--The Committee 
continues to prioritize education and awareness related to 
breast cancer and appreciates that this remains a priority for 
the Secretary. The Committee encourages the Secretary to 
continue updating outreach materials designed to inform breast 
cancer patients anticipating surgery about the availability and 
coverage of breast reconstruction, prostheses, and other 
options, with a focus on informing patients who are members of 
racial and ethnic minority groups.
    Chronic Pain.--The Committee remains concerned about the 
public health epidemic of chronic pain. The Committee is 
pleased with the Department's release of the National Pain 
Strategy and encourages the Secretary to begin implementation 
efforts across all relevant HHS agencies and in coordination 
with the DOD and VA.
    Dietary Guidelines.--The Committee encourages HHS to work 
with related agencies to ensure that Dietary Guidelines are 
consistent with Federal nutrition policy, education, outreach, 
and food assistance programs. The Department should include an 
update on these efforts in its fiscal year 2018 CJ.
    E-Health and Telemedicine.--The Committee encourages the 
Secretary to convene a national working group on e-health and 
telemedicine to communicate, coordinate, and collaborate on e-
health needs, standards, Federal goals, and Federal efforts. 
Such a working group would reduce duplication and e-health 
incompatibility, as well as improve health quality, 
effectiveness, and outcomes.
    Federal Anaphylaxis Policy.--The Committee recognizes that 
immediate access to epinephrine is the primary and most 
effective treatment for anaphylaxis. It is also critically 
important that epinephrine be readily available wherever 
allergic triggers for anaphylaxis are present. Access to 
epinephrine auto-injectors within the first 5 minutes of an 
anaphylactic event can be life-saving. The Committee encourages 
Federal Occupational Health to engage with patient groups, 
healthcare professionals and manufacturers to develop 
recommendations for a program to address treatment for 
anaphylaxis in Federal buildings, parks, and other federally 
controlled facilities.
    Geroscience.--The Committee commends NIA's leadership of 
the Trans-NIH Geroscience Interest Group, which promotes 
coordinated discussion and action on NIH-funded geroscience 
research to reduce the burden of age-related diseases. The 
Committee remains concerned over the rates of chronic disease 
in the older adult population and recognizes that accelerated 
breakthroughs from geroscience research into the biological 
basis of aging is essential to targeting changes that take 
place as a result of aging. The Committee urges the Secretary 
to consider establishing an Interagency Geroscience Research 
Coordination Committee [IGRCC] comprised of representatives 
from the NIA, NIAMS, the NCI, the NEI, NHLBI, NINDS, NIGMS, 
NHGRI, CDC, FDA, DOD, VA, and EPA. The goal of the IGRCC would 
be to identify and direct grants for new geroscience research.
    Global Health Research Strategy.--The Committee requests an 
update on how CDC, FDA, BARDA, and NIH--including NCATS--
jointly coordinate global health research activities with 
specific measurable metrics used to track progress toward 
agreed upon health goals.
    Guidance Documents.--The Committee notes that some have 
raised concerns about the Department's use of guidance 
documents, including Dear Colleague letters, because such 
documents are not legally binding, but regulated entities may 
interpret them as such. Accordingly, the Committee 
recommendation includes new directives in the overview section 
of the Committee report for each of the Departments and 
agencies included in this bill relating to the use of guidance 
documents.
    High-Containment Transport.--The need to transport patients 
quickly, safely, and without transmitting highly infectious 
diseases was an identified need during the 2014 Ebola outbreak. 
The Committee requests a report within 180 days after enactment 
of this act on how the Department is preparing for other events 
that may require the transport of highly contagious patients.
    Nonrecurring Expenses Fund [NEF].--The Department is 
directed to include in its fiscal year 2018 CJ the amount of 
expired unobligated balances available for transfer to the NEF 
and the amount of any such balances transferred to the NEF. 
This should include actual or estimated amounts for the prior, 
current, and future budget years. The description should 
include specific projects, costs, project total cost, and years 
expected to complete as well as the specific projects supported 
in the current year.
    Open Access to Federal Research.--The Committee has 
received reports by the Office of Science and Technology 
Policy's [OSTP] on the progress of all Federal agencies in 
developing and implementing policies to increase public access 
to Federally funded scientific research. The Committee is 
pleased by the progress, but previously instructed OSTP to have 
plans approved from all relevant Departments' and Agencies' 
plans in this act's jurisdiction approved by the end of 
calendar year 2014 with implementation occurring by January 1, 
2016. Agencies funded in this act are instructed to continue 
providing quarterly reports to the Committees on Appropriations 
of the House of Representatives and Senate to keep Congress 
apprised of the remaining progress needed to make federally 
funded research accessible to the public as expeditiously as 
possible.
    Opioid Use and Abuse.--The Committee notes that opiate use 
and addiction continue to pose epidemic-sized challenges in the 
United States. To increase access to life-saving anti-addiction 
medication, the Secretary is urged to consider whether naloxone 
should cease to be a prescription-only drug and be more readily 
available as a behind-the-counter drug. The Committee also 
urges the Secretary to convene or coordinate an interagency 
working group to encourage States and local governments to 
increase opportunities for disposal of opiates and to reduce 
opportunities for abuse, such as by establishing opioid 
dispensing limits at hospital emergency departments and other 
locations. The Secretary should take all appropriate action to 
increase access to treatment of opioid use disorders, including 
medication-assisted treatment.
    Prenatal Opioid Use Disorders and Neonatal Abstinence 
Syndrome.--The Committee is aware that the Protecting Our 
Infants Act of 2015 requires the Secretary to conduct a review 
of the Department's planning and coordination activities 
related to prenatal opioid use disorders and neonatal 
abstinence syndrome, as well as address gaps in research and 
treatment. The act also requires the Secretary to develop 
recommendations for preventing and treating prenatal opioid use 
disorders and neonatal abstinence syndrome. The Committee urges 
the Secretary to ensure that the report and recommendations 
required by the act are submitted within the timeframe required 
by the act.
    Pulmonary Hypertension [PH].--The Committee is concerned 
that most PH patients are not diagnosed for many years until 
the condition has reached a catastrophic stage, which leads to 
significant disability, greatly increased mortality, and the 
need for costly and dramatic medical interventions, such as 
heart-lung transplantation. Given the availability of effective 
therapies for early-stage PH, the Department is encouraged to 
work across agencies and with the patient and professional 
community to prepare recommendations to improve early diagnosis 
and treatment of PH.
    Seafood Sustainability.--The Committee prohibits the 
Department from using or recommending third party, 
nongovernmental certification for seafood sustainability.
    Tuberculosis [TB].--The Committee notes the release of the 
President's National Action Plan for Combating Multi Drug 
Resistant TB in December 2016. The Committee urges the 
Secretary to prioritize implementation of the plan in 
coordination with the Federal TB Task Force, CDC, and NIH.
    United States/Mexico Border.--The Committee notes that in 
2015, almost 181,000,000 people crossed this border, often to 
work or visit family, and were infected with, or were exposed 
to, serious infectious diseases. The Committee urges the 
Department to continue its efforts to conduct border infectious 
disease surveillance in order to identify and implement needed 
prevention and treatment. Such activity could focus on priority 
surveillance, epidemiology and preparedness activities along 
the borders in order to be able to respond to potential 
outbreaks and epidemics, including those caused by potential 
bioterrorism agents.
Teen Pregnancy Prevention
    The Committee recommendation includes $107,800,000 for the 
Teen Pregnancy Prevention [TPP] program. This program supports 
competitive grants to public and private entities to replicate 
evidence-based teen pregnancy prevention approaches.
    The Committee notes that the eligibility criteria for the 
most recent 5-year grant cycle for the TPP program was changed 
significantly from the previous grant cycle. To reflect a shift 
toward a collective impact strategy, prospective grantees were 
required to meet a minimum threshold of 700 youth to be served 
across three implementation sites. As a result, some 
communities, particularly those in rural areas, were excluded 
from consideration due to their smaller youth population and 
lack of implementation sites. These communities, with a single 
or very few youth-serving agencies, have limited ability to 
form the kind of community collaboration required by the Office 
of Adolescent Health. The Committee requests that HHS submit a 
report to the Committees on Appropriations of the House of 
Representatives and Senate on the differences between 
communities funded during the first grant cycle of the TPP 
program compared to the second, with a focus on the type of 
grantee location (urban, rural, or suburban), population size, 
and capacity to form a collective impact strategy.
Office of Minority Health
    The Committee recommends $50,000,000 for the Office of 
Minority Health [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.
    HIV Community-Based Testing Programs.--The Committee 
recognizes that several community-based programs have 
encouraged individuals at risk for HIV/AIDS to utilize FDA-
approved home-based HIV testing technology to monitor their HIV 
status. The Committee urges the OMH to consider pilot or 
demonstration program within existing resources to gauge the 
effectiveness of this approach.
    HIV/AIDS and Hepatitis C.--The Committee continues to be 
concerned about the HIV/AIDS epidemic in the African American 
community, and is aware of the concurrent high rates of co-
infection with Hepatitis C as outlined by the HHS 2015 Forum on 
Hepatitis C in African American Communities. The Committee 
urges OMH to work aggressively to address opportunities to 
reduce the burden of HIV/AIDS and Hepatitis C by exploring 
partnerships for screening and implementing community 
engagement programs.
    Lupus Initiative.--The Committee continues to support the 
OMH National Health Education Lupus Program and its efforts to 
develop a clinical trial education and implementation plan for 
lupus. The action plan will focus on developing public-private 
and community partnerships, evaluating current minority 
clinical trial education and participation programs, and 
developing a research plan for creating new clinical trial 
education models in lupus. This will inform the development of 
the broader actionable lupus clinical trial education plan.
Sexual Risk Avoidance
    The Committee recommends $15,000,000 for sexual risk 
avoidance education. This is a competitive grant program that 
funds evidenced based abstinence models for adolescents.
    Funding for competitive grants for sexual risk avoidance 
shall use medically accurate information referenced to peer-
reviewed publications by educational, scientific, governmental, 
or health organizations; implement an evidence-based approach; 
and teach the benefits associated with self-regulation, success 
sequencing for poverty prevention, healthy relationships, goal 
setting, and resisting sexual coercion, dating violence, and 
other youth risk behaviors.
Office of the Surgeon General
    The Committee understands that the Surgeon General has 
announced and is in the process of creating a Report on 
Substance Use, Addiction, and Health. Given the current 
national opioid epidemic, the Committee looks forward to the 
report focusing on opioid research and providing 
recommendations for future direction on best practices to 
address opioid abuse.
    The Committee urges the Surgeon General to develop a report 
on improving the health of America's children. Too many 
children still live in poverty, affecting their ability to be 
healthy, to succeed in school, and to raise healthy families 
themselves. A report by the Surgeon General on improving the 
health of children could increase awareness and generate 
additional effort on ameliorating this problem.
Office of Women's Health
    The Committee recommends $29,000,000 for the Office of 
Women's Health [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 to address the disparities in women's health.
    The Committee recommendation includes $3,100,000 to combat 
violence against women through the State partnership 
initiative. This program provides funding to State-level public 
and private health programs to partner with domestic and sexual 
violence organizations to improve healthcare providers' ability 
to help victims of violence and improve prevention programs.

                OFFICE OF MEDICARE HEARINGS AND APPEALS

Appropriations, 2016....................................    $107,381,000
Budget estimate, 2017...................................     120,000,000
Committee recommendation................................     112,381,000

    The Committee provides $112,381,000 for the Office of 
Medicare Hearings and Appeals [OMHA]. This Office is 
responsible for hearing Medicare appeals at the Administrative 
Law Judge [ALJ] 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 ALJ.
    Appeals Backlog.--The Committee continues to be concerned 
over the substantial backlog in the number of cases pending 
before ALJs at OMHA. In fiscal year 2016, the Committee 
provided an increase of $20,000,000 over fiscal year 2015 level 
and provides $5,000,000 in additional funding in fiscal year 
2017. The Committee directs OMHA to use the additional funds 
provided to address the current backlog and requests a spend 
plan within 30 days after enactment of this act. This spend 
plan should include an estimate of total appeals that will be 
processed in fiscal years 2016-2018 with the resources 
available. This estimate should include the effect of 
administrative actions taken to reduce the backlog.

  OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION TECHNOLOGY

Appropriations, 2016....................................     $60,367,000
Budget estimate, 2017...................................      82,000,000
Committee recommendation................................      60,367,000

    The Committee makes available $60,367,000 to the Office of 
the National Coordinator for Health Information Technology 
[ONC]. The Committee provides funding for ONC entirely through 
budget authority. 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.
    Electronic Health Records.--The Committee believes HHS' 
work to encourage the adoption of electronic health records has 
provided important new opportunities to improve the quality, 
safety, and cost-effectiveness of health care. The Secretary is 
directed to further this work by studying approaches to improve 
person-centered healthcare through patient access to health 
information. That work should examine accurate and timely 
record matching so that all EHR systems are collecting the 
information necessary for a fully interoperable system that 
protects patients from identity mismatch errors, but also 
considers patient privacy and security.
    Immunization Information Systems [IIS].--The threat of 
disease outbreaks and the ongoing work to target outreach to 
under immunized communities underscores the importance of 
maintaining robust immunization information systems [IIS]. The 
Committee is aware of the Immunization Registry Data Exchange 
and the Consumer Access Immunization Registry pilot projects 
exploring ways to improve the efficiency and effectiveness of 
IIS. The Committee encourages ONC to continue these pilots and 
requests a report to the Committee from ONC no later than 180 
days after enactment of this act with findings, results, and 
recommendations from the pilot studies. The Committee 
encourages ONC to partner with CDC and other relevant HHS 
partners to leverage knowledge and enhance education and 
information sharing opportunities between registry system 
administrators and related State and local personnel.

                      OFFICE OF INSPECTOR GENERAL

Appropriations, 2016....................................     $75,000,000
Budget estimate, 2017...................................      85,000,000
Committee recommendation................................      75,000,000

    The Committee recommends $75,000,000 for the HHS Office of 
Inspector General [OIG]. In addition to discretionary funds 
provided in this act, the Health Insurance Portability and 
Accountability Act of 1996 provides a permanent appropriation 
of $334,097,000 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, 2016....................................     $38,798,000
Budget estimate, 2017...................................      42,705,000
Committee recommendation................................      38,798,000

    The Committee recommends $38,798,000 for the Office for 
Civil Rights [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.
    Pending Complaints.--OCR is tasked with ensuring that 
individuals are not subject to unlawful discrimination in 
healthcare programs. Yet, for nearly 3 years, since September 
2014, three Weldon Amendment cases have been filed with OCR 
without resolution. Therefore, the Committee directs OCR to 
properly investigate the pending cases and urges OCR to resolve 
the pending cases expeditiously.

     RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS

Appropriations, 2016....................................    $586,188,000
Budget estimate, 2017...................................     630,408,000
Committee recommendation................................     630,408,000

    The Committee provides an estimated $630,408,000 in 
mandatory funds for Retirement Pay and Medical Benefits for 
Commissioned Officers of the U.S. Public Health Service. 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, 2016....................................  $1,532,958,000
Budget estimate, 2017...................................   1,431,117,000
Committee recommendation................................   1,532,958,000

    The Committee recommends $1,532,958,000 for the Public 
Health and Social Services Emergency Fund, which includes 
$15,000,000 in transfers from PHSSEF unobligated funds. This 
appropriation supports the activities of the Assistant 
Secretary for Preparedness and Response [ASPR] and other 
components within the Office of the Secretary to prepare for 
the health consequences of bioterrorism and other public health 
emergencies, including pandemic influenza. It also provides 
funding for the Department's cybersecurity efforts.
    The Committee does not include bill language requested by 
the administration that would provide additional transfer 
authority beyond that which is already provided to the 
Secretary.
Office of the Assistant Secretary for Preparedness and Response
    The Committee recommendation includes $1,396,628,000 for 
activities administered by ASPR. This Office was created by the 
Pandemic and All-Hazards Preparedness Act [PAHPA] to lead the 
Department's activities regarding preventing, preparing for, 
and responding to public health emergencies, including 
disasters and acts of terrorism.
    National Disaster Medical System.--The Committee continues 
bill language providing coverage under the Federal Employees 
Compensation Act for National Disaster Medical System 
intermittent employees who are activated for training or 
deployment.
    Trauma Service Availability and Systems Development.--The 
Committee continues to support efforts to improve trauma center 
sustainability and service availability in rural, exurban, 
suburban, and urban locations. The Committee encourages ASPR to 
develop a proposal for how trauma center improvements could be 
made in these areas to address problems with trauma care 
resiliency and reach to unserved populations. In doing so, ASPR 
should incorporate its analysis of the ability of existing 
trauma care infrastructure to respond to mass casualty events 
in a variety of geographic locations previously requested by 
the Committee.
Hospital Preparedness Program
    The Committee's recommendation includes $254,555,000 for 
the Hospital Preparedness Program [HPP]. 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. The Committee 
recognizes the importance of this program in helping 
communities respond to tragic events and believes this funding 
should be carefully coordinated within communities to continue 
to provide our Nation's hospitals and emergency responders the 
necessary tools to respond quickly and collaboratively to these 
and other public health emergencies that are inevitable in our 
Nation's communities.
    Bioweapon Response Assessment.--The Blue Ribbon Study Panel 
on Biodefense, published in October 2015, noted that ``certain 
requirements associated with highly infectious diseases and low 
frequency biological events fit well within hospital disaster 
preparedness frameworks designed to address earthquakes, 
hurricanes, and other disasters, but other requirements do 
not.'' The Committee believes that understanding the unique 
requirements necessary to respond to a biological attack will 
help improve our preparedness. For this reason, within 120 days 
of enactment, the Committee requests that the ASPR submit an 
assessment to the Committees on Appropriations of the House of 
Representatives and Senate of the unique response requirements 
for biological weapons attacks, including attacks that may 
result in mass fatalities. The assessment should also note the 
role of other Federal agencies in the response.
    Rural Areas.--The Committee encourages ASPR to ensure that 
hospital systems in remote and rural areas are benefiting from 
this program and are prepared in cases of emergencies, 
epidemics, or natural disasters.
Biomedical Advanced Research and Development Authority [BARDA]
    The Committee recommendation includes $511,700,000 for 
advanced research and development.
    The Committee commends BARDA for supporting advanced 
development efforts of industry to develop vaccines, 
diagnostics, drugs, and therapeutics to minimize serious 
threats of infectious disease and urges BARDA to continue to 
invest in the development of countermeasures for infectious 
diseases through the CARB initiative and the Emerging 
Infectious Disease program.
    Blood Platelet.--The Committee is aware of BARDA's 
investigation into blood platelet-derived medical counter-
measures as a hemostatic agent, and urges BARDA to expand its 
research to address the opportunities that cell stabilization 
of blood platelets provides, including radiation exposure 
remediation, acute burn healing, drug delivery, hemorrhagic 
fevers, and diagnostic imaging.
    Equine Hyperimmune Globulin.--Antibody preparations, 
produced from horse serum or plasma, have been used over the 
past century for the treatment of humans suffering from a 
variety of infectious diseases, intoxications, or 
envenomations. However, adverse reactions limited its use to 
the most life threatening of situations. The Committee is aware 
of recent improvements in processing techniques that reduce 
risks by as many as two orders of magnitude. The Committee 
encourages BARDA to explore the viability of developing medical 
countermeasures using equine hyperimmune globulin.
Project BioShield Special Reserve Fund
    The Committee recommendation includes $510,000,000 for the 
Project BioShield Special Reserve Fund. The Committee is 
committed to ensuring the Nation is adequately prepared against 
chemical, biological, radiological, and nuclear attacks. The 
Committee recognizes a public-private partnership to develop 
medical countermeasures [MCMs] is required to successfully 
prepare and defend the Nation against these threats. Where 
there is little or no commercial market, the Committee supports 
the goal of Government financing providing a market guarantee
Other Activities
    The Committee recommendation includes the following amounts 
for the following activities within ASPR:
  --Operations.--$30,938,000;
  --Preparedness and Emergency Operations.--$24,654,000;
  --National Disaster Medical System.--$49,904,000; and
  --Policy and Planning.--$14,877,000.
Office of the Assistant Secretary for Administration
    The Committee recommends $50,860,000 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/Medical Reserve Corps
    The Committee recommendation includes $6,000,000 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 $79,470,000 for 
activities within the Office of the Secretary.
Pandemic Influenza Preparedness
    The Committee recommendation includes $72,000,000 for 
Pandemic Influenza Preparedness. Of the total, $17,000,000 is 
provided in annual funding, $40,000,000 in no-year funding, and 
$15,000,000 in transfers from PHSSEF unobligated balances.
    Emergency Supplemental Pandemic Influenza Balances.--The 
Committee requests a detailed summary from ASPR in its fiscal 
year 2018 CJ about the level of unspent pandemic influenza 
supplemental balances. This summary should include an analysis 
of how funds have been spent over the previous 3 fiscal years 
and how any remaining funds will be allocated.
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

    In fiscal year 2017, the level transferred from the fund 
after accounting for sequestration is $931,000,000. The 
Committee includes bill language in section 221 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:

                                             [Dollars in thousands]
----------------------------------------------------------------------------------------------------------------
                                                                                                    Committee
                 Agency                            Account                    Program            recommendation
----------------------------------------------------------------------------------------------------------------
ACL....................................  Aging and Disability        Alzheimer's Disease                  14,700
                                          Services Programs.          Prevention Education and
                                                                      Outreach.
ACL....................................  Aging and Disability        Chronic Disease Self                  8,000
                                          Services Programs.          Management.
ACL....................................  Aging and Disability        Falls Prevention.........             5,000
                                          Services Programs.
CDC....................................  Immunization and            Section 317 Immunization            324,350
                                          Respiratory Diseases.       Grants.
CDC....................................  Emerging and Zoonotic       Epidemiology and                     40,000
                                          Infectious Diseases.        Laboratory Capacity
                                                                      Grants.
CDC....................................  Emerging and Zoonotic       Healthcare Associated                12,000
                                          Infectious Diseases.        Infections.
CDC....................................  Chronic Disease Prevention  Office of Smoking and               175,950
                                          and Health Promotion.       Health (Tobacco
                                                                      Prevention/Media & Quit
                                                                      Lines).
CDC....................................  Chronic Disease Prevention  Breast Feeding Grants                 8,000
                                          and Health Promotion.       (Hospitals Promoting
                                                                      Breastfeeding).
CDC....................................  Chronic Disease Prevention  Million Hearts Program...             4,000
                                          and Health Promotion.
CDC....................................  Chronic Disease Prevention  Heart Disease & Stroke               73,000
                                          and Health Promotion.       Prevention Program.
CDC....................................  Chronic Disease Prevention  Diabetes.................            73,000
                                          and Health Promotion.
CDC....................................  Chronic Disease Prevention  Early Care Collaboratives             4,000
                                          and Health Promotion.
CDC....................................  Environmental Health......  Lead Poisoning Prevention            17,000
CDC....................................  CDC-Wide Activities.......  Preventive Health and               160,000
                                                                      Health Services Block
                                                                      Grants.
SAMHSA.................................  Mental Health.............  Suicide Prevention                   12,000
                                                                      (Garrett Lee Smith).
----------------------------------------------------------------------------------------------------------------

                           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 limiting the 
use of certain grant funds to pay individuals more than an 
annual rate of Executive Level II.
    Section 203. The bill 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 of Representatives and the Senate on the proposed 
use of funds.
    Section 204. The bill continues a provision authorizing the 
transfer of up to 2.6 percent of PHS Act funds for evaluation 
activities.
    Section 205. The bill continues a provision restricting 
transfers of appropriated funds and requires a 15-day 
notification to the Committees on Appropriations of the House 
of Representatives and the Senate Appropriations Committees.
    Section 206. The bill continues a general provision 
allowing National Health Service Corps contracts to be canceled 
up to 60 days after award.
    Section 207. The bill continues a provision regarding 
requirements for family planning applicants.
    Section 208. The bill continues language which states that 
no provider services under title X of the PHS Act may be exempt 
from State laws regarding child abuse.
    Section 209. The bill continues 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 210. The bill continues a provision prohibiting the 
use of funds for lobbying activities related to gun control.
    Section 211. The bill continues a provision that limits the 
assignment of certain public health personnel.
    Section 212. The bill continues a provision which 
facilitates the expenditure of funds for international health 
activities.
    Section 213. The bill 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 214. The bill continues 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 ICs consistent 
with the AIDS research plan.
    Section 215. The bill 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 216. The bill continues a provision permitting NIH 
to use up to $45,000,000 per project for improvements and 
repairs of facilities.
    Section 217. The bill continues a provision that transfers 
funds from NIH to HRSA and AHRQ, to be used for National 
Research Service Awards.
    Section 218. The bill continues a provision related to 
third party payments to NIH.
    Section 219. The bill continues a 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 220. The bill continues a provision requiring a 
publicly available Web site that details expenditures from the 
PPH Fund.
    Section 221. The bill continues a 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 222. The bill continues a provision requiring CJs 
to include certain FTE information with respect to ACA.
    Section 223. The bill continues a provision related to ACA 
exchange funding transparency.
    Section 224. The bill continues a provision related to 
notifications for ACA enrollment and Community Health Centers 
awards.
    Section 225. The bill continues a provision prohibiting 
funds for the Risk Corridor program.
    Section 226. The bill continues a provision for Medicare 
and Medicaid expenses.
    Section 227. The bill restates a requirement for HHS to 
conduct an analysis of the ACA's impact on eligibility for 
certain discretionary programs.
    Section 228. The bill continues a provision related to 
breast cancer screening recommendations.
    Section 229. The bill includes new language on care 
management for Alzheimer's disease.
    Section 230. The bill includes new language on medical 
marijuana.

                               TITLE III

                        DEPARTMENT OF EDUCATION

                    Education for the Disadvantaged

Appropriations, 2016.................................... $16,043,790,000
Budget estimate, 2017...................................  16,043,790,000
Committee recommendation................................  16,093,790,000

    The Committee recommends an appropriation of 
$16,093,790,000 for education for the disadvantaged.
    The programs in the Education for the Disadvantaged account 
provide a foundation of support to help ensure that all 
children receive a high-quality education. Funds appropriated 
in this account primarily support activities in the 2017-2018 
school year.
Grants to Local Educational Agencies
    Title I grants to local educational agencies [LEAs] provide 
supplemental education funding, especially in high-poverty 
areas, for local programs that provide extra academic support 
to help raise the achievement of eligible students or, in the 
case of schoolwide programs, help all students in high-poverty 
schools meet challenging State academic standards. Title I 
grants are distributed through four formulas: basic, 
concentration, targeted, and education finance incentive grant.
    The Committee recommends $15,409,802,000 for the title I 
grants to LEAs program. Of the funds available for title I 
grants to LEAs, up to $3,984,000 shall be available on October 
1, 2016 for transfer to the Census Bureau for poverty updates; 
$4,564,641,000 will become available on July 1, 2017; and 
$10,841,177,000 will become available on October 1, 2017. The 
funds that become available on July 1, 2017, and October 1, 
2017, will remain available for obligation through September 
30, 2018.
    Consistent with the Every Student Succeeds Act [ESSA], the 
reauthorization of the Elementary and Secondary Education Act 
[ESEA], the Committee recommendation consolidates funding for 
the School Improvement Grants [SIG] program into title I grants 
to LEAs. In eliminating SIG, ESSA increases the amount States 
must reserve from their title I allocation for schools 
identified for improvement, from 4 percent under the previous 
authorization to 7 percent (or, if higher, the amount States 
reserved in fiscal year 2016 plus their fiscal year 2016 SIG 
allocation).
    ESSA shifts significant responsibility, authority, and 
accountability for schools, including school improvement 
efforts, back to States and LEAs. The Committee recommendation 
includes a total increase of $500,000,000 for title I grants to 
LEAs, including the consolidation of SIG, building on the 
$500,000,000 increase provided in fiscal year 2016, to help 
States implement ESSA. Combined, the Committee recommendation 
is $397,484,000 more than the authorized level, which will 
provide sufficient funding through authorized set-asides to 
help States implement comprehensive and targeted support and 
improvement efforts for schools identified for improvement, 
while also protecting funding for LEAs, and allowing for 
significantly more funding for LEAs than envisioned in 
reauthorization. The Committee recommendation does not include 
appropriations language requested by the administration 
increasing the amount set-aside for comprehensive support and 
improvement activities or targeted support and improvement 
activities.
    Report on Community Eligibility Program.--The Committee 
requests the Department, in collaboration with the Department 
of Agriculture, submit a report to the Committee as well as the 
Education and the Workforce Committee of the House of 
Representatives, and the Health, Education, Labor and Pensions 
Committee of the Senate, within 180 days that describes the 
impact of the Community Eligibility Program on accountability 
provisions of the ESEA, including how it impacts school 
rankings under 1113(a)(3), and how disadvantaged students are 
incorporated into State accountability systems under sections 
1111(c) and (d) and how their performance is reported under 
subsection (h).
    Parent and Family Engagement.--The Committee notes that 
ESSA includes several provisions promoting parent and family 
engagement in schools and their children's education, including 
requiring LEAs to reserve at least 1 percent of title I funds 
for such activities. The Committee strongly supports these 
activities, and the use of funds for these purposes.
    Report on Improving Conditions for Student Learning.--The 
Committee believes that improving conditions for student 
learning is vital for student success and notes that ESSA 
requires States to submit plans to the Secretary that describe 
how SEAs will support LEAs in improving conditions for student 
learning, including through reducing the use of aversive 
behavioral interventions that compromise student health and 
safety, such as seclusion and restraint. The Committee requests 
that the Secretary prepare a report on State-identified efforts 
to reduce such interventions and other completed and planned 
activities of the Department on this issue.
School Improvement Grants
    The Committee recommendation does not include funding for 
the SIG program. Consistent with ESSA, the Committee 
recommendation eliminates this program and consolidates the 
funding into title I grants to LEAs.
Comprehensive Literacy State Development Grants
    The Committee recommendation includes $190,000,000 for the 
Comprehensive Literacy State Development Grants program. This 
program, formerly the Striving Readers Comprehensive Literacy 
program, was newly authorized in ESSA and provides competitive 
grants to State educational agencies [SEAs] that then subgrant 
at least 95 percent of such funds to eligible entities to 
support efforts to improve literacy instruction in high-need 
schools and early education programs in a State for each of 
several age bands ranging from birth through 12th grade.
    The Committee notes that under the new authorization of 
this program, home-based early childhood literacy programs are 
identified as eligible entities. The Committee encourages the 
Department to provide clear guidance that States may subgrant 
funds to such programs.
Innovative Approaches to Literacy
    The Committee recommendation includes $27,000,000 for the 
Innovative Approaches to Literacy program. This program was 
funded under the authority in the Fund for the Improvement of 
Education [FIE] in fiscal year 2016, but was separately 
authorized in ESSA.
    The Innovative Approaches to Literacy program provides 
competitive grants to national not-for-profit organizations and 
school libraries for providing books and childhood literacy 
activities to children and families living in high-need 
communities.
    The Committee continues to direct the Department to reserve 
no less than 50 percent of funds under this program for grants 
to develop and enhance effective school library programs, which 
may include providing professional development to school 
librarians, books, and up-to-date materials to high-need 
schools. School library programs increase access to a wide 
range of print and electronic resources, and provide learning 
opportunities for all students, particularly those who are less 
likely to have access to such materials at home. In addition, 
the Committee directs the Department to ensure that grants are 
distributed among eligible entities that will serve 
geographically diverse areas, including rural areas.
Migrant Education Program
    The Committee recommends $374,751,000 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 migratory 
agricultural workers or migratory fishworkers. 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 $47,614,000 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.
Special Programs for Migrant Students
    The Committee recommends $44,623,000 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.

                               Impact Aid

Appropriations, 2016....................................  $1,305,603,000
Budget estimate, 2017...................................   1,305,603,000
Committee recommendation................................   1,315,603,000

    The Committee recommends $1,315,603,000 for the Impact Aid 
program.
    Impact Aid provides financial assistance to school 
districts affected by the presence of Federal activities and 
federally owned land. These school districts face unique 
challenges because they must educate children living on 
federally owned land, such as military bases, while federally 
owned property is also exempt from local taxes, a primary 
source of revenue for local school districts.
    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 
$1,176,233,000 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 is concerned that the Department is not 
notifying school districts in a timely advanced manner of 
changes in their Impact Aid eligibility status. Hold harmless 
provisions in ESEA and timely enactment of appropriations bills 
would provide school districts with adequate time to adjust to 
significant changes in funding. The Committee directs the 
Department to enhance its communication with school districts 
about significant payment decreases likely in the coming school 
year, particularly those that are likely to enter hold harmless 
provisions for a given school year.
    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 $17,406,000 for 
eligible LEAs for emergency repairs and modernization of school 
facilities.
    The Committee recommendation includes bill language 
allowing these funds to be awarded entirely on a competitive 
basis and be available for obligation through September 30, 
2018, as requested by the administration.
    Payments for Federal Property.--The Committee recommends 
$68,813,000 for Payments for Federal Property. These payments 
compensate LEAs specifically for revenue lost due to the 
removal of Federal property from local tax rolls, regardless of 
whether any federally connected children attend schools in the 
district. The budget request proposed eliminating this program. 
The Committee recommendation again rejects this elimination and 
continues to note that this funding represents a key component 
of fulfilling the Federal Government's commitment to school 
districts impacted by the presence of federally owned land.

                      School Improvement Programs

Appropriations, 2016....................................  $4,433,629,000
Budget estimate, 2017...................................   4,558,409,000
Committee recommendation................................   4,177,239,000

    The Committee recommendation includes $4,177,239,000 for 
the School Improvement Programs account.
Supporting Effective Instruction State Grants
    The Committee recommends $2,055,830,000 for Supporting 
Effective Instruction State Grants. The fiscal year 2016 
appropriation for this program included $93,993,000 in funding 
set-aside for the Supporting Effective Educator Development 
[SEED] program. ESSA reauthorized SEED as a stand-alone program 
and the Committee's fiscal year 2017 recommendation for SEED is 
included in the Innovation and Improvement account.
    The appropriation for this program primarily supports 
activities associated with the 2017-2018 academic year. Of the 
funds provided, $374,389,000 will become available on July 1, 
2017, and $1,681,441,000 will become available on October 1, 
2017. These funds will remain available for obligation through 
September 30, 2018.
    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.
    ESSA includes new provisions to promote the use of title I 
and title II funds to support principals and school leaders, 
including an optional 3 percent set-aside of title II-A funds 
for such activities. Many States already use these funds to 
support principals and school leaders but all States would 
benefit from clear guidance and examples of how States and LEAs 
could best use these funds to support effective strategies in 
this area. Therefore, the Committee strongly encourages the 
Department to issue guidance on the importance of strong school 
leadership, and how States can use existing resources to 
support principals and school leadership, including examples of 
best practices.
Mathematics and Science Partnerships
    The Committee recommendation does not include funding for 
Mathematics and Science Partnerships. ESSA eliminated this 
program and consolidated the funding into a new Student Support 
and Academic Enrichment Grants program. The Committee 
recommendation is consistent with this consolidation.
Supplemental Education Grants
    The Committee recommendation includes $16,699,000 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 
includes language requested in the budget that allows the 
Secretary of Education to reserve 5 percent of these funds to 
provide FSM and RMI with technical assistance.
21st Century Community Learning Centers
    The Committee recommends an appropriation of $1,050,000,000 
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 notes that ESSA reduced the authorized 
funding level of the 21st CCLC program below the previously 
authorized level and below the fiscal year 2015 appropriated 
level, the last enacted appropriation prior to passage of ESSA. 
Accordingly, the Committee recommends a reduced funding level 
for this program.
State Assessments Grants
    The Committee recommends $378,000,000 for the State 
Assessments Grants program.
    This program provides formula grants to States for 
developing and implementing standards and assessments required 
by the ESEA and helping States and LEAs carry out audits of 
their assessment systems to eliminate low-quality or 
duplicative assessments. It also provides competitive grants to 
States, including consortia of States, to improve the quality, 
validity, and reliability of academic assessments.
    Reducing Duplicative and Redundant Assessments.--The 
Committee strongly supports the steps that Congress took last 
year in ESSA to help address the issue of over testing in 
schools. The Committee appreciates the Department's guidance 
issued earlier this year that identifies Federal funding 
available to help States and LEAs address the issue this school 
year. The Committee requests that the Department report to 
Congress, no later than 90 days after the enactment of this 
act, on the concrete steps it has already taken and plans to 
take during this year to help States and LEAs reduce the number 
of duplicative and redundant assessments and the amount of 
classroom time spent on unnecessary test preparation, rather 
than teaching and learning.
Education for Homeless Children and Youth
    For carrying out education activities authorized by title 
VII, subtitle B of the McKinney-Vento Homeless Assistance Act, 
the Committee recommends $77,000,000.
    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.
Training and Advisory Services
    For Training and Advisory Services authorized by title IV 
of the Civil Rights Act, the Committee recommends $6,575,000.
    The funds provided will support awards to operate 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.
Native Hawaiian Education
    The Committee recommendation includes $33,397,000 for 
Native Hawaiian Education.
    The Committee bill continues a provision that allows 
funding provided by this program to be used for construction.
Alaska Native Education
    The Committee recommends $32,453,000 for the Alaska Native 
Education.
    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 directs the Department to ensure that Alaska 
Native tribes, Alaska Native regional nonprofits, and Alaska 
Native corporations have the maximum opportunity to 
successfully compete for grants under this program by providing 
these entities multiple opportunities for technical assistance 
in developing successful applications for these funds, both in 
Alaska and via various forms of telecommunications, and to make 
every effort to ensure that Alaska Natives and Alaskans 
represent a significant proportion of peer reviewers for grant 
applications submitted in fiscal year 2017.
Rural Education
    The Committee recommends $175,840,000 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.
Comprehensive Centers
    The Committee recommends $51,445,000 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.
    In fiscal year 2017, the Department is scheduled to hold a 
competition to fund a new cohort of comprehensive centers. With 
the passage of ESSA, this new cohort of comprehensive centers 
will reflect changing priorities and the expanded role and 
responsibilities of States under reauthorization. The Committee 
directs the Department to brief the Committee within 30 days of 
enactment on how they plan to ensure this new cohort of 
comprehensive centers will provide a well-coordinated, 
accessible, and robust technical assistance system for SEAs.
    In selecting priorities for a new cohort of comprehensive 
centers, the Committee directs the Department to recognize the 
unique challenges affecting rural schools, and strongly 
encourages the Department to establish at least one university-
led center in a State with a significant percentage of students 
in rural schools. Such a center could focus on rural education 
and provide assistance to rural districts, including those that 
serve high poverty and minority students.
    The Committee recommendation includes continued support for 
a comprehensive center, first funded in fiscal year 2016 and as 
authorized in ESSA, on students at risk of not attaining full 
literacy skills due to a disability, including dyslexia, or 
developmental delay.
Student Support and Academic Enrichment Grants
    The Committee recommendation includes $300,000,000 for 
Student Support and Academic Enrichment Grants. This new 
program provides formula grants to States, which then sub-grant 
to LEAs, to help support activities to provide students with a 
well-rounded education, ensure safe and supportive learning 
environments, and use technology to improve instruction. This 
program was created by consolidating funding for several 
previously individually authorized programs. The combined 
fiscal year 2016 funding level of the programs eliminated and 
consolidated into this new formula block grant was 
$277,761,000. The Committee recommendation represents a 
$22,239,000 increase above the fiscal year 2016 level.
    The Committee notes that funds available under this program 
may be used for local activities that may include programs that 
build skills in STEM, including computer science, and that 
foster innovation in learning by supporting nontraditional STEM 
education teaching methods. The Committee believes that such 
activities, including robotics competitions through 
partnerships with local schools and nonprofit organizations, 
will help further engage and inspire students to pursue further 
study or careers in STEM.
    In conducting a needs assessment pursuant to section 
4106(d) of the ESEA, the Committee encourages States to work 
with LEAs in identifying already available and appropriate 
local data and metrics, which may include incidence and 
prevalence of the issues and behaviors that are appropriate to 
be addressed by the program, such as drug use and bullying.

                            Indian Education

Appropriations, 2016....................................    $143,939,000
Budget estimate, 2017...................................     174,939,000
Committee recommendation................................     143,939,000

    The Committee recommends $143,939,000 for Indian education 
programs.
Grants to Local Educational Agencies
    For grants to LEAs, the Committee recommends $100,381,000. 
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 $37,993,000 for special programs 
for Indian children.
    Funds are used for demonstration grants to improve Indian 
student achievement from early childhood education through 
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 $5,565,000 for national 
activities.
    Funds are 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.
    The Committee notes that there are significant cognitive, 
psychological, and academic benefits that result from Native 
American language immersion programs. Schools where the 
indigenous language is the primary language of instruction have 
a strong, positive effect on the educational and social 
outcomes of American Indian, Alaska Native, and Native Hawaiian 
students compared to schools where Native students are taught 
in English. In addition, language education programs are 
essential for tribal self-determination. The Committee supports 
the dedication of resources for language maintenance and 
preservation activities. The Committee intends that funds 
available for carrying out section 6133 of the ESEA be 
allocated to all types of eligible entities in a way that 
supports the most extensive possible distribution across 
geography and language diversity and support both existing and 
new Native language immersion programs and schools. Further, 
the Committee directs the Department to give the same 
consideration to applicants that propose to provide partial 
immersion schools and programs as to full immersion, as the 
local tribes, schools, and other applicants know best what type 
of program will most effectively assist their youth to succeed.

                       Innovation and Improvement

Appropriations, 2016....................................    $894,226,000
Budget estimate, 2017...................................   1,411,556,000
Committee recommendation................................     942,743,000

    The Committee recommends $942,743,000 for programs within 
the Innovation and Improvement account.
Education Innovation and Research
    The Committee recommendation includes $120,000,000 for the 
Education Innovation and Research [EIR] program. This program, 
newly authorized in ESSA, supports the creation, development, 
implementation, replication, and scaling up of evidence-based, 
field-initiated innovations designed to improve student 
achievement and attainment for high-need students. EIR 
incorporates a tiered evidence framework that provides early-
phase, mid-phase, and expansion and replication grants. This 
supports interventions throughout the pipeline, from smaller 
grants for early stage projects that are willing to undergo 
rigorous evaluation to test their efficacy to larger grants to 
scale-up proven-effective interventions that have demonstrated 
significant impacts through multiple rigorous evaluations.
    The Committee recommendation does not include funding or 
bill language requested by the administration for a new 
Advanced Research Projects Agency--Education program.
School Leader Recruitment and Support
    The Committee recommendation includes $16,368,000 for the 
School Leader Recruitment and Support program, which funds 
activities to improve the recruitment, placement, support, and 
retention of effective principals and other school leaders in 
high-need schools.
Charter School Program
    The Committee recommends $343,172,000 for the Charter 
School Program. This program supports the start-up, 
replication, and expansion of high-quality charter schools.
    Within the total, the Committee recommendation includes 
$204,000,000 for grants to State entities to support high-
quality charter schools, including for grants directly to 
charter school developers in a State if no State entity 
receives a grant; $100,000,000 for grants to charter management 
organizations for the replication and expansion of high-quality 
charter schools; $26,000,000 for facilities financing 
assistance, of which not less than $16,000,000 shall be for the 
per-pupil facilities aid program; and not less than $11,000,000 
for national activities to provide technical assistance, 
disseminate best practices, and evaluate the impact of the 
charter school program.
Magnet Schools Assistance
    The Committee recommends $96,647,000 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; transportation, as long as 
such expenses are sustainable beyond the grant period and not a 
significant portion of the grant; and the purchase of 
technology, educational materials, and equipment.
Fund for the Improvement of Education
    The Committee recommendation does not include funding for 
FIE, which was eliminated in ESSA. For comparability, funding 
for programs funded under FIE in fiscal year 2016 that were 
separately authorized in ESSA are shown as separate programs in 
both fiscal year 2016 and fiscal year 2017.
Arts in Education
    The Committee recommendation includes $27,000,000 for the 
Arts in Education program. 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.
Javits Gifted and Talented Students
    The Committee recommendation includes $12,000,000 for the 
Javits Gifted and Talented Students Education program. Funds 
are used for awards to State and local educational agencies, 
institutions of higher education, and other public and private 
agencies for research, demonstration, and technical assistance 
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.
American History and Civics Academies
    The Committee recommendation includes $1,815,000 for 
American History and Civics Academies. Presidential Academies 
for the Teaching of American History and Civics offer 
residential workshops to elementary and secondary school 
teachers to strengthen their knowledge through instruction and 
interaction with primary scholars and accomplished teachers in 
these fields. The Congressional Academies for Students of 
American History and Civics provide similar workshops to 
students to enrich their understanding of American history and 
civics.
Teacher and School Leader Incentive Grants
    The Committee recommendation includes $213,000,000 for 
Teacher and School Leader Incentive Grants.
    This program, newly authorized in ESSA and the successor to 
the Teacher Incentive Fund, provides competitive grants to 
eligible entities to develop, implement, improve, or expand 
human capital management systems or performance-based 
compensation systems in schools. Funds can be used for a wide-
range of activities, including developing or improving 
evaluation and support systems that are based in part on 
student achievement; providing principals with necessary tools 
to make school-level decisions; implementing a differentiated 
salary structure based on a variety of factors; improving the 
recruitment and retaining of effective teachers, principals, 
and other school leaders; and instituting career advancement 
opportunities that reward effective teachers, principals and 
other school leaders.
Ready-To-Learn Television
    The Committee recommendation includes $25,741,000 for the 
Ready-to-Learn Television program.
    This program is designed to facilitate student academic 
achievement by leveraging the power and reach of public 
television to develop and distribute educational video 
programming for preschool and elementary school children and 
their parents.
Advanced Placement
    The Committee recommendation does not include funding for 
Advanced Placement [AP] programs. ESSA eliminated the AP 
program and consolidated the funding into a new Student Support 
and Academic Enrichment Grants program. The Committee 
recommendation is consistent with this consolidation.
Supporting Effective Educator Development
    The Committee recommendation includes $87,000,000 for the 
Supporting Effective Educator Development [SEED] program. SEED 
provides competitive grants to improve teacher and principal 
effectiveness by supporting pathways that help teachers, 
principals, or other school leaders with non-traditional 
preparation and certification obtain employment in underserved 
LEAs; providing evidence-based professional development; and 
making services and learning opportunities freely available to 
LEAs.
    This program was formerly funded as a set-aside of the 
title II Teacher Quality State Grants program. ESSA authorized 
SEED as a separate program and the Committee recommendation is 
consistent with that authorization.
    The Committee notes that funding provided in fiscal year 
2016 for this program, as a set-aside of the former title II 
Teacher Quality State Grants program, and funding provided in 
this bill for a separately authorized SEED program is all 
available through September 30, 2017. The Committee directs the 
Department to manage these appropriations efficiently, in a 
manner that is beneficial to all potential grantees and 
simplifies administration of the program. Further, the 
Committee directs the Department to ensure a smooth transition 
in program costs from fiscal year 2017 through fiscal year 
2018.
    Within the total for SEED, the Committee includes funding 
for a competitive award to establish a consortium of 
university-led centers operating in multiple States, to improve 
academic preparation and college readiness, including the 
college-and-career pipeline, of rural youth. Such a consortium 
would increase access to workshops and partnerships for new and 
experienced educators, and should support teachers in all grade 
levels and across disciplines, kindergarten through university, 
as well as students, families, and community members, in high-
need rural areas. University-led centers would be able to focus 
on the specific needs of local rural communities, schools, 
teachers, and students in their State. Specific activities 
could include professional development and on-site programming 
for teachers and school administrators throughout the year, 
youth writing and literacy programs, and community-based 
workshops.
STEM Master Teacher Corps
    The Committee recommendation does not include funding for 
the STEM Master Teacher Corps program, a new program authorized 
in ESSA.
Stronger Together
    The Committee recommendation does not include funding for 
Stronger Together, a new, unauthorized program.
Next Generation High Schools
    The Committee recommendation does not include funding for 
Next Generation High Schools, a new, unauthorized program.
Computer Science for All Development Grants
    The Committee recommendation does not include funding for 
Computer Science for All Development Grants, a new, 
unauthorized program. However, the Committee notes the Student 
Support and Academic Enrichment Grants program authorizes a 
range of activities to support well-rounded educational 
opportunities including computer science.
Teach to Lead
    The Committee recommendation does not include funding for 
Teach to Lead, a new, unauthorized program.

                 Safe Schools and Citizenship Education

Appropriations, 2016....................................    $254,815,000
Budget estimate, 2017...................................     228,000,000
Committee recommendation................................     143,254,000

    The Committee recommends a total of $143,254,000 for 
activities to promote safe schools, healthy students, and 
citizenship education.
Promise Neighborhoods
    The Committee recommendation includes $73,254,000 for the 
Promise Neighborhoods program. This program awards competitive 
grants 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.
    The Committee strongly believes that Promise Neighborhoods 
grantees may need more than 5 years to implement the 
transformational reforms and demonstrate the results in 
underserved communities envisioned by this program. ESSA, which 
authorizes Promise Neighborhoods as a stand-alone program, 
allows the Department to extend Promise Neighborhoods grants 
for a period of up to 2 years. This bill extends that authority 
to grants made under the previous authorization of the program. 
The Committee directs the Department to use that authority to 
extend funding for current high-quality Promise Neighborhoods 
programs operating in underserved areas that have demonstrated 
promising results through their initial implementation grant 
and propose to continue pursuing ambitious goals through 
continued innovative activities during such extension of their 
award. Further, the Committee directs the Department to ensure 
that in any new grant competition, the Department gives equal 
weight to new and current programs, including grantees 
proposing to continue programs operating in a particular 
neighborhood or community, provided they can demonstrate 
successful outcomes and justify the need for continued funding.
School Safety National Activities
    The Committee recommendation includes $70,000,000 for the 
national activities portion of the Safe and Drug-Free Schools 
and Communities program, including up to $5,000,000 for Project 
SERV. This funding will help schools address the consequences 
of their students witnessing or beingthe victim of violence and 
other root causes of unhealthy school climates. The Committee 
recommendation includes sufficient funding for Project SERV to 
help restore a stable and safe learning environment for 
schools, students and educators who have experienced violent or 
traumatic situations, including through the provision of 
extended services grants.
    The Committee recommendation includes $5,000,000 to 
continue an initiative started in fiscal year 2016 to improve 
school-based services for children in communities that have 
experienced significant episodes of civil unrest. This funding 
supports the establishment of school-based programs in such 
communities to address, including through counseling services, 
the comprehensive educational, behavioral, and mental health 
needs of youth who have experienced significant trauma related 
to recent events in their communities. This program is 
administered in coordination with SAMHSA.
Elementary and Secondary School Counseling
    The Committee recommendation does not include funding for 
the Elementary and Secondary School Counseling program. ESSA 
eliminated this program and consolidated the funding into a new 
Student Support and Academic Enrichment Grants program. The 
Committee recommendation is consistent with this consolidation.
Carol M. White Physical Education for Progress Program
    The Committee recommendation does not include funding for 
the physical education program. ESSA eliminated this program 
and consolidated the funding into a new Student Support and 
Academic Enrichment Grants program. The Committee 
recommendation is consistent with this consolidation.
Full Service Community Schools
    The Committee recommendation does not include funding for 
Full Service Community Schools. This program provides grants to 
LEAs, in partnership with community-based organizations, 
nonprofits, and other organizations, to provide comprehensive 
academic, social, and health services for students, student's 
families, and community members that will result in improved 
education outcomes for children.

                      English Language Acquisition

Appropriations, 2016....................................    $737,400,000
Budget estimate, 2017...................................     800,400,000
Committee recommendation................................     737,400,000

    The Committee recommends an appropriation of $737,400,000 
for the English Language Acquisition program.
    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. National activities funds 
shall be available for 2 years.

                           Special Education

Appropriations, 2016.................................... $12,976,858,000
Budget estimate, 2017...................................  13,066,858,000
Committee recommendation................................  13,019,358,000

    The Committee recommends an appropriation of 
$13,019,358,000 for special education programs.
Grants to States
    The Committee recommendation includes $11,952,848,000 for 
IDEA Part B 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 2017-2018 academic year. Of the 
funds available for this program, $2,669,465,000 will become 
available on July 1, 2017, and $9,283,383,000 will become 
available on October 1, 2017. These funds will remain available 
for obligation through September 30, 2018.
    The Committee recommendation includes bill language 
continuing several provisions relating to MOE requirements, as 
requested by the administration.
Preschool Grants
    The Committee recommends $368,238,000 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 $458,556,000 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 State-wide 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.
State Personnel Development
    The Committee recommends $41,630,000 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 $56,928,000 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.
    Within the total, the Committee recommendation includes 
$12,583,000, an increase of $2,500,000 above the fiscal year 
2016 funding level and the budget request, to support 
activities authorized by the Special Olympics Sport and 
Empowerment Act, including Project UNIFY. This funding supports 
efforts to expand Special Olympics programs and the design and 
implementation of Special Olympics education programs that can 
be integrated into classroom instruction and are consistent 
with academic content standards.
Personnel Preparation
    The Committee recommends $83,700,000 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 $27,411,000 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 $30,047,000 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.
    The Committee recognizes the ongoing progress made with the 
tools and services provided under the Educational Technology, 
Media and Materials program that have allowed more than 380,000 
students with disabilities free access to more than 325,000 
books in digitally accessible formats. The Committee strongly 
encourages continued effort to expand this program's reach to 
K-12 students in underserved areas.

                        Rehabilitation Services

Appropriations, 2016....................................  $3,529,605,000
Budget estimate, 2017...................................   3,541,389,000
Committee recommendation................................   3,536,389,000

Vocational Rehabilitation State Grants
    The Committee recommends $3,398,554,000 in mandatory 
funding for Vocational Rehabilitation [VR] State Grants.
    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 for 
VR State Grants be set aside for Grants for American Indians.
    The Committee recommendation continues bill language 
allowing the Department to use unobligated VR State grant funds 
that remain available subsequent to the reallottment process, 
to be used for innovative activities to improve outcomes for 
individuals with disabilities, including for the PROMISE 
initiative.
Client Assistance State Grants
    The Committee recommends $13,000,000 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. 
States must operate client assistance programs to receive VR 
State Grant funds.
Training
    The Committee recommends $30,188,000 for training 
rehabilitation personnel. This program supports grants to 
provide training to new VR staff, or upgrade the qualifications 
of existing staff.
Demonstration and Training Programs
    The Committee recommendation includes $5,796,000 for 
demonstration and training programs. These programs support 
activities designed to increase employment opportunities for 
individuals with disabilities by expanding and improving the 
availability and provision of rehabilitation and other 
services.
Protection and Advocacy of Individual Rights
    The Committee recommends $17,650,000 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 the 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 recommendation includes $27,548,000 for the 
Supported Employment State Grants Program. This program 
supports collaborative programs between States and appropriate 
public and private nonprofit organizations to provide supported 
employment services for individuals with the most significant 
disabilities.
Independent Living Services for Older Individuals Who Are Blind
    The Committee recommends $33,317,000 for Independent Living 
State Grants.
    This program supports assistance to individuals over age 55 
to help them adjust to their blindness and continue to live 
independently, including daily living skills training, 
counseling, community integration information and referral, the 
provision of low-vision and communication devices, and low-
vision screening.
Helen Keller National Center
    The Committee recommends $10,336,000 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 10 
regional field offices that provide referral and counseling 
assistance to deaf-blind persons; and an affiliate network of 
agencies.

           Special Institutions for Persons With Disabilities

                 AMERICAN PRINTING HOUSE FOR THE BLIND

Appropriations, 2016....................................     $25,431,000
Budget estimate, 2017...................................      25,431,000
Committee recommendation................................      25,431,000

    The Committee recommends $25,431,000 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 65 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 commends APH for the significant progress 
being made through the Resources with Enhanced Accessibility 
for Learning [REAL] Plan toward developing new technologies to 
translate educational materials for delivery to students who 
are blind and visually impaired. These technological advances 
will provide educational materials to students more quickly 
than ever before, enhancing opportunities for academic 
achievement. The Committee continues to support implementation 
of the REAL plan, and includes no less than $475,000 for such 
activities, the same as the fiscal year 2016 level.

               NATIONAL TECHNICAL INSTITUTE FOR THE DEAF

Appropriations, 2016....................................     $70,016,000
Budget estimate, 2017...................................      70,016,000
Committee recommendation................................      70,016,000

    The Committee recommends $70,016,000 for the National 
Technical Institute for the Deaf [NTID].
    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.
    The Committee recommendation includes $2,000,000 in 
continued funding to support NTIDs operational costs and to 
continue support for at least one regional partnership via a 
subcontract with an external organization consistent with its 
mission and strategic plan. These partnerships enable NTID to 
expand the geographic reach of services and activities 
supported by the college for individuals who are deaf and hard 
of hearing. The partnership activities include a focus on: 
promoting training and postsecondary participation in STEM 
fields; working with NTID faculty to develop postsecondary 
preparation for students; providing professional development 
for teachers and developing partnerships with business and 
industry to promote employment opportunities for individuals 
who are deaf and hard of hearing.

                          GALLAUDET UNIVERSITY

Appropriations, 2016....................................    $121,275,000
Budget estimate, 2017...................................     121,275,000
Committee recommendation................................     121,275,000

    The Committee recommends $121,275,000 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.
    This 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.

                 Career, Technical, and Adult Education

Appropriations, 2016....................................  $1,720,686,000
Budget estimate, 2017...................................   1,808,686,000
Committee recommendation................................   1,720,686,000
Career and Technical Education
    The Committee recommends $1,125,019,000 for the Career and 
Technical Education [CTE] account.
    State Grants.--The Committee recommends $1,117,598,000 for 
CTE State grants. The budget request included an increase of 
$75,000,000 for this program for a new American Technical 
Training Fund, a new competitive grant program as part of a 
larger reauthorization proposal for the Carl D Perkins Career 
and Technical Education Act. The Committee recommendation does 
not include funding for this activity.
    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, $326,598,000 will 
become available July 1, 2017, and $791,000,000 will become 
available on October 1, 2017. These funds will remain available 
for obligation until September 30, 2018.
    National Programs.--The Committee recommends $7,421,000 to 
support research, development, demonstration, dissemination, 
evaluation, and assessment of activities aimed at improving the 
quality and effectiveness of CTE.
Adult Education
    The Committee recommends $595,667,000 for Adult Education 
programs.
    Adult Education State Grants.--The Committee recommendation 
includes $581,955,000 for Adult Education State Grants, which 
provides grants to States for programs that assist adults in 
becoming literate and in obtaining the skills necessary for 
employment and self-sufficiency.
    National Leadership Activities.--The Committee recommends 
$13,712,000 for adult education national leadership activities.

                      Student Financial Assistance

Appropriations, 2016.................................... $24,198,210,000
Budget estimate, 2017...................................  24,198,210,000
Committee recommendation................................  24,198,210,000

    The Committee recommends an appropriation of 
$24,198,210,000 for programs under the Student Financial 
Assistance account.
Federal Pell Grant Program
    The Committee recommends $22,475,352,000 in discretionary 
funding for the Pell grant program. Pell grants provide need-
based financial assistance that helps undergraduate students 
and their families defray a portion of the costs of 
postsecondary education. Awards are determined according to a 
statutory need-analysis formula that takes into account a 
student's family income and assets, household size, and the 
number of family members, excluding parents, attending 
postsecondary institutions.
    The Committee recommended funding level is more than 
sufficient to support an increase in the maximum Pell grant 
award, from $5,815 for the 2016-17 school year to an estimated 
$5,935 for the 2017-18 school year.
    Over the last several years, the Labor-HHS-Education bill 
has appropriated significantly more discretionary funding than 
has been needed to fully fund the Pell grant program. That was 
in anticipation of future increased costs in the program, which 
have not materialized. Instead, projected costs have 
significantly, and consistently, decreased year-after-year 
relative to prior estimates. This has resulted in significant 
current and projected unobligated balances that are expected to 
persist through fiscal year 2024. CBO's estimate of the fiscal 
year 2015 Omnibus projected unobligated Pell ``surplus'' 
funding would be exhausted in fiscal year 2016, and there would 
be a $206,000,000 shortfall in funding. In the most recent 
estimate, with no increase in funding or legislative changes to 
the program in the meantime, CBO now estimates, instead of a 
shortfall in funding, there will be surplus funding of 
$7,754,000,000 in fiscal year 2016, that will grow to over 
$9,000,000,000 by fiscal year 2018, and will not be fully 
exhausted until fiscal year 2025.
    Given the significant unobligated balances in the program, 
the projected balances going forward, and the significant 
improvement in the overall discretionary funding outlook for 
the program, the Committee recommendation restores and modifies 
a provision previously implemented from the Higher Education 
Opportunity Act of 2008 allowing students to receive Pell 
grants year-round. This provision will allow a student who has 
exhausted their Pell grant award for the academic year, and 
wishes to enroll in additional coursework, to receive a Pell 
grant for an additional payment period during the academic 
year, traditionally the summer term. The total Pell grant a 
student may receive during an academic year, who is receiving 
an additional Pell grant under this provision, is capped at 150 
percent of the maximum Pell grant award. Currently, full-time 
students and some part-time students exhaust their Pell grant 
award after two semesters or the equivalent. This expanded 
eligibility and flexibility for the Pell grant program will 
provide an incentive for students to take classes year-round 
and stay continuously enrolled. This will help students stay on 
track for graduation or accelerate completion of their program. 
This provision is expected to provide an estimated 1 million 
students an average additional Pell grant of $1,650 for the 
2017-2018 award year.
    The Committee intends the expanded eligibility to be 
implemented in such a way to maximize flexibility for 
institutions of higher education and avoid unnecessary 
administrative burdens associated with the previous 
implementation of year-round Pell grants, while still ensuring 
the best interests of students. The Committee believes that 
this can be facilitated by issuing guidance on this expanded 
authority not later than 90 days after enactment of this act. 
The Committee strongly encourages the Department to implement 
this provision as soon as possible. The Committee also expects 
the Department to provide reliable data on the implementation 
of this provision.
    Finally, given the significant decrease in estimated costs 
compared to estimates used in formulating prior year 
appropriations, the Committee recommendation includes a one-
time rescission of $1,200,000,000 from unobligated prior-year 
discretionary balances appropriated in the Labor-HHS-Education 
bill. Based on CBO estimates, after restoring year-round Pell 
and assuming level funding going forward, the discretionary 
costs of the Pell grant program are estimated to be fully 
funded through fiscal year 2021. This one-time rescission 
prevents cuts to other programs in this bill serving students, 
children, families, and workers this coming fiscal year, while 
allowing for targeted increases and investments in other 
critical programs.
Federal Supplemental Educational Opportunity Grant Program
    The Committee recommends $733,130,000 for the Supplemental 
Educational Opportunity Grant [SEOG] program.
    The SEOG program provides funds to approximately 3,700 
postsecondary institutions for need-based grants to more than 
1.5 million 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.
Federal Work-Study Program
    The Committee bill provides $989,728,000 for the Federal 
Work-Study [FWS] program.
    This program provides grants to approximately 3,300 
institutions and helps nearly 700,000 undergraduate, graduate, 
and professional students meet the costs of postsecondary 
education through part-time employment. Institutions must 
provide at least 25 percent of student earnings.
    Within the total for FWS, the Committee recommendation 
includes $8,390,000 for the Work Colleges program authorized 
under section 448 of the HEA.

                       Student Aid Administration

Appropriations, 2016....................................  $1,551,854,000
Budget estimate, 2017...................................   1,631,990,000
Committee recommendation................................   1,546,854,000

    The Committee recommends $1,546,854,000 for the Student Aid 
Administration account. These funds are available until 
September 30, 2018, and support the Department's student aid 
management expenses.
    The Committee recommendation includes $691,643,000 for 
administrative costs and $855,211,000 for loan servicing 
activities.
    The Committee directs the Department to continue to provide 
quarterly reports detailing its obligation plan by quarter for 
student aid administrative activities broken out by servicer 
and activity. Further, any reallocation of funds between 
administrative costs and servicing activities within this 
account should be treated as a reprogramming of funds, and the 
Committee should be notified in advance of any such changes.
    Student Loan Servicing.--The Committee has serious concerns 
about the Department's management of the student loan servicing 
system, including how it has adhered to congressional 
directives, intent, and notice requirements in this area. The 
Department is currently in the process of re-competing 
contracts that will significantly change the current student 
loan servicing system. The Committee supports the Department's 
efforts to improve the student loan servicing process by moving 
to a more simple, consistent, and unified experience for all 
student borrowers and to take steps that will reduce student 
delinquencies and defaults. However, the Committee is concerned 
that other changes the Department is proposing in the current 
solicitation could ultimately jeopardize the quality of service 
to student borrowers. The Committee directs the Department to 
ensure that the new student loan servicing contract includes 
the participation of multiple student loan servicers, each 
responsible for all aspects of servicing loans, which would 
allow the Department to allocate loans to different servicers 
based on performance. The Committee strongly believes this will 
promote competition and increase incentives for such entities 
to provide high-quality service to student borrowers. The 
Department should brief the Committee on Appropriations of the 
House of Representatives and the Senate, the Senate Committee 
on Health, Education, Labor, and Pensions, and the House 
Committee on Education and the Workforce no less than 15 days 
prior to releasing a final request for proposals for a new 
student loan servicing contract.
    Until a new student loan servicing contract is implemented, 
the Committee directs the Department to continue to allocate 
new student loan accounts to servicers based on performance 
compared against all servicers, utilizing common metrics 
established by the Department. The Committee appreciates recent 
efforts to work with servicers to develop these common metrics. 
However, the Committee remains concerned about the quality of 
servicing being provided to borrowers and servicers' compliance 
with the law, and expects the Department to adhere to 
congressional directive to produce a common policies and 
procedures manual that applies to all Direct Loan servicers and 
provides voluntary best practices intended to improve the 
consistency of servicing for student loan borrowers. Finally, 
the Committee directs the Department, no later than March 1, 
2017, to allow Federal student loan borrowers who are 
consolidating their student loans to select from any of the 
existing student loan servicers to service their new 
consolidated student loans. Furthermore, borrowers who are 
consolidating their loans should have ready access to the 
aforementioned common performance metrics to help guide their 
decision for which servicer to select. Allowing the student 
borrower to select from any of the servicers will allow the 
borrower to remain with their existing servicer if they wish 
to, limit unnecessary disruption for borrowers, and provide 
another incentive for servicers to provide high-quality 
services to student borrowers.
    Federal Student Aid Enforcement Office.--The Committee 
notes that in fiscal year 2016 the Department established an 
independent enforcement office within the Office of Federal 
Student Aid. However, budget justification materials provide 
little information about the specific focus of the unit, how it 
will operate and be managed, and how its work will relate to 
and be coordinated with other work being done in FSA, elsewhere 
in the Department, and other enforcement agencies. The 
Committee appreciates the need to ensure students are protected 
and that there is proper oversight of the significant taxpayer 
investment in Federal student aid. However, the Committee 
directs the Secretary to ensure that the work of this unit is 
transparent, and not duplicative of other work being done at 
the Department. The Committee directs the Department to brief 
the Committees on Appropriations of the House of 
Representatives and the Senate, the Senate Health, Education, 
Labor, and Pensions Committee, and House Education and 
Workforce Committee within 30 days of enactment on the current 
and planned actions of this new office. Further, the Secretary 
shall ensure that the Chief Operating Officers reports on the 
operations of the enforcement unit as part of the required 
reports under section 141 of the HEA, including how information 
is shared internally within FSA and between relevant agencies.
    Interagency Task Force on For Profit Colleges.--The 
Committee is concerned about the lack of available public 
information on a task force the Department of Education 
established on for-profit colleges and universities, including 
the frequency of meetings, contact information, and topics of 
discussion and the focus on one particular sector of higher 
education. The Committee directs the Department to brief the 
Committees on Appropriations of the House of Representatives 
and the Senate, the Senate Health, Education, Labor, and 
Pensions Committee, and House Education and Workforce Committee 
within 30 days of enactment on the current and planned actions 
of the taskforce, and how it works with and shares information 
with other Federal and State agencies.
    National Student Loan Data System.-- The Committee 
encourages the Department to determine the steps necessary to 
expand the National Student Loan Data System, develop a new 
system or adopt or improve upon an existing system to ensure 
that borrowers have access to all of their student loan 
information, both Federal and private, in one central online 
location.

                            Higher Education

Appropriations, 2016....................................  $1,982,185,000
Budget estimate, 2017...................................   2,189,200,000
Committee recommendation................................   1,986,792,000

    The Committee recommends an appropriation of $1,986,792,000 
for higher education programs.
Aid for Institutional Development
    The Committee recommends $579,514,000 in discretionary 
funding for Aid for Institutional Development. These totals do 
not include separately authorized and appropriated mandatory 
funding.
    Strengthening Institutions.--The Committee bill recommends 
$86,534,000 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 $107,795,000 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.
    Promoting Postbaccalaureate Opportunities for Hispanic 
Americans.--The Committee recommends $9,671,000 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 $244,694,000 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.
    Strengthening Historically Black Graduate Institutions 
[HBGIs].--The Committee recommends $63,281,000 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 $9,942,000 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.
    Strengthening Asian American and Native American Pacific 
Islander-Serving Institutions [AANAPISIs].--The Committee 
recommends $3,348,000 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.
    Strengthening Alaska Native and Native Hawaiian-Serving 
Institutions [ANNHs].--The Committee recommends $13,802,000 for 
the Strengthening ANNHs program.
    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 Non-Tribal 
Institutions.--The Committee recommends $3,348,000 for this 
program, which serves institutions that enroll at least 10 
percent Native American students and at least 50 percent low-
income students. This program helps 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 $27,599,000 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.
    Strengthening Masters Degree Programs at Historically Black 
Colleges and Universities.--The Committee recommends $9,500,000 
for this program, authorized by section 723 of the HEA. This 
program provides grants to specified colleges and universities 
making a substantial contribution to graduate education 
opportunities at the masters level in mathematics, engineering, 
the physical or natural sciences, computer science, information 
technology, nursing, allied health, or other scientific 
disciplines.
International Education and Foreign Language Studies
    The bill includes a total of $67,271,000 for International 
Education and Foreign Language Studies programs.
    Funds are used to increase the number of experts in foreign 
languages and area or international studies to meet national 
security needs through visits and study in foreign countries.
    Domestic Programs.--The Committee recommends $65,103,000 
for domestic program activities related to international 
education and foreign language studies under title VI of the 
HEA. Funds are used to support centers, programs, and 
fellowships. 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.
    Overseas Programs.--The Committee recommends $2,168,000 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 to improve foreign language and area 
studies education in the United States.
Fund for the Improvement of Postsecondary Education
    The Committee recommendation does not include funding for 
the Fund for the Improvement of Postsecondary Education.
Model Comprehensive Transition and Postsecondary Programs for Students 
        With Intellectual Disabilities
    The Committee recommendation includes $11,800,000 for 
competitive grants to postsecondary institutions to support 
model programs that help students with intellectual 
disabilities transition to and complete college, as authorized 
by section 767 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.
Minority Science and Engineering Improvement
    The Committee recommends $9,648,000 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 $8,286,000 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 $900,000,000 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 Committee recommendation does not include funding for a 
new demonstration program proposed by the administration. The 
Committee also directs the Department, when additional funding 
is provided to non-competing programs based on increased 
appropriations, to provide the maximum amount of flexibility to 
such programs in how to best allocate those additional 
resources under existing authorities. Finally, the Committee 
directs the Department to ensure that fiscal year 2017 grant 
competitions are announced and awarded in a timely manner, to 
allow grantees sufficient lead-time prior to the beginning of 
their program-year.
Gaining Early Awareness and Readiness for Undergraduate Programs
    The Committee recommends $322,754,000 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 continues bill language allowing the 
Department to set aside up to 1.5 percent of the total provided 
for evaluation purposes.
Graduate Assistance in Areas of National Need and Javits Fellowships
    The Committee recommends $29,293,000 to support the 
Graduate Assistance in Areas of National Need [GAANN] program.
    GAANN supports fellowships through 3-year competitive 
grants to graduate academic departments and programs in 
scientific and technical fields and other areas of national 
need as determined by the Secretary. Fellowship recipients must 
have excellent academic records and high financial need and 
must be pursuing doctoral degrees or the highest graduate 
degrees in their academic field. Each fellowship consists of a 
student stipend to cover living costs and an institutional 
payment to cover each fellow's tuition and other expenses. 
Institutions of higher education must match 25 percent of the 
grant amount.
Teacher Quality Partnership Program
    The Committee recommends $43,092,000 for the Teacher 
Quality Partnership [TQP] program. The budget request 
consolidates activities supported by this program into a 
proposed new Teacher and Principals Pathways program. The TQP 
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.
    Within the TQP program, the Committee encourages the 
Department to consider funding for programs, including those 
operating in HBCUs, focused on increasing the number of high-
quality teachers from diverse and underrepresented backgrounds. 
The Committee further directs the Department to ensure that 
grants are distributed among eligible entities that will serve 
geographically diverse areas, including rural areas.
Child Care Access Means Parents in Schools
    The Committee recommendation includes $15,134,000 for the 
Child Care Access Means Parents in Schools program. This 
program provides competitive grants to institutions of higher 
education to establish or support campus-based child care 
programs, to help support needs and participation of low-income 
parents in post-secondary education.
Teacher and Principal Pathways
    The Committee recommendation does not include funding 
Teacher and Principal Pathways, a new, unauthorized program.

                           Howard University

Appropriations, 2016....................................    $221,821,000
Budget estimate, 2017...................................     221,821,000
Committee recommendation................................     221,821,000

    The Committee recommends an appropriation of $221,821,000 
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 38 percent of the 
university's operating costs. The Committee recommends, within 
the funds provided, not less than $3,405,000 for the endowment 
program.
    Howard University Hospital.--Within the funds provided, the 
Committee recommends $27,325,000 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, 2016....................................        $435,000
Budget estimate, 2017...................................         457,000
Committee recommendation................................         435,000

    Federal Administration.--The Committee bill includes 
$435,000 for Federal administration of the CHAFL, College 
Housing Loans, and Higher Education Facilities Loans programs. 
Prior to fiscal year 1994, these programs provided financing 
for the construction, reconstruction, and renovation of 
housing, academic, and other educational facilities. While no 
new loans have been awarded since fiscal year 1993, costs for 
administering the outstanding loans will continue through 2030. 
These funds will be used to reimburse the Department for 
administrative expenses incurred in managing the existing loan 
portfolio.

  Historically Black College and University Capital Financing Program 
                                Account

Appropriations, 2016....................................     $20,484,000
Budget estimate, 2017...................................      20,499,000
Committee recommendation................................      20,484,000

    The Committee recommends $20,484,000 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 an estimated $282,212,855 in 
new loan volume in fiscal year 2017. The remaining $334,000 
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.

                    Institute of Education Sciences

Appropriations, 2016....................................    $618,015,000
Budget estimate, 2017...................................     693,818,000
Committee recommendation................................     612,525,000

    The Committee recommends $612,525,000 for the Institute of 
Education Sciences [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 directs the Director to submit an operating 
plan within 90 days of enactment of this act to the Committees 
on Appropriations of the House of Representatives and the 
Senate detailing how IES plans to allocate funding available to 
the Institute for research, evaluation, and other activities 
authorized under law.
    The Committee is aware of serious concerns about the 
privacy of student data, particularly personally identifiable 
information [PII]. The Committee directs the Department to 
ensure that its employees, contractors, and grantees, including 
States that receive funds from Statewide Longitudinal Data 
System grants, adhere to the strictest and highest standards 
for protecting PII. The Committee further directs the 
Department to report to the Committee, as well as to the Senate 
Health, Education, Labor, and Pensions Committee and the House 
Education and the Workforce Committee, no later than one year 
from the date of enactment of this act, on the actions it has 
taken to comply with this directive.

                RESEARCH, DEVELOPMENT, AND DISSEMINATION

    The Committee recommends $190,000,000 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.
    The Committee recognizes the importance of research in 
guiding the implementation of evidence-based practices 
throughout our education system. The Committee is particularly 
interested in research that addresses the specific needs of 
diverse rural schools. The Committee directs the Department to 
brief the Committees on Appropriations of the Senate and House 
of Representatives within 120 days of enactment on how IES is 
contributing to research in this area.

                               STATISTICS

    The Committee recommends $112,000,000 for data gathering 
and statistical analysis activities at the National Center for 
Education Statistics [NCES].
    NCES collects, analyzes, and reports statistics on 
education in the United States. Activities are carried out 
directly and through grants and contracts. The Center collects 
data on educational institutions at all levels, longitudinal 
data on student progress, and data relevant to public policy. 
NCES also provides technical assistance to SEAs, LEAs, and 
postsecondary institutions.

                   REGIONAL EDUCATIONAL LABORATORIES

    The Committee recommends $54,423,000 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 $54,000,000 for research and 
innovation in special education conducted by the National 
Center for Special Education Research.
    The Center addresses gaps in scientific knowledge to 
improve special education and early intervention services and 
outcomes for infants, toddlers, and children with disabilities. 
Funds provided to the Center are available for obligation for 2 
fiscal years.

               SPECIAL EDUCATION STUDIES AND EVALUATIONS

    The Committee recommends $10,818,000 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 $34,539,000 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.

                               ASSESSMENT

    The Committee recommends $156,745,000 to provide support 
for the National Assessment of Educational Progress [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 
$7,745,000 for the National Assessment Governing Board [NAGB], 
which is responsible for formulating policy for NAEP.
    The Committee is pleased that the NAGB reinstated 
assessments for 8th and 12th grade students in United States 
History, Civics, and Geography. Previous assessments conducted 
by NAGB indicate that fewer than one in four 4th, 8th, and 12th 
grade students at all grade levels are proficient in United 
States History. The Committee directs the NAGB to continue 
administering the assessments in these three areas at least 
every four years, in accordance with the current NAEP schedule. 
According to this schedule, the next administration will be in 
2018.

                        Departmental Management

                         PROGRAM ADMINISTRATION

Appropriations, 2016....................................    $432,000,000
Budget estimate, 2017...................................     474,827,000
Committee recommendation................................     432,000,000

    The Committee recommends $432,000,000 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 is also provided under this account.
    The Committee notes that some have raised concerns about 
the Department's use of guidance documents, including Dear 
Colleague letters, because such documents are not legally 
binding, but regulated entities may interpret them as such. 
Accordingly, the Committee recommendation includes new 
directives in the overview section of the Committee Report for 
each of the Departments and agencies included in this bill 
relating to the use of guidance documents.
    The Committee urges the Secretary to provide clear and 
coordinated technical assistance and guidance for ESEA student 
data collection and reporting early in fiscal year 2017, to 
help States and LEAs prepare for the 2017-18 school year, the 
first full year of implementation of the recent reauthorization 
of ESEA. This could include highlighting existing best 
practices in the field, convening working groups, hosting 
webinars, and other methods that will best support effective 
and efficient data collection and reporting.
    Competitive Grant Priorities for Rural Areas.--The 
Committee urges the Department to continue efforts to ensure 
that competitive grants are reaching rural areas and States so 
that support and solutions developed with Federal funding are 
relevant to and available in such areas.
    Open Textbooks.--The Committee directs the Department to 
provide a report to the Committee no later than 180 days after 
enactment of this act on steps it has taken or plans to take to 
help achieve the highest level of savings possible for students 
through the sustainable, expanded use of open textbooks at 
institutions of higher education and production of the highest 
quality open textbooks.
    Performance Partnerships.--Performance Partnerships allow 
States and localities to demonstrate better ways of improving 
outcomes for disconnected youth (low-income people, ages 14-24, 
who are homeless, in foster care, involved in the justice 
system, or are not working or enrolled in an educational 
institution) by giving them additional flexibility in using 
discretionary funds across multiple Federal programs. States 
and localities that elect to participate in these pilots will 
commit to achieving significant improvements in educational, 
employment and other key outcomes in exchange for this new 
flexibility. This eases the strain on communities trying to 
meet the needs of disconnected youth, while advancing the goals 
of individual Federal programs. In making awards under this 
program the administration shall continue to give priority to 
those communities that have experienced civil unrest. Such 
events in communities across the Nation have illustrated, in 
part, the important need to improve opportunities and services 
for disconnected populations, and Performance Partnerships 
focused in these communities will allow localities to pilot 
better ways of improving outcomes. The Committee also notes 
that thus far a number of factors have led to a more modest 
start to utilizing flexibility available to pilot sites. The 
Committee urges the administration to enhance its efforts 
working with existing and new sites on the full range of 
flexibility that could be employed to improve outcomes for 
youth served through pilot sites. Further, the Committee bill 
also includes language extending the flexibility for current 
and future pilot sites by up to an additional 5 years in 
recognition of the challenges associated with implementing 
sustainable, positive change in systems serving this 
population. Finally, the Committee directs the administration 
to continue to provide annual reports providing the following 
information: detailed summary of all involved pilot programs, 
overview of how pilots were selected, summary of findings from 
the various pilots, and recommendations for Congress on how to 
apply any best practices learned more broadly.
    Pooled Evaluation Authority.--The Committee requests that 
the Department provide a report to the Committees on 
Appropriations on the planned use of pooled evaluation funds 
under section 8601 of the ESEA, consistent with the required 
plan under such section, not later than 15 days prior to any 
transfer of funds.

                        OFFICE FOR CIVIL RIGHTS

Appropriations, 2016....................................    $107,000,000
Budget estimate, 2017...................................     137,708,000
Committee recommendation................................     110,000,000

    The Committee recommends $110,000,000 for the Office of 
Civil Rights [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 INSPECTOR GENERAL

Appropriations, 2016....................................     $59,256,000
Budget estimate, 2017...................................      61,941,000
Committee recommendation................................      59,256,000

    The Committee recommends $59,256,000 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 
Republic of Palau to receive certain Federal funds.
    Section 306. The bill includes a new provision making 
evaluation funds pooled under section 8601 of the ESEA 
available for obligation from July 1, 2017 through September 
30, 2018.
    Section 307. The bill continues a general provision 
allowing certain institutions to continue to use endowment 
income for student scholarships.
    Section 308. The bill continues a provision extending 
authorization of the National Advisory Committee on 
Institutional Quality and Integrity.
    Section 309. The bill continues a provision extending 
authority to provide account maintenance fees to guarantee 
agencies.
    Section 310. The bill includes a new general provision 
expanding eligibility and flexibility in the Pell grant program 
relating to year-round Pell grants.
    Section 311. The bill includes a new general provision 
rescinding discretionary unobligated balances from the Pell 
grant program.

                                TITLE IV

                            RELATED AGENCIES

 Committee for Purchase From People Who Are Blind or Severely Disabled

                         SALARIES AND EXPENSES

Appropriations, 2016....................................      $6,191,000
Budget estimate, 2017...................................      10,612,000
Committee recommendation................................       8,000,000

    The Committee recommends $8,000,000 for the Committee for 
Purchase from People Who Are Blind or Severely Disabled, of 
which no less than $1,000,000 shall be made available for the 
Office of Inspector General.
    The AbilityOne program provides more than 46,000 blind or 
severely disabled Americans with employment opportunities each 
year. 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. Encompassing approximately 
$3,000,000,000 in contracts, it is the Federal Government's 
largest employment program for the severely disabled. The 
Committee is encouraged by the steps the Commission has taken 
to implement the recommendations outlined in the May 2013 GAO 
report addressing the concerns regarding the oversight of the 
Central Nonprofit Agencies, the independent contracted 
organizations which administer the program. The Committee 
directs the Commission to provide an update on these efforts to 
the Committees on Appropriations of the House of 
Representatives and the Senate within 120 days of enactment of 
this act.

             Corporation for National and Community Service

    The 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 $1,030,358,000.

                           OPERATING EXPENSES

Appropriations, 2016....................................    $787,929,000
Budget estimate, 2017...................................     794,608,000
Committee recommendation................................     736,529,000

    The Committee recommends $736,529,000 for the operating 
expenses of CNCS.
Volunteers in Service to America [VISTA]
    The Committee recommends $92,364,000 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 $202,117,000 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. These programs include the Retired 
Senior Volunteer Program [RSVP], the Foster Grandparent 
Program, and the Senior Companion Program.
AmeriCorps State and National Grants
    The Committee recommends $386,010,000 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.
    The fiscal year 2016 appropriations act modified a bill 
language provision to allow CNCS to use an authorized set-aside 
to reserve up to 2.5 percent of program funds for evaluation, 
training, and technical assistance. This provision had 
previously been overridden by appropriations language. The 
Committee directs CNCS to use this authority to provide no less 
than $7,500,000 for training and technical assistance 
activities for State commissions, to expand the capacity of 
current and potential AmeriCorps programs, particularly in 
underserved areas.
    The Committee continues to strongly encourage CNCS to 
provide AmeriCorps grants to organizations to support 
activities in communities that have experienced civil unrest. 
AmeriCorps programs are uniquely situated to respond to such 
sudden crises that have impacted communities across the country 
but also the challenges underlying them. The Committee strongly 
supports activities focused in this area.
    The Committee notes that over the last several years CNCS 
has begun limiting operating funds for professional corps 
programs. The Committee is concerned that significantly 
limiting these resources may have an impact on professional 
corps programs being able to provide high-quality services, 
particularly those operating in underserved communities without 
ready access to other funding sources. The Committee directs 
CNCS to issue clear, extensive guidance as part of their fiscal 
year 2017 request for proposals for AmeriCorps grants outlining 
specifically how grantees can demonstrate and justify the need 
for operating funds as part of their professional corps grant. 
Further, the Committee directs CNCS to provide potential 
grantees flexibility in justifying this need to ensure these 
programs are able to provide high-quality services in all 
communities, regardless of the availability of other funding 
sources. Finally, the Committee directs CNCS to provide a 
report to the Committees on Appropriations on how they have 
awarded operating funds as part of professional corps grants 
from fiscal year 2010 through fiscal year 2016, including a 
breakdown of operating funds provided by programs operating in 
different geographic areas.
    The Committee has serious concerns about CNCS management 
and oversight of its AmeriCorps programs, including grantee 
compliance with Federal laws and CNCS regulations. The 
Committee directs CNCS to submit a report to the Committee on 
what specific steps it has taken, and plans to take, to improve 
oversight of AmeriCorps programs, and to ensure compliance with 
Federal laws and regulations.
    The Committee encourages CNCS to work with State service 
commissions, current grantees engaged in service-learning 
activities, and other relevant stakeholders, to create a plan 
to support activities and programs previously sustained by 
Learn and Serve America.
National Civilian Community Corps [NCCC]
    The Committee recommendation includes $30,000,000 for NCCC, 
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 $5,000,000 for 
innovation, demonstration, and assistance activities.
    Social Innovation Fund [SIF].--The Committee recommendation 
does not include funding for SIF and instead focuses resources 
on the core national and community service activities at CNCS.
    Volunteer Generation Fund.--Within the total, the Committee 
recommendation includes $3,800,000 for the Volunteer Generation 
Fund authorized under section 198P of the SERVE America Act, 
the same as the comparable fiscal year 2016 funding level.
Evaluation
    The Committee recommendation includes $4,000,000 for CNCS 
evaluation activities.
State Commission Grants
    The Committee recommendation includes $17,038,000 for State 
Commission Grants.
    The Committee strongly encourages CNCS to improve 
coordination with State commissions as part of CNCS' grant 
making process, including in announcing the availability and 
awarding of funds under AmeriCorps. State Commissions are a 
vital local resource and primary point of entry for national 
and community service at the local level. Improving 
coordination between CNCS and local State commissions would 
improve the administration of service programs at the local 
level and promote innovation by supporting the organizations 
that know their communities best.

                 PAYMENT TO THE NATIONAL SERVICE TRUST

Appropriations, 2016....................................    $220,000,000
Budget estimate, 2017...................................     206,842,000
Committee recommendation................................     206,842,000

    The Committee recommends an appropriation of $206,842,000 
for making payments to the National Service Trust, as requested 
by the administration.
    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.

                         SALARIES AND EXPENSES

Appropriations, 2016....................................     $81,737,000
Budget estimate, 2017...................................      89,330,000
Committee recommendation................................      81,737,000

    The Committee recommends an appropriation of $81,737,000 
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.

                      OFFICE OF INSPECTOR GENERAL

Appropriations, 2016....................................      $5,250,000
Budget estimate, 2017...................................       6,100,000
Committee recommendation................................       5,250,000

    The Committee recommends an appropriation of $5,250,000 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.

                       ADMINISTRATIVE PROVISIONS

    The Committee retains language from the fiscal year 2016 
appropriations act concerning five 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); aligning requirements regarding the use of 
Education Awards at GI bill-eligible institutions (section 
404); and allowing the required background check of certain 
applicants to be processed by States under terms of the 
National Child Protection Act (section 405).

                  Corporation for Public Broadcasting

Appropriations, 2018....................................    $445,000,000
Budget estimate, 2019...................................     445,000,000
Committee recommendation, 2019..........................     445,000,000

    The Committee recommends $445,000,000 for the Corporation 
for Public Broadcasting [CPB] as an advance appropriation for 
fiscal year 2019.
    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.
    The Committee recommendation includes the additional 
$50,000,000 in fiscal year 2017 requested for the replacement 
of the public broadcasting interconnection system. Technology 
and distribution systems have greatly evolved since Congress 
established the practice of funding the public television and 
radio interconnection systems. The Committee is aware that 
improved technology may enable the public television and radio 
stations to share certain elements of the planned 
interconnection system, leading to greater efficiencies.

               Federal Mediation and Conciliation Service


                         SALARIES AND EXPENSES

Appropriations, 2016....................................     $48,748,000
Budget estimate, 2017...................................      50,738,000
Committee recommendation................................      48,638,000

    The Committee recommends $48,638,000 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, FMCS may utilize up to $2,500,000 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, 2016....................................     $17,085,000
Budget estimate, 2017...................................      17,184,000
Committee recommendation................................      17,184,000

    The Committee recommends $17,184,000 for the Federal Mine 
Safety and Health Review Commission [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's decisions. In allocating resources and staff, the 
Committee directs the Commission to make reducing the excessive 
time substantive cases on appeal are awaiting a decision a top 
priority.

                Institute of Museum and Library Services

       OFFICE OF MUSEUM AND LIBRARIES: GRANTS AND ADMINISTRATION

Appropriations, 2016....................................    $230,000,000
Budget estimate, 2017...................................     230,000,000
Committee recommendation................................     231,000,000

    The Committee recommends $231,000,000 for the Institute of 
Museum and Library Services [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 2016  Fiscal year 2017      Committee
                      Budget activity                         appropriation        request       recommendation
----------------------------------------------------------------------------------------------------------------
Library Services Technology Act (LSTA):
    Grants to States......................................           155,789           154,848           156,103
    Native American Library Services......................             4,063             3,861             3,861
    National Leadership: Libraries........................            13,092            13,720            13,406
    Laura Bush 21st Century Librarian.....................            10,000            10,000            10,000
                                                           -----------------------------------------------------
      Subtotal LSTA.......................................           182,944           182,429           183,370
 
Museum Services Act:
    Museums for America...................................            21,149            20,200            20,392
    Native American/Hawaiian Museum Services..............               972               924               924
    National Leadership: Museums..........................             7,741             9,120             9,120
                                                           -----------------------------------------------------
      Subtotal, MSA.......................................            29,862            30,244            30,436
 
African American History and Culture Act..................             1,481             1,407             1,481
Administration............................................             1,713             1,920             1,713
Research, Analysis and Data Collection....................            14,000            14,000            14,000
                                                           -----------------------------------------------------
      IMLS Total..........................................           230,000           230,000           231,000
----------------------------------------------------------------------------------------------------------------

            Medicaid and CHIP Payment and Access Commission

                         SALARIES AND EXPENSES

Appropriations, 2016....................................      $7,765,000
Budget estimate, 2017...................................       8,700,000
Committee recommendation................................       7,765,000

    The Committee recommends $7,765,000 for the Medicaid and 
CHIP Payment and Access Commission [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 carry out these 
activities.

                  Medicare Payment Advisory Commission

                         SALARIES AND EXPENSES

Appropriations, 2016....................................     $11,925,000
Budget estimate, 2017...................................      12,234,000
Committee recommendation................................      11,925,000

    The Committee recommends $11,925,000 for the Medicare 
Payment Advisory Commission [MedPAC], which provides 
independent policy and technical advice on issues affecting the 
Medicare program.

                     National Council on Disability

                         SALARIES AND EXPENSES

Appropriations, 2016....................................      $3,250,000
Budget estimate, 2017...................................       3,468,000
Committee recommendation................................       3,439,000

    The Committee recommends $3,439,000 for the National 
Council on Disability [NCD]. NCD is mandated to make 
recommendations to the President, Congress, the Rehabilitation 
Services Administration, and the National Institute on 
Disability and Rehabilitation Research on issues of concern to 
individuals with disabilities. The Council gathers information 
on the implementation, effectiveness, and impact of the 
Americans with Disabilities Act and examines emerging policy 
issues as they affect persons with disabilities and their 
ability to enter or re-enter the Nation's workforce and to live 
independently.

                     National Labor Relations Board

                         SALARIES AND EXPENSES

Appropriations, 2016....................................    $274,224,000
Budget estimate, 2017...................................     274,695,000
Committee recommendation................................     274,224,000

    The Committee recommends $274,224,000 for the National 
Labor Relations Board [NLRB or ``the Board''], which 
administers and enforces the National Labor Relations Act and 
protects employee and employer rights provided under that act.
    The Committee is aware of concerns expressed by some 
employers that employee professional development and mobility 
may be hindered by having collective bargaining units that are 
limited to distinct departments within a workplace. The 
Committee requests the NLRB to report back to the Committee 
regarding these concerns, and any suggestions to ensure that 
cross-training and career advancement may continue between 
employees in departments who are represented by a union, and 
employees in departments who are not represented by a union.
    In the fiscal year 2016 report, the Committee noted that 
the Board had submitted a diminished, superficial CJ for its 
appropriations request. In previous years, the NLRB 
justification had provided far more complete information about 
workload, performance, administrative plans and priorities, and 
other supporting detail relevant to its annual budget 
requirements. The Committee requires more substantial 
information about the agencies' activities and needs to 
appropriate resources among many competing priorities. 
Unfortunately, the Board ignored the Committee's direction and 
again submitted an incomplete CJ with little justification. The 
Board is once again directed to provide justification for its 
fiscal year 2018 request, including at least as much detail as 
it has traditionally provided prior to fiscal year 2016.

                       ADMINISTRATIVE PROVISIONS

    The Committee maintains language from the fiscal year 2016 
appropriations act restricting the use of electronic voting 
(section 406).

                        National Mediation Board

                         SALARIES AND EXPENSES

Appropriations, 2016....................................     $13,230,000
Budget estimate, 2017...................................      13,300,000
Committee recommendation................................      14,000,000

    The Committee recommends $14,000,000 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 bill provides an additional $700,000 above the 
administration's request for NMB and directs the additional 
funds to be used for arbitrator salaries and expenses. The 
Committee is concerned about the length of time it takes the 
NMB to resolve arbitration cases, and the impact that the delay 
has on the individuals served by the NMB. The Committee directs 
the NMB to provide detailed information as to how these funds 
are used and their impact on the backlog in the fiscal year 
2018 CJ.

            Occupational Safety and Health Review Commission

                         SALARIES AND EXPENSES

Appropriations, 2016....................................     $12,639,000
Budget estimate, 2017...................................      13,411,000
Committee recommendation................................      13,411,000

    The Committee recommends $13,411,000 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, 2016....................................     $29,000,000
Budget estimate, 2017...................................      25,000,000
Committee recommendation................................      25,000,000

    The Committee recommends $25,000,000 for the Dual Benefits 
Payments Account. This amount includes an estimated $2,000,000 
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 ACCOUNTS

Appropriations, 2016....................................        $150,000
Budget estimate, 2017...................................         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, 2016....................................    $111,225,000
Budget estimate, 2017...................................     122,499,000
Committee recommendation................................     113,500,000

    The Committee recommends $113,500,000 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 maintains bill language giving RRB the 
authority to hire new attorneys in the excepted service.

           LIMITATION ON THE OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2016....................................      $8,437,000
Budget estimate, 2017...................................      10,499,000
Committee recommendation................................      10,000,000

    The Committee recommends $10,000,000 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, 2016....................................     $11,400,000
Budget estimate, 2017...................................      11,400,000
Committee recommendation................................      11,400,000

    The Committee recommends $11,400,000 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, 2016.................................... $46,305,733,000
Budget estimate, 2017...................................  43,824,868,000
Committee recommendation................................  43,618,163,000

    The Committee recommends $43,618,163,000 in fiscal year 
2017 mandatory funds for the SSI program. This is in addition 
to the $14,500,000,000 provided in the fiscal year 2016 
appropriations act for the first quarter of fiscal year 2017. 
In addition, the Committee recommends $15,000,000,000 in 
advance funding for the first quarter of fiscal year 2018. 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 2017 
program level of $52,941,736,000 for Federal benefit payments. 
This will support an average monthly benefit of approximately 
$561 for 8,200,000 recipients.
Beneficiary Services
    The Committee recommendation includes $89,000,000 in new 
mandatory budget authority for beneficiary services.
    These funds reimburse vocational rehabilitation [VR] 
agencies for successfully rehabilitating disabled SSI 
recipients by helping them achieve and sustain productive, 
self-supporting work activity. Funds also support the Ticket to 
Work program that provides SSI recipients with a ticket to 
offer employment networks [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 $58,000,000 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.
    The Committee commends the SSA for developing a pilot to 
test innovative and evidence-based approaches to improving 
outcomes for individuals with disabilities who are eligible for 
Social Security disability benefits as well as youth through 
the multi-agency PROMISE initiative. The Committee strongly 
encourages SSA to consider what is being learned from the 
PROMISE evaluation in order to undertake further demonstration 
project work for young adults with disabilities who are 
eligible for SSI. In developing this initiative, the Committee 
directs the SSA to work in close consultation with the 
Departments of Labor, Education and Health and Human Services, 
and nationwide disability and peer advocacy organizations. The 
Committee also directs the SSA to submit a report to the House 
and Senate Appropriations Committees no later than 180 days 
after the enactment of this act regarding the agency's progress 
in developing this proposal.
Administrative Expenses
    The Committee recommendation includes $5,029,427,000 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, 2016.................................... $12,161,945,000
Budget estimate, 2017...................................  13,064,000,000
Committee recommendation................................  12,481,945,000

    The Committee recommends $12,481,945,000 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 recommendation includes $1,819,000,000 for 
program integrity activities, including CDRs and SSI 
redeterminations of non-medical eligibility. This includes 
$273,000,000 in base funding and $1,546,000,000 in cap 
adjustment funding allowed under the Budget Control Act [BCA]. 
The Committee recommendation is a $393,000,000 increase over 
the fiscal year 2016 funding level, as specified in the BCA. 
Combined, these activities are estimated to save approximately 
$10,897,000,000 for the Social Security, Medicare, and Medicaid 
programs by preventing waste, fraud, abuse, and improper 
payments.
    The Committee bill adopts language included in the 
President's budget allowing these funds to be used for a 
broader range of program integrity activities identified in the 
BCA. The bill also removes bill language allowing SSA to use 
additional non-cap adjustment program integrity funding for the 
full costs of CDRs and redeterminations given SSA's budgeting 
of the full cost for such activities without this additional 
authority.
    The Committee is supportive of efforts to reduce improper 
payments and improve program integrity in the SSA's disability 
and Supplemental Security Income benefits programs. As part of 
the Bipartisan Budget Act of 2015, Congress empowered SSA to 
enter into an information exchange with a payroll data provider 
to prevent improper payments of such benefits. These programs 
have proven to be beneficial in reducing improper payments for 
other Federal and State benefits programs, and the Committee 
urges SSA to prioritize the utilization of these opportunities.
    Within the funds provided to SSA for continuing disability 
reviews under titles II and XVI of the Social Security Act and 
conducting redeterminations of eligibility, the Committee 
encourages SSA to utilize all of the tools available to it from 
commercial and non-commercial entities that collect and 
maintain data regarding employment and wages, to ensure that 
disability and SSI benefits are properly paid and to reduce 
fraud and abuse. The Committee requests an update in the fiscal 
year 2018 CJ on the progress that SSA has made in utilizing 
additional tools to identify improper payments, as well as 
progress it has made in those efforts.
    Disability Hearing Pilot Program Expansion.--The Committee 
supports SSA's efforts to reduce the backlog of disability 
claims hearings. Given the successful implementation of the 
Disability Hearing Pilot Program in Region 1, the Committee 
encourages SSA to implement the changes on a nationwide level. 
The changes should include providing advance notice of a 
hearing date, and requiring claimants to inform SSA or submit 
written evidence within a certain period in advance of the 
hearing, subject to the good cause exception. Furthermore, as 
recommended in the pilot, SSA should consider removing ``new 
and material evidence'' as a basis for reopening any decision 
made at the hearing of Appeals Council levels for benefits 
based on disability. The Committee requests a report on plans 
for implementation no later than 60 days after the enactment of 
this act.
    Duplication.--As part of its annual duplication report GAO 
identified areas within the SSA where there are opportunities 
to improve efficiency and effectiveness and reduce costs. GAO 
report 15-531 recommends that the SSA evaluate the costs and 
benefits of alternatives for reducing the potential 
overpayments to individuals receiving concurrent Federal 
Employees' Compensation Act payments to determine how best to 
strengthen internal controls. The Committee is encouraged by 
the Administration's willingness to implement these 
recommendations, and requests a report on the progress of the 
implementation in the fiscal year 2018 CJ.
    Medical Vocational Guidelines.--The Committee is dedicated 
to ensuring that the disabled have access to needed benefits, 
and strongly encourages SSA to work with us to achieve that 
goal. The Committee continues to be concerned that SSA uses 
outdated rules to determine whether or not a claimant meets 
SSA's definition of disability. The Committee is encouraged by 
SSA's indication that they are beginning the regulatory 
process, having already received input from the National 
Disability Forum, the National Institute of Medicine, as well 
as various aging and employment experts. These initial steps 
are well received by the Committee as we continue to work with 
the Administration to modernize the outdated vocational 
guidelines into a structure that reflects the 21st century 
labor market. As this is the first significant overhaul of the 
grid in nearly 40 years, the Committee requests SSA to submit, 
no later than 60 days after the enactment of this act, a report 
on its ongoing efforts to update the grid. In addition, the 
report shall include a study assessing the feasibility of 
maintaining a continuous update of the medical vocational 
guidelines every 10 years.
    Muscular Dystrophy.--The Committee is aware that the Social 
Security Administration is included in the Muscular Dystrophy 
Coordinating Committee under the Muscular Dystrophy CARE Act 
Amendments enacted in September 2014. The Committee expects the 
agency to make data available on the rate at which persons with 
Duchenne and Becker Muscular Dystrophy utilize SSA programs, 
particularly those focused on promoting employment and 
community independence such as the Ticket to Work Program.
    Prioritizing Continuing Disability Reviews To Maximize Cost 
Savings.--While the Committee commends SSA on its continued 
Program Integrity efforts towards becoming current with regards 
to the Continuing Disability Review [CDR] backlog, a recent GAO 
report found that SSA's CDR prioritization models fail to 
maximize potential cost savings to the trust funds and the 
Treasury. Within 1 year, and every 3 years thereafter, the 
Committee directs SSA to review and update the models for 
prioritization of CDRs with the primary intent of efficiently 
and effectively maximizing lifetime cost savings to the Federal 
Government, both for the DI trust fund and Treasury. A 
detailed, cost-based explanation for the model's prioritization 
of different CDR types and justification for any updates made 
should be included in the annual CDR Report to Congress.
    Reducing the Hearing Backlog.--The Committee is aware of 
the discord between SSA and the ALJ community regarding the 
implementation of part of SSA's Compassionate and Responsive 
Service [CARES] plan to reduce the significant hearing backlog 
at the agency. Specifically, there is concern regarding the 
Administration's hiring of Administrative Appeals Judges for 
non-disability and remanded cases. The Committee recognizes the 
need for further discussion regarding this matter and 
encourages SSA to engage with the ALJ community and appropriate 
stakeholders to find innovative solutions to address hearing 
wait times, keeping in mind the goal of reducing the backlog to 
serve the over 1.1 million individuals and their families 
awaiting a hearing decision.
    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.
    The Medical Improvement Standard.--The Committee commends 
SSA for its work to improve program integrity. However, the 
Committee is concerned, per previous GAO testimony and report 
findings from the SSA Office of the Inspector General, that 
confusion still exists about the Medical Improvement Standard 
(MIRS) and its exceptions. The Committee directs SSA to submit 
a report no later than 60 days after the enactment of this act 
on its progress in educating Disability Determinations Services 
in the proper application of the MIRS and its exceptions.
    The Treating Physician Rule.--The Committee expects that in 
resolving claims for disability insurance, SSA's consideration 
of medical evidence should reflect the degree of relevance and 
familiarity each medical source has with the effect of an 
individual's medically determinable impairment(s) on his or her 
ability to perform Substantial Gainful Activity [SGA]. Since 
the Treating Physician rule was first published in the Federal 
Register in 1991, healthcare delivery in the United States has 
changed significantly and the Treating Physician rule no longer 
reflects the present reality of the medical personnel with 
greatest knowledge of an individual's physical and/or mental 
condition. The Committee encourages SSA to consider revising 
the controlling weight doctrine in the Treating Physician rule 
and revising its Acceptable Medical Sources to reflect the new 
degree of familiarity with their patients, and rigorous 
training of, nurse practitioners, physician assistants, 
licensed clinical social workers, audiologists, and speech and 
language pathologists for the particular impairments that they 
are well-equipped to treat.
    User Fees.--Within the total for LAE, the Committee 
recommendation includes up to $124,000,000 for administrative 
activities funded from user fees. This includes $123,000,000 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.
    Vocational Experts [VE].--The Committee notes that the 
SSA's OIG has recommended that SSA periodically determine 
whether VE fees are appropriate to obtain the required level of 
VE service. The Committee understands that SSA plans to conduct 
such a review, including benchmark studies of VE fees paid in 
the national economy and those paid by other governmental and 
non-governmental organizations, during SSA's acquisition 
planning process for the contracts to be awarded in fiscal year 
2018. The Committee looks forward to an update in the fiscal 
year 2018 CJ regarding these studies.
    Work Incentives Planning and Assistance [WIPA] and 
Protection and Advocacy for Beneficiaries of Social Security 
[PABSS].--The Committee recommendation includes $23,000,000 for 
WIPA and $7,000,000 for PABSS, the same as the comparable 
fiscal year 2016 levels, respectively. These programs provide 
valuable services to help Social Security disability 
beneficiaries return to work.

                      OFFICE OF INSPECTOR GENERAL

Appropriations, 2016....................................    $105,500,000
Budget estimate, 2017...................................     112,000,000
Committee recommendation................................     105,500,000

    The Committee recommends $105,500,000 for SSA's OIG. This 
includes $75,713,000 funded from the OASI and DI trust funds 
for those programs' share of OIG's expenses and $29,787,000 
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 SSA 
from processing earnings for work performed under a fraudulent 
social security number if based on a conviction for a violation 
under section 208(a)(6) or (7) of the Social Security Act.
    Section 519. The bill continues a provision prohibiting SSA 
from establishing a totalization agreement with Mexico.
    Section 520. The bill continues a provision regarding 
funding for programs that carry out distribution of sterile 
needles or syringes.
    Section 521. The bill continues a provision requiring 
computer networks to block pornography.
    Section 522. The bill continues a provision prohibiting 
funding from going to the Association of Community 
Organizations for Reform Now [ACORN], or any of its affiliates, 
subsidiaries, allied organizations, or successors.
    Section 523. The bill continues a provision related to 
reporting requirements for conference spending.
    Section 524. The bill continues a provision related to 
advertisement costs.
    Section 525. The bill continues a modified provision on 
Performance Partnerships.
    Section 526. The bill continues a provision regarding 
reporting status of balances of appropriations.
    Section 527. The bill includes a new provision 
reauthorizing the Special Olympics Sport and Empowerment Act of 
2004.
    Section 528. The bill continues a provision rescinding 
funds from the Independent Payment Advisory Board.
    Section 529. The bill modifies a provision rescinding funds 
from the Children's Health Insurance Program child enrollment 
contingency fund.
    Section 530. The bill modifies a provision rescinding funds 
from the Children's Health Insurance Program regarding State 
allotments.
    Section 531. The bill includes a new provision rescinding 
funds from the Children's Health Insurance Program Performance 
Bonus Fund.
    Section 532. The bill includes a new provision regarding 
the use of funds in this act for background checks of school 
personnel.

  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: Institute of 
Education Sciences; parts C and D of the Individuals with 
Disabilities Education Act; Special Olympics Sport and 
Empowerment Act of 2004; 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; 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; Low Income 
Home Energy Assistance Program; Refugee and Entrant Assistance 
programs (except for Victims of Trafficking); 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; YouthBuild Transfer Act; 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 June 9, 2016, 
the Committee ordered favorably reported an original bill (S. 
3040) making appropriations for the Departments of Labor, 
Health and Human Services, and Education, and related agencies 
for the fiscal year ending September 30, 2017, and for other 
purposes, provided, that the bill be subject to amendment and 
that the bill be consistent with its budget allocation, and 
provided that the Chairman of the Committee or his designee be 
authorized to offer the substance of the original bill as a 
Committee amendment in the nature of a substitute to the House 
companion measure, by a recorded vote of 29-1, a quorum being 
present. The vote was as follows:
        Yeas                          Nays
Chairman Cochran                    Mr. Lankford
Mr. McConnell
Mr. Shelby
Mr. Alexander
Ms. Collins
Ms. Murkowski
Mr. Graham
Mr. Kirk
Mr. Blunt
Mr. Moran
Mr. Hoeven
Mr. Boozman
Mrs. Capito
Mr. Cassidy
Ms. Mikulski
Mr. Leahy
Mrs. Murray
Mrs. Feinstein
Mr. Durbin
Mr. Reed
Mr. Tester
Mr. Udall
Mrs. Shaheen
Mr. Merkley
Mr. Coons
Mr. Schatz
Ms. Baldwin
Mr. Murphy

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

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

                          TITLE 20--EDUCATION


     CHAPTER 28--HIGHER EDUCATION RESOURCES AND STUDENT ASSISTANCE


                    SUBCHAPTER I--GENERAL PROVISIONS


                 Part B--Additional General Provisions


Sec. 1011c. National Advisory Committee on Institutional Quality and 
                    Integrity

(a) Establishment

           *       *       *       *       *       *       *

(f) Termination

    The Committee shall terminate on September 30, [2016] 2017.

           *       *       *       *       *       *       *


                   SUBCHAPTER IV--STUDENT ASSISTANCE


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


                     SUBPART 1--FEDERAL PELL GRANTS

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

(a) Program authority and method of distribution

           *       *       *       *       *       *       *

(b) Purpose and amount of grants

    (1) * * *

    (7) Additional funds.--

            (A) In general.--* * *

                    (i) * * *

           *       *       *       *       *       *       *

                    (vi) to carry out this section--

                            (I) * * *

           *       *       *       *       *       *       *

                            (VII) [$1,574,000,000] 
                        $1,320,000,000 for fiscal year 2017;

           *       *       *       *       *       *       *

                            (XI) $1,145,000,000 for fiscal year 
                        2021 and each succeeding fiscal year.

    (8)(A) Effective in the 2017-2018 award year and 
thereafter, the Secretary shall award an eligible student not 
more than one and one-half Federal Pell Grants during a single 
award year to permit such student to work toward completion of 
an eligible program if, during that single award year, the 
student--

            (i) has received a Federal Pell Grant for an award 
        year and is enrolled in an eligible program for one or 
        more additional payment periods during the same award 
        year that are not otherwise fully covered by the 
        student's Federal Pell Grant; and

            (ii) is enrolled on at least a half-time basis 
        while receiving any funds under this section.

    (B) In the case of a student receiving more than one 
Federal Pell Grant in a single award year under subparagraph 
(A), the total amount of Federal Pell Grants awarded to such 
student for the award year may exceed the maximum basic grant 
level specified in the appropriate appropriations Act for such 
award year.

    (C) Any period of study covered by a Federal Pell Grant 
awarded under subparagraph (A) shall be included in determining 
a student's duration limit under subsection (c)(5).

    (D) In any case where an eligible student is receiving a 
Federal Pell Grant for a payment period that spans two award 
years, the Secretary shall allow the eligible institution in 
which the student is enrolled to determine the award year to 
which the additional period shall be assigned, as it determines 
is most beneficial to students.

           *       *       *       *       *       *       *


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


Sec. 1087h. Funds for administrative expenses

(a) Program authority and method of distribution

  (1) Mandatory funds for fiscal year 2006

           *       *       *       *       *       *       *

  (4)Continuing mandatory funds for account maintenance fees

    For each of the fiscal years 2007 through [2016] 2017, 
there shall be available to the Secretary, from funds not 
otherwise appropriated, funds to be obligated for account 
maintenance fees payable to guaranty agencies under part B and 
calculated in accordance with subsection (b).
                                ------                                


                TITLE 42--THE PUBLIC HEALTH AND WELFARE


                       Chapter 7--Social Security


        SUBCHAPTER XVIII--HEALTH INSURANCE FOR AGED AND DISABLED


 Part B--Supplementary Medical Insurance Benefits for Aged and Disabled


Sec. 1395w-4. Payment for physicians' services

(a) Payment based on fee schedule

           *       *       *       *       *       *       *

(b) Establishment of fee schedules

  (1) In general

           *       *       *       *       *       *       *

  (11) Special rule for certain radiation therapy services

    The code definitions, the work relative value units under 
subsection (c)(2)(C)(i), and the direct inputs for the practice 
expense relative value units under subsection (c)(2)(C)(ii) for 
radiation treatment delivery and related imaging services 
(identified in 2016 by HCPCS G-codes G6001 through G6015) for 
the fee schedule established under this subsection for services 
furnished in 2017 and 2018 shall be the same as such 
definitions, units, and inputs for such services for the fee 
schedule established for services furnished in 2016.

    (12) Encouraging care management for individuals with 
alzheimer's disease or related dementias.--

            (A) In general.--In order to care for individuals 
        with Alzheimer's disease or related dementias the 
        Secretary shall, subject to subparagraphs (B) and (C), 
        make payment (as the Secretary determines to be 
        appropriate) under this section for a care planning 
        session furnished on or after January 1, 2018, by a 
        physician (as defined in section 1861(r)(1)), physician 
        assistant or nurse practitioner (as defined in section 
        1861(aa)(5)(A)), clinical nurse specialist (as defined 
        in section 1861(aa)(5)(B)), or other practitioners 
        deemed appropriate by the Secretary.

            (B) Policies relating to payment.--In carrying out 
        this paragraph, the Secretary shall--

                    (i) make payment to only one applicable 
                provider for a care planning session furnished 
                to a beneficiary diagnosed with Alzheimer's or 
                related dementia;

                    (ii) not make payment under subparagraph 
                (A) if such payment would be duplicative of 
                payment that is otherwise made under this 
                title; and

                    (iii) not require that an annual wellness 
                visit (as defined in section 1861(hhh)) or an 
                initial preventive physical examination (as 
                defined in section 1861(ww)) be furnished as a 
                condition of payment for such care planning 
                session.

            (C) Requirements.--A care planning session provided 
        under this paragraph shall include the following:

                    (i) An explanation of Alzheimer's disease 
                or related dementias, as well as the expected 
                progression of the disease and related 
                dementias as appropriate.

                    (ii) Creation of a patient-centered 
                comprehensive care plan, as determined 
                appropriate by the Secretary.

                    (iii) Information regarding treatment 
                options.

                    (iv) A discussion of resources and services 
                available in the individual's community that 
                may reduce the individual's health risks and 
                promote self-management of Alzheimer's disease 
                or related dementias.

                    (v) Other information, as determined 
                appropriate by the Secretary.

            (D) Stakeholder input.--The Secretary shall seek 
        input from physicians, practitioners, and other 
        stakeholders regarding the structure of care planning 
        sessions provided under this paragraph.
                                ------                                


             TITLE 48--TERRITORIES AND INSULAR POSSESSIONS


          Chapter 18--Micronesia, Marshall Islands, and Palau


             SUBCHAPTER I--MICRONESIA AND MARSHALL ISLANDS


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


Sec. 1921d. Supplemental provisions

(a) Domestic program requirements

           *       *       *       *       *       *       *

(f) Continuing programs and laws

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

           *       *       *       *       *       *       *

          (A) Emergency and disaster assistance

           *       *       *       *       *       *       *

          (B) Treatment of additional programs

                  (i) Consultation

           *       *       *       *       *       *       *

                  (ix) Applicability

                    The government, institutions, and people of 
                Palau shall remain eligible for appropriations 
                and to receive grants under the provisions of 
                law specified in clauses (ii) and (iii) until 
                the end of fiscal year [2016] 2017, to the 
                extent the government, institutions, and people 
                of Palau were so eligible under such provisions 
                in fiscal year 2003.
                                ------                                


 SPECIAL OLYMPICS SPORT AND EMPOWERMENT ACT OF 2004, PUBLIC LAW 108-406


SEC. 5. AUTHORIZATION OF APPROPRIATIONS.

    There are authorized to be appropriated--

            (1) for grants, contracts, or cooperative 
        agreements under section 3(a), [$5,500,000 for fiscal 
        year 2005, and such sums as may be necessary for each 
        of the 4 succeeding fiscal years;] such sums as may be 
        necessary for fiscal year 2017 and each of the 4 
        succeeding fiscal years;

            (2) for grants, contracts, or cooperative 
        agreements under section 3(b), [$3,500,000 for fiscal 
        year 2005, and such sums as may be necessary for each 
        of the 4 succeeding fiscal years; and] such sums as may 
        be necessary for fiscal year 2017 and each of the 4 
        succeeding fiscal years; and

            (3) for grants, contracts, or cooperative 
        agreements under section 3(c), [$6,000,000 for each of 
        fiscal years 2005 through 2009.] such sums as may be 
        necessary for fiscal year 2017 and each of the 4 
        succeeding fiscal years.
                                ------                                


                CONSOLIDATED APPROPRIATIONS ACT, 2014, 
                           PUBLIC LAW 113-76


   DIVISION H--DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND 
        EDUCATION, AND RELATED AGENCIES APPROPRIATIONS ACT, 2014


                                TITLE V


                           GENERAL PROVISIONS

Sec. 526. (a) Definitions.--* * *

           *       *       *       *       *       *       *

    (b) Use of Discretionary Funds in [Fiscal Year 2014] Fiscal 
Year 2017.--* * *

           *       *       *       *       *       *       *


    (c) Performance Partnership Agreements.* * *

            (1) is entered into between--

           *       *       *       *       *       *       *

            (2) specifies, at a minimum, the following 
        information:

                    (A) the length of the Agreement (which 
                shall not extend beyond [September 30, 2018] 
                September 30, 2021);

           *       *       *       *       *       *       *

    (e) Transfer Authority.--For the purpose of carrying out 
the Pilot in accordance with the Performance Partnership 
Agreement, and subject to the written approval of the Director 
of the Office of Management and Budget, the head of each 
participating Federal agency may transfer Federal discretionary 
funds that are being used in the Pilot to an account of the 
lead Federal administering agency that includes Federal 
discretionary funds that are being used in the Pilot. Subject 
to the waiver authority under subsection (f), such transferred 
funds shall remain available for the same purposes for which 
such funds were originally appropriated: Provided, That such 
transferred funds shall remain available for obligation by the 
Federal Government until the expiration of the period of 
availability for those Federal discretionary funds (which are 
being used in the Pilot) that have the longest period of 
availability, except that any such transferred funds shall not 
remain available beyond [September 30, 2018] September 30, 
2021.

                        BUDGETARY IMPACT OF BILL


  PREPARED IN CONSULTATION WITH THE CONGRESSIONAL BUDGET OFFICE PURSUANT TO SEC. 308(A), PUBLIC LAW 93-344, AS
                                                     AMENDED
                                            [In millions of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                  Budget authority               Outlays
                                                             ---------------------------------------------------
                                                               Committee    Amount  in   Committee    Amount  in
                                                               allocation      bill      allocation      bill
----------------------------------------------------------------------------------------------------------------
Comparison of amounts in the bill with the subcommittee
 allocation for 2017: Subcommittee on Labor, HHS, Education,
 and Related Agencies:
    Mandatory...............................................      775,898      775,898      775,274   \1\775,274
    Discretionary...........................................      161,857      163,817      168,923   \1\170,554
        Security............................................  ...........  ...........           NA           NA
        Nonsecurity.........................................      161,857      163,817           NA           NA
Projections of outlays associated with the recommendation:
    2017....................................................  ...........  ...........  ...........   \2\846,261
    2018....................................................  ...........  ...........  ...........       74,484
    2019....................................................  ...........  ...........  ...........       21,263
    2020....................................................  ...........  ...........  ...........        3,575
    2021 and future years...................................  ...........  ...........  ...........        3,260
Financial assistance to State and local governments for                NA      422,105           NA   \2\423,379
 2017.......................................................
 
----------------------------------------------------------------------------------------------------------------
\1\Includes outlays from prior-year budget authority.
\2\Excludes outlays from prior-year budget authority.
 
NA: Not applicable.
 
NOTE.--Consistent with the funding recommended in the bill for continuing disability reviews and
  redeterminations and for healthcare fraud and abuse control and in accordance with subparagraphs (B) and (C)
  of section 251(b)(2) of the BBEDCA of 1985, the Committee anticipates that the Budget Committee will provide a
  revised 302(a) allocation for the Committee on Appropriations reflecting an upward adjustment of
  $1,960,000,000 in budget authority plus associated outlays.


  COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2016 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL FOR FISCAL
                                                                        YEAR 2017
                                                                [In thousands of dollars]
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                        Senate Committee recommendation
                                                                                                                            compared with (+ or -)
                             Item                                     2016         Budget estimate      Committee    -----------------------------------
                                                                  appropriation                      recommendation         2016
                                                                                                                        appropriation    Budget estimate
--------------------------------------------------------------------------------------------------------------------------------------------------------
                 TITLE I--DEPARTMENT OF LABOR
 
            EMPLOYMENT AND TRAINING ADMINISTRATION
 
               Training and Employment Services
 
Grants to States:
    Adult Training, current year..............................          103,556           130,376            70,000           -33,556           -60,376
        Advance from prior year...............................         (712,000)         (712,000)         (712,000)  ................  ................
        Fiscal year 2018......................................          712,000           712,000           712,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................          815,556           842,376           782,000           -33,556           -60,376
 
    Youth Training............................................          873,416           902,139           838,000           -35,416           -64,139
    Dislocated Worker Assistance, current year................          160,860           243,346           156,000            -4,860           -87,346
        Advance from prior year...............................         (860,000)         (860,000)         (860,000)  ................  ................
        Fiscal year 2018......................................          860,000           860,000           860,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................        1,020,860         1,103,346         1,016,000            -4,860           -87,346
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Grants to States..........................        2,709,832         2,847,861         2,636,000           -73,832          -211,861
 
            Current Year......................................       (1,137,832)       (1,275,861)       (1,064,000)         (-73,832)        (-211,861)
            Fiscal year 2018..................................       (1,572,000)       (1,572,000)       (1,572,000)  ................  ................
 
National Programs:
    Dislocated Worker Assistance National Reserve:
        Current year..........................................           20,859            30,859            20,859   ................          -10,000
        Advance from prior year...............................         (200,000)         (200,000)         (200,000)  ................  ................
        Fiscal year 2018......................................          200,000           200,000           200,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................          220,859           230,859           220,859   ................          -10,000
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Dislocated Worker Assistance..............        1,241,719         1,334,205         1,236,859            -4,860           -97,346
 
    Native American Programs..................................           50,000            52,000            48,500            -1,500            -3,500
    Migrant and Seasonal Farmworker programs..................           81,896            81,896            81,896   ................  ................
    Women in Apprenticeship...................................              994   ................  ................             -994   ................
    YouthBuild activities.....................................           84,534            84,534            84,534   ................  ................
    Technical assistance......................................            3,232             3,232             2,500              -732              -732
    Reintegration of Ex-Offenders.............................           88,078            95,078            88,078   ................           -7,000
    Workforce Data Quality Initiative.........................            6,000            40,000             6,000   ................          -34,000
    Apprenticeship programs...................................           90,000            90,000           100,000           +10,000           +10,000
                                                               -----------------------------------------------------------------------------------------
      Total, National Programs................................          625,593           677,599           632,367            +6,774           -45,232
          Current Year........................................         (425,593)         (477,599)         (432,367)          (+6,774)         (-45,232)
          Fiscal year 2018....................................         (200,000)         (200,000)         (200,000)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Training and Employment Services [TES]...........        3,335,425         3,525,460         3,268,367           -67,058          -257,093
          Current Year........................................       (1,563,425)       (1,753,460)       (1,496,367)         (-67,058)        (-257,093)
          Fiscal year 2018....................................       (1,772,000)       (1,772,000)       (1,772,000)  ................  ................
 
                           Job Corps
 
Operations....................................................        1,581,825         1,608,535         1,591,625            +9,800           -16,910
Construction, Rehabilitation and Acquisition..................           75,000           105,000            86,000           +11,000           -19,000
Administration................................................           32,330            41,055            32,330   ................           -8,725
                                                               -----------------------------------------------------------------------------------------
      Total, Job Corps........................................        1,689,155         1,754,590         1,709,955           +20,800           -44,635
          Current Year........................................       (1,689,155)       (1,754,590)       (1,709,955)         (+20,800)         (-44,635)
 
Community Service Employment For Older Americans..............          434,371           434,371           400,000           -34,371           -34,371
Federal Unemployment Benefits and Allowances (indefinite).....          861,000           849,000           849,000           -12,000   ................
 
State Unemployment Insurance and Employment Service Operations
 
Unemployment Compensation [UI]:
    State Operations..........................................        2,745,550         2,777,919         2,697,019           -48,531           -80,900
    National Activities.......................................           14,547            15,247            15,247              +700   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Unemployment Compensation.....................        2,760,097         2,793,166         2,712,266           -47,831           -80,900
 
Employment Service [ES]:
    Allotments to States:
        Federal Funds.........................................           21,413            21,413            21,413   ................  ................
        Trust Funds...........................................          658,587           658,587           650,000            -8,587            -8,587
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Trust Funds...............................          658,587           658,587           650,000            -8,587            -8,587
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Allotments to States......................          680,000           680,000           671,413            -8,587            -8,587
 
    ES National Activities....................................           19,818            19,818            19,818   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Employment Service............................          699,818           699,818           691,231            -8,587            -8,587
          Federal Funds.......................................          (21,413)          (21,413)          (21,413)  ................  ................
          Trust Funds.........................................         (678,405)         (678,405)         (669,818)          (-8,587)          (-8,587)
 
Foreign Labor Certification:
    Federal Administration....................................           48,028            48,666            48,028   ................             -638
    Grants to States..........................................           14,282            14,282            14,282   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Foreign Labor Certification...................           62,310            62,948            62,310   ................             -638
 
One-Stop Career Centers/Labor Market Information..............           67,653            75,153            70,153            +2,500            -5,000
                                                               -----------------------------------------------------------------------------------------
      Total, State UI and ES..................................        3,589,878         3,631,085         3,535,960           -53,918           -95,125
          Federal Funds.......................................          (89,066)          (96,566)          (91,566)          (+2,500)          (-5,000)
          Trust Funds.........................................       (3,500,812)       (3,534,519)       (3,444,394)         (-56,418)         (-90,125)
 
State Paid Leave Fund.........................................  ................  ................  ................  ................  ................
 
                    Program Administration
 
Training and Employment.......................................           60,074            76,331            63,274            +3,200           -13,057
    Trust Funds...............................................            8,639            10,615             8,639   ................           -1,976
Employment Security...........................................            3,469             3,640             3,469   ................             -171
    Trust Funds...............................................           39,264            39,821            39,264   ................             -557
Apprenticeship Services.......................................           34,000            40,089            36,160            +2,160            -3,929
Executive Direction...........................................            7,034             8,251             7,271              +237              -980
    Trust Funds...............................................            2,079             2,079             2,079   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Program Administration...........................          154,559           180,826           160,156            +5,597           -20,670
          Federal Funds.......................................         (104,577)         (128,311)         (110,174)          (+5,597)         (-18,137)
          Trust Funds.........................................          (49,982)          (52,515)          (49,982)  ................          (-2,533)
                                                               =========================================================================================
      Total, Employment and Training Administration...........       10,064,388        10,375,332         9,923,438          -140,950          -451,894
          Federal Funds.......................................        6,513,594         6,788,298         6,429,062           -84,532          -359,236
              Current Year....................................       (4,741,594)       (5,016,298)       (4,657,062)         (-84,532)        (-359,236)
              Fiscal year 2018................................       (1,772,000)       (1,772,000)       (1,772,000)  ................  ................
          Trust Funds.........................................        3,550,794         3,587,034         3,494,376           -56,418           -92,658
 
       EMPLOYEE BENEFITS SECURITY ADMINISTRATION [EBSA]
 
                     Salaries and Expenses
 
Enforcement and Participant Assistance........................          147,400   ................          147,400   ................         +147,400
Policy and Compliance Assistance..............................           26,901   ................           26,901   ................          +26,901
Executive Leadership, Program Oversight and Administration....            6,699   ................            6,699   ................           +6,699
Employee benefits security programs...........................  ................          205,761   ................  ................         -205,761
                                                               -----------------------------------------------------------------------------------------
      Total, EBSA.............................................          181,000           205,761           181,000   ................          -24,761
 
          PENSION BENEFIT GUARANTY CORPORATION (PBGC)
 
           Pension Benefit Guaranty Corporation Fund
 
Consolidated Administrative budget............................         (431,799)         (421,006)         (421,006)         (-10,793)  ................
Operational Support...........................................  ................  ................  ................  ................  ................
Headquarters space costs......................................  ................          (98,500)          (98,500)         (+98,500)  ................
WAGE AND HOUR DIVISION, Salaries and Expenses.................          227,500           276,599           227,500   ................          -49,099
OFFICE OF LABOR-MANAGEMENT STANDARDS, Salaries and Expenses...           40,593            45,691            35,529            -5,064           -10,162
OFFICE OF FEDERAL CONTRACT COMPLIANCE PROGRAMS, Salaries and            105,476           114,169           104,476            -1,000            -9,693
 Expenses.....................................................
 
           OFFICE OF WORKERS' COMPENSATION PROGRAMS
 
Salaries and Expenses.........................................          113,324           123,982           115,424            +2,100            -8,558
    Trust Funds...............................................            2,177             2,177             2,177   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Salaries and Expenses............................          115,501           126,159           117,601            +2,100            -8,558
          Federal Funds.......................................         (113,324)         (123,982)         (115,424)          (+2,100)          (-8,558)
          Trust Funds.........................................           (2,177)           (2,177)           (2,177)  ................  ................
 
                       Special Benefits
 
Federal Employees' Compensation Benefits......................          207,000           217,000           217,000           +10,000   ................
Longshore and Harbor Workers' Benefits........................            3,000             3,000             3,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Special Benefits.................................          210,000           220,000           220,000           +10,000   ................
 
           Special Benefits for Disabled Coal Miners
 
Benefit Payments..............................................           85,000            75,000            75,000           -10,000   ................
Administration................................................            5,302             5,319             5,319               +17   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Fiscal year 2017 program level................           90,302            80,319            80,319            -9,983   ................
 
        Less funds advanced in prior year.....................          -21,000           -19,000           -19,000            +2,000   ................
                                                               -----------------------------------------------------------------------------------------
          Total, Current Year.................................           69,302            61,319            61,319            -7,983   ................
 
          New advances, 1st quarter, fiscal year 2018.........           19,000            16,000            16,000            -3,000   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Special Benefits for Disabled Coal Miners........           88,302            77,319            77,319           -10,983   ................
 
    Energy Employees Occupational Illness Compensation Fund
 
Administrative Expenses.......................................           58,552            59,846            59,846            +1,294   ................
 
               Black Lung Disability Trust Fund
 
Benefit Payments and Interest on Advances.....................          275,261           302,115           302,115           +26,854   ................
Workers' Compensation Programs, Salaries and Expenses.........           35,244            38,246            38,246            +3,002   ................
Departmental Management, Salaries and Expenses................           30,279            30,594            30,594              +315   ................
Departmental Management, Inspector General....................              327               330               330                +3   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Black Lung Disability.........................          341,111           371,285           371,285           +30,174   ................
 
Treasury Department Administrative Costs......................              356               356               356   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Black Lung Disability Trust Fund.................          341,467           371,641           371,641           +30,174   ................
                                                               =========================================================================================
      Total, Workers' Compensation Programs...................          813,822           854,965           846,407           +32,585            -8,558
          Federal Funds.......................................          811,645           852,788           844,230           +32,585            -8,558
              Current year....................................         (792,645)         (836,788)         (828,230)         (+35,585)          (-8,558)
              Fiscal year 2018................................          (19,000)          (16,000)          (16,000)          (-3,000)  ................
          Trust Funds.........................................            2,177             2,177             2,177   ................  ................
 
     OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION [OSHA]
 
                     Salaries and Expenses
 
Safety and Health Standards...................................           20,000            23,173            18,000            -2,000            -5,173
Federal Enforcement...........................................          208,000           225,972           208,000   ................          -17,972
Whistleblower enforcement.....................................           17,500            21,604            17,500   ................           -4,104
State Programs................................................          100,850           104,337           100,850   ................           -3,487
Technical Support.............................................           24,469            25,403            24,469   ................             -934
Compliance Assistance:
    Federal Assistance........................................           68,433            72,784            70,981            +2,548            -1,803
    State Consultation Grants.................................           57,775            59,775            59,500            +1,725              -275
    Training Grants...........................................           10,537            10,537            10,537   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Compliance Assistance.........................          136,745           143,096           141,018            +4,273            -2,078
 
Safety and Health Statistics..................................           34,250            40,095            32,900            -1,350            -7,195
Executive Direction and Administration........................           10,973            11,343            10,050              -923            -1,293
                                                               =========================================================================================
      Total, OSHA.............................................          552,787           595,023           552,787   ................          -42,236
 
             MINE SAFETY AND HEALTH ADMINISTRATION
 
                     Salaries and Expenses
 
Coal Enforcement..............................................          167,859           171,768           162,071            -5,788            -9,697
Metal/Non-Metal Enforcement...................................           91,697            97,563            94,500            +2,803            -3,063
Standards Development.........................................            5,416             6,197             4,500              -916            -1,697
Assessments...................................................            6,976             8,277             6,627              -349            -1,650
Educational Policy and Development............................           36,320            40,419            39,320            +3,000            -1,099
Technical Support.............................................           33,791            35,041            35,041            +1,250   ................
Program Evaluation and Information Resources [PEIR]...........           17,990            21,815            17,990   ................           -3,825
Program Administration........................................           15,838            16,292            15,838   ................             -454
                                                               =========================================================================================
      Total, Mine Safety and Health Administration............          375,887           397,372           375,887   ................          -21,485
                                                               =========================================================================================
      Total, Worker Protection Agencies.......................        1,598,744         1,760,774         1,594,780            -3,964          -165,994
          Federal Funds.......................................       (1,596,567)       (1,758,597)       (1,592,603)          (-3,964)        (-165,994)
          Trust Funds.........................................           (2,177)           (2,177)           (2,177)  ................  ................
 
                  BUREAU OF LABOR STATISTICS
 
                     Salaries and Expenses
 
Employment and Unemployment Statistics........................          208,000           219,258           208,000   ................          -11,258
Labor Market Information......................................           65,000            67,016            65,000   ................           -2,016
Prices and Cost of Living.....................................          207,000           219,672           207,000   ................          -12,672
Compensation and Working Conditions...........................           83,500            87,517            83,500   ................           -4,017
Productivity and Technology...................................           10,500            10,993            10,500   ................             -493
Executive Direction and Staff Services........................           35,000            36,487            35,000   ................           -1,487
                                                               =========================================================================================
      Total, Bureau of Labor Statistics.......................          609,000           640,943           609,000   ................          -31,943
          Federal Funds.......................................          544,000           573,927           544,000   ................          -29,927
          Trust Funds.........................................           65,000            67,016            65,000   ................           -2,016
 
            OFFICE OF DISABILITY EMPLOYMENT POLICY
 
Salaries and Expenses.........................................           38,203            38,544            38,203   ................             -341
 
                    DEPARTMENTAL MANAGEMENT
 
                     Salaries and Expenses
 
Executive Direction...........................................           31,010            37,406            30,250              -760            -7,156
Departmental Program Evaluation...............................            8,040             9,500             8,040   ................           -1,460
Legal Services................................................          125,000           140,374           121,745            -3,255           -18,629
    Trust Funds...............................................              308               310               308   ................               -2
International Labor Affairs...................................           86,125           101,230            91,125            +5,000           -10,105
Administration and Management.................................           28,413            36,604            28,834              +421            -7,770
Adjudication..................................................           32,000            36,325            35,336            +3,336              -989
Women's Bureau................................................           11,536            12,902            11,536   ................           -1,366
Civil Rights Activities.......................................            6,880             8,041             6,880   ................           -1,161
Chief Financial Officer.......................................            5,061             5,233             5,132               +71              -101
                                                               =========================================================================================
      Total, Departmental Management..........................          334,373           387,925           339,186            +4,813           -48,739
          Federal Funds.......................................         (334,065)         (387,615)         (338,878)          (+4,813)         (-48,737)
          Trust Funds.........................................             (308)             (310)             (308)  ................              (-2)
 
               Veterans Employment and Training
 
State Administration, Grants..................................          175,000           175,000           175,000   ................  ................
Transition Assistance Program.................................           14,100            14,600            14,600              +500   ................
Federal Administration........................................           40,487            42,506            41,027              +540            -1,479
National Veterans' Employment and Training Services Institute.            3,414             3,414             3,414   ................  ................
Homeless Veterans Program.....................................           38,109            50,000            40,500            +2,391            -9,500
                                                               -----------------------------------------------------------------------------------------
      Total, Veterans Employment and Training.................          271,110           285,520           274,541            +3,431           -10,979
          Federal Funds.......................................           38,109            50,000            40,500            +2,391            -9,500
          Trust Funds.........................................          233,001           235,520           234,041            +1,040            -1,479
 
                       IT Modernization
 
Departmental support systems..................................            4,898             4,898             4,898   ................  ................
Infrastructure technology modernization.......................           24,880            58,264            13,880           -11,000           -44,384
                                                               -----------------------------------------------------------------------------------------
      Total, IT Modernization.................................           29,778            63,162            18,778           -11,000           -44,384
 
                  Office of Inspector General
 
Program Activities............................................           80,640            88,881            82,061            +1,421            -6,820
    Trust Funds...............................................            5,660             5,660             5,660   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Office of Inspector General......................           86,300            94,541            87,721            +1,421            -6,820
                                                               =========================================================================================
      Total, Departmental Management..........................          721,561           831,148           720,226            -1,335          -110,922
          Federal Funds.......................................          482,592           589,658           480,217            -2,375          -109,441
              Current Year....................................         (482,592)         (589,658)         (480,217)          (-2,375)        (-109,441)
          Trust Funds.........................................          238,969           241,490           240,009            +1,040            -1,481
                                                               =========================================================================================
      Total, Workforce Investment Act Programs................        5,023,586         5,280,050         4,978,322           -45,264          -301,728
          Current Year........................................       (3,251,586)       (3,508,050)       (3,206,322)         (-45,264)        (-301,728)
          Fiscal year 2018....................................       (1,772,000)       (1,772,000)       (1,772,000)  ................  ................
                                                               =========================================================================================
      Total, Title I, Department of Labor.....................       13,730,217        14,375,547        13,614,453          -115,764          -761,094
          Federal Funds.......................................        9,873,277        10,477,830         9,812,891           -60,386          -664,939
              Current Year....................................       (8,082,277)       (8,689,830)       (8,024,891)         (-57,386)        (-664,939)
              Fiscal year 2018................................       (1,791,000)       (1,788,000)       (1,788,000)          (-3,000)  ................
          Trust Funds.........................................        3,856,940         3,897,717         3,801,562           -55,378           -96,155
 
       TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES
 
      HEALTH RESOURCES AND SERVICES ADMINISTRATION [HRSA]
 
                      Primary Health Care
 
Community Health Centers......................................        1,491,422         1,341,422         1,490,522              -900          +149,100
Free Clinics Medical Malpractice..............................              100             1,000             1,000              +900   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Primary Health Care..............................        1,491,522         1,342,422         1,491,522   ................         +149,100
 
                       Health Workforce
 
National Health Service Corps.................................  ................           20,000   ................  ................          -20,000
 
Training for Diversity:
    Centers of Excellence.....................................           21,711            21,711            21,711   ................  ................
    Health Careers Opportunity Program........................           14,189            14,189   ................          -14,189           -14,189
    Faculty Loan Repayment....................................            1,190             1,190             1,190   ................  ................
    Scholarships for Disadvantaged Students...................           45,970            49,070            49,070            +3,100   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Training for Diversity...........................           83,060            86,160            71,971           -11,089           -14,189
 
Training in Primary Care Medicine.............................           38,924            38,924            38,924   ................  ................
Oral Health Training..........................................           35,873            35,873            35,873   ................  ................
Interdisciplinary Community-Based Linkages:
    Area Health Education Centers.............................           30,250   ................           30,250   ................          +30,250
    Geriatric Programs........................................           38,737            38,737            38,737   ................  ................
Behavioral Health Workforce Education and Training............           50,000            56,000            50,000   ................           -6,000
    Mental and Behavorial Health..............................            9,916             9,916             9,916   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Interdisciplinary Community Linkages.............          128,903           104,653           128,903   ................          +24,250
 
Workforce Information and Analysis............................            4,663             4,663             4,663   ................  ................
Public Health and Preventive Medicine programs................           21,000            17,000            17,000            -4,000   ................
 
Nursing Programs:
    Advanced Education Nursing................................           64,581            64,581            64,581   ................  ................
    Nurse Education, Practice, and Retention..................           39,913            39,913            39,913   ................  ................
    Nursing Workforce Diversity...............................           15,343            15,343            15,343   ................  ................
    Loan Repayment and Scholarship Program....................           83,135            83,135            83,135   ................  ................
    Nursing Faculty Loan Program..............................           26,500            26,500            26,500   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Nursing programs.................................          229,472           229,472           229,472   ................  ................
 
Children's Hospitals Graduate Medical Education...............          295,000   ................          300,000            +5,000          +300,000
National Practitioner Data Bank...............................           18,814            21,037            18,814   ................           -2,223
    User Fees.................................................          -18,814           -21,037           -18,814   ................           +2,223
                                                               -----------------------------------------------------------------------------------------
      Total, Health Workforce.................................          836,895           536,745           826,806           -10,089          +290,061
 
                   Maternal and Child Health
 
Maternal and Child Health Block Grant.........................          638,200           638,200           641,700            +3,500            +3,500
Sickle Cell Anemia Demonstration Program......................            4,455             4,455             4,455   ................  ................
Autism and Other Developmental Disorders......................           47,099            47,099            47,099   ................  ................
Heritable Disorders...........................................           13,883            13,883            11,883            -2,000            -2,000
Healthy Start.................................................          103,500           103,500           103,500   ................  ................
Universal Newborn Hearing Screening...........................           17,818            17,818            17,818   ................  ................
Emergency Medical Services for Children.......................           20,162            20,162            20,162   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Maternal and Child Health........................          845,117           845,117           846,617            +1,500            +1,500
 
                  Ryan White HIV/AIDS Program
 
Emergency Assistance..........................................          655,876           655,876           655,876   ................  ................
Comprehensive Care Programs...................................        1,315,005         1,315,005         1,315,005   ................  ................
    AIDS Drug Assistance Program [ADAP] (NA)..................         (900,313)         (900,313)         (900,313)  ................  ................
Early Intervention Program....................................          205,079           280,167           201,079            -4,000           -79,088
Children, Youth, Women, and Families..........................           75,088   ................           75,088   ................          +75,088
AIDS Dental Services..........................................           13,122            13,122            13,122   ................  ................
Education and Training Centers................................           33,611            33,611            33,611   ................  ................
Special Projects of National Significance.....................           25,000   ................  ................          -25,000   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Ryan White HIV/AIDS program......................        2,322,781         2,297,781         2,293,781           -29,000            -4,000
        (Evaluation Tap Funding)..............................  ................          (34,000)  ................  ................         (-34,000)
 
                      Health Care Systems
 
Organ Transplantation.........................................           23,549            23,549            23,549   ................  ................
National Cord Blood Inventory.................................           11,266            11,266            11,266   ................  ................
CW Bill Young Cell Transplantation program....................           22,109            22,109            22,109   ................  ................
340B Drug Pricing program/Office of Pharmacy Affairs..........           10,238            26,238            19,238            +9,000            -7,000
    User Fees.................................................  ................           -9,000            -9,000            -9,000   ................
Poison Control................................................           18,846            18,846            18,846   ................  ................
National Hansen's Disease Program.............................           15,206            15,206            15,206   ................  ................
Hansen's Disease Program Buildings and Facilities.............              122               122               122   ................  ................
Payment to Hawaii, Treatment of Hansen's......................            1,857             1,857             1,857   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Health Care Systems..............................          103,193           110,193           103,193   ................           -7,000
 
                         Rural Health
 
Rural Outreach Grants.........................................           63,500            63,500            65,500            +2,000            +2,000
Rural Health Research/Policy Development......................            9,351             9,351             9,351   ................  ................
Rural Hospital Flexibility Grants.............................           41,609            26,200            41,609   ................          +15,409
State Offices of Rural Health.................................            9,511             9,511             9,511   ................  ................
Black Lung Clinics............................................            6,766             6,766             6,766   ................  ................
Radiation Exposure Screening and Education Program............            1,834             1,834             1,834   ................  ................
Telehealth....................................................           17,000            17,000            18,000            +1,000            +1,000
Rural Opioid Overdose Reversal grant program..................  ................           10,000   ................  ................          -10,000
                                                               -----------------------------------------------------------------------------------------
      Total, Rural Health.....................................          149,571           144,162           152,571            +3,000            +8,409
 
Family Planning...............................................          286,479           300,000           286,479   ................          -13,521
Program Management............................................          154,000           157,061           154,000   ................           -3,061
 
        Vaccine Injury Compensation Program Trust Fund
 
Post-fiscal year 1988 Claims..................................          237,000           240,000           240,000            +3,000   ................
HRSA Administration...........................................            7,500             9,200             7,500   ................           -1,700
                                                               -----------------------------------------------------------------------------------------
      Total, Vaccine Injury Compensation Trust Fund...........          244,500           249,200           247,500            +3,000            -1,700
                                                               =========================================================================================
      Total, Health Resources and Services Administration.....        6,434,058         5,982,681         6,402,469           -31,589          +419,788
 
          CENTERS FOR DISEASE CONTROL AND PREVENTION
 
Immunization and Respiratory Diseases.........................          459,055           411,716           459,055   ................          +47,339
    Pandemic Flu balances (Public Law 111-32).................          (15,000)  ................          (15,000)  ................         (+15,000)
    Prevention and Public Health Fund\1\......................         (324,350)         (336,350)         (324,350)  ................         (-12,000)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (798,405)         (748,066)         (798,405)  ................         (+50,339)
 
HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and         1,122,278         1,127,278         1,112,278           -10,000           -15,000
 Tuberculosis Prevention......................................
Emerging and Zoonotic Infectious Diseases.....................          527,885           577,485           526,885            -1,000           -50,600
    Prevention and Public Health Fund\1\......................          (52,000)          (52,000)          (52,000)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          579,885           629,485           578,885            -1,000           -50,600
 
Chronic Disease Prevention and Health Promotion...............          838,146           679,745           726,696          -111,450           +46,951
    Prevention and Public Health Fund\1\......................         (338,950)         (437,400)         (337,950)          (-1,000)         (-99,450)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................        1,177,096         1,117,145         1,064,646          -112,450           -52,499
 
Birth Defects, Developmental Disabilities, Disabilities and             135,610            67,644           137,560            +1,950           +69,916
 Health.......................................................
    Prevention and Public Health Fund\1\......................  ................          (67,966)  ................  ................         (-67,966)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          135,610           135,610           137,560            +1,950            +1,950
 
Public Health Scientific Services.............................          491,597           464,355           485,000            -6,597           +20,645
    Prevention and Public Health Fund\1\......................  ................          (36,276)  ................  ................         (-36,276)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (491,597)         (500,631)         (485,000)          (-6,597)         (-15,631)
 
Environmental Health..........................................          165,303           167,825           165,303   ................           -2,522
    Prevention and Public Health Fund\1\......................          (17,000)          (14,478)          (17,000)  ................          (+2,522)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          182,303           182,303           182,303   ................  ................
 
Injury Prevention and Control.................................          236,059           268,629           264,059           +28,000            -4,570
National Institute for Occupational Safety and Health.........          339,121           213,621           334,121            -5,000          +120,500
    Evaluation Tap Funding....................................  ................          (72,000)  ................  ................         (-72,000)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (339,121)         (285,621)         (334,121)          (-5,000)         (+48,500)
 
Energy Employees Occupational Illness Compensation Program....           55,358            55,358            55,358   ................  ................
Global Health.................................................          427,121           442,121           432,121            +5,000           -10,000
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (427,121)         (442,121)         (432,121)          (+5,000)         (-10,000)
 
Public Health Preparedness and Response.......................        1,405,000         1,402,166         1,396,800            -8,200            -5,366
Buildings and Facilities......................................           10,000            31,221   ................          -10,000           -31,221
 
            CDC-Wide Activities and Program Support
 
Prevention and Public Health Fund\1\..........................         (160,000)  ................         (160,000)  ................        (+160,000)
Office of the Director........................................          113,570           113,570           113,570   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, CDC-Wide Activities...........................         (273,570)         (113,570)         (273,570)  ................        (+160,000)
                                                               =========================================================================================
      Total, Centers for Disease Control......................        6,326,103         6,022,734         6,208,806          -117,297          +186,072
      Pandemic Flu balances (Public Law 111-32)...............          (15,000)  ................          (15,000)  ................         (+15,000)
      Prevention and Public Health Fund\1\....................         (892,300)         (944,470)         (891,300)          (-1,000)         (-53,170)
      Total, Centers for Disease Control Program Level........       (7,233,403)       (7,039,204)       (7,115,106)        (-118,297)         (+75,902)
 
                 NATIONAL INSTITUTES OF HEALTH
 
National Cancer Institute.....................................        5,213,509         5,097,287         5,429,769          +216,260          +332,482
National Heart, Lung, and Blood Institute.....................        3,113,533         3,069,901         3,242,685          +129,152          +172,784
National Institute of Dental and Craniofacial Research........          413,396           404,560           430,544           +17,148           +25,984
National Institute of Diabetes and Digestive and Kidney               1,816,310         1,786,086         1,891,652           +75,342          +105,566
 Diseases [NIDDK].............................................
    Juvenile Diabetes (mandatory).............................         (150,000)         (150,000)         (150,000)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, NIDDK program level...........................        1,966,310         1,936,086         2,041,652           +75,342          +105,566
 
National Institute of Neurological Disorders and Stroke.......        1,695,180         1,659,416         1,803,306          +108,126          +143,890
National Institute of Allergy and Infectious Diseases.........        4,715,697         4,700,548         4,961,305          +245,608          +260,757
National Institute of General Medical Sciences................        1,732,437         1,586,655         1,776,755           +44,318          +190,100
    Evaluation Tap Funding....................................         (780,000)         (847,489)         (857,000)         (+77,000)          (+9,511)
                                                               -----------------------------------------------------------------------------------------
      Subtotal, NGMS program level............................        2,512,437         2,434,144         2,633,755          +121,318          +199,611
 
Eunice Kennedy Shriver National Institute of Child Health and         1,338,348         1,316,607         1,395,811           +57,463           +79,204
 Human Development............................................
National Eye Institute........................................          707,998           687,249           740,826           +32,828           +53,577
National Institute of Environmental Health Sciences...........          693,533           681,613           722,301           +28,768           +40,688
National Institute on Aging...................................        1,598,246         1,265,133         2,067,138          +468,892          +802,005
National Institute of Arthritis and Musculoskeletal and Skin            541,662           532,753           564,131           +22,469           +31,378
 Diseases.....................................................
National Institute on Deafness and Other Communication                  422,936           416,146           441,778           +18,842           +25,632
 Disorders....................................................
National Institute of Nursing Research........................          145,912           143,942           151,965            +6,053            +8,023
National Institute on Alcohol Abuse and Alcoholism............          467,445           459,578           488,782           +21,337           +29,204
National Institute on Drug Abuse..............................        1,050,550         1,020,459         1,103,032           +52,482           +82,573
National Institute of Mental Health...........................        1,518,673         1,459,700         1,619,537          +100,864          +159,837
National Human Genome Research Institute......................          513,227           509,762           534,516           +21,289           +24,754
National Institute of Biomedical Imaging and Bioengineering...          343,506           334,025           361,062           +17,556           +27,037
National Center for Complementary and Integrative Health......          129,941           126,673           136,195            +6,254            +9,522
National Institute on Minority Health and Health Disparities..          280,680           279,680           292,323           +11,643           +12,643
John E. Fogarty International Center..........................           70,117            69,175            73,026            +2,909            +3,851
National Library of Medicine [NLM]............................          395,684           395,110           412,097           +16,413           +16,987
National Center for Advancing Translational Sciences..........          685,417           660,131           713,849           +28,432           +53,718
Office of the Director........................................        1,571,200         1,445,459         1,443,752          -127,448            -1,707
    Common Fund (non-add).....................................         (675,639)         (565,639)         (790,542)        (+114,903)        (+224,903)
    Gabriella Miller Kids First Research Act (Common Fund)              (12,600)          (12,600)          (12,600)  ................  ................
     (non-add)................................................
    Transfers from Non-Recurring Expense Fund (non-add).......  ................  ................         (300,000)        (+300,000)        (+300,000)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................        1,571,200         1,445,459         1,743,752          +172,552          +298,293
 
Buildings and Facilities......................................          128,863           128,863           128,863   ................  ................
NIH undistributed.............................................  ................  ................  ................  ................  ................
                                                               =========================================================================================
      Total, National Institutes of Health [NIH]..............       31,304,000        30,236,511        32,927,000        +1,623,000        +2,690,489
        (Evaluation Tap Funding)..............................         (780,000)         (847,489)         (857,000)         (+77,000)          (+9,511)
        (Transfers from Non-Recurring Expense Fund)...........  ................  ................         (300,000)        (+300,000)        (+300,000)
      Total, NIH Program Level................................      (32,084,000)      (31,084,000)      (34,084,000)      (+2,000,000)      (+3,000,000)
 
   SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION
                           [SAMHSA]
 
                         Mental Health
 
Programs of Regional and National Significance................          402,609           386,388           375,659           -26,950           -10,729
    Evaluation Tap Funding....................................  ................          (10,000)  ................  ................         (-10,000)
    Prevention and Public Health Fund\1\......................          (12,000)          (10,000)          (12,000)  ................          (+2,000)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          414,609           406,388           387,659           -26,950           -18,729
 
Mental Health block grant.....................................          511,532           511,532           541,532           +30,000           +30,000
    Evaluation Tap Funding....................................          (21,039)          (21,039)          (21,039)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (532,571)         (532,571)         (562,571)         (+30,000)         (+30,000)
 
Children's Mental Health......................................          119,026           119,026           119,026   ................  ................
Grants to States for the Homeless (PATH)......................           64,635            64,635            64,635   ................  ................
Protection and Advocacy.......................................           36,146            36,146            36,146   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Mental Health.................................        1,133,948         1,117,727         1,136,998            +3,050           +19,271
        (Evaluation Tap Funding)..............................          (21,039)          (31,039)          (21,039)  ................         (-10,000)
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Mental Health program level...............       (1,166,987)       (1,158,766)       (1,170,037)          (+3,050)         (+11,271)
 
                   Substance Abuse Treatment
 
Programs of Regional and National Significance................          335,345           298,269           334,484              -861           +36,215
    Evaluation Tap Funding....................................           (2,000)          (30,000)           (2,000)  ................         (-28,000)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (337,345)         (328,269)         (336,484)            (-861)          (+8,215)
 
Substance Abuse block grant...................................        1,778,879         1,778,879         1,778,879   ................  ................
    Evaluation Tap Funding....................................          (79,200)          (79,200)          (79,200)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, block grant...................................       (1,858,079)       (1,858,079)       (1,858,079)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Substance Abuse Treatment.....................        2,114,224         2,077,148         2,113,363              -861           +36,215
        (Evaluation Tap Funding)..............................          (81,200)         (109,200)          (81,200)  ................         (-28,000)
      Subtotal, Program level.................................       (2,195,424)       (2,186,348)       (2,194,563)            (-861)          (+8,215)
 
                  Substance Abuse Prevention
 
Programs of Regional and National Significance................          211,219           194,680           225,219           +14,000           +30,539
    Evaluation Tap Funding....................................  ................          (16,468)  ................  ................         (-16,468)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          211,219           194,680           225,219           +14,000           +30,539
 
Health Surveillance and Program Support.......................          124,878            99,228           115,830            -9,048           +16,602
    Evaluation Tap Funding (NA)...............................          (31,428)          (56,828)          (32,428)          (+1,000)         (-24,400)
    Prevention and Public Health Fund\1\......................  ................          (17,830)  ................  ................         (-17,830)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          156,306           173,886           148,258            -8,048           -25,628
                                                               =========================================================================================
      Total, SAMHSA...........................................        3,584,269         3,488,783         3,591,410            +7,141          +102,627
        (Evaluation Tap Funding)..............................         (133,667)         (213,535)         (134,667)          (+1,000)         (-78,868)
        (Prevention and Public Health Fund)\1\................          (12,000)          (27,830)          (12,000)  ................         (-15,830)
          Total, SAMHSA Program Level.........................       (3,729,936)       (3,730,148)       (3,738,077)          (+8,141)          (+7,929)
 
       AGENCY FOR HEALTHCARE RESEARCH AND QUALITY [AHRQ]
 
                Healthcare Research and Quality
 
Research on Health Costs, Quality, and Outcomes:
    Federal Funds.............................................          196,800           140,519           184,279           -12,521           +43,760
        Evaluation Tap funding................................  ................          (83,458)  ................  ................         (-83,458)
        Patient-Centered Outcomes Research transfer...........  ................  ................  ................  ................  ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Health Costs, Quality, and Outcomes.......         (196,800)         (223,977)         (184,279)         (-12,521)         (-39,698)
          (Evaluation Tap Funding)............................  ................          (83,458)  ................  ................         (-83,458)
 
Medical Expenditures Panel Surveys:
    Federal Funds.............................................           66,000            68,877            68,877            +2,877   ................
Program Support:
    Federal Funds.............................................           71,200            70,844            70,844              -356   ................
                                                               -----------------------------------------------------------------------------------------
      Total, AHRQ Program Level...............................         (334,000)         (363,698)         (324,000)         (-10,000)         (-39,698)
          Federal funds.......................................         (334,000)         (280,240)         (324,000)         (-10,000)         (+43,760)
          (Evaluation Tap Funding)............................  ................          (83,458)  ................  ................         (-83,458)
                                                               =========================================================================================
      Total, Public Health Service [PHS] appropriation........       47,982,430        46,010,949        49,453,685        +1,471,255        +3,442,736
        (Evaluation Tap Funding)..............................  ................  ................  ................  ................  ................
      Total, Public Health Service Program Level..............      (49,815,397)      (48,233,731)      (51,363,652)      (+1,548,255)      (+3,129,921)
 
          CENTERS FOR MEDICARE AND MEDICAID SERVICES
 
                 Grants to States for Medicaid
 
Medicaid Current Law Benefits.................................      334,936,328       354,223,901       354,223,901       +19,287,573   ................
State and Local Administration................................       17,771,915        18,975,984        18,975,984        +1,204,069   ................
Vaccines for Children.........................................        4,109,307         4,386,584         4,386,584          +277,277   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Medicaid Program Level........................      356,817,550       377,586,469       377,586,469       +20,768,919   ................
          Less funds advanced in prior year...................     -113,272,140      -115,582,502      -115,582,502        -2,310,362   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Grants to States for Medicaid....................      243,545,410       262,003,967       262,003,967       +18,458,557   ................
 
            New advance, 1st quarter, fiscal year 2018........      115,582,502       125,219,452       125,219,452        +9,636,950   ................
              Payments to Health Care Trust Funds
 
Supplemental Medical Insurance................................      198,530,000       214,944,000       214,944,000       +16,414,000   ................
Federal Uninsured Payment.....................................          158,000           147,000           147,000           -11,000   ................
Program Management............................................        1,044,000           877,500           877,500          -166,500   ................
General Revenue for Part D Benefit............................       82,453,000        82,512,000        82,512,000           +59,000   ................
General Revenue for Part D Administration.....................          691,000           405,000           405,000          -286,000   ................
HCFAC Reimbursement...........................................          291,000           299,000           299,000            +8,000   ................
State Low-Income Determination for Part D.....................            4,800             3,200             3,200            -1,600   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Payments to Trust Funds, Program Level...........      283,171,800       299,187,700       299,187,700       +16,015,900   ................
 
                      Program Management
 
Research, Demonstration, Evaluation...........................           20,054   ................           20,054   ................          +20,054
Program Operations............................................        2,519,823         2,936,499         2,519,823   ................         -416,676
State Survey and Certification................................          397,334           437,200           397,334   ................          -39,866
Federal Administration........................................          732,533           735,850           732,533   ................           -3,317
                                                               -----------------------------------------------------------------------------------------
      Total, Program management...............................        3,669,744         4,109,549         3,669,744   ................         -439,805
 
          Health Care Fraud and Abuse Control Account
 
Centers for Medicare and Medicaid Services....................          486,120           486,936           486,935              +815                -1
HHS Office of Inspector General...............................           67,200           121,824            79,355           +12,155           -42,469
Medicaid/CHIP.................................................           67,200   ................           79,355           +12,155           +79,355
Department of Justice.........................................           60,480           116,240            79,355           +18,875           -36,885
                                                               -----------------------------------------------------------------------------------------
      Total, Health Care Fraud and Abuse Control..............          681,000           725,000           725,000           +44,000   ................
                                                               =========================================================================================
      Total, Centers for Medicare and Medicaid Services.......      646,650,456       691,245,668       690,805,863       +44,155,407          -439,805
          Federal funds.......................................      642,299,712       686,411,119       686,411,119       +44,111,407   ................
              Current year....................................     (526,717,210)     (561,191,667)     (561,191,667)     (+34,474,457)  ................
              New advance, fiscal year 2018...................     (115,582,502)     (125,219,452)     (125,219,452)      (+9,636,950)  ................
          Trust Funds.........................................        4,350,744         4,834,549         4,394,744           +44,000          -439,805
 
        ADMINISTRATION FOR CHILDREN AND FAMILIES [ACF]
 
  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................................................           34,000            34,000            34,000   ................  ................
 
Child Support Enforcement:
    State and Local Administration............................        3,541,359         3,680,840         3,680,840          +139,481   ................
    Federal Incentive Payments................................          519,547           585,791           585,791           +66,244   ................
    Access and Visitation.....................................           10,000            10,000            10,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Child Support Enforcement.....................        4,070,906         4,276,631         4,276,631          +205,725   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Family Support Payments Program Level............        4,104,906         4,310,631         4,310,631          +205,725   ................
          Less funds advanced in previous years...............       -1,160,000        -1,300,000        -1,300,000          -140,000   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Family Support Payments, current year............        2,944,906         3,010,631         3,010,631           +65,725   ................
            New advance, 1st quarter, fiscal year 2018........        1,300,000         1,400,000         1,400,000          +100,000   ................
 
          Low Income Home Energy Assistance [LIHEAP]
 
Formula Grants................................................        3,390,304         3,000,304         3,390,304   ................         +390,000
Utility Innovation Fund.......................................  ................  ................  ................  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, LIHEAP, Program Level............................        3,390,304         3,000,304         3,390,304   ................         +390,000
 
                Refugee and Entrant Assistance
 
Transitional and Medical Services.............................          490,000           581,357           490,000   ................          -91,357
Victims of Trafficking........................................           18,755            22,000            18,755   ................           -3,245
Social Services...............................................          155,000           176,927           155,000   ................          -21,927
Preventive Health.............................................            4,600             4,600             4,600   ................  ................
Targeted Assistance...........................................           47,601            55,601            47,601   ................           -8,000
Unaccompanied Minors..........................................          948,000         1,226,000           948,000   ................         -278,000
Unaccompanied Minors Contingency Fund.........................  ................           95,000   ................  ................          -95,000
    CBO adjustment............................................  ................           65,000   ................  ................          -65,000
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................  ................          160,000   ................  ................         -160,000
 
Victims of Torture............................................           10,735            23,375            10,735   ................          -12,640
                                                               -----------------------------------------------------------------------------------------
      Total, Refugee and Entrant Assistance...................        1,674,691         2,249,860         1,674,691   ................         -575,169
 
Payments to States for the Child Care and Development Block           2,761,000         2,961,672         2,786,000           +25,000          -175,672
 Grant........................................................
Social Services Block Grant (Title XX)........................        1,700,000         1,681,500         1,700,000   ................          +18,500
Social Services Block Grant Research/Evaluation...............  ................           18,500   ................  ................          -18,500
                                                               -----------------------------------------------------------------------------------------
      Total, Social Services Block Grant......................        1,700,000         1,700,000         1,700,000   ................  ................
 
            Children and Families Services Programs
 
Programs for Children, Youth and Families:
    Head Start, current funded................................        9,168,095         9,601,724         9,203,095           +35,000          -398,629
    Preschool Development Grants\3\...........................          250,000           350,000           250,000   ................         -100,000
    Consolidated Runaway, Homeless Youth Program..............          101,980           108,330           101,980   ................           -6,350
    Prevention Grants to Reduce Abuse of Runaway Youth........           17,141            17,491            17,141   ................             -350
    Child Abuse State Grants..................................           25,310            25,310            25,310   ................  ................
    Child Abuse Discretionary Activities......................           33,000            43,744            33,000   ................          -10,744
    Community Based Child Abuse Prevention....................           39,764            39,764            39,764   ................  ................
    Child Welfare Services....................................          268,735           268,735           268,735   ................  ................
    Child Welfare Training, Research, or Demonstration                   17,984            21,984            17,984   ................           -4,000
     projects.................................................
    Adoption Opportunities....................................           39,100            39,100            39,100   ................  ................
    Adoption Incentive........................................           37,943            37,943            37,943   ................  ................
Social Services and Income Maintenance Research...............            6,512            10,762             6,512   ................           -4,250
Native American Programs......................................           50,000            53,100            50,000   ................           -3,100
 
Community Services:
    Community Services Block Grant Act programs:
        Grants to States for Community Services...............          715,000           674,000           715,000   ................          +41,000
        Economic Development..................................           29,883   ................  ................          -29,883   ................
        Rural Community Facilities............................            6,500   ................  ................           -6,500   ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................          751,383           674,000           715,000           -36,383           +41,000
 
        Individual Development Account Initiative.............           18,950            18,950   ................          -18,950           -18,950
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Community Services........................          770,333           692,950           715,000           -55,333           +22,050
 
Domestic Violence Hotline.....................................            8,250            12,300             8,250   ................           -4,050
Family Violence/Battered Women's Shelters.....................          150,000           151,000           151,000            +1,000   ................
Chafee Education and Training Vouchers........................           43,257            43,257            43,257   ................  ................
Faith-Based Center............................................  ................  ................  ................  ................  ................
Disaster Human Services Case Management.......................            1,864             1,864             1,864   ................  ................
Program Direction.............................................          205,000           205,699           205,000   ................             -699
                                                               -----------------------------------------------------------------------------------------
      Total, Children and Families Services Programs..........       11,234,268        11,725,057        11,214,935           -19,333          -510,122
 
         Children's Research and Technical Assistance
 
Systems Innovation Center and other expenses..................  ................           10,000   ................  ................          -10,000
    (By transfer).............................................  ................          (15,000)  ................  ................         (-15,000)
                                                               -----------------------------------------------------------------------------------------
      Total, Children's research and technical assistance.....  ................           25,000   ................  ................          -25,000
 
Promoting Safe and Stable Families............................          345,000           345,000           325,000           -20,000           -20,000
    Discretionary Funds.......................................           59,765            79,765            59,765   ................          -20,000
                                                               -----------------------------------------------------------------------------------------
      Total, Promoting Safe and Stable Families...............          404,765           424,765           384,765           -20,000           -40,000
 
            Payments for Foster Care and Permanency
 
Foster Care...................................................        4,772,100         4,992,000         4,992,000          +219,900   ................
Adoption Assistance...........................................        2,562,900         2,780,000         2,780,000          +217,100   ................
Guardianship..................................................          123,000           152,000           152,000           +29,000   ................
Independent Living............................................          140,000           140,000           140,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Payments to States...............................        7,598,000         8,064,000         8,064,000          +466,000   ................
        Less Advances from Prior Year.........................       -2,300,000        -2,300,000        -2,300,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
          Total, payments, current year.......................        5,298,000         5,764,000         5,764,000          +466,000   ................
            New Advance, 1st quarter, fiscal year 2018........        2,300,000         2,500,000         2,500,000          +200,000   ................
                                                               =========================================================================================
      Total, ACF..............................................       33,007,934        34,746,289        33,825,326          +817,392          -920,963
 
          Current year........................................      (29,407,934)      (30,846,289)      (29,925,326)        (+517,392)        (-920,963)
          Fiscal year 2018....................................       (3,600,000)       (3,900,000)       (3,900,000)        (+300,000)  ................
      Total, ACF Program Level................................       33,007,934        34,761,289        33,825,326          +817,392          -935,963
 
              ADMINISTRATION FOR COMMUNITY LIVING
 
            Aging and Disability Services Programs
 
Grants to States:
    Home and Community-based Supportive Services..............          347,724           357,724           347,724   ................          -10,000
    Preventive Health.........................................           19,848            19,848            19,848   ................  ................
    Protection of Vulnerable Older Americans-Title VII........           20,658            20,658            20,658   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          388,230           398,230           388,230   ................          -10,000
 
    Family Caregivers.........................................          150,586           150,586           150,586   ................  ................
    Native American Caregivers Support........................            7,531             7,531             7,531   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Caregivers....................................          158,117           158,117           158,117   ................  ................
 
    Nutrition:
        Congregate Meals......................................          448,342           454,091           448,342   ................           -5,749
        Home Delivered Meals..................................          226,342           234,397           226,342   ................           -8,055
        Nutrition Services Incentive Program..................          160,069           160,069           160,069   ................  ................
        Nutrition Initiative..................................  ................  ................  ................  ................  ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................          834,753           848,557           834,753   ................          -13,804
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Grants to States..............................        1,381,100         1,404,904         1,381,100   ................          -23,804
 
Grants for Native Americans...................................           31,158            31,158            26,158            -5,000            -5,000
Aging Network Support Activities..............................            9,961             9,961             9,961   ................  ................
Alzheimer's Disease Demonstrations............................            4,800             4,800             4,800   ................  ................
    Prevention and Public Health Fund\1\......................          (14,700)          (14,700)          (14,700)  ................  ................
Lifespan Respite Care.........................................            3,360             5,000             3,360   ................           -1,640
Chronic Disease Self-Management Program.......................  ................  ................  ................  ................  ................
    Prevention and Public Health Fund\1\......................           (8,000)           (8,000)           (8,000)  ................  ................
Elder Falls Prevention........................................  ................  ................  ................  ................  ................
    Prevention and Public Health Fund\1\......................           (5,000)           (5,000)           (5,000)  ................  ................
Senior Medicare Patrol Program................................  ................  ................  ................  ................  ................
Elder Rights Support Activities...............................           11,874            13,874            13,874            +2,000   ................
Aging and Disability Resources................................            6,119             8,119             6,119   ................           -2,000
State Health Insurance Program................................           52,115            52,115   ................          -52,115           -52,115
National Clearinghouse for Long-Term Care Information.........  ................  ................  ................  ................  ................
Paralysis Resource Center.....................................            7,700             7,700             7,700   ................  ................
Limb loss.....................................................            2,810             2,810             2,810   ................  ................
Traumatic Brain Injury........................................            9,321             9,321             9,321   ................  ................
Developmental Disabilities Programs:
    State Councils............................................           73,000            73,000            73,000   ................  ................
    Protection and Advocacy...................................           38,734            38,734            38,734   ................  ................
    Voting Access for Individuals with Disabilities...........            4,963             4,963             4,963   ................  ................
    Developmental Disabilities Projects of National                      10,000            10,000            10,000   ................  ................
     Significance.............................................
    University Centers for Excellence in Developmental                   38,619            38,619            38,619   ................  ................
     Disabilities.............................................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Developmental Disabilities Programs...........          165,316           165,316           165,316   ................  ................
 
Workforce Innovation and Opportunity Act Independent Living...          101,183           101,183           101,183   ................  ................
    National Institute on Disability, Independent Living, and           103,970           103,970           103,970   ................  ................
     Rehabilitation Research..................................
    Assistive Technology......................................           34,000            32,000            32,000            -2,000   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Workforce Innovation and Opportunity Act......          239,153           237,153           237,153            -2,000   ................
 
Program Administration........................................           40,063            41,063            40,063   ................           -1,000
                                                               =========================================================================================
      Total, Administration for Community Living [ACL]........        1,964,850         1,993,294         1,907,735           -57,115           -85,559
          Federal funds.......................................        1,912,735         1,941,179         1,907,735            -5,000           -33,444
          Trust Funds.........................................          (52,115)          (52,115)  ................         (-52,115)         (-52,115)
      (Prevention and Public Health Fund)\1\..................          (27,700)          (27,700)          (27,700)  ................  ................
          Total, ACL program level............................        1,992,550         2,020,994         1,935,435           -57,115           -85,559
 
                    OFFICE OF THE SECRETARY
 
                General Departmental Management
 
General Departmental Management, Federal Funds................          200,000           214,610           199,620              -380           -14,990
    Teen Pregnancy Prevention Community Grants................          101,000           104,790           101,000   ................           -3,790
    Evaluation Tap Funding....................................           (6,800)           (6,800)           (6,800)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Grants........................................         (107,800)         (111,590)         (107,800)  ................          (-3,790)
 
Faith-Based Center............................................            1,299             1,382             1,299   ................              -83
Sexual Risk Avoidance.........................................           10,000   ................           15,000            +5,000           +15,000
Minority Health...............................................           56,670            56,670            50,000            -6,670            -6,670
Office of Women's Health......................................           32,140            32,140            29,000            -3,140            -3,140
Minority HIV/AIDS prevention and treatment....................           53,900            53,900            48,000            -5,900            -5,900
Embryo Adoption Awareness Campaign............................            1,000   ................            1,000   ................           +1,000
Planning and Evaluation, Evaluation Tap Funding...............          (58,028)          (59,278)          (58,028)  ................          (-1,250)
                                                               -----------------------------------------------------------------------------------------
      Subtotal, General Departmental Management...............          456,009           463,492           444,919           -11,090           -18,573
 
DATA Act activities...........................................  ................           10,320   ................  ................          -10,320
HHS Digital Service Team......................................  ................            5,000   ................  ................           -5,000
                                                               -----------------------------------------------------------------------------------------
      Total, General Departmental Management..................          456,009           478,812           444,919           -11,090           -33,893
          Federal Funds.......................................         (456,009)         (478,812)         (444,919)         (-11,090)         (-33,893)
          (Evaluation Tap Funding)............................          (64,828)          (66,078)          (64,828)  ................          (-1,250)
      Total, General Departmental Management Program..........          520,837           544,890           509,747           -11,090           -35,143
 
Office of Medicare Hearings and Appeals.......................          107,381           120,000           112,381            +5,000            -7,619
Office of the National Coordinator for Health Information                60,367   ................           60,367   ................          +60,367
 Technology...................................................
    Evaluation Tap Funding....................................  ................          (82,000)  ................  ................         (-82,000)
                                                               -----------------------------------------------------------------------------------------
      Total, Program Level....................................          (60,367)          (82,000)          (60,367)  ................         (-21,633)
 
                  Office of Inspector General
 
Inspector General Federal Funds...............................           75,000            85,000            75,000   ................          -10,000
    HCFAC funding (NA)........................................         (333,893)  ................         (334,097)            (+204)        (+334,097)
                                                               -----------------------------------------------------------------------------------------
      Total, Inspector General Program Level..................         (408,893)          (85,000)         (409,097)            (+204)        (+324,097)
 
                    Office for Civil Rights
 
Federal Funds.................................................           38,798            42,705            38,798   ................           -3,907
 
 Retirement Pay and Medical Benefits for Commissioned Officers
 
Retirement Payments...........................................          441,977           457,459           457,459           +15,482   ................
Survivors Benefits............................................           28,603            31,559            31,559            +2,956   ................
Dependents' Medical Care......................................          115,608           141,390           141,390           +25,782   ................
                                                               -----------------------------------------------------------------------------------------
      Total,Medical Benefits for Commissioned Officers........          586,188           630,408           630,408           +44,220   ................
                                                               =========================================================================================
   Public Health and Social Services Emergency Fund [PHSSEF]
 
       Assistant Secretary for Preparedness and Response
 
Operations....................................................           30,938            30,938            30,938   ................  ................
Preparedness and Emergency Operations.........................           24,654            24,654            24,654   ................  ................
National Disaster Medical System..............................           49,904            55,054            49,904   ................           -5,150
Hospital Preparedness Cooperative Agreement Grants:
    Formula Grants............................................          254,555           254,555           254,555   ................  ................
Biomedical Advanced Research and Development Authority [BARDA]          511,700           511,700           511,700   ................  ................
Policy and Planning...........................................           14,877            14,877            14,877   ................  ................
Project BioShield.............................................          510,000           350,000           510,000   ................         +160,000
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Preparedness and Response.....................        1,396,628         1,241,778         1,396,628   ................         +154,850
 
            Assistant Secretary for Administration
 
Assistant Secretary for Administration, Cybersecurity.........           50,860            50,860            50,860   ................  ................
Office of Security and Strategic Information..................            7,470             7,470             7,470   ................  ................
 
                   Public Health and Science
 
Medical Reserve Corps.........................................            6,000             6,000             6,000   ................  ................
Pandemic Influenza Preparedness...............................           72,000           125,009            57,000           -15,000           -68,009
Pandemic Flu balances (Public Law 111-32).....................  ................  ................          (15,000)         (+15,000)         (+15,000)
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Non-pandemic flu/BioShield/Parklawn/Other               950,958           956,108           950,958   ................           -5,150
       construction...........................................
                                                               =========================================================================================
      Total, PHSSEF...........................................        1,532,958         1,431,117         1,517,958           -15,000           +86,841
      Total, PHSSEF, program level............................        1,532,958         1,431,117         1,532,958   ................         +101,841
                                                               =========================================================================================
      Total, Office of the Secretary..........................        2,856,701         2,788,042         2,879,831           +23,130           +91,789
          Federal Funds.......................................        2,749,320         2,668,042         2,767,450           +18,130           +99,408
          Trust Funds.........................................          107,381           120,000           112,381            +5,000            -7,619
          (Evaluation Tap Funding)............................          (64,828)         (148,078)          (64,828)  ................         (-83,250)
                                                               -----------------------------------------------------------------------------------------
      Total, Office of the Secretary Program Level............        2,921,529         2,936,120         2,959,659           +38,130           +23,539
                                                               =========================================================================================
      Total, Title II, Health and Human Services..............      732,462,371       776,784,242       778,872,440       +46,410,069        +2,088,198
          Federal Funds.......................................      727,944,631       771,768,378       774,357,815       +46,413,184        +2,589,437
              Current year....................................     (608,762,129)     (642,648,926)     (645,238,363)     (+36,476,234)      (+2,589,437)
              Fiscal year 2018................................     (119,182,502)     (129,119,452)     (129,119,452)      (+9,936,950)  ................
          Trust Funds.........................................        4,517,740         5,015,864         4,514,625            -3,115          -501,239
          Pandemic Flu balances (Public Law 111-32)...........          (15,000)  ................          (30,000)         (+15,000)         (+30,000)
      Total, Prevention and Public Health Fund\1\.............         (932,000)       (1,000,000)         (931,000)          (-1,000)         (-69,000)
 
              TITLE III--DEPARTMENT OF EDUCATION
 
                EDUCATION FOR THE DISADVANTAGED
 
Grants to Local Educational Agencies [LEAs] Basic Grants:
    Advance from prior year...................................       (2,890,776)       (2,390,776)       (2,390,776)        (-500,000)  ................
    Forward funded............................................        4,064,641         4,513,625         4,564,641          +500,000           +51,016
    Current funded............................................            3,984             5,000             3,984   ................           -1,016
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Basic grants current year approp..............        4,068,625         4,518,625         4,568,625          +500,000           +50,000
      Subtotal, Basic grants total funds available............       (6,959,401)       (6,909,401)       (6,959,401)  ................         (+50,000)
 
    Basic Grants fiscal year 2018 Advance.....................        2,390,776         1,940,776         1,890,776          -500,000           -50,000
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Basic grants, program level...................        6,459,401         6,459,401         6,459,401   ................  ................
 
    Concentration Grants:
        Advance from prior year...............................       (1,362,301)       (1,362,301)       (1,362,301)  ................  ................
        Fiscal year 2018 Advance..............................        1,362,301         1,362,301         1,362,301   ................  ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................        1,362,301         1,362,301         1,362,301   ................  ................
 
    Targeted Grants:
        Advance from prior year...............................       (3,294,050)       (3,544,050)       (3,544,050)        (+250,000)  ................
        Fiscal year 2018 Advance..............................        3,544,050         3,769,050         3,794,050          +250,000           +25,000
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................        3,544,050         3,769,050         3,794,050          +250,000           +25,000
 
    Education Finance Incentive Grants:
        Advance from prior year...............................       (3,294,050)       (3,544,050)       (3,544,050)        (+250,000)  ................
        Fiscal year 2018 Advance..............................        3,544,050         3,769,050         3,794,050          +250,000           +25,000
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................        3,544,050         3,769,050         3,794,050          +250,000           +25,000
                                                               =========================================================================================
      Subtotal, Grants to LEAs, program level.................       14,909,802        15,359,802        15,409,802          +500,000           +50,000
 
School Improvement Grants.....................................          450,000   ................  ................         -450,000   ................
Innovative Approaches to Literacy.............................           27,000            27,000            27,000   ................  ................
Comprehensive literacy development grants (formerly Striving            190,000           190,000           190,000   ................  ................
 Readers).....................................................
State Agency Programs:
    Migrant...................................................          374,751           374,751           374,751   ................  ................
    Neglected and Delinquent/High Risk Youth..................           47,614            47,614            47,614   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, State Agency programs.........................          422,365           422,365           422,365   ................  ................
 
Migrant Education:
    High School Equivalency Program...........................           44,623            44,623            44,623   ................  ................
                                                               =========================================================================================
      Total, Education for the disadvantaged..................       16,043,790        16,043,790        16,093,790           +50,000           +50,000
          Current Year........................................       (5,202,613)       (5,202,613)       (5,252,613)         (+50,000)         (+50,000)
          Fiscal year 2018....................................      (10,841,177)      (10,841,177)      (10,841,177)  ................  ................
      Subtotal, Forward Funded................................       (5,127,006)       (5,125,990)       (5,177,006)         (+50,000)         (+51,016)
 
                          IMPACT AID
 
Basic Support Payments........................................        1,168,233         1,168,233         1,176,233            +8,000            +8,000
Payments for Children with Disabilities.......................           48,316            48,316            48,316   ................  ................
Facilities Maintenance (Sec. 8008)............................            4,835            71,648             4,835   ................          -66,813
Construction (Sec. 8007)......................................           17,406            17,406            17,406   ................  ................
Payments for Federal Property (Sec. 8002).....................           66,813   ................           68,813            +2,000           +68,813
                                                               =========================================================================================
      Total, Impact aid.......................................        1,305,603         1,305,603         1,315,603           +10,000           +10,000
 
                  SCHOOL IMPROVEMENT PROGRAMS
 
State Grants for Supporting Effective Instruction.............          668,389           568,559           374,389          -294,000          -194,170
    Advance from prior year...................................       (1,681,441)       (1,681,441)       (1,681,441)  ................  ................
    Fiscal year 2018..........................................        1,681,441         1,681,441         1,681,441   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, State Grants for Improving Teacher Quality,           2,349,830         2,250,000         2,055,830          -294,000          -194,170
       program level..........................................
 
Mathematics and Science Partnerships..........................          152,717   ................  ................         -152,717   ................
Supplemental Education Grants.................................           16,699            16,699            16,699   ................  ................
21st Century Community Learning Centers.......................        1,166,673         1,000,000         1,050,000          -116,673           +50,000
State Assessments/Enhanced Assessment Instruments.............          378,000           403,000           378,000   ................          -25,000
Education for Homeless Children and Youth.....................           70,000            85,000            77,000            +7,000            -8,000
Training and Advisory Services (Civil Rights).................            6,575             6,575             6,575   ................  ................
Education for Native Hawaiians................................           33,397            33,397            33,397   ................  ................
Alaska Native Education Equity................................           32,453            32,453            32,453   ................  ................
Rural Education...............................................          175,840           175,840           175,840   ................  ................
Comprehensive Centers.........................................           51,445            55,445            51,445   ................           -4,000
Student Support and Academic Enrichment grants................  ................          500,000           300,000          +300,000          -200,000
                                                               =========================================================================================
      Total, School Improvement Programs......................        4,433,629         4,558,409         4,177,239          -256,390          -381,170
          Current Year........................................       (2,752,188)       (2,876,968)       (2,495,798)        (-256,390)        (-381,170)
          Fiscal year 2018....................................       (1,681,441)       (1,681,441)       (1,681,441)  ................  ................
      Subtotal, Forward Funded................................       (2,611,619)       (2,232,399)       (2,055,229)        (-556,390)        (-177,170)
 
                       INDIAN EDUCATION
 
Grants to Local Educational Agencies..........................          100,381           100,381           100,381   ................  ................
 
Federal Programs:
    Special Programs for Indian Children......................           37,993            67,993            37,993   ................          -30,000
    National Activities.......................................            5,565             6,565             5,565   ................           -1,000
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Federal Programs..............................           43,558            74,558            43,558   ................          -31,000
                                                               =========================================================================================
      Total, Indian Education.................................          143,939           174,939           143,939   ................          -31,000
 
                  INNOVATION AND IMPROVEMENT
 
Education Innovation and Research.............................          120,000           180,000           120,000   ................          -60,000
STEM Master Teacher Corps.....................................  ................           10,000   ................  ................          -10,000
American History and Civics Academies.........................            1,815             1,815             1,815   ................  ................
School Leader Recruitment and Support.........................           16,368            30,000            16,368   ................          -13,632
Charter Schools Grants........................................          333,172           350,000           343,172           +10,000            -6,828
Magnet Schools Assistance.....................................           96,647           115,000            96,647   ................          -18,353
Fund for the Improvement of Education [FIE]...................            3,000   ................  ................           -3,000   ................
Teacher and School Leader Incentive Grants....................          230,000           250,000           213,000           -17,000           -37,000
Ready-to-Learn television.....................................           25,741            25,741            25,741   ................  ................
Advanced Placement............................................           28,483   ................  ................          -28,483   ................
Supporting Effective Educator Development [SEED]..............  ................          100,000            87,000           +87,000           -13,000
Art in Education..............................................           27,000            27,000            27,000   ................  ................
Javits Giffted and Talented Students..........................           12,000            12,000            12,000   ................  ................
Teach to Lead (proposed legislation)..........................  ................           10,000   ................  ................          -10,000
Stronger Together (proposed legislation)......................  ................          120,000   ................  ................         -120,000
Next Generation High Schools (proposed legislation)...........  ................           80,000   ................  ................          -80,000
Computer Science for All Development Grants (proposed           ................          100,000   ................  ................         -100,000
 legislation).................................................
                                                               =========================================================================================
      Total, Innovation and Improvement.......................          894,226         1,411,556           942,743           +48,517          -468,813
          Current Year........................................         (894,226)       (1,411,556)         (942,743)         (+48,517)        (-468,813)
 
            SAFE SCHOOLS AND CITIZENSHIP EDUCATION
 
Promise Neighborhoods.........................................           73,254           128,000            73,254   ................          -54,746
School Safety National Activities.............................           75,000            90,000            70,000            -5,000           -20,000
Elementary and Secondary School Counseling....................           49,561   ................  ................          -49,561   ................
Carol M. White Physical Education Program.....................           47,000   ................  ................          -47,000   ................
Full-Service Community Schools................................           10,000            10,000   ................          -10,000           -10,000
                                                               =========================================================================================
      Total, Safe Schools and Citizenship Education...........          254,815           228,000           143,254          -111,561           -84,746
 
                 ENGLISH LANGUAGE ACQUISITION
 
Current funded................................................           47,931            52,026            47,931   ................           -4,095
Forward funded................................................          689,469           748,374           689,469   ................          -58,905
                                                               =========================================================================================
      Total, English Language Acquisition.....................          737,400           800,400           737,400   ................          -63,000
 
                       SPECIAL EDUCATION
 
State Grants:
    Grants to States Part B current year......................        2,629,465         2,629,465         2,669,465           +40,000           +40,000
        Part B advance from prior year........................       (9,283,383)       (9,283,383)       (9,283,383)  ................  ................
    Grants to States Part B (fiscal year 2018)................        9,283,383         9,283,383         9,283,383   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, program level.................................       11,912,848        11,912,848        11,952,848           +40,000           +40,000
 
    Preschool Grants..........................................          368,238           403,238           368,238   ................          -35,000
    Grants for Infants and Families...........................          458,556           503,556           458,556   ................          -45,000
                                                               -----------------------------------------------------------------------------------------
      Subtotal, program level.................................       12,739,642        12,819,642        12,779,642           +40,000           -40,000
 
IDEA National Activities (current funded):
    State Personnel Development...............................           41,630            41,630            41,630   ................  ................
    Technical Assistance and Dissemination (including Special            54,428            64,428            56,928            +2,500            -7,500
     Olympics Education)......................................
    Personnel Preparation.....................................           83,700            83,700            83,700   ................  ................
    Parent Information Centers................................           27,411            27,411            27,411   ................  ................
    Technology and Media Services.............................           30,047            30,047            30,047   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, IDEA special programs.........................          237,216           247,216           239,716            +2,500            -7,500
                                                               =========================================================================================
      Total, Special education................................       12,976,858        13,066,858        13,019,358           +42,500           -47,500
          Current Year........................................       (3,693,475)       (3,783,475)       (3,735,975)         (+42,500)         (-47,500)
          Fiscal year 2018....................................       (9,283,383)       (9,283,383)       (9,283,383)  ................  ................
      Subtotal, Forward Funded................................       (3,456,259)       (3,536,259)       (3,496,259)         (+40,000)         (-40,000)
 
        REHABILITATION SERVICES AND DISABILITY RESEARCH
 
Vocational Rehabilitation State Grants........................        3,391,770         3,398,554         3,398,554            +6,784   ................
Client Assistance State grants................................           13,000            13,000            13,000   ................  ................
Training......................................................           30,188            30,188            30,188   ................  ................
Demonstration and Training programs...........................            5,796             5,796             5,796   ................  ................
Protection and Advocacy of Individual Rights [PAIR]...........           17,650            17,650            17,650   ................  ................
Supported Employment State grants.............................           27,548            30,548            27,548   ................           -3,000
Independent Living:
    Services for Older Blind Individuals......................           33,317            35,317            33,317   ................           -2,000
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................           33,317            35,317            33,317   ................           -2,000
 
Helen Keller National Center for Deaf/Blind Youth and Adults..           10,336            10,336            10,336   ................  ................
Assistive Technology..........................................  ................  ................  ................  ................  ................
                                                               =========================================================================================
      Total, Rehabilitation services..........................        3,529,605         3,541,389         3,536,389            +6,784            -5,000
 
      SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES
 
American Printing House for the Blind.........................           25,431            25,431            25,431   ................  ................
National Technical Institute for the Deaf [NTID]:
    Operations................................................           70,016            70,016            70,016   ................  ................
Gallaudet University:
    Operations................................................          121,275           121,275           121,275   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Gallaudet University.............................          121,275           121,275           121,275   ................  ................
                                                               =========================================================================================
      Total, Special Institutions for Persons with                      216,722           216,722           216,722   ................  ................
       Disabilities...........................................
 
            CAREER, TECHNICAL, AND ADULT EDUCATION
 
Career Education:
    Basic State Grants/Secondary & Technical Education State            326,598           401,598           326,598   ................          -75,000
     Grants, current funded...................................
        Advance from prior year...............................         (791,000)         (791,000)         (791,000)  ................  ................
        Fiscal year 2018......................................          791,000           791,000           791,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Basic State Grants, program level.........        1,117,598         1,192,598         1,117,598   ................          -75,000
 
    National Programs.........................................            7,421             9,421             7,421   ................           -2,000
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Career Education..............................        1,125,019         1,202,019         1,125,019   ................          -77,000
 
Adult Education:
    State Grants/Adult Basic and Literacy Education:
        State Grants, current funded..........................          581,955           581,955           581,955   ................  ................
National Leadership Activities................................           13,712            24,712            13,712   ................          -11,000
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Adult education...............................          595,667           606,667           595,667   ................          -11,000
                                                               =========================================================================================
      Total, Career, Technical, and Adult Education...........        1,720,686         1,808,686         1,720,686   ................          -88,000
          Current Year........................................         (929,686)       (1,017,686)         (929,686)  ................         (-88,000)
          Fiscal year 2018....................................         (791,000)         (791,000)         (791,000)  ................  ................
      Subtotal, Forward Funded................................         (929,686)       (1,017,686)         (929,686)  ................         (-88,000)
 
                 STUDENT FINANCIAL ASSISTANCE
 
Pell Grants--maximum grant (NA)...............................           (4,860)           (4,860)           (4,860)  ................  ................
Pell Grants...................................................       22,475,352        22,475,352        22,475,352   ................  ................
Federal Supplemental Educational Opportunity Grants...........          733,130           733,130           733,130   ................  ................
Federal Work Study............................................          989,728           989,728           989,728   ................  ................
                                                               =========================================================================================
      Total, Student Financial Assistance [SFA]...............       24,198,210        24,198,210        24,198,210   ................  ................
 
                  STUDENT AID ADMINISTRATION
 
Salaries and Expenses.........................................          696,643           732,352           691,643            -5,000           -40,709
Servicing Activities..........................................          855,211           899,638           855,211   ................          -44,427
                                                               =========================================================================================
      Total, Student Aid Administration.......................        1,551,854         1,631,990         1,546,854            -5,000           -85,136
 
                       HIGHER EDUCATION
 
Aid for Institutional Development:
    Strengthening Institutions................................           86,534            86,534            86,534   ................  ................
    Hispanic Serving Institutions.............................          107,795           107,795           107,795   ................  ................
    Promoting Post-Baccalaureate Opportunities for Hispanic               9,671             9,671             9,671   ................  ................
     Americans................................................
    Strengthening Historically Black Colleges [HBCUs].........          244,694           244,694           244,694   ................  ................
    Strengthening Historically Black Graduate Institutions....           63,281            63,281            63,281   ................  ................
    Strengthening Predominantly Black Institutions............            9,942             9,942             9,942   ................  ................
    Asian American Pacific Islander...........................            3,348             3,348             3,348   ................  ................
    Strengthening Alaska Native and Native Hawaiian-Serving              13,802            13,802            13,802   ................  ................
     Institutions.............................................
    Strengthening Native American-Serving Nontribal                       3,348             3,348             3,348   ................  ................
     Institutions.............................................
    Strengthening Tribal Colleges.............................           27,599            27,599            27,599   ................  ................
    Strengthening HBCU Masters programs.......................  ................  ................            9,500            +9,500            +9,500
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Aid for Institutional development.............          570,014           570,014           579,514            +9,500            +9,500
 
International Education and Foreign Language:
    Domestic Programs.........................................           65,103            65,103            65,103   ................  ................
    Overseas Programs.........................................            7,061             2,168             2,168            -4,893   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, International Education & Foreign Lang........           72,164            67,271            67,271            -4,893   ................
 
Fund for the Improvement of Postsec. Ed. [FIPSE]-First in the   ................          100,000   ................  ................         -100,000
 World........................................................
Postsecondary Program for Students with Intellectual                     11,800            11,800            11,800   ................  ................
 Disabilities.................................................
Minority Science and Engineering Improvement..................            9,648             9,648             9,648   ................  ................
Tribally Controlled Postsec Voc/Tech Institutions.............            8,286             8,286             8,286   ................  ................
Federal TRIO Programs.........................................          900,000           900,000           900,000   ................  ................
GEAR UP.......................................................          322,754           322,754           322,754   ................  ................
Graduate Assistance in Areas of National Need.................           29,293            29,293            29,293   ................  ................
Teacher Quality Partnerships..................................           43,092   ................           43,092   ................          +43,092
Child Care Access Means Parents in School.....................           15,134            15,134            15,134   ................  ................
HCBU and Minority-Serving Institutions Innovation for           ................           30,000   ................  ................          -30,000
 Completion Fund (proposed legislation).......................
Teacher and Principal Pathways (proposed legislation).........  ................          125,000   ................  ................         -125,000
                                                               =========================================================================================
      Total, Higher Education.................................        1,982,185         2,189,200         1,986,792            +4,607          -202,408
 
                       HOWARD UNIVERSITY
 
Academic Program..............................................          191,091           191,091           191,091   ................  ................
Endowment Program.............................................            3,405             3,405             3,405   ................  ................
Howard University Hospital....................................           27,325            27,325            27,325   ................  ................
                                                               =========================================================================================
      Total, Howard University................................          221,821           221,821           221,821   ................  ................
 
COLLEGE HOUSING AND ACADEMIC FACILITIES LOANS PROGRAM.........              435               457               435   ................              -22
 
       HISTORICALLY BLACK COLLEGE AND UNIVERSITY [HBCU]
 
               CAPITAL FINANCING PROGRAM ACCOUNT
 
HBCU Federal Administration...................................              334               349               334   ................              -15
HBCU Loan Subsidies...........................................           20,150            20,150            20,150   ................  ................
                                                               =========================================================================================
      Total, HBCU Capital Financing Program...................           20,484            20,499            20,484   ................              -15
 
             INSTITUTE OF EDUCATION SCIENCES [IES]
 
Research, Development and Dissemination.......................          195,000           209,273           190,000            -5,000           -19,273
Statistics....................................................          112,000           125,360           112,000   ................          -13,360
Regional Educational Laboratories.............................           54,423            54,423            54,423   ................  ................
Research in Special Education.................................           54,000            54,000            54,000   ................  ................
Special Education Studies and Evaluations.....................           10,818            13,000            10,818   ................           -2,182
Statewide Data Systems........................................           34,539            81,017            34,539   ................          -46,478
Assessment:
    National Assessment.......................................          149,000           149,000           149,000   ................  ................
    National Assessment Governing Board.......................            8,235             7,745             7,745              -490   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Assessment....................................          157,235           156,745           156,745              -490   ................
                                                               =========================================================================================
      Total, IES..............................................          618,015           693,818           612,525            -5,490           -81,293
 
                    DEPARTMENTAL MANAGEMENT
 
Program Administration:
    Salaries and Expenses.....................................          431,000           450,342           431,000   ................          -19,342
    Building Modernization....................................            1,000            24,485             1,000   ................          -23,485
                                                               -----------------------------------------------------------------------------------------
      Total, Program administration...........................          432,000           474,827           432,000   ................          -42,827
 
Office for Civil Rights.......................................          107,000           137,708           110,000            +3,000           -27,708
Office of Inspector General...................................           59,256            61,941            59,256   ................           -2,685
                                                               =========================================================================================
      Total, Departmental management..........................          598,256           674,476           601,256            +3,000           -73,220
                                                               =========================================================================================
      Total, Title III, Department of Education...............       71,448,533        72,786,823        71,235,500          -213,033        -1,551,323
          Current Year........................................      (48,851,532)      (50,189,822)      (48,638,499)        (-213,033)      (-1,551,323)
          Fiscal year 2018....................................      (22,597,001)      (22,597,001)      (22,597,001)  ................  ................
 
                  TITLE IV--RELATED AGENCIES
 
COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY              6,191            10,612             8,000            +1,809            -2,612
 DISABLED.....................................................
 
        CORPORATION FOR NATIONAL AND COMMUNITY SERVICE
 
                      Operating Expenses
 
Domestic Volunteer Service Programs:
    Volunteers in Service to America [VISTA]..................           92,364            95,880            92,364   ................           -3,516
    National Senior Volunteer Corps:
        Foster Grandparents Program...........................          107,702           107,702           107,702   ................  ................
        Senior Companion Program..............................           45,512            45,512            45,512   ................  ................
        Retired Senior Volunteer Program......................           48,903            48,903            48,903   ................  ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Senior Volunteers.........................          202,117           202,117           202,117   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Domestic Volunteer Service....................          294,481           297,997           294,481   ................           -3,516
 
National and Community Service Programs:
    AmeriCorps State and National Grants......................          386,010           386,010           386,010   ................  ................
    Innovation, Assistance, and Other Activities..............           57,400            57,601             5,000           -52,400           -52,601
    Evaluation................................................            4,000             6,000             4,000   ................           -2,000
    National Civilian Community Corps [NCCC]..................           30,000            30,000            30,000   ................  ................
    State Commission Support Grants...........................           16,038            17,000            17,038            +1,000               +38
                                                               -----------------------------------------------------------------------------------------
      Subtotal, National and Community Service................          493,448           496,611           442,048           -51,400           -54,563
                                                               -----------------------------------------------------------------------------------------
      Total, Operating expenses...............................          787,929           794,608           736,529           -51,400           -58,079
 
National Service Trust........................................          220,000           206,842           206,842           -13,158   ................
Salaries and Expenses.........................................           81,737            89,330            81,737   ................           -7,593
Office of Inspector General...................................            5,250             6,100             5,250   ................             -850
                                                               =========================================================================================
      Total, Corp. for National and Community Service.........        1,094,916         1,096,880         1,030,358           -64,558           -66,522
 
CORPORATION FOR PUBLIC BROADCASTING:
    Fiscal year 2019 (current) with fiscal year 2017                    445,000           445,000           445,000   ................  ................
     comparable...............................................
    Fiscal year 2018 advance with fiscal year 2016 comparable          (445,000)         (445,000)         (445,000)  ................  ................
     (NA).....................................................
    Fiscal year 2017 advance with fiscal year 2015 comparable          (445,000)         (445,000)         (445,000)  ................  ................
     (NA).....................................................
    Public television interconnection system (current)........           40,000            50,000            50,000           +10,000   ................
FEDERAL MEDIATION AND CONCILIATION SERVICE..