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Calendar No. 137
114th Congress } { Report
SENATE
1st Session } { 114-74
======================================================================
DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND
RELATED AGENCIES APPROPRIATION BILL, 2016
_______
June 25, 2015.--Ordered to be printed
_______
Mr. Blunt, from the Committee on Appropriations,
submitted the following
REPORT
[To accompany S. 1695]
The Committee on Appropriations reports the bill (S. 1695)
making appropriations for Departments of Labor, Health and
Human Services, and Education, and related agencies for the
fiscal year ending September 30, 2016, 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.................$879,922,043,000
Amount of 2015 appropriations........................... 848,302,078,000
Amount of 2016 budget estimate.......................... 892,775,228,000
Bill as recommended to Senate compared to:
2015 appropriations................................. +31,619,965,000
2016 budget estimate................................ -12,853,185,000
CONTENTS
----------
Page
List of Abbreviations............................................ 4
Summary of Budget Estimates and Committee Recommendations........ 8
Overview..................................................... 8
National Institutes of Health................................ 8
Preventing Bureaucratic Overreach............................ 10
Improving Fiscal Accountability.............................. 12
Fighting Opioid Abuse........................................ 13
Combating Antibiotic Resistant Bacteria...................... 13
Rural Health Care............................................ 14
Increasing the Efficiency and Cost Effectiveness of
Government................................................. 14
Other Highlights of the Bill................................. 16
Title I: Department of Labor:
Employment and Training Administration....................... 19
Employee Benefits Security Administration.................... 27
Pension Benefit Guaranty Corporation......................... 27
Wage and Hour Division....................................... 28
Office of Labor-Management Standards......................... 28
Office of Federal Contract Compliance Programs............... 29
Office of Workers' Compensation Programs..................... 29
Occupational Safety and Health Administration................ 32
Mine Safety and Health Administration........................ 33
Bureau of Labor Statistics................................... 34
Office of Disability Employment Policy....................... 34
Departmental Management...................................... 35
General Provisions........................................... 37
Title II: Department of Health and Human Services:
Health Resources and Services Administration................. 39
Centers for Disease Control and Prevention................... 56
National Institutes of Health................................ 78
Substance Abuse and Mental Health Services Administration.... 108
Agency for Healthcare Research and Quality................... 116
Centers for Medicare and Medicaid Services................... 119
Administration for Children and Families..................... 128
Administration for Community Living.......................... 138
Office of the Secretary...................................... 144
General Provisions........................................... 157
Title III: Department of Education:
Education for the Disadvantaged.............................. 159
Impact Aid................................................... 161
School Improvement Programs.................................. 162
Indian Education............................................. 166
Innovation and Improvement................................... 167
Safe Schools and Citizenship Education....................... 171
English Language Acquisition................................. 172
Special Education............................................ 173
Rehabilitation Services and Disability Research.............. 175
Special Institutions for Persons With Disabilities:
American Printing House for the Blind.................... 177
National Technical Institute for the Deaf................ 177
Gallaudet University..................................... 178
Career, Technical, and Adult Education....................... 178
Student Financial Assistance................................. 179
Student Aid Administration................................... 181
Higher Education............................................. 183
Howard University............................................ 187
College Housing and Academic Facilities Loans Program........ 188
Historically Black College and University Capital Financing
Program Account............................................ 188
Institute of Education Sciences.............................. 188
Departmental Management:
Program Administration................................... 191
Office for Civil Rights.................................. 192
Office of the Inspector General.......................... 192
General Provisions........................................... 192
Title IV: Related Agencies:
Committee for Purchase From People Who Are Blind or Severely
Disabled................................................... 194
Corporation for National and Community Service............... 194
Corporation for Public Broadcasting.......................... 197
Federal Mediation and Conciliation Service................... 197
Federal Mine Safety and Health Review Commission............. 198
Institute of Museum and Library Services..................... 198
Medicaid and CHIP Payment and Access Commission.............. 199
Medicare Payment Advisory Commission......................... 199
National Council on Disability............................... 199
National Labor Relations Board............................... 200
National Mediation Board..................................... 200
Occupational Safety and Health Review Commission............. 201
Railroad Retirement Board.................................... 201
Social Security Administration............................... 202
Title V: General Provisions...................................... 206
Compliance With Paragraph 7, Rule XVI of the Standing Rules of
the Sen-
ate............................................................ 208
Compliance With Paragraph 7(c), Rule XXVI of the Standing Rules
of the Senate.................................................. 208
Compliance With Paragraph 12, Rule XXVI of the Standing Rules of
the Senate..................................................... 209
Budgetary Impact of Bill......................................... 217
Comparative Statement of New Budget Authority.................... 218
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--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
HFFI--Healthy Foods Financing Initiative
HHS--Health and Human Services
HRSA--Health Resources and Services Administration
IC--Institute and Center
IDeA--Institutional Development Award
IDEA--Individuals with Disabilities Education Act
IES--Institute of Education Sciences
IMLS--Institute of Museum and Library Services
IOM--Institute of Medicine
LEA--local educational agency
LIHEAP--Low Income Home Energy Assistance Program
MACPAC--Medicaid and CHIP Payment and Access Commission
MCH--maternal and child health
MedPAC--Medicare Payment Advisory Commission
MSHA--Mine Safety and Health Administration
NAEP--National Assessment of Educational Progress
NAGB--National Assessment Governing Board
NCATS--National Center for Advancing Transitional Sciences
NCBDDD--National Center on Birth Defects and Developmental
Disabilities
NCES--National Center for Education Statistics
NCHS--National Center for Health Statistics
NCI--National Cancer Institute
NEI--National Eye Institute
NHGRI--National Human Genome Research Institute
NHLBI--National Heart, Lung, and Blood Institute
NIA--National Institute on Aging
NIAAA--National Institute on Alcohol Abuse and Alcoholism
NIAID--National Institute of Allergy and Infectious Disease
NIAMS--National Institute of Arthritis and Musculoskeletal
and Skin Diseases
NIBIB--National Institute of Biomedical Imaging and
Bioengineering
NICHD--Eunice Kennedy Shriver National Institute of Child
Health and Human Development
NIDA--National Institute on Drug Abuse
NIDCD--National Institute on Deafness and Other
Communication Disorders
NIDCR--National Institute of Dental and Craniofacial
Research
NIDDK--National Institute of Diabetes and Digestive and
Kidney Disease
NIDRR--National Institute on Disability and Rehabilitation
Research
NIEHS--National Institute of Environmental Health Sciences
NIGMS--National Institute of General Medical Sciences
NIH--National Institutes of Health
NIMH--National Institute on Mental Health
NIMHD--National Institute on Minority Health and Health
Disparities
NINDS--National Institute of Neurological Disorders and
Stroke
NINR--National Institute of Nursing Research
NLM--National Library of Medicine
NLRB--National Labor Relations Board
NSF--National Science Foundation
NSIP--Nutrition Services Incentives Program
NTID--National Technical Institute for the Deaf
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 2016, the Committee recommends total budget
authority of $879,922,043,000 for the Departments of Labor,
Health and Human Services, and Education, and Related Agencies.
This amount includes $153,188,000,000 in current year
discretionary funding subject to discretionary spending caps
and $1,561,000,000 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 2015 levels cited in this report reflect the
enacted amounts in Public Law 113-235, the Consolidated and
Further Continuing Appropriations Act, 2015 and exclude funds
designated as emergency requirements for Ebola response and
preparedness.
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 2016. Total
spending in this bill subject to discretionary spending caps is
$3,575,000,000 or 2.3 percent, below the comparable fiscal year
2015 level. This significant funding reduction has required the
Committee to make difficult decisions regarding funding
reductions and consider the appropriate role and jurisdiction
of Federal programs.
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 $32,084,000,000 for
the National Institutes of Health [NIH], an increase of
$2,000,000,000. This is the largest increase the NIH has
received since Congress doubled the agency's funding in 2003.
The Committee strongly believes that in this difficult budget
environment that the Labor-HHS-Education appropriations bill
must reprioritize how funding is allocated and must clearly
recognize the essential role biomedical research plays in every
American's life.
NIH-funded research has raised life expectancy, improved
quality of life, and is an economic engine helping to sustain
American competitiveness. NIH-funded biomedical research is the
catalyst behind many of the advances that are now helping
Americans live longer and healthier lives. Because of the
Federal investment in biomedical research, U.S. cancer death
rates are falling 1 percent each year, with each 1 percent
decline saving our Nation about $500,000,000,000. U.S. death
rates from heart disease and stroke have declined more than 60
percent in the last half-century. Between 1997 and 2006, the
death rate among adults with diabetes declined by 23 percent.
The Committee recommendation places a high priority on
funding for the NIH and believes this funding is necessary to
address our Nation's growing health concerns, spur medical
innovation, sustain America's competitiveness, and reduce
healthcare costs. Over the past decade, the NIH has lost
approximately 22 percent of its purchasing power for research.
The likelihood that a grant application will receive funding
has fallen to the lowest percentage in decades, now less than
20 percent. However, under the Committee recommendation, these
trends will begin to reverse. Within this bill, Research
Project Grants, NIH's funding mechanism for investigator-
initiated research, will increase over 7 percent. The Committee
recommendation is estimated to support over 11,500 new and
competing grants in fiscal year 2016, an increase of nearly
2,500 grants or more than 26 percent above the fiscal year 2015
estimate.
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.
Alzheimer's Disease.--Estimates indicate that more than 5
million people age 65 and older suffer from Alzheimer's disease
in the United States. This disease is not just a burden on our
health; it is also a burden on our economy. The total payments
for healthcare, long-term care, and hospice for people with
Alzheimer's and other dementias are projected to increase from
$226,000,000,000 in 2015 to $1,100,000,000,000 in 2050. Without
a medical breakthrough to prevent, slow, or stop the disease,
Medicare- and Medicaid-related costs could rise nearly five-
fold. Yet, for every $260 Medicare and Medicaid spends on
caring for individuals with Alzheimer's disease, the Federal
Government spends only $1 on Alzheimer's research.
NIH-funded research is the only way to manage this disease
in the future. Therefore, the Committee recommendation includes
an increase of approximately $350,000,000 for the National
Institute on Aging, the NIH Institute with the primary
responsibility for preventing, treating, and curing Alzheimer's
disease.
Antimicrobial Resistance.--Antibiotics have been used to
successfully treat patients for more than 70 years, but over
time the drugs have become less effective as organisms adapt to
the drugs designed to kill them. Recognizing the growing public
health threat of antimicrobial resistance, the Committee
recommendation includes an increase of $100,000,000 for the
National Institute of Allergy and Infectious Diseases to help
expand efforts to develop new antibiotics and rapid diagnostic
tests, and build a national genome sequence database on all
reported resistant human infections. Funding is provided as
part of the Combating Antibiotic Resistant Bacteria [CARB]
initiative requested by the administration.
BRAIN.--The Committee continues to support the Brain
Research through Advancing Innovative Neurotechnologies [BRAIN]
Initiative and fully funds the administration's request for the
program in fiscal year 2016, an increase of $70,000,000 above
fiscal year 2015. The BRAIN Initiative will help develop a
deeper 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, and traumatic
brain injury.
Precision Medicine.--$200,000,000 is provided in the
Committee's recommendation for the new Precision Medicine
Initiative. Instead of a one-size-fits-all approach, the
Precision Medicine Initiative will allow physicians to
individualize treatment to patients and allow treatments to be
as individualized as the disease.
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, researchers must have access to
appropriate research facilities. $50,000,000 is provided for
grants or contracts to research entities to expand, remodel,
renovate, or alter existing research facilities or construct
new research facilities as authorized under 42 U.S.C. 283k.
PREVENTING BUREAUCRATIC OVERREACH
The growth in bureaucracy under the current administration
has brought with it numerous rules and regulations that push
the administration's statutory authority as well as overburden
job creators, educators, and healthcare providers. Such
overreach threatens to undermine entire sectors of the economy,
and in some cases, is clearly intended to achieve no other end
than to upset the balance between employers and employees. The
Committee has included several provisions to limit the onerous
rules and regulations released by the administration over the
past several years.
Independent Payment Advisory Board [IPAB].--The Committee
recommendation eliminates funding for the IPAB, an
unaccountable panel tasked with rationing Medicare spending.
Labor Regulations.--The Federal Government can play an
important role in supporting economic growth through the
establishment of a measured regulatory environment that
protects both the employee and the employer and does not unduly
hinder job creation. However, issuing excessive or burdensome
regulations that stifle growth or slow or reverse job creation
can result in the opposite--greater cost than benefit and a
weaker economy.
The Committee recommendation includes several provisions to
restrain regulatory overreach by the administration. For
example, the bill prohibits the National Labor Relations Board
[NLRB] from allowing small groups of employees to create a
``micro-union'' in spite of opposition to the creation of a
union by the majority of workers, and blocks a potential
revision of the joint employer standard that could undermine
the foundation of how franchise businesses operate. The bill
also curbs new regulations from the Department of Labor
regarding temporary, seasonal workers. The Committee believes
it is critical to ensure that the Federal Government creates
economic conditions that support job creators, and these
provisions restore a reasonable balance to make certain that
regulations serve both the workforce and employers fairly.
Higher Education Regulations.--The Committee recommendation
prohibits the Department of Education from unilaterally moving
forward with several recent and significant policy changes
impacting higher education programs until Congress is able to
weigh in through the authorization process. Specifically, the
bill prohibits the Department from developing a post-secondary
institution rating system, administratively defining the phrase
``gainful employment'', establishing requirements governing the
State authorization process for higher education programs,
establishing a Federal definition of the term ``credit hour'',
and establishing a Federal framework for evaluating teacher
preparation programs, at least until Congress reauthorizes the
Higher Education Act. The Committee supports many of the goals
of these regulations, but each represents a significant
expansion of administrative authority. The Committee strongly
believes these issues should be addressed as part of the normal
legislative process. Regarding the post-secondary institution
ratings system in particular, the Committee strongly believes
this represents a misguided use of limited resources and the
lack of specificity in the draft framework is an indication of
the inherent flaw in the proposal.
The Committee recommendation also includes language
directing the Department of Education to evaluate all higher
education regulations to eliminate unnecessary or duplicative
requirements, as part of an overall effort to improve
affordability of and access to post-secondary education.
Dietary Guidelines.--Significant concerns have been raised
about the 2015 Dietary Guidelines for Americans, including
basing some recommendations on environmental sustainability.
Making a recommendation based on anything but a preponderance
of sound science is outside the scope of the Advisory Committee
and contrary to the statute creating the Advisory Committee
itself. The Committee recommendation includes a provision to
prohibit the Secretary of the Department of Health and Human
Services, who has the administrative leadership for the 2015
Dietary Guidelines edition, from moving forward with the
Guidelines unless the guidelines are solely nutritional and
dietary in nature and based on a preponderance of scientific
evidence.
Recovery Audit Contractors [RAC] Audits.--To decrease the
number of Medicare improper payments, CMS utilizes RACs to
provide post payment reviews of Medicare payments. However,
because RACs are paid on a contingency fee basis, they have a
strong incentive to focus on the quantity of reviews versus the
quality of the audit. As a result, healthcare providers are
using precious resources and staff time to fight erroneous
audit findings instead of providing care to patients. The
Committee includes language directing CMS to expeditiously
resolve any pending issues with the new RAC contracts so that
the new, more tailored RAC requirements can be implemented to
require RACs to focus on the quality of their reviews. This
will also help providers resolve their audit appeals faster by
reducing the number of claims appealed at the Office of
Medicare and Medicaid Appeals [OMHA]. In addition, language is
included directing the Department of Health and Human Services
to continue to evaluate the process until this issue is
resolved.
IMPROVING FISCAL ACCOUNTABILITY
The Committee has an obligation to promote fiscal
accountability and the effective use of U.S. taxpayer funds.
The annual appropriation 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.
Affordable Care Act [ACA] Oversight.--The Committee
includes several provisions to increase transparency and
oversight of the billions of dollars spent on the ACA. The
Committee is proactively protecting discretionary funds in the
bill by preventing the administration from transferring these
funds to bail out ACA activities that were never intended to be
funded through the discretionary appropriations process. The
Committee includes the following:
--Risk Corridor.--The Committee continues bill language
requiring the administration to operate the Risk
Corridor program in a budget neutral manner by
prohibiting any funds from the Labor-HHS-Education
appropriations bill to be used as payments for the Risk
Corridor program.
--State-Based Exchanges.--With the increasing number of
State-Based Exchanges failing due to lack of revenue,
the Committee includes new bill language preventing the
administration from using discretionary funds to pay
for operational costs for these Exchanges.
--Health Exchange Transparency.--The Committee continues bill
language requiring the administration to publish ACA-
related spending by category since its inception.
--ACA Personnel.--The Committee continues bill language
requiring the administration to publish information on
the number of employees, contractors, and activities
involved in implementing, administering, or enforcing
provisions of the ACA.
--Notification.--The Committee recommendation requires the
administration to provide prior notification to the
Appropriations Committees of the House of
Representatives and the Senate before releasing
information to the press.
NLRB Right-Sizing.--Since 2008, the NLRB's budget has
increased 8.9 percent while its workload has remained
relatively flat. The administration has requested an additional
30 full-time employees in fiscal year 2016 even though a recent
reorganization was intended to yield further efficiencies and
eliminate unneeded infrastructure. To put NLRB's budget
increases in perspective, NIH research funding increased only
1.5 percent during the same timeframe. Further, the Committee
remains concerned about recent action the agency has taken to
reverse long-standing policies and other regulatory
initiatives. Most recently, both the Senate and House of
Representatives voted to reject the NLRB's new regulation on
``ambush'' elections which will aggressively reduce the time
for union elections. Yet, the agency is moving forward to
implement the rule anyway. In an effort to right-size and
reprioritize funding within this bill, the Committee
recommendation reduces funding for the NLRB to $246,802,000.
Taxpayer Transparency.--The U.S. taxpayer has 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
includes a new 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.
Program Eliminations.--Lean economic times require tough
choices and a critical review of all programs in the bill, even
those that have been funded for decades. The Committee
recommendation includes 44 program eliminations, equating to
$1,256,180,000 in spending reductions.
FIGHTING OPIOID ABUSE
According to the Centers for Disease Control and Prevention
[CDC], deaths from prescription opioids quadrupled between 1999
and 2013 claiming more than 145,000 lives over the past decade.
These overdoses cost the economy an estimated $20,000,000,000
in medical costs and work loss productivity each year. Even
more dangerous, prescription opioids can act as a gateway drug
to heroin use, another form of opioids. Approximately three out
of four new heroin users abused prescription opioids before
switching to heroin. To stop the spread of further opioid
abuse, the bill provides $67,000,000, an increase of
$35,000,000 above fiscal year 2015, in funding to fight both
prescription opioid and heroin abuse:
Abuse Prevention.--$37,500,000 to CDC for expanding 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.--$29,500,000 to
Substance Abuse and Mental Health Services Administration
[SAMHSA] for State grants to expand access to drug treatment
services for those with a dependence on prescription opioids or
heroin. Funds will be targeted to States that have experienced
the greatest increase in treatment admissions for these drugs.
Funds will also be used to help States purchase and train first
responders on emergency devices that rapidly reverse the
adverse effects of opioid overdoses and to increase awareness
of the dangers of opioid use to the public.
COMBATING ANTIBIOTIC RESISTANT BACTERIA
Antibiotic resistance is an increasingly serious public
health threat: Each year in the United States over 2 million
people become infected with bacteria that are resistant to
antibiotics, and at least 23,000 people die as a direct result
of these infections. According to the latest available data,
antibiotic resistance in the United States costs an estimated
$20,000,000,000 a year in healthcare costs. Without immediate
action, routine infections as well as common surgical
procedures are likely to become life-threatening events. The
Committee recommendation includes $664,000,000, an increase of
$193,000,000 above fiscal year 2015, to combat antibiotic
resistant bacteria using a multi-pronged strategy:
Detect and Protect.--The Committee includes an increase of
$30,000,000 to CDC for faster identification and
characterization of emerging resistance patterns as well as
collaborations with healthcare facilities to implement best
practices for antibiotic prescribing and infection prevention.
Antibiotic Discovery.--With the health system rapidly
running short of ammunition in the battle against resistant
infections, the development of new drugs is of prime
importance. The Committee includes $461,000,000, a $100,000,000
increase over fiscal year 2015 to NIH and $143,000,000, a
$59,000,000 increase over fiscal year 2015 to BARDA to spur the
development of novel antibiotics and help revitalize the drug
development pipeline.
Antibiotic Stewardship.--The Committee includes
$10,000,000, a $4,000,000 increase over fiscal year 2015, for
AHRQ to support activities developing new antibiotic
stewardship programs specifically focused on ambulatory and
long-term care facilities.
RURAL HEALTH CARE
The obstacles faced by patients and providers in rural
communities are unique and often significantly different than
those in urban areas. These issues can range from a lack of
access to primary care physicians to difficulty finding
specialists. As a result, many patients have to drive long
distances to receive care or may not seek care until it is too
late. This creates unnecessary disparities in healthcare not
found in other parts of the country and which will ultimately
cost taxpayers more in Medicare and Medicaid expenditures. The
Committee recommendation addresses the unique challenges faced
by rural patients and providers in several ways:
First, the Committee rejects the administration's request
to eliminate the Small Hospital Improvement Program [SHIP].
Instead, the Committee recommendation provides $14,942,000 for
SHIP to support quality improvement and meaningful use of
health information technology for small hospitals with under 49
beds. Second, the Committee includes $18,000,000, an increase
of $3,100,000, for Telehealth programs. The Committee believes
it is important for telehealth capabilities to be expanded and
improved in rural and remote healthcare settings. Finally, the
Committee recommendation provides $63,500,000, an increase of
$4,500,000, for Rural Health Outreach Grants. These grants are
critical to improving access to care, coordination of care, and
integration of services in rural health settings.
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 $706,000,000 for the Health Care Fraud and Abuse
Control [HCFAC] program at CMS. The Committee notes that the
latest data demonstrates for every $1 spent on fraud and abuse,
$8.10 is recovered by the Treasury. By utilizing the cap
adjustment provided in the Budget Control Act, the Committee
recommendation will create over $5,718,000,000 in savings to
the U.S. Treasury.
Preventing Improper Social Security Payments.--The
Committee recommendation includes $1,439,000,000, a $43,000,000
increase for the Social Security Administration to conduct
continuing disability reviews and SSI program redeterminations
of non-medical eligibility. Combined these activities are
estimated to save approximately $10,000,000,000 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 new language
strengthening oversight of Social Security disability programs.
Specifically, the Committee will work with SSA to expedite
efforts to update 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.
Taxpayer Accountability.--In recent reports, the Government
Accountability Office [GAO] identified several areas, in
particular, in the healthcare sector where the Federal
Government had opportunities to improve overall performance.
Given the current fiscal environment, it is imperative for
Government agencies to increase efficiencies to maximize the
effectiveness of agency programs.
--Recovery Audit Data Warehouse.--The Committee was
disappointed to learn that CMS was not effectively
utilizing the Recovery Audit Data Warehouse which was
designed to prevent contractors from conducting
duplicative audits on the same claim. The Committee
recommendation directs CMS to implement GAO's
recommendations to prevent further waste of resources
or additional burdens on healthcare providers.
--Mental Health.--The Committee is concerned that SAMHSA, the
Federal Government's lead agency for addressing mental
health issues, failed to provide high level
coordination within the Department of Health and Human
Services on serious mental health issues, and did not
properly evaluate some of its own programs. GAO also
highlighted SAMHSA's failure to document how it applied
its own grant criteria before making awards for mental
health grants, and their lack of documentation used to
oversee these programs. Without such coordination and
oversight, scarce Federal funds are being wasted on
duplicative and ineffective mental health programs run
by several different agencies without any clear,
overarching objective or accountability. As a result,
the Committee recommendation directs SAMHSA to
implement the GAO recommendations in fiscal year 2016.
In addition, SAMHSA shall provide any additional
training to its grants staff and develop an internal
grants compliance plan.
Empowering States With Flexibility To Meet Their Own Unique
Needs.--The Committee recommendation restores the Governors'
State Workforce Innovation and Opportunity Act [WIOA] training
set-aside to the full 15 percent level authorized by law. The
Governors' set-aside is a powerful tool for States to meet
their own unique workforce and employment needs on a State-wide
or regional basis. With additional funding, States will be able
to enhance services at their discretion on a State-wide basis.
Many States want to offer additional job training for
regionally-demanded occupations aligned with business needs, to
enhance the coordination of workforce development services
throughout the State, to develop new online resources for job
seekers and employers, and to provide additional services to
at-risk populations such as the long-term unemployed,
disconnected youth, and veterans.
Public Health Services Act [PHS] Evaluation Transfer.--The
Committee recommendation continues to ensure that in fiscal
year 2016, no funds will leave NIH via the transfer required by
section 241 of the PHS Act.
Inspectors General.--The Committee recommendation provides
$213,352,000 for the inspectors general at the three
Departments and the Corporation for National and Community
Service to conduct additional audits and investigations of
possible waste and fraud in Government programs.
Printing Costs.--The Committee is concerned about the
millions of taxpayer dollars spent on wasteful printing
practices each year and the lack of clear printing policies
within each of the agencies. While progress has been made to
better utilize the cloud and digitalize records, little
progress has been made to reform in-house printing practices.
The Committee directs each agency to work with Office of
Management and Budget to reduce printing and reproduction by 34
percent and report to the Committee within 60 days after
enactment of this act on what steps have been taken to reduce
printing volume and costs. The report should specifically
identify how much money each agency will be saving.
OTHER HIGHLIGHTS OF THE BILL
Community Health Centers [CHC].--The Committee
recommendation includes $1,491,522,000 for CHCs. Combined with
the $3,600,000,000 in mandatory funding appropriated for fiscal
year 2016, and $138,478,000 in unobligated balances from prior
years, the Committee's recommended program level totals
$5,200,000,000, an increase of $830,478,000 above the
President's budget request. In addition, the Committee took
into account in the program level the possibility that
$30,000,000 may be transferred from the Community Health
Centers mandatory funds by Public Law 114-22. This funding is
projected to support at least 75 new access points and continue
quality improvement activities for more than 1,300 health
centers operating over 9,000 primary sites.
Child Care.--The Committee recommendation includes
$2,585,000,000 for the Child Care and Development Block Grant
[CCDBG], a $150,000,000 increase. In November 2014, Congress
overwhelmingly passed a reauthorization of the CCDBG Act. This
bill included important reforms to strengthen child care health
and safety standards, and improve the overall quality of child
care programs. The Committee recommendation will help States
implement these and other key changes.
Early Head Start.--The Committee recommendation includes a
$100,000,000 increase to expand Early Head Start, including
through Early Head Start-Child Care Partnerships. Research
increasingly points towards the importance of high-quality
early childhood care and education beginning at birth, and for
families starting before birth. Early Head Start provides high-
quality early childhood services for children and families from
before birth to age 3. Early Head Start-Child Care Partnerships
in particular leverage resources within the Child Care and
Development Fund to help further improve the availability of
high-quality child care programs.
Children's Hospitals Graduate Medical Education [CHGME].--
The Committee recommendation includes $270,000,000 for CHGME,
an increase of $5,000,000 above fiscal year 2015. This funding
supports freestanding children's teaching hospitals to provide
Graduate Medical Education for physicians. The Committee
rejects the administration's proposal to pay only for direct
costs of the program.
Cancer Screenings.--The Committee rejects the
administration's proposed cuts to CDC's breast, cervical, and
colorectal cancer screening programs. These programs
specifically serve low-income, uninsured, and underinsured
adults. The administration made a political choice to cut the
cancer screening programs because the ACA is supposed to cover
these individuals. However, the ACA has fallen short of
insuring every individual. Recent data show that up to 4.5
million women may remain eligible for CDC's National Breast and
Cervical Cancer Early Detection Program. Therefore, the
Committee recommendation provides $250,287,000 for these cancer
screenings.
Immunization Program.--The Committee rejects the
administration's proposed funding reduction for the 317
Immunization program and restores full funding for this
program. Similar to CDC's cancer screening programs, the
administration made a choice to cut funding because of the
promises of the ACA. Yet, as we have seen with the recent
measles outbreak, vaccine programs should not be taken for
granted. The 317 Immunization program serves as a safety-net
for the uninsured and underinsured populations that remain even
with the implementation of the ACA. Vaccines remain one of the
most important and successful public health breakthroughs to
prevent death and disability. The Committee recommendation
includes $610,847,000 for the 317 Immunization program.
Increase in Maximum Pell Grant.--The Committee
recommendation provides funding to maintain the discretionary
portion of the maximum Pell grant, which triggers an automatic
increase in the overall maximum Pell grant, from $5,775 in the
2015-2016 school-year, to an estimated $5,915 for the 2016-2017
school-year. This builds on increases in the maximum award over
the last several years, which by the 2016-17 school year will
have increased by over $1,800 over the last decade.
Supports State and Local Flexibility in Elementary and
Secondary Education.--The Committee recommendation includes
$14,559,802,000 for title I grants to LEAs, a $150 million
increase; $12,414,642,000 for IDEA parts B and C, a
$125,000,000 increase; and $273,172,000 for charter school
grants, a $20,000,000 increase. In addition, the Committee
includes language affirming that the Federal Government cannot
mandate or incentivize in any way the adoption of any specific
standards or assessments. Combined, this helps provide flexible
resources that States, LEAs, and schools can decide how to use
best to improve student outcomes, including students with
disabilities.
Training Assistance to Coal Workers.--The bill dedicates
$19,000,000 of the Dislocated Worker National Reserve to ensure
reemployment and training assistance are provided to workers
dislocated from coal mines and coal-fired power plants as
requested by the administration.
License Portability.--The Committee funds a new proposal by
the administration to reduce barriers created by unnecessary
occupational licensing requirements. Funding is provided for
States 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, and
transitioning servicemembers.
Medicare Appeals Process.--The number of cases appealed to
OMHA has increased 545 percent in 3 years. OMHA currently
receives over a year's worth of work every 8 weeks, and at the
start of fiscal year 2015, OMHA already had 10 years' worth of
work with the existing staff. The Committee recommendation
includes a $10,000,000 increase to help OMHA expand capacity to
address the significant backlog of appeals.
Unemployment Insurance Trust Fund Integrity.--The Committee
provides an increase to enhance Reemployment Services and
Eligibility Assessments for fiscal year 2016. Recent research
cited by the administration has 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 study
estimated that $2.60 in savings are produced for every $1 in
cost. 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.
Reducing the Backlog of Foreign Labor Certifications.--The
Department of Labor plays a role in supporting economic growth
by certifying, on a case-by-case basis, that the admission of
foreign workers into the United States will not adversely
affect the job opportunities, wages, and working conditions of
American workers. Employers who are unable to find qualified
American workers to fill positions rely on prompt and fair
review of their petitions. The Committee recommendation makes
funds available for 1 year to hire temporary employees to
address a growing backlog of Permanent Labor Certification
cases. The additional funds will provide for the processing of
about 96,450 cases, reducing the backlog by approximately
16,000 cases.
TITLE I
DEPARTMENT OF LABOR
Employment and Training Administration
TRAINING AND EMPLOYMENT SERVICES
Appropriations, 2015.................................... $3,139,706,000
Budget estimate, 2016................................... 3,402,431,000
Committee recommendation................................ 2,936,244,000
The Training and Employment Services account provides
funding primarily for activities under the Workforce Innovation
and Opportunity Act [WIOA], and is comprised of programs
designed to enhance the employment and earnings of economically
disadvantaged and dislocated workers, operated through a
decentralized integrated system of skill training and related
services. Funds provided for fiscal year 2016 will support the
program from July 1, 2016, through June 30, 2017. A portion of
this account's funding, $1,772,000,000, is available on October
1, 2016, for the 2016 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, the President's budget request
should include recommendations and specific proposals for
consolidation of programs.
The Committee notes that the disparity between the skills
job seekers have and the skills employers need to fill
available positions, also known as the ``skills gap,'' can
hinder employers from expanding, innovating, and improving
productivity and limit workers' ability to obtain well-paying
jobs in in-demand industries. The Committee encourages the
Department to continue and expand its efforts in preparing
workers for in-demand occupations through a coordinated
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 commends the Employment and Training
Administration [ETA] for its collaborative work with the
Institute for Museum and Library Services to integrate the
education, employment, and training services provided by public
libraries into the workforce development system. The Committee
encourages ETA to continue to strengthen partnerships between
the one-stop system and public libraries.
Grants to States
The Committee recommends $2,492,000,000 for Training and
Employment Services Grants to States.
Under WIOA, a local board is given significant 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 set aside by Governors. Therefore, the 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 $737,000,000.
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 2016, which occurs from
July 1, 2016, through June 30, 2017. The bill provides that
$25,000,000 is available for obligation on July 1, 2016, and
that $712,000,000 is available on October 1, 2016. Both
categories of funding are available for obligation through June
30, 2017.
Youth Training.--For youth training activities, the
Committee recommends $790,000,000.
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 2016, which occurs from April 1, 2016, through
June 30, 2017.
Dislocated Worker Assistance.--For dislocated worker
assistance, the Committee recommends $965,000,000.
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 2016, which occurs from July 1, 2016, through June
30, 2017. The bill provides that $105,000,000 is available for
obligation on July 1, 2016, and that $860,000,000 is available
on October 1, 2016. Both categories of funding are available
for obligation through June 30, 2017.
Federally Administered Programs
Dislocated Worker Assistance National Reserve.--The
Committee recommends $200,000,000 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.
The bill provides that the full $200,000,000 is available
on October 1, 2016.
The Committee bill includes new language setting aside
$19,000,000 to ensure assistance is provided to workers
dislocated from coal mines and coal-fired power plants as
requested by the administration.
Indian and Native American Programs.--The Committee
recommends $40,500,000 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 (Public Law 113-128).
Office of Disability Employment Policy [ODEP].--The
Committee recommendation transfers ODEP to ETA. ETA is the
premier grant-making and employment policy entity within the
Department of Labor and has always coordinated closely with
ODEP. By co-locating ODEP with ETA, ETA will be able to
coordinate and integrate the effort to assist Americans with
disabilities more fully into the workforce development system
consistent with the consolidated approach of WIOA.
The Committee recommendation includes $23,750,000 for ODEP,
of which $15,000,000 shall be for grants, and $8,750,000 shall
be for salaries and expenses. The recommended funding level
allows ETA to retain ODEP's subject matter expertise as well as
provides funding consistent with the range of total grant
awards approximated by the Department for Disability Employment
Initiative grants for fiscal year 2015 to continue the
dedicated grant program. The Committee expects ODEP and ETA to
continue to develop not only appropriate focus areas for future
grant rounds, but also innovative approaches through the
comprehensive WIOA system to help individuals with disabilities
enhance their job skills and overcome barriers to employment.
Migrant and Seasonal Farmworker Programs.--The Committee
recommends $73,000,000 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 $67,306,000 be
used for State service area grants. The Committee
recommendation also includes bill language directing that
$5,200,000 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.
Women in Apprenticeship.--The Committee accepts the
administration's request to eliminate the Women in
Apprenticeship program.
YouthBuild.--The Committee strongly supports the YouthBuild
program and recommends $79,689,000 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.
National Activities
Reintegration of Ex-Offenders.--The Committee recommends
$22,305,000 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, or on parole, or who would benefit from alternatives
to incarceration or diversion from formal judicial proceedings.
Programs are carried out directly through State and local
governmental entities and community based organizations, as
well as indirectly through intermediary organizations. Given
Federal budget constraints, States are encouraged to continue
to support reintegration efforts for ex-offenders with
resources available through the comprehensive workforce
development investment system. The funds appropriated for
fiscal year 2016 shall be for competitive grants for activities
that prepare young ex-offenders and school dropouts for
employment. The Committee directs the Department to use funding
to support efforts in high-crime, high-poverty areas and, in
particular, communities that have recently experienced
significant civil unrest.
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 0.5 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.
The 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 $4,000,000 for the Workforce Data Quality
Initiative, the same as last year. 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.
JOB CORPS
Appropriations, 2015.................................... $1,688,155,000
Budget estimate, 2016................................... 1,715,944,000
Committee recommendation................................ 1,683,155,000
The recommendation for operations of Job Corps centers is
$1,578,008,000. The Committee recommendation for administrative
costs is $31,147,000.
The Committee also recommends a total of $74,000,000 in
construction, renovation, and acquisition [CRA] funds. This
amount is available from July 1, 2016, to June 30, 2019. 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 accepts the Department's proposed bill
provision clarifying that the Secretary, in consultation with
the Secretary of Agriculture, may use a competitive process to
select an entity to operate a Civilian Conservation Center
[CCC] in accordance with section 147 of WIOA if the Center has
had consistently low performance. CCCs are operated by the
Department of Agriculture under an agreement with the Secretary
of Labor. The competitive process provided for under this
provision would be the same process used to select operators of
other Job Corps Centers and consistent with WIOA. This process
would provide an important opportunity to improve the
performance of such Centers with respect to the outcomes
achieved by program participants, including their placement in
unsubsidized employment or further education and training after
they exit the program, their median earnings, and their
attainment of recognized credentials.
Gulfport Job Corps Center.--The Committee remains deeply
concerned with the emergency reconstruction of the Gulfport Job
Corps Center in Gulfport, MS, after it was badly damaged during
Hurricane Katrina in 2005. A decade has now passed, and the
damaged structures are not restored and serviceable in spite of
funds appropriated for this purpose. The Department should
remain committed to ensuring that the Center is rebuilt and
able to return to serving the number of young people that it
once served, while reserving the funds set aside for the
project until the facility can be fully restored. Therefore,
the Committee directs the Department to provide a report, not
later than 90 days after the enactment of this act to the
Committees on Appropriations of the House of Representatives
and the Senate, that outlines a plan for successful completion
of the Gulfport Job Corps Center.
The WIOA included reforms to the Job Corps procurement
process, including changes to ensure that high performing Job
Corps operators would be able to compete for contracts. The
Committee urges the Department to implement these provisions
immediately. The Committee directs the Department to report on
its progress in implementing these provisions within 30 days of
enactment of this act to the Committees on Appropriations of
the House of Representatives and the Senate.
COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS
Appropriations, 2015.................................... $434,371,000
Budget estimate, 2016................................... 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, 2015.................................... $710,600,000
Budget estimate, 2016................................... 664,200,000
Committee recommendation................................ 664,200,000
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 2016 consistent with the continuation
provided in fiscal year 2015.
STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS
Appropriations, 2015.................................... $3,597,150,000
Budget estimate, 2016................................... 4,138,023,000
Committee recommendation................................ 3,519,561,000
The Committee recommendation includes $3,433,133,000
authorized to be drawn from the Employment Security
Administration account of the Unemployment Trust Fund and
$86,428,000 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 $2,738,442,000 for UI
activities. For UI State operations, the Committee recommends
$2,725,550,000. Of these funds, the Committee includes
$100,000,000, an increase of $20,000,000, to help address and
prevent long-term unemployment through a Reemployment and
Eligibility Assessments and Reemployment Services [REA/RES]
initiative. Of the funding included in the budget request,
$30,000,000 was proposed to be provided through a discretionary
cap adjustment amendment to the Balanced Budget and Emergency
Deficit Control Act of 1985. The Committee recommendation does
not include funding through the cap adjustment.
The Committee recommendation continues to support
investments in UI program integrity activities, including
technology-based programs that identify and reclaim
overpayments. The Committee continues bill language allowing
funding to pay for the administration of trade adjustment
allowances for individuals certified for the Trade Adjustment
Assistance program under petitions filed prior to January 1,
2016.
The Committee recommendation does not provide funding for
an additional round of incentive grants related to worker
misclassification. The Committee notes that the first round of
funding from fiscal year 2014 is newly awarded and proposals
for fiscal year 2015 have not yet been solicited. Therefore, no
performance results are yet available to assess its efficacy.
The Committee recommendation maintains bill language, as
requested by the administration, providing $3,000,000 for
continued support of the UI Integrity Center of Excellence. The
Center's mission is to develop, implement, and promote
innovative integrity strategies in the UI program, focusing on
the prevention and detection of fraud.
The Committee recommendation provides for a contingency
reserve amount should the unemployment workload exceed an
average weekly insured claims volume of 2,957,000.
The Committee maintains bill language to improve
efficiencies by allowing the Department to consolidate and make
payments on behalf of States from administration grants to the
entity operating the State Information Data Exchange System.
The Committee recommendation maintains bill language
allowing funds used to carry out national activities of the
employment service to be obligated in contracts, grants, or
agreements with States as well as non-State entities.
The Committee recommends $12,892,000 for UI national
activities, which will support activities that benefit the
Federal-State UI system, including helping States adopt common
technology-based solutions to improve efficiency and
performance, including the replacement of the aging UI
Reporting System hardware infrastructure and software
applications installed in the State workforce agencies and to
support the Interstate Connection Network, which enables the
timely and accurate payment of UI benefits.
For the Employment Service allotments to States, the
Committee recommends $634,775,000. This amount includes
$20,775,000 in general funds together with an authorization to
spend $614,000,000 from the Employment Security Administration
account of the Unemployment Trust Fund.
The Committee also recommends $19,000,000 for Employment
Service national activities. The administration of the work
opportunity tax credit program accounts for $18,200,000 of the
recommended amount; the balance is for technical assistance and
training to States.
For carrying out the Department's responsibilities related
to foreign labor certification activities, the Committee
recommends $61,691,000. 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. Further, the Committee has included a new general
provision to allow the use of H-1B fees to address the backlog
of certifications in the PERM program. The Department is
authorized to use $13,000,000 for that purpose, the same amount
requested by the administration.
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 Survey
data are available unless the Secretary determines that the
methodology and data in the provided survey are not
statistically supported. The bill also contains new general
provisions related to enforcement of new H-2B rules.
For one-stop career centers and labor market information,
the Committee recommends $65,653,000. The Committee supports
the new proposal 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. ETA is
directed to use $7,500,000 of the funds provided in this budget
activity to initiate this effort.
The request for $5,000,000 to conduct a study and pilot
approaches to modernize the O*NET is not funded.
ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS
The Committee bill continues language providing such sums
as are necessary in mandatory funds for this account. The
appropriation is available to provide advances to several
accounts for purposes authorized under various Federal and
State unemployment compensation laws and the Black Lung
Disability Trust Fund, whenever balances in such accounts prove
insufficient.
PROGRAM ADMINISTRATION
Appropriations, 2015.................................... $154,559,000
Budget estimate, 2016................................... 176,564,000
Committee recommendation................................ 144,017,000
The Committee recommendation of $144,017,000 for program
administration includes $97,733,000 in general funds and
$46,284,000 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 funding provided for Program Administration, the
Committee recommendation includes $31,450,000 for the Office of
Apprenticeship, a decrease of $2,550,000 below the fiscal year
2015 level.
Employee Benefits Security Administration
SALARIES AND EXPENSES
Appropriations, 2015.................................... $181,000,000
Budget estimate, 2016................................... 207,455,000
Committee recommendation................................ 168,930,000
The Committee recommends $168,930,000 for the Employee
Benefits Security Administration [EBSA].
EBSA plays a critical role in protecting health benefits
and retirement security for American workers and their
families. EBSA is responsible for the enforcement of title I of
ERISA in both civil and criminal areas and for enforcement of
sections 8477 and 8478 of the Federal Employees' Retirement
Security Act of 1986. EBSA administers an integrated program of
regulation, compliance assistance and education, civil and
criminal enforcement, and research and analysis.
Benefits under EBSA's jurisdiction consist of approximately
$8.5 trillion in assets covering approximately 142 million
workers, retirees, and their families. EBSA oversees benefit
security for an estimated 677,000 private retirement plans, 2.4
million health plans, and similar numbers of other welfare
benefit plans, such as those providing life or disability
insurance.
Mental health disorders affected an estimated 43.8 million
adults in the United States in 2013. The Committee believes
that progress has been made in this country in recognizing the
significance of mental healthcare and treating it equitably
with physical health. Nonetheless, there is little information
available assessing activities of the States toward this end.
The Committee requests the Secretary to coordinate with the
Secretary of Health and Human Services to prepare a report
within 180 days of enactment of this act to the Committees on
Appropriation of the Senate and House of Representatives
assessing activities of the States on this issue.
Pension Benefit Guaranty Corporation
PBGC's estimated obligations for fiscal year 2016 include
single-employer benefit payments of $6,386,000,000, multi-
employer financial assistance of $269,000,000, and
administrative expenses of $431,799,000. Administrative
expenses are comprised of three activities: pension insurance
activities, pension plan termination expenses, and operational
support. These expenditures are financed by permanent
authority. The Committee has 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. However, PBGC is directed to continue
providing detail on the three activities in its annual
congressional budget justification.
The PBGC is a wholly owned Government corporation
established by ERISA. The law places it within DOL and makes
the Secretary the chair of its board of directors. The
Corporation receives its income primarily from insurance
premiums collected from covered pension plans, assets of
terminated pension plans, collection of employer liabilities
imposed by the act, and investment earnings. The primary
purpose of the Corporation is to guarantee the payment of
pension plan benefits to participants if covered defined
benefit plans fail or go out of existence.
PBGC's single-employer program protects about 31 million
workers and retirees in approximately 22,000 pension plans. The
multi-employer insurance program protects about 10 million
participants in roughly 1,400 plans.
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, 2017, 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, 2015.................................... $227,500,000
Budget estimate, 2016................................... 277,100,000
Committee recommendation................................ 210,000,000
The Committee recommends $210,000,000 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, 2015.................................... $39,129,000
Budget estimate, 2016................................... 46,981,000
Committee recommendation................................ 36,000,000
The Committee recommends $36,000,000 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, 2015.................................... $106,476,000
Budget estimate, 2016................................... 113,687,000
Committee recommendation................................ 96,000,000
The Committee recommends $96,000,000 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.
The Committee is concerned that OFCCP has lost its focus on
identifying and addressing real employment discrimination and
is imposing excessive compliance burdens on contractors. More
specifically, OFCCP appears to prioritize specific quota
results rather than equal consideration and opportunity because
of its reliance on statistical analysis in evaluating
contractor hiring practices. OFCCP should focus on actual
discriminatory treatment instead of presumed discrimination
based solely on benchmarks that may not be uniformly
applicable. Strict and exclusive use of statistical
significance tests effectively requires contractors to use a
quota hiring system in violation of the Civil Rights Act to
avoid adverse impact claims by OFCCP. The Committee is also
concerned about reports that OFCCP is increasingly subjecting
contractors to overly broad and unnecessary document and data
requests as well as unreasonably numerous and lengthy
compliance reviews. The OFCCP is directed to cease utilization
of this de facto quota system for evaluating hiring practices
and to report within 120 days of enactment to the Committees on
Appropriations of the House of Representatives and Senate on
steps it is taking to enforce non-discrimination standards on a
more fair, case-by-case basis focused on evidence of actual
discrimination rather than on statistical generalizations and
quota benchmarks.
Office of Workers' Compensation Programs
SALARIES AND EXPENSES
Appropriations, 2015.................................... $113,000,000
Budget estimate, 2016................................... 119,574,000
Committee recommendation................................ 109,677,000
The Committee recommends $109,677,000 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, 2015.................................... $210,000,000
Budget estimate, 2016................................... 210,000,000
Committee recommendation................................ 210,000,000
The Committee recommends $210,000,000 for this account.
This mandatory appropriation, which is administered by OWCP,
primarily provides benefits under FECA.
The Committee recommends continuation of appropriations
language to provide authority to require disclosure of Social
Security account numbers by individuals filing claims under
FECA or the Longshore and Harbor Workers' Compensation Act and
its extensions.
The Committee recommends continuation of appropriations
language that provides authority to use FECA funds to reimburse
a new employer for a portion of the salary of a newly
reemployed injured Federal worker. FECA funds will be used to
reimburse new employers during the first 3 years of employment,
not to exceed 75 percent of salary in the worker's first year,
and declining thereafter.
The Committee recommendation 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.
The Committee bill includes language that allows fair share
collections to be used to pay for capital investment projects
and specific initiatives to strengthen compensation fund
control and oversight.
Finally, the Committee recommends 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, 2015.................................... $77,262,000
Budget estimate, 2016................................... 69,302,000
Committee recommendation................................ 69,302,000
The Committee recommends a mandatory appropriation of
$69,302,000 in fiscal year 2016 for special benefits for
disabled coal miners. This is in addition to the $21,000,000
appropriated last year as an advance for the first quarter of
fiscal year 2016, for a total program level of $90,302,000 in
fiscal year 2016. The decrease in this account below the fiscal
year 2015 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
$19,000,000 for the first quarter of fiscal year 2017. 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, 2015.................................... $56,406,000
Budget estimate, 2016................................... 58,552,000
Committee recommendation................................ 58,552,000
The Committee recommends $58,552,000 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 2016, the volume of incoming claims under
part B of EEOICPA is estimated at about 5,400 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 4,440 new claims will be
received during fiscal year 2016. 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, 2015.................................... $325,955,000
Budget estimate, 2016................................... 341,467,000
Committee recommendation................................ 341,467,000
The Committee bill provides an estimated $341,467,000 as
requested for this mandatory appropriations account. This
estimate is comprised of $66,206,000 for administrative
expenses and an estimated $275,261,000 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
$35,244,000 for the part C costs of the Division of Coal Mine
Workers' Compensation Programs; up to $30,279,000 for
Departmental Management, Salaries and Expenses; and up to
$327,000 for Departmental Management, Inspector General. The
bill also allows a transfer of up to $356,000 for the
Department of the Treasury.
The Trust Fund pays all black lung compensation/medical and
survivor benefit expenses when no responsible mine operation
can be assigned liability for such benefits or when coal mine
employment ceased prior to 1970, as well as all administrative
costs that are incurred in administering the benefits program
and operating the trust fund.
Occupational Safety and Health Administration
SALARIES AND EXPENSES
Appropriations, 2015.................................... $552,787,000
Budget estimate, 2016................................... 592,071,000
Committee recommendation................................ 524,476,000
The Committee recommends $524,476,000 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 effectively
exempt farms employing 10 or fewer people from the provisions
of the act with the exception of those farms having a temporary
labor camp. The bill also retains language exempting small
firms in industry classifications having a lost workday injury
rate less than the national average from general schedule
safety inspections.
The 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 $98,746,000 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, including the grant program
that supports such training, are a critical part of a
comprehensive approach to worker protection. Under the program,
grants are made to various types of organizations representing
employers and labor organizations for direct training of
workers on occupational safety and health. The Committee
recommendation includes $10,149,000 for the OSHA Susan Harwood
Training Grant Program.
The Committee is aware of recent reports of unhealthy and
dangerous working conditions in some nail salons. While OSHA
has previously awarded several grants that support training and
compliance assistance in this area, the Committee notes that
employment for nail salon workers is projected to grow by 16
percent from 2012 to 2020--faster than the average for all
occupations. Therefore, the Committee directs the agency to
allocate funds within the Susan Harwood grants program to
strengthen safety and health competencies in the nail salon
industry, as well as to train workers to understand the
requirements of OSHA regulations and standards and how to
assert their rights.
The Committee recognizes that fewer injuries mean lower
worker's compensation and healthcare costs, and safer, more
productive workers. Statistical evidence for the Voluntary
Protection Program's [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.
OSHA shall dedicate not less than $3,500,000 per year for
the purpose of administering the VPP in its Federal Compliance
Assistance budget. OSHA shall not reduce funding levels or the
number of full time 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 understands that, as a result of Executive
Order 13650, Improving Chemical 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.
Mine Safety and Health Administration
SALARIES AND EXPENSES
Appropriations, 2015.................................... $375,887,000
Budget estimate, 2016................................... 394,932,000
Committee recommendation................................ 356,878,000
The Committee recommendation includes $356,878,000 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.
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, 2015.................................... $592,212,000
Budget estimate, 2016................................... 632,737,000
Committee recommendation................................ 579,194,000
The Committee recommends $579,194,000 for the Bureau of
Labor Statistics [BLS]. This amount includes $63,700,000 from
the Employment Security Administration account of the
Unemployment Trust Fund and $515,494,000 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.
Office of Disability Employment Policy
Appropriations, 2015.................................... $38,500,000
Budget estimate, 2016................................... 38,203,000
Committee recommendation................................................
The Committee recommendation transfers the Office of
Disability Employment Policy [ODEP] into the Employment and
Training Administration [ETA]. The Committee expects ODEP and
ETA to continue to provide technical assistance to the
workforce system in support of effective disability employment
policies, to manage the Disability Employment Initiative [DEI]
grant program with resources provided, and to manage the
Advisory Committee on Increasing Competitive Integrated
Employment for Individuals with Disabilities through the
completion of a final report in fiscal year 2016, and to
further integrate services for adults and youth with
disabilities into the WIOA system. The recommended funding
level allows ETA to maintain the DEI grant program and to
retain the core of ODEP's subject matter expertise to pair with
ETA's grant management and policy support.
Departmental Management
SALARIES AND EXPENSES
Appropriations, 2015.................................... $337,929,000
Budget estimate, 2016................................... 375,985,000
Committee recommendation................................ 259,020,000
The Committee recommendation includes $259,020,000 for the
Departmental Management account. Of this amount, $258,727,000
is available from general funds and $293,000 is available by
transfer from the Employment Security account of the
Unemployment Trust Fund. In addition, $30,279,000 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
staff to initiate an Office of Labor Compliance. This request
is denied by the Committee; no funds in the bill have been
provided for this purpose. 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 recommendation includes $30,000,000 for the
Bureau of International Labor Affairs [ILAB]. ILAB's
appropriation is available to help improve working conditions
and labor standards for workers around the world by carrying
out ILAB's statutory mandates and international
responsibilities. Funds for new international grants are not
provided for fiscal year 2016.
The Committee recommendation provides $7,236,000 for
program evaluation and allows these funds to be available for
obligation through September 30, 2017. 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
0.5 percent of certain Department appropriations for evaluation
activities identified by the chief evaluation officer. The
Committee expects to be notified of the planned uses of funds
derived from this authority.
The Committee recommendation provides $9,465,000 for the
Women's Bureau. The Committee continues bill language allowing
the Bureau to award grants.
The Committee notes a report issued on March 31, 2015, by
the Department's Inspector General Office of Audit which
outlines significant failures by the Department to comply with
Federal requirements for the costs, approvals, and reporting of
employee conferences. These requirements stem from
appropriations law, Executive order, and the Office of
Management and Budget direction to ensure that conference
expenses are appropriate, necessary, and managed in a manner
that minimizes expense to taxpayers. The Inspector General
found that DOL did not obtain required approval for every
conference it sponsored costing greater than $100,000, it
failed to disclose five of these conferences, and two were not
reported to the Inspector General as required. The audit also
noted that other conferences were not reported and that, due to
omissions of some categories of costs, the Department's claim
that it met total conference cost reduction targets could not
be verified. The Department is strongly urged to improve its
adherence to conference cost reduction requirements and to
cooperate with the OIG to strengthen internal controls,
compliance, and reporting procedures.
VETERANS EMPLOYMENT AND TRAINING
Appropriations, 2015.................................... $269,981,000
Budget estimate, 2016................................... 271,110,000
Committee recommendation................................ 269,981,000
The Committee recommendation of $269,981,000 for VETS
includes $38,109,000 in general revenue funding and
$231,872,000 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 $14,000,000 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 $39,458,000 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 $38,109,000 for the Homeless
Veterans' Reintegration Program [HVRP] 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,
2016, 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, 2015.................................... $15,394,000
Budget estimate, 2016................................... 119,602,000
Committee recommendation................................ 12,898,000
The Committee recommends $12,898,000 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.
These funds help align IT investments with the Department's
strategic objectives. The second budget activity, for which
$8,000,000 is provided, assists the Department in consolidating
and optimizing common IT infrastructure services, protecting
privacy, and improving timely and efficient services to the
public. The first year of a new activity proposed in the budget
request involves support for a digital government integrated
platform initiative is deferred. It is not funded for fiscal
year 2016 due to budgetary constraints.
OFFICE OF THE INSPECTOR GENERAL
Appropriations, 2015.................................... $81,590,000
Budget estimate, 2016................................... 87,985,000
Committee recommendation................................ 79,311,000
The Committee recommends $79,311,000 for the DOL OIG. The
bill includes $73,721,000 in general funds and authority to
transfer $5,590,000 from the Employment Security Administration
account of the Unemployment Trust Fund. In addition, an amount
of $327,000 is available by transfer from the Black Lung
Disability Trust Fund.
Through a comprehensive program of audits, investigations,
inspections, and program evaluations, OIG attempts to reduce
the incidence of fraud, waste, abuse, and mismanagement, and to
promote economy, efficiency, and effectiveness.
General Provisions
Section 101. The bill continues a provision limiting the
use of Job Corps funding for compensation of an individual that
is not a Federal employee at a rate not to exceed Executive
Level II.
Section 102. The bill continues a provision providing for
general transfer authority.
Section 103. The bill continues a provision prohibiting
funding for the procurement of goods and services utilizing
forced or indentured child labor in industries and host
countries already identified by the Department in accordance
with Executive Order 13126.
Section 104. The bill modifies 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. The provision is expanded to
provide an exception, setting aside $13,000,000 to eliminate
the PERM processing backlog. This authority is an alternative
to the administration's request for a direct appropriation for
this purpose to the Office of Foreign Labor Certification.
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.
Section 107. The bill continues a provision allowing up to
0.5 percent of discretionary appropriations provided in this
act for all Department agencies to be used by the Office of the
Chief Evaluation Officer for evaluation purposes consistent
with the terms and conditions in this act applicable to such
office.
Section 108. The bill modifies the application of the Fair
Labor Standards Act after the occurrence of a major disaster.
Section 109. The bill includes a new provision requested by
the Administration providing for competition for the operation
of Civilian Conservation Centers under certain circumstances.
Section 110. The bill includes a new provision related to
regulation from the Department regarding the circumstances
under which an individual is considered a fiduciary.
Section 111. The bill includes a new provision related to
the wage methodology under the H-2B program.
Section 112. The bill includes a new provision regarding
the three-fourths guarantee and definitions of corresponding
employment and temporary need for purposes of the H-2B program.
Section 113. The bill includes a new provision related to
enforcement of H-2B program regulations.
Section 114. The bill retains a provision that provides
flexibility with respect to the crossing of H-2B nonimmigrants.
Section 115. The bill includes a new provision related to
regulation of respirable crystalline silica.
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, 2015.................................... $1,491,522,000
Budget estimate, 2016................................... 1,491,522,000
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
$5,200,000,000, an increase of $199,367,000 above last year and
an increase of $830,478,000 above the President's request for
fiscal year 2016.
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 2016, and $138,478,000 in
unobligated balances from prior years. In addition, the
Committee took into account in the program level the
possibility that $30,000,000 may be transferred from the
Community Health Centers mandatory funds by Public Law 114-22.
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.
Frontier Health.--The Committee recognizes the importance
of the Frontier Community Health Integration Project
Demonstration to providing coordinated healthcare to the
Nation's most rural counties. The Committee urges the Health
Resources and Services Administration to use available funds to
provide continuing technical assistance and analysis to
participants in the demonstration.
The Committee strongly supports Community Health Centers
and the high-quality, cost-effective primary healthcare they
provide. However, the Committee is concerned by the
administration's refusal to put forth a comprehensive plan for
the upcoming fiscal cliff facing Community Health Centers in
fiscal year 2017. HRSA is directed to provide a report to the
Committees on Appropriations of the House of Representatives
and the Senate 90 days after enactment of this act that details
how the administration will support ongoing health center
operations at existing sites within current appropriations.
Further, the Committee notes the importance of prudent planning
and execution of available unobligated balances available for
Community Health Centers. Therefore, the Committee directs that
no more than $138,478,000 in unobligated balances from amounts
appropriated in prior years is available for obligation in
fiscal year 2016.
Of the available funding for fiscal year 2016, bill
language directs that not less than $50,000,000 shall be
awarded for the establishment of new delivery sites. In
addition, not less than $40,000,000 will be awarded for
construction, and quality and capital improvement projects.
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.
Native Hawaiian Health Care.--The Committee includes
sufficient funding in the Community Health Centers program to
support healthcare activities funded under the Native Hawaiian
Health Care Program, which is specifically cited in the bill.
The Committee urges that not less than the fiscal year 2015
level be provided for these activities.
School-Based Health Centers [SBHC].--The Committee
recognizes school-based health centers are an important part of
the health center safety net program, as they provide a
critical access point for vulnerable school-aged children,
youth, and their families in communities across the country.
The Committee urges HRSA to prioritize fiscal year 2016 grant
awards to include the establishment of new school-based health
center delivery sites, and to report to the Committee in the
fiscal year 2017 CJ how many organizations applied for funding
for new delivery sites in SBHC's and how many were funded.
Tuberculosis [TB].--Cases of TB continue to be reported in
every State in the United States, and CDC has identified drug
resistant TB as a serious antibiotic resistant threat to the
nation. The Committee urges HRSA to strengthen coordination
between Community Health Centers and State and local
tuberculosis control programs to ensure appropriate
identification, treatment, and prevention of TB among
vulnerable populations.
Free Clinics Medical Malpractice Coverage
The Committee provides $99,893,000 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, 2015.................................... $751,600,000
Budget estimate, 2016................................... 856,820,000
Committee recommendation................................ 720,970,000
The Committee recommendation for the activities of the
Bureau of Health Professions is $720,970,000.
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.
In its grant-making under the title VII and VIII health
professions programs, HRSA should give priority consideration,
in alignment with statutory requirements, to medical schools
and health professions schools/programs with a strong emphasis
on primary care, particularly those with programs to foster
education and training in patient-centered, interdisciplinary
team-based primary care. Numerous studies show that primary
care produces better outcomes and reduces the costs of care.
National Health Service Corps
The Committee recommendation does not include discretionary
funding for the National Health Service Corps [Corps], as
proposed by the administration, because adequate funding was
included for fiscal year 2016 in Public Law 114-10. 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.
The Committee recognizes the importance of the Corps
scholarship and loan-repayment programs for serving medically
underserved communities and populations with health
professional shortages and/or high unmet needs for health
services. The Committee notes with concern that the criteria
and methodology for designating a Health Professional Shortage
Areas [HPSA] has not been significantly updated in more than 20
years. The HPSA methodology is outdated and therefore may not
be reliably identifying areas with primary care shortages or
help target Federal resources to areas experiencing the
greatest shortages. The ability to accurately identify areas
experiencing shortages of health workers is essential to the
Secretary's ability to use scarce resources as efficiently as
possible. Therefore, the Committee encourages the Secretary to
prioritize updating the HPSA designation and scoring
methodology based on stakeholder recommendations made by the
Negotiated Rulemaking Committee in 2011. The Committee
encourages HRSA to consider utilizing all authorized priority
categories when granting awards, including prioritizing
applicants willing to continue to serve in a HPSA area after
the period of obligated service, as authorized by 42 U.S.C.
254l-1(d)(2)(B) and 42 U.S.C. 254l(d)(2)(B) and additional
flexibility available to the Secretary to ensure the Corps
scholarship and loan-repayment programs serve the underserved
communities in every State, to the extent appropriate under the
law.
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--individuals recognized as part of the primary care
team in medical home demonstration programs--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 Program.
The Committee recognizes that the Centers of Excellence
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.
Health Careers Opportunity Program
The Committee eliminates the Health Careers Opportunity
Program as proposed by the administration in fiscal years 2015
and 2016. 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
2015 enacted level and the budget request.
Scholarships for Disadvantaged Students
The Committee provides $50,970,000 for Scholarships for
Disadvantaged Students, an increase of $5,000,000 above the
fiscal year 2015 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.
Health Workforce Diversity Program
The Committee recommendation does not include funding for
this new program, as proposed by the administration, due to
budget constraints.
Primary Care Training and Enhancement
The Committee provides $36,831,000 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 background in any new grant
competition in fiscal year 2016.
Training in Oral Health Care
The Committee provides $32,000,000 for Training in Oral
Health Care programs, which includes not less than $9,000,000
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 Committee directs HRSA to prioritize programs that
support underserved communities and applicants from
disadvantaged background in any new grant competition. Further,
the Committee encourages HRSA to focus on training programs
that target vulnerable populations in risk-based clinical
disease management of all populations. The Committee urges HRSA
to work with Centers for Medicare and Medicaid Services [CMS]
on the evaluation and support of additional models for
expanding access to oral healthcare. Such models should include
emergency room diversion programs and efforts under State law
to deploy and evaluate new provider types.
The Committee continues long-standing bill language that
prohibits funding for section 340G-1 of the PHS Act.
Rural Physicians Training
The Committee recommendation does not include funding for
this new program, as proposed by the administration, due to
budget constraints.
Interdisciplinary, Community-Based Linkages
Area Health Education Centers
The Committee provides $31,000,000 for Area Health
Education Centers [AHECs], an increase of $750,000 above the
fiscal year 2015 level. The Committee once again rejects the
administration proposal to eliminate AHEC funding. 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 requests HRSA provide
an update on the AHEC program's impact to increase the primary
healthcare workforce and the AHEC program's nationwide
activities in the fiscal year 2017 CJ.
Geriatric Education
The Committee provides $35,076,000 for Geriatric Education
programs.
In fiscal year 2015, HRSA combined the Comprehensive
Geriatric Education Program, Geriatrics Education Centers
program, Geriatric Training for Physicians, Dentists, and
Behavioral/Mental Health Professionals program, and the
Geriatric Academic Career Awards programs into one competition,
the Geriatric Workforce Enhancement Program. HRSA stated the
combined competition would, ``improve health outcomes for older
adults by integrating geriatrics with primary care, maximizing
patient and family engagement, and transforming the healthcare
system.'' Therefore, the Committee has consolidated the
Comprehensive Geriatric Education program with the Geriatric
Program.
Mental and Behavioral Health
The Committee provides $8,916,000 for Mental and Behavioral
Health programs. These programs provide grants to higher
education institutions and accredited training programs to
recruit and train professionals and faculty in the fields of
social work, psychology, psychiatry, marriage and family
therapy, substance abuse prevention and treatment, and other
areas of mental and behavioral health.
The mental and behavioral healthcare needs of older adults,
returning military veterans and their families, those dealing
with unemployment, job loss, or income reductions have
increased the demand for mental and behavioral health
providers. The Committee supports efforts by HRSA through the
Graduate Psychology Education program that would expand
training sites, reinstate the geropsychology training
component, initiate a veteran-specific education and training
component, and better integrate health service psychology
trainees at federally Qualified Health Centers.
The Committee supports the Department's initiative to
increase the number of social workers and psychologists that
will pursue clinical work with high need and high demand
populations defined as rural, vulnerable, and/or underserved
populations, and veterans, military personnel, and their
families through the Mental and Behavioral Health Education and
Training Grants Program. The Committee is aware that 24 grants
were awarded throughout the country and approximately half
targeted veterans, military personnel, and their families. The
Committee is concerned that as more servicemembers begin to
reintegrate into civilian life after numerous deployments,
there will not be adequate numbers of social workers and
psychologists to assist this population. The Committee supports
HRSA for its collaboration with SAMHSA to integrate primary
care and behavioral health. HRSA should include an update on
this initiative in the fiscal year 2017 CJ.
Health Professions Workforce Information and Analysis
The Committee provides $2,782,000 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 $9,864,000 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.
Due to funding constraints, the Committee recommendation
does not include funding for Public Health Traineeships, the
Preventative Medicine Residency program, or the Integrative
Medicine Program. The Public Health Training Centers Program is
fully funded at the administration's request level of
$9,864,000.
Nursing Workforce Development Programs
The Committee provides $220,630,000 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 recommends funding for the following
activities in the following amounts:
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year
Budget activity 2015 Fiscal year Committee
appropriation 2016 request recommendation
----------------------------------------------------------------------------------------------------------------
Advanced Education Nursing...................................... 63,581 63,581 61,089
Nurse Education, Practice, and Retention........................ 39,913 39,913 39,913
Nurse Workforce Diversity....................................... 15,343 15,343 15,343
Nurse Loan Repayment and Scholarship Program.................... 81,785 81,785 79,785
Comprehensive Geriatric Education............................... 4,500 4,500 ..............
Nursing Faculty Loan Program.................................... 26,500 26,500 24,500
----------------------------------------------------------------------------------------------------------------
Comprehensive Geriatric Education.--In fiscal year 2015,
HRSA combined the Comprehensive Geriatric Education program,
Geriatrics Education Centers program, Geriatric Training for
Physicians, Dentists, and Behavioral/Mental Health
Professionals program, and the Geriatric Academic Career Awards
programs into one competition, the Geriatric Workforce
Enhancement Program. HRSA stated the combined competition
would, ``improve health outcomes for older adults by
integrating geriatrics with primary care, maximizing patient
and family engagement, and transforming the healthcare
system.'' Therefore, the Committee has consolidated the
Comprehensive Geriatric Education program with the Geriatric
Program.
Children's Hospitals Graduate Medical Education
The Committee provides $270,000,000, an increase of
$5,000,000, for the Children's Hospitals Graduate Medical
Education [CHGME] program and rejects the administration's
proposal to only pay direct program costs. 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.
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 BUREAU
Appropriations, 2015.................................... $851,738,000
Budget estimate, 2016................................... 851,738,000
Committee recommendation................................ 828,014,000
The Committee recommendation for the Maternal and Child
Health [MCH] Bureau is $828,014,000. 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 $615,276,000 for the MCH Block
Grant, which provides a flexible source of funding that allows
States to target their most urgent maternal and child health
needs. The program supports a broad range of activities
including: providing prenatal care, well child services, and
immunizations; reducing infant mortality; preventing injury and
violence; expanding access to oral healthcare; addressing
racial and ethnic disparities; and providing comprehensive care
through clinics, home visits, and school-based health programs.
The Committee includes bill language requiring that the
State grant portion of the block grant be funded at not less
than $555,000,000, an increase of $5,369,000 above the fiscal
year 2015 level. The Committee also includes bill language
identifying $50,000,000 for the title V SPRANS set-aside.
Within that total, the Committee recommendation includes
sufficient funding to fully fund the set-asides for oral
health, epilepsy, sickle cell anemia, and fetal alcohol
syndrome at the fiscal year 2015 enacted level.
Children's Health and Development.--There is increased
evidence that experiences in early childhood have long-term
health consequences over the course of one's life. These
experiences are critical in all areas of children's
educational, social, and physical development, and economic
well-being. Children living in States with persistently high
child poverty rates experience more negative health outcomes
than their peers in other States. Therefore, the Committee
directs HRSA to fund studies focused on systemic change that
would positively affect the policy of child-health-related
institutions and systems in States with the highest levels of
childhood poverty. Recipient programs should 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 Committee
intends that this effort will provide a model for other States
to utilize in improving child health and development outcomes.
Prenatal Oral Health.--The Committee recognizes the
importance of prenatal oral healthcare for the health of both
mother and child and encourages the MCH Bureau within HRSA to
continue its efforts to improve the oral health of pregnant
women.
Vision Health.--The Committee is concerned that vision
disorders are the leading cause of impaired health in childhood
and 1 in 4 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.
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 2015
funding level for protection and advocacy services, as
authorized under section 1305 of Public Law 106-310.
Autism and Other Developmental Disorders
The Committee provides $47,099,000 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.
The Committee is concerned that the Autism and Other
Developmental Disorders program's State System Grants are not
of a sufficient size to accomplish their objectives to improve
access to comprehensive, coordinated healthcare and related
services for children and youth with autism spectrum disorder
[ASD] and other developmental disabilities. Many rural States
need significant assistance with diagnosis of ASD and building
networks to provide access to properly trained health
providers. The Committee requests that HRSA report in the
fiscal year 2017 CJ on which rural States have received such
grants and what scale of improvement they were able to achieve.
The Committee directs that HRSA provide not less than the
fiscal year 2015 level for LEND programs to maintain their
capacity to train professionals to diagnose, treat, and provide
interventions to individuals with autism spectrum disorders.
Newborn Screening for Heritable Disorders
The Committee provides $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.
Krabbe Disease.--Krabbe Disease is a rare, inherited
degenerative disorder of the nervous system that causes severe
deterioration of mental and motor skills. The disease most
often affects infants and is generally fatal before the age of
2. There is no cure for Krabbe Disease, but early detection and
beginning treatment prior to the onset of symptoms may help
prevent severe health outcomes. The Committee encourages HRSA
to expand the ability of States to screen for Krabbe disease
and other leukodystrophies, and to continue to educate the
public on the importance of newborn screening and in some cases
supplemental newborn screening.
Healthy Start
The Committee provides $102,000,000 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 Initiatives and
providing evidence-based interventions are 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 the
FIMR.
Necrotizing Enterocolitis [NEC].--HRSA shall identify best
practices and successful interventions for the prevention of
NEC, particularly in premature infants. The Committee directs
HRSA to prioritize prevention of NEC when awarding grants
through the Healthy Start Initiative program.
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, 2015.................................... $2,318,781,000
Budget estimate, 2016................................... 2,322,781,000
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, level with fiscal year
2015, 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, level with fiscal
year 2015, 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 includes bill language providing
$900,313,000, level with fiscal year 2015, for AIDS medications
in ADAP.
Early Intervention Services
The Committee provides $201,079,000, level with fiscal year
2015, 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, level with fiscal year
2015, 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, level with fiscal year
2015, for the AIDS Dental Services program. This program
provides grants to dental schools, dental hygiene schools, and
postdoctoral dental education programs to assist with the cost
of providing unreimbursed oral healthcare to patients with HIV.
AIDS Education and Training Centers
The Committee provides $33,611,000, level with fiscal year
2015, 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 BUREAU
Appropriations, 2015.................................... $103,193,000
Budget estimate, 2016................................... 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 $7,500,000 in fiscal year 2017. The Committee expects
HRSA to report the estimated and actual amounts generated by
the fee in HRSA's annual CJ.
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
multistate regions; and, in a handful of cases, more than one
grantee serves a single State.
In 2014 more than 3.3 million poisoning, toxic exposure,
drug, food safety, and public health emergency calls were
managed by the Nation's 55 accredited poison centers--an
average of more than 9,000 calls per day. Multiple studies have
demonstrated that accurate assessment and triage of poisoning,
drug, and toxic exposures by the Nation's poison centers save
critical healthcare dollars by reducing the severity of
illness, preventing deaths, and avoiding the expense of
unnecessary trips to emergency departments and the length of
hospital stays. HRSA reports that utilization of poison centers
by hospitals and healthcare professionals continues to increase
as the severity and complexity of poisonings and toxic
exposures require the need for increased toxicological
expertise in clinical settings. It is estimated that every $1
invested in the national poison center program saves $13.39 in
medical costs and lost productivity, thus generating annual
cost savings exceeding $1,800,000,000. The Committee directs
the Secretary to continue the discussions with the Nation's
poison control centers to develop an action plan to achieve
these possible new Medicare and Medicaid cost savings.
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 for Hansen's disease
services. Payments are made to the State of Hawaii for the
medical care and treatment of persons with Hansen's disease in
hospital and clinic facilities at Kalaupapa, Molokai, and
Honolulu. Expenses above the level of appropriated funds are
borne by the State of Hawaii.
RURAL HEALTH
Appropriations, 2015.................................... $147,471,000
Budget estimate, 2016................................... 127,562,000
Committee recommendation................................ 150,571,000
The Committee recommendation for Rural Health programs is
$150,571,000, an increase of $3,100,000 above the fiscal year
2015 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 health facilities, including dialysis
centers, in rural parts of the United States 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 dialysis procedures. This problem could be solved
with alternative power generation capacity located at health
facilities. The Committee encourages HRSA to support energy
reliability and power generation capacity for health and
dialysis facilities in rural areas of the United States.
Rural Health Outreach
The Committee provides $63,500,000 for the Rural Health
Outreach program, an increase of $4,500,000 above the fiscal
year 2015 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 $10,000,000 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.
The Committee encourages HRSA to partner with the Delta
Regional Authority [DRA] on the awarding and administration of
grants under the Delta States network grant program and, to the
extent possible, ensure that such awards are in accordance with
DRA's strategic plan.
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.
Rural Access to Emergency Devices
The Committee accepts the budget request's elimination of
the Rural Access to Emergency Devices program. Activities
related to access to emergency medical devices and training are
available through other funding sources available to grantees,
such as the Rural Outreach and Rural Network Development
programs.
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 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 healthcare services
provided by this program. 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 healthcare 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
$3,100,000 above the fiscal year 2015 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. The Committee directs OAT to use these
funds to expand existing telehealth networks and to award new
grants under the Telehealth Network Grant Program while also
increasing activities that demonstrate the use and success of
telehealth networks across the country. The Committee directs
OAT to fund sustainable programs with demonstrable
accomplishments, placing particular emphasis on programs
seeking to aid diverse populations in regions with significant
chronic disease burden and evident health disparities.
The Committee encourages OAT to strongly consider a pilot
program on telemedicine efforts to expand access to key health
services in schools in high poverty areas.
The Committee remains encouraged by the ability of
telehealth services to provide access to vital care for
patients in underserved areas. One very promising area for the
expansion of telemedicine is in the area of stroke treatment,
in which patients that are without access to specialty
neurological care are at a significant disadvantage in
receiving the highest standard of care. Stroke is a major cause
of death and long-term disability, and the speedy access to
appropriate care is the key factor in determining patient
mortality and recovery. Accordingly, the Committee strongly
encourages the inclusion and expansion of telestroke
initiatives in the Telehealth Network Grant Program to improve
patient care in rural, urban, and suburban settings.
FAMILY PLANNING
Appropriations, 2015.................................... $286,479,000
Budget estimate, 2016................................... 300,000,000
Committee recommendation................................ 257,832,000
The Committee provides $257,832,000 for the title X Family
Planning program. This program supports preventive and primary
healthcare services at clinics nationwide.
Funding for family planning services is primarily provided
from other sources of revenue, specifically Medicaid, State and
local Governments, other Federal, State, and private grants,
including the ACA, and private insurance. As stated in the
budget request, these sources of funding ``will remain at
historical proportions of the total Title X revenue.''
The Committee directs HRSA to ensure that any pregnancy
options counseling funded under this title includes adoption
counseling and is provided by counselors who have knowledge and
experience in adoption practices.
PROGRAM MANAGEMENT
Appropriations, 2015.................................... $154,000,000
Budget estimate, 2016................................... 157,061,000
Committee recommendation................................ 151,000,000
The Committee provides $151,000,000 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, 2015.................................... $242,500,000
Budget estimate, 2016................................... 244,500,000
Committee recommendation................................ 244,500,000
The Committee provides that $244,500,000 be released from
the Vaccine Injury Compensation Trust Fund in fiscal year 2016.
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
$6,710,614,000 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], $892,950,000 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, 2015.................................... $798,405,000
Budget estimate, 2016................................... 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 $210,300,000 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 2015 Fiscal year 2016 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
----------------------------------------------------------------------------------------------------------------
Adult Vaccinations.--National childhood vaccination rates
are high, but adult vaccination rates continue to lag. Adult
immunizations are important to prevent long-term illness,
hospitalization, death, and unnecessary healthcare
expenditures. Therefore, the Committee directs CDC to find new
ways to increase adult immunization rates for recommended
vaccines to achieve Healthy People 2020 targets.
Cost Estimates.--The Committee directs CDC to update its
report on estimated funding needs for the Section 317
Immunization Program no later than February 1, 2016, to reflect
fiscal year 2017 cost estimates. The updated report shall 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 as in
fiscal year 2015 in budget authority 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 remaining supplemental balances are used
by CDC in fiscal year 2016.
Section 317.--The Committee rejects the reduction to the
Section 317 Immunization program proposed by the administration
and provides the same level as in fiscal year 2015,
$610,847,000. The Committee believes a strong public health
immunization infrastructure is critical for ensuring high
vaccination coverage levels, the prevention of vaccine-
preventable diseases, and for responding to outbreaks. The
Committee recommendation includes $8,000,000 to build the
capacity of public health departments to bill insurers for
immunizations and encourages the continuation of billing
demonstration projects in State and local health departments.
Universal Influenza Vaccine.--The Committee recognizes the
significant threat of epidemic and pandemic influenza and
encourages CDC to support organizations with the research and
development capacity to combine computational modeling, vaccine
development including human and animal testing for efficacy,
and global threat surveillance capabilities to quantify the
incidence of secondary infection from influenza.
HIV, VIRAL HEPATITIS, SEXUALLY TRANSMITTED DISEASES, AND TUBERCULOSIS
PREVENTION
Appropriations, 2015.................................... $1,117,609,000
Budget estimate, 2016................................... 1,161,747,000
Committee recommendation................................ 1,090,609,000
The Committee recommendation for the activities of the
National Center for HIV, Viral Hepatitis, Sexually Transmitted
Diseases [STDs], and TB Prevention is $1,090,609,000.
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 2015 Fiscal year 2016 Committee
Budget activity appropriation request recommendation
----------------------------------------------------------------------------------------------------------------
Domestic HIV/AIDS Prevention and Research................. 786,712 799,361 786,712
HIV Prevention by Health Department................... 397,161 397,161 397,161
HIV Surveillance...................................... 119,861 119,861 119,861
Activities to Improve Program Effectiveness........... 103,208 109,561 103,208
National, Regional, Local, Community & Other 135,401 135,401 135,401
Organizations........................................
School Health......................................... 31,081 37,377 31,081
Viral Hepatitis........................................... 31,331 62,820 36,331
Sexually Transmitted Infections........................... 157,310 157,310 125,310
Tuberculosis.............................................. 142,256 142,256 142,256
----------------------------------------------------------------------------------------------------------------
Drug Resistant Tuberculosis [TB].--In its 2013 report on
antimicrobial resistance, CDC identified drug resistant TB as a
serious public health threat to the United States. The
Committee recognizes the urgent need for shorter, safer, and
more tolerable treatments for drug resistant TB. Further, the
Committee applauds the CDC Division of TB Elimination for its
efforts assisting State and local public health programs to
prevent outbreaks of drug resistant TB and urges the Secretary
to work with CDC and the Federal TB Task Force to ensure that
States have the resources to identify, treat, and prevent drug
resistant TB.
Hepatitis B.--The Committee is concerned that the Division
of Viral Hepatitis [DVH] has not been prioritizing Hepatitis B
Virus [HBV], as evidenced by the Center's most recent strategic
plan that neglected to include goals, indicators, or strategies
for reducing morbidity, mortality, and health disparities
associated with chronic HBV infection. The Committee encourages
DVH to focus on strategies that focus on the elimination of HBV
for all populations.
HIV School Health.--The Committee is concerned by the
burden of new HIV infections among young people and encourages
CDC to evaluate and improve school HIV prevention activities
and to continue outreach strategies and interventions for youth
most disproportionately at risk for HIV infection.
HIV/AIDS Prevention and Research.--Racial and ethnic
minorities continue to have higher rates of HIV/AIDS compared
to the overall U.S. population. Therefore, the Committee urges
CDC to continue to prioritize HIV/AIDS funding to target racial
and ethnic minority communities.
Prevention Coordinator.--The Committee encourages CDC to
continue to support the Viral Hepatitis Prevention Coordinator
Program, restore funding for screening and linkage to care
programs, and continue to expand its investment in surveillance
projects for the creation of a national infrastructure for
monitoring the viral hepatitis outbreak. Furthermore, the
Committee urges CDC to target funding for immediate support in
the field and strengthening health departments and community
responses that target youth and young adults, with particular
emphasis on persons who inject drugs, persons under 30 years
old, and persons living in rural areas.
Primary Care Screening.--The Committee commends CDC for
working to integrate recommended viral hepatitis screening in
primary care services and urges CDC to continue outreach to
underserved populations through screening activities in non-
clinical and public health settings, including the use of
point-of-care tests.
Viral Hepatitis.--The Committee is concerned that three out
of four people with hepatitis C are part of the baby boom
generation and that almost 60 percent of people infected are
unaware of their condition despite the availability of
effective treatments. Furthermore, mother-to-child
transmissions of hepatitis B continue to occur, potentially
leaving infants with serious liver problems. The Committee
provides an increase over the fiscal year 2015 level to help
stop viral hepatitis transmission and prevent related illness
and deaths in accordance with the HHS Action Plan for the
Prevention, Care, and Treatment of Viral Hepatitis.
EMERGING AND ZOONOTIC INFECTIOUS DISEASES
Appropriations, 2015.................................... $404,990,000
Budget estimate, 2016................................... 699,267,000
Committee recommendation................................ 440,590,000
The Committee recommendation for the activities of the
National Center for Emerging and Zoonotic Diseases is
$440,590,000, 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 2015 Fiscal year 2016 Committee
Budget activity appropriation request recommendation
----------------------------------------------------------------------------------------------------------------
Core Infectious Diseases.................................. 225,393 500,955 254,993
Antibiotic Resistance Initiative...................... ................ 264,328 30,000
Lab Safety and Quality................................ ................ 10,000 5,000
Vector-borne Diseases................................. 26,410 26,831 26,410
Lyme Disease.......................................... 10,663 10,688 10,663
Prion Disease......................................... 5,850 5,862 5,850
Chronic Fatigue Syndrome.............................. 5,400 5,412 ................
Emerging Infectious Diseases.......................... 147,230 147,573 147,230
All Other Infectious Diseases......................... 29,840 30,261 29,840
Food Safety............................................... 47,993 50,089 48,993
National HealthCare Safety Network........................ 18,032 32,071 23,032
Quarantine................................................ 31,572 31,572 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 14,580 12,000
----------------------------------------------------------------------------------------------------------------
Combating Antibiotic-Resistant Bacteria [CARB].--Antibiotic
resistant bacteria is a serious public health and economic
threat to the United States. CDC estimates that 2,000,000
infections and 23,000 deaths are caused annually by antibiotic-
resistant bacteria, costing taxpayers up to $20,000,000,000 in
excess healthcare costs. The Committee supports the CARB
initiative and provides $30,000,000 for this effort. The
Committee encourages CDC to support funding for collaborations
between entities such as academic medical centers, veterinary
schools, schools of public health, State public health
departments, and other academic institutions whose proposals
are in line with CDC's strategy for addressing antibiotic-
resistant bacteria. The Committee understands the importance of
addressing antibiotic-resistant bacteria both in human and
agricultural areas. Therefore, the Committee directs CDC to
collaborate with NIH, AHRQ, BARDA, 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. CDC shall provide a spend
plan to the Committee within 30 days after enactment of this
act and include an update on these efforts in the fiscal year
2017 CJ.
Emerging and Zoonotic Infectious Diseases.--The Committee
is aware of the arrival of Chikungunya in the Caribbean and
encourages the CDC to continue its work to prepare and monitor
any potential arrival of Chikungunya in the United States as
well as address other neglected tropical diseases found in the
United States such as Dengue and Chagas disease. CDC should
encourage the National Center for Emerging and Zoonotic
Infectious Diseases to work with the Center for Global Health
on cross-cutting issues, particularly in support of the Global
Health Security Program.
Food Safety.--The Committee is aware that the PulseNet
laboratory system is 20 years old and without any
modernization, its technology will no longer be effective in
detecting foodborne disease outbreaks and helping CDC stop them
in the food supply chain. Currently, new diagnostics are
replacing the use of traditional cultured bacteria. Therefore,
the Committee includes a $1,000,000 increase above the fiscal
year 2015 level to upgrade the PulseNet system to ultimately
enhance surveillance, detection and response, and prevention
activities.
Guideline for Disinfection and Sterilization.--The
Committee directs CDC to update its 2008 Guideline for
Disinfection and Sterilization in Healthcare Facilities and
incorporate recent peer-reviewed literature regarding the role
of the healthcare environment in the spread of antibiotic-
resistant bacteria and the current best practices for
containment that have been demonstrated in health facility
environments.
Healthcare-Associated Infections.--CDC has made significant
progress on healthcare-associated infection [HAI] prevention
and data collection at acute care hospitals, but significant
gaps in data collection and reporting on HAIs persist across
non-hospital healthcare settings such as ambulatory surgical
centers. The Committee encourages CDC to continue to expand its
data collection efforts to additional providers in non-hospital
settings.
Laboratory Capacity.--The Epidemiology and Laboratory
Capacity for Infectious Diseases Program strengthens the
epidemiologic and laboratory capacity in 50 States, six local
health departments, and eight territories by supporting
improvements in surveillance for infectious diseases, early
detection of newly emerging disease threats, and identification
and response to outbreaks. The Committee encourages CDC to
increase core capacity and ensure State and local
epidemiologists are equipped to rapidly respond to current and
emerging threats, including antibiotic resistant bacteria.
Laboratory Safety and Quality.--As the primary agency
responsible for disease prevention, CDC works with some of the
world's most dangerous infectious diseases. To safely continue
the research necessary to protect the public and staff, CDC has
begun to modernize and improve safety practices and safeguards
currently in place. The Committee includes $5,000,000 for these
improvements which will enable CDC to expand laboratory
training, improve pathogen identification, and implement
changes identified in safety reviews. The Committee directs CDC
to provide a detailed update on these improvements in the
fiscal year 2017 CJ.
National Healthcare Safety Network.--In support of the CARB
initiative, the Committee includes a $5,000,000 increase above
the fiscal year 2015 level for the National Healthcare Safety
Network. This increase will allow CDC to expand the network of
reporting healthcare facilities with the ultimate goal of
eliminating and preventing hospital acquired infections.
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.
Sepsis.--Over 200,000 Americans die of sepsis every year.
Hospital costs are annually in the billions of dollars, with
uncounted costs due to organ injury such as kidney failure,
disability, and lost productivity. With early recognition and
treatment with appropriate and aggressive antibiotic therapy,
major improvements in outcomes can be achieved but there has
been no effort to educate the public or medical providers as to
the signs, symptoms, importance of early diagnosis and
treatment. The Committee encourages CDC to start efforts in
this area.
Surveillance Strategy.--The Committee urges CDC to
expeditiously implement its Surveillance Strategy, including
improving standardization and commonality of platforms across
CDC systems, reducing duplication, tackling workforce and
informatics challenges at CDC and State and local public health
systems, and reducing the burden of participation in
surveillance for healthcare and public health.
CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION
Appropriations, 2015.................................... $1,199,220,000
Budget estimate, 2016................................... 1,058,058,000
Committee recommendation................................ 1,052,922,000
The Committee recommendation for the activities of the
National Center for Chronic Disease Prevention and Health
Promotion is $1,052,922,000, which includes $457,650,000 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 2015 Fiscal year 2016 Committee
Budget activity appropriation request recommendation
----------------------------------------------------------------------------------------------------------------
Tobacco................................................... 216,492 215,492 216,492
Nutrition, Physical Activity and Obesity.................. 47,585 40,092 48,585
High Obesity Rate Counties (non-add).................. 7,500 ................ 8,500
School Health............................................. 15,383 15,383 15,383
Health Promotion.......................................... 19,970 19,970 13,622
Community Health Promotion............................ 6,348 6,348 ................
Glaucoma.............................................. 3,294 3,294 3,294
Visual Screening Education............................ 512 512 512
Alzheimer's Disease................................... 3,344 3,344 3,344
Inflammatory Bowel Disease............................ 716 716 716
Interstitial Cystitis................................. 659 659 659
Excessive Alchohol Use................................ 3,000 3,000 3,000
Chronic Kidney Disease................................ 2,097 2,097 2,097
Prevention Research Centers............................... 25,461 25,000 25,461
Heart Disease and Stroke.................................. 130,037 130,037 130,037
Diabetes.................................................. 140,129 140,129 140,129
National Diabetes Prevention Program...................... 10,000 10,000 10,000
Cancer Prevention and Control............................. 352,649 297,876 352,649
Breast and Cervical Cancer............................ 206,993 169,204 206,993
WISEWOMAN (non-add)............................... 21,114 21,170 21,114
Breast Cancer Awareness for Young Women............... 4,951 4,951 4,951
Cancer Registries..................................... 49,440 49,440 49,440
Colorectal Cancer..................................... 43,294 39,515 43,294
Comprehensive Cancer.................................. 19,673 19,673 19,673
Johanna's Law......................................... 5,500 5,500 5,500
Ovarian Cancer........................................ 7,000 7,000 7,000
Prostate Cancer....................................... 13,205 ................ 13,205
Skin Cancer........................................... 2,121 2,121 2,121
Cancer Survivorship Resource Center................... 472 472 472
Oral Health............................................... 15,749 15,749 15,749
Safe Motherhood/Infant Health............................. 45,473 45,473 45,473
Arthritis................................................. 9,598 13,113 9,598
Epilepsy.................................................. 7,994 7,994 7,994
National Lupus Registry................................... 5,750 5,750 5,750
Racial and Ethnic Approach to Community Health............ 50,950 ................ ................
Partnerships to Improve Community Health.................. 80,000 60,000 ................
Million Hearts............................................ 4,000 4,000 4,000
Workplace Wellness........................................ 10,000 ................ ................
National Early Child Care Collaboratives.................. 4,000 4,000 4,000
Hospitals Promoting Breastfeeding......................... 8,000 8,000 8,000
----------------------------------------------------------------------------------------------------------------
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,
for its work on cognitive surveillance in 47 States and
territories, and for its efforts to update the National Public
Health Road Map to Maintaining Cognitive Health. The Committee
encourages CDC to implement the action steps listed in the
updated Road Map and further develop and expand the
surveillance system on cognitive decline and caregiving,
including widespread dissemination of the data gathered.
Atrial Fibrillation [AFib].--An estimated 2,000,000
Americans have AFib, which puts them at an elevated risk for a
fatal or permanently debilitating stroke. The Committee
encourages CDC to utilize its publications to promote the
adoption of best practices in AFib treatment, expand patient
and family caregiver education on AFib-related stroke risk and
treatment, leverage existing stroke prevention initiatives, and
address gaps in research on prediction of stroke and bleeding
risk in AFib.
Breast and Cervical Cancer Early Detection Program.--The
Committee again rejects the administration's proposed funding
reduction to the Breast and Cervical Cancer program and
provides funding at the fiscal year 2015 level of $206,993,000.
The ACA has fallen short of insuring every individual through
the Exchanges and Medicaid. Specifically, recent data shows
that up to 4,500,000 women may remain eligible for CDC's
National Breast and Cervical Cancer Early Detection Program.
Breastfeeding.--The Committee provides sufficient funding
for CDC to continue supporting breastfeeding as a strategy to
reduce obesity and promote activities proven to increase
breastfeeding through the State Public Health Actions to
Prevent Chronic Disease.
Chronic Pain.--The Committee commends CDC for including
chronic pain in the Healthy People 2020 initiative. The
Committee encourages CDC to include pain research questions in
the 2016 National Health Interview Survey, promptly analyze
collected data and make this information available to the
public, and expand the topic area on chronic pain in the
Healthy People 2030 initiative.
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. Furthermore, the Committee is
pleased with CDC's recent activities on the colorectal cancer
screening program and requests an update on the impact of the
program including screening rates in the fiscal year 2017 CJ.
Community Grants.--Due to tight budget constraints, the
Committee eliminates the Partnerships to Improve Community
Health [PICH] and the Racial and Ethnic Approaches to Community
Health [REACH] programs. The elimination of REACH was
consistent with the administration's budget request. The
Committee believes the community grants are duplicative of
CDC's State Public Health Actions program and supports the same
goals through this program.
Division of Diabetes Translation [DDT].--The Committee
encourages CDC to provide resources to expand State and local
community diabetes control and prevention activities while
supporting the translation of research into better prevention
and care, the National Diabetes Prevention Program, the
expansion of diabetes surveillance, and other DDT activities.
These activities must include clear outcomes, ensure
transparency and accountability, and specifically how diabetes
funding reached State and local communities.
Epilepsy.--The Committee commends CDC for making
considerable progress over the past decade in establishing and
advancing a public health agenda to meet the needs of Americans
with epilepsy. CDC, in partnership with other stakeholders,
will determine national outcome protocols to use to capture and
document information related to these issues: employment,
school, social life and the general well-being of people with
epilepsy.
Food Allergy.--Deaths due to anaphylactic reaction to food
allergens are preventable. National medical and school
organizations recommend that schools maintain a supply of back-
up epinephrine for emergency treatment of potentially fatal
anaphylactic reactions. CDC should encourage schools to
purchase epinephrine and support implementation of the food
allergy school guidelines.
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.
High Obesity Rate Counties.--The Committee is concerned
about the growing body of evidence suggesting that obesity is
the most significant challenge 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 includes a
$1,000,000 increase over the fiscal year 2015 level to expand
support for the rural extension and outreach services to
support additional 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. CDC should focus its
efforts in areas of the country with the highest burden of
obesity and with the co-morbidities of hypertension, cardiac
disease, and diabetes from county level data in the Behavioral
Risk Factor Surveillance System. The Committee encourages CDC
childhood obesity efforts to only support activities that are
supported by scientific evidence.
Inflammatory Bowel Disease [IBD].--The Committee commends
CDC for implementing a robust IBD epidemiology study and
communicating study results with the public. The Committee
encourages CDC to continue exploring the disease burden of IBD
and to communicate these findings to patients and providers in
an effort to improve current interventions and inform best
public health practices in managing IBD.
Interstitial Cystitis [IC].--The Committee commends CDC for
its work on IC and encourages CDC to continue to make IC a
priority by expanding public awareness through education for
healthcare providers and the general public, and enhanced
information sharing.
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 challenges still remain. Burden of illness studies
are lacking in lupus and 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.
Therefore, the Committee urges CDC to support the lupus cohort
and burden of illness studies.
Marfan Syndrome.--Marfan syndrome-related thoracic aortic
aneurysm and dissection claims the lives of young athletes
across the country each year, but few States incorporate Marfan
syndrome testing into their sports screening for high school
athletes. The Committee urges CDC to develop a program to
support, assist, and encourage States to incorporate Marfan
syndrome testing into their sports screening criteria for at-
risk young athletes.
Melanie Blocker Stokes Act.--The Committee urges CDC to
develop a program to assist providers that educate women and
their families about post-partum depression [PPD], and to help
new mothers receive screenings during the first year of
postnatal checkups. As many as 20 percent of new mothers
experience some form of PPD. The Committee requests an update
on this research in the fiscal year 2017 CJ.
Million Hearts.--The Committee supports the Million Hearts
program, a public-private initiative to prevent 1,000,000 heart
attacks and strokes by 2017, and that provides enhanced
prevention, detection, treatment and control of high blood
pressure, a key cause of heart disease and stroke.
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 together 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
2017 CJ.
Oral Health.--The Committee urges CDC to support clinical
and public health interventions that target pregnant women and
young children at highest risk for dental caries. These
interventions result in significant cost-savings to State
Medicaid programs. CDC is encouraged to continue to work across
the Department to improve coordination of oral health
surveillance that reliably measures and reports health
outcomes.
Ovarian Cancer.--The Committee commends the CDC for its
work to evaluate existing risk assessment tools and directs CDC
in their fiscal year 2017 CJ, to include the findings of this
review along with recommendations on how CDC can support the
deployment of the tools found to have the greatest value and
utility. In addition, the Committee directs CDC to provide a
report within 90 days after enactment of this act to the
Committees on Appropriations of the House of Representatives
and Senate on the Institute of Medicine's review of the state
of the sciences in ovarian cancer research.
Preterm Birth.--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. The Committee encourages
CDC to increase the number of States receiving assistance for
perinatal collaboratives.
Psoriasis and Psoriatic Arthritis.--Psoriasis affects an
estimated 7,500,000 people in the United States. The Committee
recognizes the growing body of evidence regarding linkages
between psoriatic disease and cardiovascular disease, alcohol
consumption, metabolic syndrome, and depression and remains
concerned as to the continued gaps in the public health
response to such linkages. The Committee encourages CDC to use
their Prevention Research Centers to build on past investments
including the CDC's Psoriasis and Psoriatic Arthritis: A Public
Health Agenda to define and implement public health self-
management interventions for psoriatic disease. This network
would explore the research needed to better understand the
relationships between the listed and other possible chronic
conditions to help position psoriatic disease appropriately
within the larger world of public health.
Scleroderma.--The Committee recognizes the serious health
challenges faced by patients affected by scleroderma. Due to
various manifestations of the disease, the Committee encourages
CDC to consider opportunities to raise awareness and improve
recognition of scleroderma.
Visual Screening Education.--The Committee is concerned
that people with vision impairment often report chronic
conditions, such as heart disease, stroke, and diabetes, at
substantially higher rates than individuals without vision
impairment. The Committee encourages CDC to increase vision
impairment and eye disease surveillance efforts, apply previous
CDC vision and eye health research findings to develop
effective prevention and early detection interventions, and
begin to incorporate vision and eye health promotion activities
into State and national public health chronic disease
initiatives, with an initial focus on early detection of
diabetic retinopathy.
WISEWOMAN.--The Committee commends the WISEWOMAN program
that helps uninsured and under-insured low-income women ages 40
to 64 prevent, delay, or control heart disease and stroke by
providing preventive health services, referrals to local
healthcare providers, lifestyle programs, and health counseling
tailored to identified risk factors to promote lasting, healthy
behavior change. From July 2008 through June 2013, WISEWOMAN
served nearly 150,000 women and 90 percent of them had at least
one heart disease and stroke risk factor.
Workplace Wellness.--The Committee eliminates the Workplace
Wellness program as requested by the administration.
NATIONAL CENTER ON BIRTH DEFECTS, DEVELOPMENTAL DISABILITIES,
DISABILITY AND HEALTH
Appropriations, 2015.................................... $131,781,000
Budget estimate, 2016................................... 131,781,000
Committee recommendation................................ 132,781,000
The Committee recommendation for the activities of the
National Center on Birth Defects and Developmental Disabilities
[NCBDDD] is $132,781,000.
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 2015 Fiscal year 2016 Committee
Budget activity appropriation request recommendation
----------------------------------------------------------------------------------------------------------------
Child Health and Development.............................. 64,232 64,232 64,232
Other Birth Defects................................... 18,074 18,074 18,074
Fetal Death........................................... 891 891 891
Fetal Alcohol Syndrome................................ 10,505 10,505 10,505
Folic Acid............................................ 3,121 3,121 3,121
Infant Health......................................... 8,639 8,639 8,639
Autism................................................ 23,002 23,002 23,002
Health and Development with Disabilities.................. 52,440 52,440 53,440
Disability and Health................................. 20,042 20,042 21,042
Tourette Syndrome..................................... 2,000 2,000 2,000
Early Hearing Detection and Intervention.............. 10,752 10,752 10,752
Muscular Dystrophy.................................... 6,000 6,000 6,000
Attention Deficit Hyperactivity Disorder.............. 1,850 1,850 1,850
Fragile X............................................. 1,800 1,800 1,800
Spina Bifida.......................................... 5,996 5,996 5,996
Congenital Heart Defects.............................. 4,000 4,000 4,000
Public Health Approach to Blood Disorders................. 4,500 4,500 4,500
Hemophilia CDC Activities................................. 3,504 3,504 3,504
Hemophilia Treatment Centers.............................. 5,000 5,000 5,000
Thalassemia............................................... 2,105 2,105 2,105
----------------------------------------------------------------------------------------------------------------
Birth Defects Prevention.--The Committee commends the
Center for Birth Defects Research and Prevention for its work
toward greater understanding of the causes of birth defects and
for expanding the National Birth Defects Prevention Network to
include the work of the BD-STEPS program. The Committee
supports further expansion of the BD-STEPS program with the
goal of incorporating States that do not currently have a birth
defects surveillance system. Priority should be given to
programs in States with diverse populations and a high burden
of risk factors for birth defects that have previously
submitted meritorious applications but did not receive funding
due to budget constraints.
Cerebral Palsy.--The Committee encourages CDC to build on
established surveillance and research methods to develop a
robust research infrastructure focused on Cerebral Palsy across
various geographic U.S. regions.
Congenital Heart Disease [CHD].--CHD is a serious public
health concern, and it remains the most common birth defect and
leading cause of birth defect-related infant mortality. With
increasing medical treatment options, survival is improving
resulting in a growing population that estimates suggest
exceeds 2,000,000 people. However, children and adults with
congenital heart disease require ongoing, costly, specialized
cardiac care and face a lifelong risk of permanent disability
and premature death. The Committee commends the CDC for its
efforts to address the lifelong needs of this growing
population with CHD, particularly in the areas of critical
congenital heart screening and attention to adolescent and
adult surveillance needs. The Committee remains concerned that
there continues to be a lack of rigorous epidemiological and
longitudinal data on individuals of all ages with CHD. The
Committee encourages CDC to collect and analyze nationally
representative, population-based epidemiological and
longitudinal data on infants, children, and adults with CHD to
improve understanding of CHD incidence, prevalence, and disease
burden, further assess the public health impact of CHD.
Fragile X.--The Committee commends the significant progress
made on the Fragile X Clinical and Research Consortium in
growing its FORWARD Database and its Patient Registry and urges
CDC to continue this effort. The Committee supports the public-
private partnership which resulted in the Fragile X Research
Agenda 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.
Hemophilia.--The Committee maintains funding for the
surveillance and research activities of the national network of
hemophilia treatment centers and the outreach and education
programs of the national hemophilia consumer organizations.
Hereditary Hemorrhagic Telangiectasia [HHT].--HHT is a
genetic disorder that can result in life-threatening strokes
and other complications, but if diagnosed in time is treatable
and manageable. The Committee encourages CDC to develop newborn
screening initiatives that focus on early detection and
intervention methods for newborns from families with a history
of HHT.
Improving the Health of People With Intellectual
Disabilities.--People with disabilities are more often in
poorer health that results in billions in additional healthcare
costs each year. However, with the appropriate help, people
living with disabilities can be productive citizens within
their communities. Therefore, the Committee includes $3,500,000
for the Healthy Athletes program.
Krabbe Disease.--Krabbe Disease is a rare, inherited
degenerative disorder of the nervous systems that causes severe
deterioration of mental and motor skills. The disease most
often affects infants and is generally fatal before the age of
2. There is no cure for Krabbe Disease, but identifying it
early and beginning treatment prior to the onset of symptoms
may help to prevent severe health outcomes. The Committee
encourages CDC to include efforts for Krabbe disease and other
leukodystrophies when rapid diagnosis may lead to potentially
live saving treatments.
Muscular Dystrophy.--The Committee requests an update on
the Muscular Dystrophy CARE Act in the fiscal year 2017 CJ. The
update shall include CDC's plans and timeframe to enhance its
collection of surveillance data across all forms of muscular
dystrophy and to develop updated care standards, including for
adults with Duchenne and for other forms of muscular dystrophy.
National Center on Health, Physical Activity and Disability
[NCHPAD].--The Committee supports the work of 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
organizations with health promotion training, and by
disseminating effective strategies and tools for disability
service providers, the NCHPAD plays an important role in
encouraging a healthier lifestyle for Americans with
disabilities. The Committee urges CDC to increase support for
these efforts.
Neonatal Abstinence Syndrome Data.--The Committee directs
CDC to provide technical assistance to States to improve the
availability and quality of data collection and surveillance
activities regarding neonatal abstinence syndrome, including:
(a) the incidence and prevalence of neonatal abstinence
syndrome; (b) the identification of causes for neonatal
abstinence syndrome, including new and emerging trends; and (c)
the demographics and other relevant information associated with
neonatal abstinence syndrome. CDC shall also collect any
available surveillance data described in the previous sentence
from States and make it publicly available on an appropriate
web site. Furthermore, the Committee directs CDC to increase
utilization of effective public health measures to reduce
neonatal abstinence syndrome.
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.
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
as it confronts this genetic blood disorder.
Tourette Syndrome.--The Committee is pleased with CDC's
current activities on Tourette Syndrome and urges CDC to use
its resources to increase scientific knowledge of the
prevalence and risk factors in both children and adults, as
well as determine the impact of this disorder on the quality of
life of those who are affected.
Tuberous Sclerosis Complex [TSC].--The Committee encourages
CDC to take into consideration all the major manifestations of
TSC in its surveillance network, including epilepsy, autism,
renal angiomyolipomas, facial angiofibromas,
lymphangioleiomyomatosis, retinal hamartomas, subependymal
giant cell astrocytomas, and cardiac rhabdomyomas.
PUBLIC HEALTH SCIENTIFIC SERVICES
Appropriations, 2015.................................... $481,061,000
Budget estimate, 2016................................... 538,809,000
Committee recommendation................................ 471,061,000
The Committee recommendation for Public Health Scientific
Services is $471,061,000.
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 2015 Fiscal year 2016 Committee
Budget activity appropriation request recommendation
----------------------------------------------------------------------------------------------------------------
Health Statistics......................................... 155,397 160,397 145,397
Surveillance, Epidemiology, and PH Informatics............ 273,464 311,008 273,464
Public Health Workforce................................... 52,200 67,404 52,200
----------------------------------------------------------------------------------------------------------------
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. Such statistics would elevate Alzheimer's disease
from the sixth leading cause of death to the third leading
cause of death. The Committee urges CDC to work with
stakeholders to develop recommendations for obtaining more
accurate and complete measurements of Alzheimer's and dementia
death rates and requests a report no later than 180 days after
enactment of this act. The report shall include a consensus on
the mortality burden of these diseases.
Collecting Vital Statistics.--Accurate vital statistics
provide complete and continuous data on births, deaths, and
fetal deaths that are essential for understanding our Nation's
health. The Committee provides the National Center for Health
Statistics [NCHS] the same level of funding as in fiscal year
2015 for the National Vital Statistics System and sufficient
funding to purchase data items currently collected by States
and territories and collect 12 months of these data within the
calendar year.
Epidemiology Fellowship Program.--A well-trained public
health workforce is essential to ensuring the highest level of
efficiency and effectiveness in protecting health. The
Committee encourages CDC to prioritize investments in
established training programs with a demonstrated record of
success in supporting high-quality, on-the-job training at
State and local health agencies and transitioning these
professionals into public health careers, including the Applied
Epidemiology Fellowship Program.
Modernizing the Vital Statistics Infrastructure.--The
Committee understands that not all States and territories have
implemented electronic death registration systems which would
provide more accurate, timely, and secure death data for use in
monitoring our Nation's health and reducing waste, fraud, and
abuse in Federal benefits programs. The Committee urges the
NCHS to support States in modernizing their infrastructure and
directs NCHS to include in the fiscal year 2017 CJ a plan for
modernizing the vital statistics infrastructure, including
steps to address States and territories that have not yet
implemented these systems.
ENVIRONMENTAL HEALTH
Appropriations, 2015.................................... $179,404,000
Budget estimate, 2016................................... 178,500,000
Committee recommendation................................ 145,286,000
The Committee recommendation for the National Center for
Environmental Health is $145,286,000. The Committee
recommendation includes $13,000,000 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 these substances are harmful to
humans and at what level of exposure.
The Committee recommendation includes funding for the
following activities:
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year 2015 Fiscal year 2016 Committee
Budget activity appropriation request recommendation
----------------------------------------------------------------------------------------------------------------
Environmental Health Laboratory........................... 55,870 55,870 55,870
Newborn Screening Quality Assurance Program........... 8,243 8,243 8,243
Newborn Screening for SCID............................ 1,175 1,175 1,175
Other Environmental Health............................ 46,452 46,452 46,452
Environmental Health Activities........................... 45,580 55,580 29,366
Safe Water............................................ 8,601 8,601 ................
Amyotrophic Lateral Sclerosis Registry................ 7,820 7,820 8,820
Built Environment & Health Initiative................. 2,843 2,843 2,843
Climate Change........................................ 8,613 18,613 ................
All Other Environmental Health........................ 17,703 17,703 17,703
Environmental and Health Outcome Tracking Network......... 34,904 24,000 17,000
Asthma.................................................... 27,528 27,528 27,528
Childhood Lead Poisoning.................................. 15,522 15,522 15,522
----------------------------------------------------------------------------------------------------------------
Amyotrophic Lateral Sclerosis [ALS] Registry.--The
Committee provides a $1,000,000 increase above the fiscal year
2015 level for the ALS Registry to further understand and
potentially cure and prevent this disease. CDC and the Agency
for Toxic Substances and Disease Registry [ATSDR] should
continue their current registry activities, including helping
to notify people with ALS about research studies for which they
may qualify and funding risk factor and other ALS research
utilizing registry information. The Committee supports the
implementation of a nation-wide biorepository and encourages
CDC and ATSDR to continue to consult with external stakeholders
and Federal agencies, including NIH, VA, and FDA to coordinate
efforts, raise awareness of the registry, and help ensure that
the registry is available as a resource to support ALS research
and care services and the development of treatments for the
disease.
Asthma.--The Committee is concerned by the impact on people
living with asthma as a result of there being significantly
fewer States participating in the National Asthma Control
Program [NACP]. The Committee encourages NACP to increase the
number of States carrying out programmatic activities and use a
population-adjusted burden of disease criterion as a
significant factor for new competitive awards in the future.
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 health housing activities.
INJURY PREVENTION AND CONTROL
Appropriations, 2015.................................... $170,447,000
Budget estimate, 2016................................... 256,977,000
Committee recommendation................................ 187,947,000
The Committee recommendation for the National Center for
Injury Prevention and Control is $187,947,000.
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 2015 Fiscal year 2016 Committee
Budget activity appropriation request recommendation
----------------------------------------------------------------------------------------------------------------
Intentional Injury........................................ 92,001 107,611 92,001
Domestic Violence and Sexual Violence................. 32,674 32,679 32,674
Child Maltreatment (non-add)...................... 7,250 7,250 7,250
Youth Violence Prevention............................. 15,086 15,086 15,086
Domestic Violence Community Projects.................. 5,414 5,414 5,414
Rape Prevention....................................... 38,827 44,432 38,827
Gun Violence Prevention Research...................... ................ 10,000 ................
National Violent Death Reporting System................... 11,302 23,570 11,302
Unintentional Injury...................................... 8,598 8,598 8,598
Traumatic Brain Injury................................ 6,548 6,548 6,548
Elderly Falls......................................... 2,050 2,050 2,050
Injury Prevention Activities.............................. 28,950 29,023 28,950
Prescription Drug Overdose................................ 20,000 68,000 31,921
Illicit Opioid Use Risk Factors........................... ................ 5,579 5,579
Injury Control Research Centers........................... 9,596 9,596 9,596
----------------------------------------------------------------------------------------------------------------
Combating Opioid Abuse.--The Committee includes
$37,500,000, an increase of $17,500,000 above fiscal year 2015,
for efforts to respond to and reverse the opioid epidemic in
the United States. This includes $31,921,000 to fund the
Prescription Drug Overdose [PDO] Prevention for States program,
a competitive cooperative agreement that targets those States
with the greatest burden of opioid overdoses and demonstrated
readiness to implement prevention strategies, and $5,579,000 to
specifically strengthen surveillance efforts for heroin-related
deaths. The Committee notes the strong connection between
prescription opioids and 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. In
addition, the Committee directs CDC to use the funds provided
to expand the surveillance of heroin-related deaths beyond
CDC's current activities in HHS' Region One by targeting States
that have the greatest burden of heroin abuse.
Concussion Surveillance.--The Committee encourages CDC to
establish and oversee a national surveillance system to
accurately determine the incidence of sports-related
concussions, including youth ages 5 to 21.
Opioid Prescribing Guidelines.--The Committee directs CDC
to complete its work in developing safe opioid prescribing
guidelines for chronic, non-cancer pain in outpatient settings
for release no later than July 31, 2016, and a technical
package to guide States in the implementation of safe opioid
prescribing through coordinated care. The guidelines and
technical package should include information for providers on
the use of opioids for pregnant women and women that might
become pregnant, as well as the potential risks of birth
defects and neonatal abstinence syndrome from exposure to such
medications. The Committee directs CDC to broadly disseminate
the guidelines and technical package and to immediately
evaluate the effects of the new guidance. Furthermore, the
Committee urges CDC to work with the VA and the DOD in
implementing these guidelines in the appropriate facilities and
directs CDC to share data and best practices on safe opioid
prescribing with these agencies.
Sports Injuries.--The Committee is concerned about the
number and severity of injuries related to sports activities at
every age and experience level. Therefore, the Committee
encourages CDC to educate coaches at all levels on how to
prevent common injuries, how to recognize symptoms of
potentially dangerous conditions, and how to plan for emergency
situations is critical to this ever growing problem in sports
safety.
OCCUPATIONAL SAFETY AND HEALTH
Appropriations, 2015.................................... $334,863,000
Budget estimate, 2016................................... 283,418,000
Committee recommendation................................ 305,887,000
The Committee recommendation for National Institute for
Occupational Safety and Health [NIOSH] programs is
$305,887,000.
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.
The Committee recommendation includes funding for the
following activities at the following amounts:
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year 2015 Fiscal year 2016 Committee
Budget activity appropriation request recommendation
----------------------------------------------------------------------------------------------------------------
National Occupational Research Agenda..................... 114,500 90,500 90,500
Agriculture, Forestry, Fishing (non-add).............. 24,000 ................ ................
Education and Research Centers............................ 27,445 ................ 27,445
Personal Protective Technology............................ 19,695 19,695 19,695
Healthier Workforce Center................................ 4,976 4,976 ................
Mining Research........................................... 59,420 59,420 59,420
National Mesothelioma Registry and Tissue Bank............ 1,106 1,106 1,106
Other Occupational Safety and Health Research............. 107,721 107,721 107,721
----------------------------------------------------------------------------------------------------------------
Agriculture, Forestry, and Fishing [AgFF].--The Committee
eliminates the AgFF programs as proposed by the administration.
The Committee recommendation preserves the nine core industry
sectors within the National Occupational Research Agenda and
prioritizes funding to support emerging priorities such as
nanotechnology and mining hazards.
ENERGY EMPLOYEES OCCUPATIONAL INJURY COMPENSATION ACT
Appropriations, 2015.................................... $55,358,000
Budget estimate, 2016................................... 55,358,000
Committee recommendation................................ 55,358,000
The Committee recommendation for EEOICPA is $55,358,000.
This mandatory funding supports NIOSH scientists who
reconstruct radiation dose levels to inform compensation
decisions.
GLOBAL HEALTH
Appropriations, 2015.................................... $416,517,000
Budget estimate, 2016................................... 448,092,000
Committee recommendation................................ 411,758,000
The Committee recommends $411,758,000 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 2015 Fiscal year 2016 Committee
Budget activity appropriation request recommendation
----------------------------------------------------------------------------------------------------------------
Global HIV/AIDS Program................................... 128,421 128,421 128,421
Global Immunization Program............................... 208,608 218,608 213,608
Polio Eradication..................................... 158,774 168,774 163,774
Measles and Other Vaccine Preventable Diseases........ 49,834 49,834 49,834
Parasitic Diseases and Malaria............................ 24,369 24,369 24,369
Global Health Security.................................... ................ 11,575 ................
Global Disease Detection and Emergency Response........... 45,360 45,360 45,360
Global Public Health Capacity Development................. 9,759 19,759 ................
----------------------------------------------------------------------------------------------------------------
Global Diseases.--The Committee is pleased with CDC's
ongoing efforts to fight malaria and neglected tropical
diseases and encourages CDC to continue to research, monitor,
and evaluate efforts for malaria and NTDs in collaboration with
other divisions and agencies.
Global Health.--In a constrained budget environment, the
Committee chose to preserve the Global Disease Detection and
Emergency Response program which remains the core activity
within the Division of Global Health Protection at CDC to
rapidly detect, identify, and control emerging infectious
diseases abroad. From 2006-2014, this program has responded to
over 1,700 disease outbreaks and public health emergencies,
established 289 new diagnostic tests in 59 countries, and
covers a population of 13.1 million people within its
surveillance efforts. In addition, the Committee continues to
support the Global Health Security Agenda, but notes this
program and the National Public Health Institutes received
almost $600,000,000 in the Ebola emergency supplemental in
fiscal year 2015, and therefore, did not need additional
funding in this fiscal year.
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 2015 level to help conquer this disease.
PUBLIC HEALTH PREPAREDNESS AND RESPONSE
Appropriations, 2015.................................... $1,352,551,000
Budget estimate, 2016................................... 1,381,818,000
Committee recommendation................................ 1,340,118,000
The Committee recommendation for the Office of Public
Health Preparedness and Response [PHPR] is $1,340,118,000.
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 2015 Fiscal year 2016 Committee
Budget activity appropriation request recommendation
----------------------------------------------------------------------------------------------------------------
Public Health Emergency Preparedness Cooperative Agreement 643,609 643,609 643,609
Academic Centers for Public Health Preparedness........... 8,018 ................ ................
All Other State & Local................................... 9,415 ................ ................
BioSense.................................................. 23,369 23,369 23,369
All Other CDC Preparedness................................ 133,797 143,797 138,797
Strategic National Stockpile.............................. 534,343 571,043 534,343
----------------------------------------------------------------------------------------------------------------
Emergency Preparedness.--The Committee requests more
detailed information on how State Public Health Emergency
Preparedness [PHEP] funding is distributed at the local level
by States. CDC is directed to require States to report how much
of their Federal PHEP funding is being allocated to local
health departments and what basis or formula each State is
using to make such allocations. The Committee directs CDC to
include this in the fiscal year 2017 CJ.
Procurement.--The Committee encourages CDC to consider
maintaining its planned procurement of anthrax vaccines when
adjusting to changes in commercial pricing or PHEMCE
requirements.
Select Agent Program.--To create a safer laboratory setting
including the handling of dangerous agents, the Committee
includes a $5,000,000 increase above the fiscal year 2015 level
for CDC's Select Agent Program. This will allow CDC to upgrade
their existing databases for tracking select agents and
increase the number of inspections. The Committee requests an
update on these efforts in the fiscal year 2017 CJ.
State and Local Preparedness and Response.--The Committee
does not provide funding for the Academic Centers for Public
Health Preparedness and All Other State and Local Capacity as
requested by the administration. CDC will continue to support
research and training through its Office of Public Health
Preparedness and Response and will provide oversight and
technical assistance to health departments through the Public
Health Emergency Preparedness program. The Committee notes that
CDC also received $410,000,000 as part of the Ebola emergency
supplemental in fiscal year 2015 to expand current domestic
preparedness capacities.
Strategic National Stockpile [SNS].--The Committee
encourages the CDC to evaluate the latest approved advances in
influenza prevention and antiviral treatment for inclusion in
the SNS in preparation for pandemic influenza.
Update of Response Plans.--The Committee is aware that, as
a result of the success of Project BioShield, several new
medical countermeasures have been procured for inclusion in the
SNS. Additionally, the Committee is aware that CDC has
responsibility for developing response plans that will guide
the public health response to possible outbreaks and threats
such anthrax and smallpox. The Committee is concerned that the
response plans CDC has developed do not include guidance to
State and local public health officials regarding new
acquisitions to the SNS and how those new acquisitions should
be used in a response effort. To ensure that healthcare
providers and first responders have the most up-to-date
guidance to respond to potential threats, the Committee directs
CDC to update all current response plans within 120 days of
enactment to include countermeasures procured with Project
BioShield funds since its inception.
BUILDINGS AND FACILITIES
Appropriations, 2015.................................... $10,000,000
Budget estimate, 2016................................... 10,000,000
Committee recommendation................................ 10,000,000
The Committee provides $10,000,000 for capital projects and
National Repair and Improvement activities at CDC.
Demolition.--The Committee includes new demolition
authority to allow CDC to eliminate structures that are no
longer used and have gone beyond their intended lifespan, such
as small modular trailers and storage facilities. Due to the
age and condition of some of the structures, they pose a
significant danger if left in their current state. By
eliminating these structures, the Federal government will save
almost $90,000 per year in maintenance costs.
Fort Collins Campus.--The Committee includes new bill
language that is needed to provide CDC with the authority to
construct a replacement freezer at the Fort Collins, Colorado
campus.
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 90 days after enactment, the CDC shall submit a
detailed accounting 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.
CDC-WIDE ACTIVITIES
Appropriations, 2015.................................... $273,570,000
Budget estimate, 2016................................... 113,570,000
Committee recommendation................................ 267,892,000
The Committee provides $267,892,000 for public health
leadership and support 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 2015 Fiscal year 2016 Committee
Budget activity appropriation request recommendation
----------------------------------------------------------------------------------------------------------------
Preventive Health and Health Services Block Grant......... 160,000 ................ 160,000
Public Health Leadership and Support...................... 113,570 113,570 107,892
----------------------------------------------------------------------------------------------------------------
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 2015. 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.
Recurring Reports.--The Committee is concerned by the
increasing amount of time and money Federal agencies spend on
unnecessary administrative tasks. In particular, the Committee
is aware of several recurring reports requested in past
appropriations acts that are no longer necessary. Therefore, to
reduce government bureaucracy and increase efficiency, the
Committee directs CDC to discontinue any recurring reports
requested in appropriations bills prior to the enactment of
this act.
Respirator Certification Program.--The Committee includes
new bill language allowing CDC to have an additional fiscal
year to spend user fees collected late in the year through the
Respirator Certification program.
Transfer Authority.--The Committee recommendation does not
include language requested by the administration to provide
additional transfer authority for the Director of CDC. The
Committee believes that the Director has sufficient transfer
authority provided in section 205 of this act to implement any
transfer of funds he deems necessary
National Institutes of Health
National Institutes of Health [NIH] funded research has
raised life expectancy, improved quality of life, and is an
economic engine helping to sustain American competitiveness.
Over the past year, cutting-edge NIH-supported research
identified a set of 10 compounds in blood that might be used to
distinguish the risk for developing memory deficits or
Alzheimer's disease; designed and tested a class of new
antibiotics to treat tuberculosis; and helped individuals
paralyzed because of spinal cord injuries regain some movement
after receiving spinal stimulation.
The Committee provides $32,084,000,000 for NIH activities,
an increase of $2,000,000,000. This is the largest increase the
NIH has received since the doubling ended in fiscal year 2003.
This includes $940,000,000 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 $650,000,000 in new
funding from the Department's Non-recurring Expenses Fund
[NEF]. Bill language is included to repurpose the NEF, created
in fiscal year 2008, specifically for biomedical research
activities at the NIH. The NEF provides a new, additional
source of funding for biomedical research.
The Committee also includes $200,000,000 for the new
Precision Medicine Initiative; approximately $350,000,000 for
the National Institute on Aging, a significant portion of which
the Committee expects to be dedicated to Alzheimer's disease
research; $135,381,000 for the BRAIN Initiative; $461,000,000
for research to combat Antimicrobial Resistance; $12,600,000
for the Gabriella Miller Kids First Act; and increases to every
Institute and Center to continue investments in innovative
research that will advance fundamental knowledge and speed the
development of new therapies, diagnostics, and preventive
measures to improve the health of all Americans.
NATIONAL CANCER INSTITUTE
Appropriations, 2015.................................... $4,953,028,000
Budget estimate, 2016................................... 5,098,479,000
Committee recommendation................................ 5,204,058,000
The Committee recommendation includes $5,204,058,000 for
the National Cancer Institute [NCI]. Of this amount,
$16,000,000 is available for repairs and improvements to the
NCI facility in Frederick, Maryland.
Breast Cancer Screening.--The Committee is aware of studies
regarding mammography screening for breast cancer that evaluate
the benefits and harms of mammography screening. Research has
demonstrated value of early detection of breast cancers through
screening, and also has demonstrated that screening sometimes
results in false positives and over treatment. This has created
a less clear picture of the benefits of screening and may lead
women to avoid periodic mammography, an experience some women
already view as uncomfortable. Therefore, the Committee
encourages NCI to continue to support research on new imaging
technologies, as well as studies to develop molecular and
cellular markers in screen-detected lesions, to distinguish
cancers that are truly life threatening and require aggressive
treatment from those for which treatment is unnecessary. The
NCI should continue to make research and validation data
available to the U.S. Preventive Services Task Force as they
continue to systematically review the evidence of effectiveness
of various breast cancer screening modalities.
Deadliest Cancers.--While overall cancer incidence and
death rates are declining, the Committee is concerned that some
cancers, often referred to as recalcitrant cancers, continue to
have a 5-year survival rate below 50 percent. The Committee is
pleased that NCI has released Scientific Frameworks for
pancreatic ductal adenocarcinoma [PDAC] and small cell lung
cancer, as called for by the Recalcitrant Cancer Research Act.
The Committee recognizes that NCI supports critical research
efforts exploring potential advances for other recalcitrant
cancers and conducts scientific meetings and other horizon
scanning efforts to stimulate research in these fields. The
Committee looks forward to an update in the fiscal year 2017 CJ
on research underway focusing on recalcitrant cancers in
addition to PDAC and small cell lung cancer.
Gastric Cancer.--The Committee continues to be concerned
about the deadly outcomes of gastric cancer, particularly among
young people, and is pleased that gastric cancer was included
in The Cancer Genome Atlas [TCGA]. This research effort led to
the discovery that gastric cancers fall into four distinct
molecular subtypes. This finding, published in July 2014, is
changing the way researchers think about treatments for gastric
cancers, informing the development of targeted therapies for
defined sets of patients whose tumors have specific genomic
abnormalities. The Committee notes that research on gastric
cancer is less advanced than that of many cancers. The
Committee, therefore, encourages NCI to help investigators in
this field to make the best possible use of genomic data from
the TCGA, as well as to pursue other research opportunities.
Liver Cancer.--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.--Given the rising incidence of melanoma coupled
with the immense untapped potential for prevention and
screening, the Committee urges NCI to continue to work across
divisions and in coordination with other Federal agencies and
advocates, aligning resources to decrease the impact of this
disease on our Nation's public health. The Committee commends
NCI's MATCH Trial and Exceptional Responders Initiative--each
stand to benefit melanoma subpopulations. The Committee
continues to urge NCI's portfolio to encompass all molecular
subtypes of melanoma. While sequencing studies provide
significant information about molecular heterogeneity and
characteristics of BRAF wildtype tumors, this data has yet to
result in effective therapies. Further, as melanoma has the
highest incidence of central nervous system metastases among
the common cancers, identifying patients at risk and developing
prevention and treatment strategies are important. Research
into mechanisms underlying clinical dormancy is a critical area
of cancer biology and could provide effective means of
preventing recurrence. The Committee requests an update on
these requests in the fiscal year 2017 CJ.
Minority Cancer Rates.--The Committee is concerned that
preventable and detectable cancer rates are falling for the
general population, but for some cancers, minority communities
are still suffering at disproportionate rates. The Committee
requests that NCI and NIMHD continue to coordinate and support
research focused on treatment, prevention, communication, and
outreach to minority communities for early intervention to
reduce and eliminate these disparities.
National Clinical Trials Network [NCTN].--The Committee
recognizes that the NCTN is critical to the development of
improved, personalized treatments for cancer. The Committee
also recognizes that the burden of cancer mortality is felt
disproportionately among racial and ethnic minorities.
Continued research is needed regarding the biological,
socioeconomic, environmental, and behavioral factors that cause
these disparities. The Committee urges NCI to continue research
in these areas through the NCI Community Oncology Research
Program, NCI's Center to Reduce Cancer Health Disparities,
minority participation in NCTN clinical trials, and additional
NCI-supported research focused on health disparities.
Pancreatic Cancer.--The Committee understands that the
Scientific Framework for Pancreatic Ductal Adenocarcinoma
[PDAC] released last year will enable NCI to capitalize on the
full range of its expertise and that of extramural scientists
and academic institutions to assess progress against one of the
Nation's deadliest cancers. The Committee also appreciates the
establishment of the NCI's PDAC Progress Working Group and the
release of a funding opportunity announcement on the
relationship between pancreatic cancer and diabetes and the
establishment of the RAS program. The Committee is aware that
pancreatic cancer has a 5 year survival rate of less than 5
percent due largely to a lack of early detection. Given that
biomarkers are uniquely powerful tools to effectively screen
and provide for early detection of pancreatic cancer, the
Committee recommends that the NCI support research efforts to
study non-invasive methods to screen for pancreatic cancers.
The Committee also encourages NCI to continue to support
clinical research focusing on high-risk pancreatic cancer
families. In particular, the Committee recommends that the NCI
support clinical trials utilizing non-invasive methods to
screen for pancreatic cancer based on protein production. The
Committee looks forward to hearing about next steps for the RAS
program, as well as progress made on the other initiatives
outlined in the PDAC Framework in the NIH biennial report.
Pediatric Oncology Research.--The Committee encourages NCI
to continue its important investments in pediatric oncology
research, including clinical studies for children with brain
tumors, and development of the novel pediatric ``MATCH'' study,
as well as the important pediatric preclinical testing program
evaluating new agents for treating pediatric malignancies. The
Committee supports NCI's longstanding investment in the
Childhood Cancer Survivor Study and encourages continued
childhood cancer survivorship research efforts.
Precision Medicine.--Cancer presents an exceptionally
promising opportunity to refine the principles and practices
that will serve as the foundation for Precision Medicine. The
Committee strongly supports the new Initiative and provides
$70,000,000 for NCI's portion of the program. The Committee
understands that NCI's priorities for the fiscal year 2016
Precision Medicine Initiative include accelerating precision
oncology studies, undertaking new studies in particular cancers
based on the genomic information learned from other clinical
trials, and expanding efforts to address the persistent problem
of drug resistance to cancer treatments. Consistent with these
objectives, the Committee asks NCI to consider exploration of
cancer models such as In Vitro clinical trials to improve
Precision Medicine, especially as it relates to complicated
cancers and in populations with a significant number of
patients who fail to respond to traditional treatments. In
addition, the Committee notes the NCI's Community Oncology
Research Program is an important element of NCI's ongoing
efforts in precision medicine, and will allow NCI to
incorporate underserved populations into cancer clinical trials
under the fiscal year 2016 Precision Medicine Initiative.
Proton Therapy.--The Committee recognizes the value of
proton therapy in treating many forms of cancer as well as the
benefits possible from continued research in this space. The
Committee encourages NCI to continue its support of proton
therapy research, comparing protons versus other kinds of
modern radiation therapy, including initiatives for pediatric
populations.
NATIONAL HEART, LUNG, AND BLOOD INSTITUTE
Appropriations, 2015.................................... $2,995,865,000
Budget estimate, 2016................................... 3,071,906,000
Committee recommendation................................ 3,135,519,000
The Committee recommendation includes $3,135,519,000 for
the National Heart, Lung, and Blood Institute [NHLBI].
Alpha-1 Antitrypsin Deficiency [Alpha-1].--The Committee is
aware that Alpha-1 is the major genetic risk factor for
developing Chronic Obstructive Pulmonary Disease [COPD], which
is the third leading cause of death in the United States.
Alpha-1 is often undiagnosed or misdiagnosed, leading to a need
to raise public awareness about Alpha-1 and provide appropriate
information to health professionals. The Committee encourages
NHLBI to convene a group of expert stakeholders to establish a
treatment algorithm for Alpha-1 Antitrypsin related disease to
assist physicians in correctly diagnosing and treating it.
Asthma.--The Committee applauds NHLBI for its efforts to
develop new approaches to treat and manage severe asthma and
urges the Institute to expand clinical trials in this area.
Centers for Accelerated Innovation.--The Committee is aware
of recent efforts by NHLBI to assist with the commercialization
of its basic science research, discoveries, and advancements.
The Committee is encouraged by the creation of these pilot
National Centers for Accelerated Innovation and looks forward
to the possible expansion of this model to fully exploit the
full spectrum of NIH-supported research. As such, the Committee
encourages NIH to assess the progress of this NHLBI pilot
initiative and investigate the feasibility of developing a
broader effort that would foster an ecosystem to support the
commercialization of technologies from academic institutions
that impact the health and welfare of all Americans.
Congenital Heart Disease.--Congenital heart disease remains
the most common birth defect. With increasing medical treatment
options, survival is improving, but with likely complications
across the lifespan. The Committee is aware of NHLBI convening
the ``Working Group on Adult Congenital Heart Disease: Emerging
Research Topics'', and urges NHLBI to address the needs of
those with the most life-threatening congenital heart defects
in the Institute's research, as well as collaborate with
administrators of existing databases and registries,
professional societies, industry, advocacy organizations,
patients, and the CDC to address research gaps noted in the
meeting report. 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 congenital heart disease.
Chronic Obstructive Pulmonary Disease.--The Committee
applauds NHLBI for its efforts to develop novel and more
precise therapeutics and management strategies to address the
rising public health burden of this disease.
Cystic Fibrosis [CF].--The Committee encourages new
personalized approaches to CF therapeutics, including new means
to identify and characterize the efficacy of multidrug therapy
that addresses the mutant protein that is the underlying cause
of CF in the majority of those with the disease. These
approaches include predictive tools to measure individualized
responses to treatment, which will help capitalize on recent
momentum that has led to revolutionizing treatments for a
minority of CF patients. Furthermore, the Committee encourages
the development of additional drugs and drug combinations that
are even more effective than currently available cystic
fibrosis transmembrane conductance modulating treatments, the
extension of protein modulation to the greatest number of
patients possible, and the study of how best to manage patients
on protein modulation therapy. The Committee also supports
research into nonsense mutations of CF, which impact about 10
percent of the CF population and also contribute to thousands
of other genetic diseases. In addition, the Committee urges
further research into live imaging modalities that are able to
characterize mucus and monitor mucociliary clearance, defense
mechanisms at the heart of CF, and many other respiratory
diseases. The Committee encourages funding new technologies
aimed at genetic repair of CF. 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.
Heart Disease.--The Committee recognizes that heart disease
presents a grave risk to our Nation's long-term health and
economic stability and notes that the prevalence and costs
associated with this disease will increase significantly as the
population ages. The Committee is concerned that NHLBI's
extramural heart research has dropped 17 percent in constant
dollars since 2002, and the Committee urges NHLBI to increase
heart research commensurate with its impact on public health
and scientific opportunity.
Hemophilia.--The Committee encourages NHLBI to investigate
the use of precision medicine for rare diseases such as
hemophilia. 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.
Inherited Hematologic Disorders.--Inherited hematologic
disorders, such as the hemoglobinopathies (Sickle Cell Disease
and Thalassemia) and hemophilia are ideal targets for gene
correction strategies. Recent advances in gene editing
technologies and gene therapy approaches could lead to cures
for these diseases rather than life-long treatment. The
Committee encourages NHLBI to further research efforts in gene
editing and gene therapy to correct inherited blood disorders.
National Registry of Genetically Triggered Thoracic Aortic
Aneurysms and Cardiovascular Condition [GenTAC].--The Committee
recognizes NHLBI for its leadership and support of the GenTAC
Registry. The Committee understands this important initiative
will be concluding in 2016 and requests an update on the
Institute's plans in the fiscal year 2017 CJ.
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.
Women's Heart Disease.--Heart disease is the number one
killer of women in the United States, and increased research on
women's heart disease, including sex-specific analysis in
clinical trials is needed to make progress against the disease.
Therefore, the Committee urges NHLBI to prioritize research on
women and heart disease. Further, the Committee urges NIH, when
making research awards, to ensure inclusion of women and
minority groups in clinical research in a manner that is
appropriate to the scientific question under study. For those
studies where sex is identified as a primary or secondary
outcome measure, with stratification on that basis, NIH should
continue to ensure that sex-based analysis of results is
reported on clinicaltrials.gov. Furthermore, the Committee
encourages NIH to continue to work with scientific journals to
report sex-specific data in its publications.
NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH
Appropriations, 2015.................................... $397,700,000
Budget estimate, 2016................................... 406,746,000
Committee recommendation................................ 415,169,000
The Committee recommendation includes $415,169,000 for the
National Institute of Dental and Craniofacial Research [NIDCR].
Usher Syndrome.--The Committee supports research into the
prevention and treatment of Usher Syndrome, including research
that will lead to improved genetic counseling, early diagnosis,
and eventually expanded treatment options for individuals
suffering from severe hearing and vision loss. The Committee
requests an update in the fiscal year 2017 CJ on the planned
and on-going activities related to this syndrome, including the
manner in which various Institutes and Centers [ICs] coordinate
on common goals and objectives.
NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES
Appropriations, 2015.................................... $1,749,140,000
Budget estimate, 2016................................... 1,788,133,000
Committee recommendation................................ 1,825,162,000
The Committee recommendation includes $1,825,162,000 in
this bill for the National Institute of Diabetes and Digestive
and Kidney Diseases [NIDDK].
Chronic Constipation.--The Committee is pleased with
NIDDK's commitment to explore chronic constipation,
gastroparesis, and irritable bowel syndrome, and urges NIDDK to
continue research in these areas to help inform treatment and
prevention, especially among children.
Diabetes.--The Committee recognizes the important work of
NIDDK, the primary Federal agency conducting research to find a
cure for diabetes and improving diabetes care. 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 past successes, improve
prevention and treatment, and bring the Nation closer to a
cure.
End-Stage Renal Disease [ESRD].--The Committee commends
NIDDK's commitment to promoting research on an array of common,
costly diseases, including kidney disease. More than 20 million
Americans, including children, have kidney disease, the ninth
leading cause of death in the United States, and all are at
risk for progressing to kidney failure or end-stage renal
disease [ESRD]. ESRD is the only health condition covered by
Medicare regardless of age or disability. ESRD is the only
health condition covered by Medicare regardless of age or
disability. Nearly 637,000 Americans rely on the Medicare ESRD
Program for life-saving dialysis and transplants at an annual
cost of $35,000,000,000. Even though the ESRD population
remains less than 1 percent of the total Medicare population,
it has accounted for about 7 percent of Medicare spending in
recent years. Recognizing the unique status and high cost of
the Medicare ESRD Program, the Committee believes more
investments are needed in kidney research to spur innovative
therapies for preventing, treating, and reducing the
significant burden of kidney disease among all patient
populations, Medicare, and taxpayers. In particular, the
Committee encourages investigation regarding genetic,
biological, and environmental causes of the health disparities
among minority populations. NIDDK should prioritize more
investments in kidney research in collaboration with other
Federal stakeholders involved in kidney research, including
NHLBI, NIA, and the VA.
Functional Gastrointestinal Disorders [FGID].--The
Committee continues to be concerned by the prevalence of FGIDs
and their impact on children. The Committee urges multi-
Institute collaborations on FGID research to understand this
disease.
Gastrointestinal Disorders.--The Committee recognizes
NIDDK's work to create a long-term scientific framework for
treating pancreatic, celiac disease, and other gastrointestinal
disorders. The Committee requests NIDDK provide an update in
the fiscal year 2017 CJ that details how NIDDK is accelerating
cures for these diseases.
Gestational Diabetes.--The Committee recognizes that women
with gestational diabetes and their babies face long-term
health consequences as a result of the disease, including an
increased risk of developing type 2 diabetes. Therefore, the
Committee urges NIDDK to explore additional opportunities for
research on gestational diabetes, a disease affecting up to 18
percent of all pregnant women.
Hepatitis B.--The Committee urges more work on hepatitis B
with the goal of curing or discovering more effective treatment
of hepatitis B.
Inflammatory Bowel Disease.--The Committee commends NIDDK
for hosting a conference on inflammatory bowel disease in
children which could lead to further research in this area. The
Committee urges NIDDK to continue efforts to identify the
etiology of the disease to inform the development of cures.
Interstitial Cystitis.--Interstitial cystitis patients
continue to face delays receiving an accurate diagnosis, as
well as limited treatment options. The Committee applauds NIDDK
for studying novel diagnostic methods and for supporting
industry efforts to develop new therapies for patients.
Pediatric Kidney Disease.--The Committee is encouraged by
the research funded by NIDDK to support pediatric kidney
disease and encourages NIDDK to assign a higher priority to
research that explores kidney disease through the course of
life. By developing and testing novel bench research techniques
and innovative patient-oriented clinical studies, cutting-edge
translational research leads to breakthroughs that truly
propagate the ``bench-to-bedside'' ethos. To this end, the
Committee urges NIDDK to support research endeavors that
include funding for collaborative multicenter pediatric
prospective clinical/translational trials that elucidate the
origins of disease. These should help direct development of new
treatments to improve outcomes in children with kidney disease
and hinder the development of renal and cardiovascular disease
in adults.
NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE
Appropriations, 2015.................................... $1,604,607,000
Budget estimate, 2016................................... 1,660,375,000
Committee recommendation................................ 1,694,758,000
The Committee recommendation includes $1,694,758,000 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 NINDS to
further support promising ALS research related to induced
pluripotent stem cells, whole genome sequencing, biomarkers,
precision medicine, natural history studies, and translational
research that could help identify new treatments for the
disease. NINDS also is encouraged to partner with ALS
organizations and other Federal agencies and programs,
including the ALS Research Program at DOD and the National ALS
Registry at CDC. The Committee further encourages NIH to work
with the FDA to identify opportunities to inform and advance
the development of treatments for ALS.
Cerebral Palsy [CP].--Over 800,000 Americans are impacted
by CP and it is the number one motor disability in children.
Currently, there are no identified best practices at diagnosis
or through the life span, no organized standards of care, no
national CP registry, and few proven therapy protocols. The
Committee urges NIH to work with scientists and stakeholders to
develop a 5-year strategic plan for research on CP prevention,
treatment, and cure through the lifespan with the goal of
reducing the number of people impacted by CP overall, as well
as improving the opportunity for recovery of those already
diagnosed. The Committee urges NIH participation in work groups
to develop a research registry of individuals with different
forms of CP that could facilitate research related to the
impact of diverse impairments and health issues on functioning,
participation and well-being across the life span.
Chronic Overlapping Pain Conditions.--The Committee notes
that evidence-based diagnostic and treatment guidelines do not
exist for chronic overlapping pain conditions, resulting in
routine misdiagnosis, ineffective and oftentimes harmful
treatment, and a significant economic burden on patients, the
healthcare system, and society at large. The Committee commends
NIH for its efforts to develop a case definition, and uniform
minimal dataset, and its support of existing data repositories
to collect patient information on chronic overlapping pain
conditions. The Committee encourages NIH to build upon these
activities by ensuring that the Interagency Pain Research
Coordinating Committee [IPRCC] addresses the research needs for
chronic overlapping pain conditions in its ongoing efforts to
develop a Federal pain research strategy that spans basic,
translational, and clinical research across the Federal
agencies that fund pain research.
Chronic Pain Research.--The Committee applauds NIH for
instituting the NIH Office of Pain Policy and for leading the
development of the first Federal pain research strategy with
the IPRCC. The Committee remains concerned that NIH's
investment in pain research is incommensurate with the
significant public health and economic impact of chronic pain.
The Committee strongly urges NIH to expand its basic,
translational, and clinical research efforts in this area, as
well as include chronic pain in ongoing NIH initiatives that
have potential for yielding significant advancements in this
area.
Facioscapulohumeral Muscular Dystrophy [FSHD].--The
Committee encourages NIH to foster opportunities for
multidisciplinary research on FSHD, a common and complex form
of muscular dystrophy, commensurate with its prevalence and
disease burden.
Muscular Dystrophy.--The Committee is aware that amendments
to the Muscular Dystrophy CARE Act were enacted into law in
2014 and requests an update from NIH in the fiscal year 2017 CJ
as to the implementation of the updated provisions,
particularly a plan to address emerging research opportunities
in non-skeletal muscle manifestations such as bone health and
endocrine-functioning. The Committee also requests that NIH
provide an update on its plans to finalize and implement an
updated Action Plan for the Muscular Dystrophies and to convene
at least two meetings per calendar year of the Muscular
Dystrophy Coordinating Committee.
Neurodegenerative Disorders.--The Committee recognizes that
neurodegenerative disorders such as ALS, Parkinson's disease,
progressive supranuclear palsy, multiple system atrophy, the
dementias, including Alzheimer's disease, and related dementias
and Huntington's disease, among others, represent an enormous
and growing burden on the U.S. population in terms of quality
of life and economic cost and that the incidence of
neurodegenerative diseases is expected to soar as the U.S.
population ages. Currently there are no neuroprotective
therapies for these patients. Conventional drug development for
neurological diseases has presented many challenges due to the
lack of validated biomarkers for these diseases. The Committee
urges NINDS to prioritize research into neuroprotective
therapies.
Respiratory Problems and Strokes.--Stroke-induced
respiratory dysfunction is one of many important challenges
facing stroke patients, and abnormal breathing patterns can
have a negative impact on recovery and prognosis. The Committee
encourages NIH to consider supporting basic research to
understand the molecular and neural mechanisms that regulate
breathing and the effect of respiratory dysfunction on stroke
outcomes, which in turn could lead to the development of novel
therapies that may dramatically improve stroke outcomes and
public health.
Stroke.--The Committee is aware that stroke presents a
significant challenge to our Nation's long-term health and
economic stability as a result of the aging of the population.
Therefore, the Committee encourages that NINDS continue its
commitment to implementing the top priorities that emerged from
the 2012 stroke planning effort for stroke prevention,
treatment, and recovery research, particularly enhancement of
the Stroke Clinical Trials Network to answer the most pressing
clinical questions in stroke.
NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES
Appropriations, 2015.................................... $4,417,558,000
Budget estimate, 2016................................... 4,614,779,000
Committee recommendation................................ 4,710,342,000
The Committee recommendation includes $4,710,342,000 for
the National Institute of Allergy and Infectious Diseases
[NIAID].
Alopecia Areata.--The Committee recognizes the recent
breakthroughs in alopecia areata research related to
repurposing drugs used to treat other autoimmune diseases.
NIAID is encouraged to study alopecia areata due to the
potential cross-cutting benefit of these autoimmune disease
research activities.
Antimicrobial Resistance [AMR].--AMR is one of the most
significant public health threats facing the world today. The
Committee is concerned that AMR and the lack of new antibiotics
are threating the Nation's health and the healthcare system.
The CDC reports that antibiotic-resistant infections account
for at least $20,000,000,000 in excess direct healthcare costs
and up to $35,000,000,000 in lost productivity due to
hospitalizations and sick days each year. The Committee
provides $461,000,000, an increase of $100,000,000 for AMR
research. The Committee commends NIAID on its efforts to
increase the drug development pipeline for novel antibiotics,
develop rapid diagnostics, assist NCBI in creating create a
national catalogue of genome sequence data, and other recent
initiatives to fund research in prevention and treatment of
AMR. However, a considerable bottleneck continues at the first
step in delivering new antibiotics: discovery. The Committee
encourages NIAID to support basic discovery research to help
resolve the bottleneck, in particular: studying unculturable
bacteria; turning on silent genes; efficiently identifying
attractive natural products; establishing rules understanding
mechanisms for the penetration of antibiotics into bacterial
cells; and developing platforms of antibiotic discovery.
Chronic Inflammatory Demyelinating Polyneuropathy [CIDP].--
The Committee encourages NIAID to initiate research activities
into CIDP and related rare and debilitating autoimmune
conditions to improve our scientific understanding of immune
dysfunction including the underlying disease process.
Clinical Specimen Access for Diagnostic Development.--The
Committee applauds the establishment of NIAID's Antibacterial
Resistance Leadership Group Virtual Biorepository Catalogue to
promote clinical specimen access. To further support research
and development of desperately needed diagnostics and treatment
of nonbacterial pathogens, the Committee urges NIAID to explore
opportunities to support the development of virtual
biorepositories for virus, fungi, and other pathogens already
collected under existing NIAID funded research. The Committee
also urges NIAID to examine incentives to support institutions
to save de-identified specimens and participate in the virtual
biorepository catalogues when possible.
Drug Allergy.--The Committee is pleased that NIAID
sponsored a workshop to develop a research agenda on the
diagnosis and management of patients with drug
hypersensitivity. The Committee requests an update on steps
that are being taken to implement the recommendations from the
report of that workshop in the fiscal year 2017 CJ.
Gram Negative Bacterial Infections.--The threat of severe
or fatal pulmonary infections caused by highly resistant Gram-
negative bacteria is increasing in the United States and
globally. The Committee notes the recent multiple successes in
the development of rapid diagnostics and urges NIAID to
continue its efforts, including for acute pulmonary infections
in the critically ill and enhanced clinical outcomes evaluation
of these diagnostic platforms.
Hepatitis B.--The Committee urges NIAID to take aggressive
and innovative steps to discover and develop new therapies for
hepatitis B that have the potential to be a ``cure.'' The
Committee understands that finding a ``cure'' will most likely
require new direct acting antivirals as well as methods that
harness the immune system. Based on the success of other NIH
coordination initiatives, the Committee notes the recompetition
of NIDDK's HBV Research Network, and encourages NIAID to
explore potential opportunities to engage with the Network.
Immunotherapy Research.--The Committee is pleased that
NIAID has joined AHRQ in co-sponsoring a workshop on allergen
immunotherapy effectiveness. The Committee requests an update
in the fiscal year 2017 CJ on steps that will be taken to
implement the recommendations of the workshop and promote
research in this area.
Malaria and Other Tropical Diseases.--One-sixth of the
world's population suffers from one or more neglected tropical
diseases [NTDs]. The Committee urges NIH to continue its
investment in NTDs and malaria research, including work in
applied research for NTDs, and to continue to work with other
agencies as well as philanthropic and private partners to
foster research and help ensure that basic discoveries are
translated into much needed solutions.
NIAID Biodefense Plan.--The Committee appreciates the
Assistant Secretary for Preparedness and Response's completion
of the 5-year spend plan for medical countermeasure [MCM]
enterprise, but remains concerned about the level of detail
included for NIAID. The Committee requests NIAID include in
future annual spend plans, as well as the fiscal year 2017 CJ,
details on the future goals for NIAID's MCM research
investments, including transition to advanced research at
Biomedical Advanced Research and Development Authority [BARDA],
and NIAID's coordination with BARDA's advanced development and
procurement priorities. Details should be provided over the
next 5 years and include a specific breakdown of priority MCM
candidates and a description of future development goals for
each of these candidates.
Non-Tuberculous Mycobacteria [NTM].--According to CDC, the
incidence of NTM disease is increasing in the United States and
treatments for this disease are very limited. The Committee
notes NIAID's participation in a May 2014 workshop to develop a
comprehensive research agenda on this disease and encourages
NIAID to support the implementation of this agenda.
NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES
Appropriations, 2015.................................... $2,372,301,000
Budget estimate, 2016................................... 2,433,780,000
Committee recommendation................................ 2,511,431,000
The Committee recommendation includes $2,511,431,000 for
the National Institute of General Medical Sciences [NIGMS],
which includes $940,000,000 in transfers available under
section 241 of the PHS Act.
Institutional Development Award [IDeA].--The Committee
provides $300,000,000 for the IDeA program, an increase of
$26,700,000. The Committee believes the IDeA program has made
significant contributions to biomedical research and has led to
the creation of a skilled workforce and made the IDeA program
an essential component of NIH's research portfolio.
Unfortunately, many institutions eligible for funding under the
National Science Foundation Experimental Program to Stimulate
Competitive Research [EPSCoR] program are ineligible for
funding under the IDeA program. After several years of specific
direction in this bill, the administration continues to refuse
to submit legislative information to update the eligibility
criteria of the IDeA program to bring it in line with EPSCoR
eligibility. Therefore, new bill language is included to allow
entities eligible for participation in the EPSCoR program for
the past 2 consecutive years to apply for inclusion in the IDeA
Networks of Biomedical Research Excellence award.
Small Business Research Funding.--The Committee supports
the initiative in the President's budget request for fiscal
year 2016 calling for directed 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 4
IDeA regions that would be competitively bid among IDeA States
to serve IDeA States. NIH should not use funding from the IDeA
program to fund these grants.
EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN
DEVELOPMENT
Appropriations, 2015.................................... $1,286,869,000
Budget estimate, 2016................................... 1,318,061,000
Committee recommendation................................ 1,345,355,000
The Committee recommendation includes $1,345,355,000 for
the Eunice Kennedy Shriver National Institute of Child Health
and Human Development [NICHD].
Demographic Research.--Recent NICHD-supported research
confirms the world's population will reach 11 billion in 2100--
a 2 billion increase over previous estimates. Demographic, or
population, research is essential for understanding the short
and long-term consequences of this dramatic growth on
individuals and communities. NICHD-funded longitudinal studies,
including the National Longitudinal Survey of Adolescent to
Adult Health and the Fragile Families and Child Well Being
Study, are yielding important data about the linkages between
health, socioeconomic status, family dynamics, genetics, and
environment--data that are key to improving the health, well-
being, and development of future generations. The Committee
encourages NICHD to continue supporting these and other similar
studies such as the Human Placenta Project, affecting
population health and well-being.
Down Syndrome.--The NIH Research Plan on Down Syndrome,
updated in December 2014, calls for expanding research on
cognitive and behavioral outcomes and potential pharmacologic
and behavioral therapies for individuals with Down syndrome
who, in addition to the associated developmental intellectual
disability, also have a significant and diverse set of comorbid
psychiatric and medical conditions that occur throughout the
lifespan. The Committee supports this priority, and urges NIH
to take steps to develop a system for measuring the differences
in variability related to co-occurring psychiatric or medical
conditions and genetic differences among individuals. Further,
the NIH Research Plan on Down Syndrome, updated in December
2014, proposes that high priority consideration also be given
to developing a Down syndrome biobank, linked and coordinated
with DS-ConnectTM, the Down Syndrome Registry to
systematically collect, store and distribute brain and other
tissue samples to Down syndrome researchers. Such a repository
could leverage and be linked with the NIH NeuroBioBank and the
existing Alzheimer's Disease Brain Banks so that Down syndrome
tissues can be compared to those obtained from individuals with
Alzheimer's disease and other disorders. The Committee requests
an update in the fiscal year 2017 CJ.
Dual Use/Dual Benefit.--The Dual Purpose with Dual Benefit:
Research in Biomedicine and Agriculture Using Agriculturally
Important Domestic Species is an interagency partnership grants
program funded by NICHD and the U.S. Department of Agriculture
[USDA]. Both the USDA and NIH should be commended for
developing this important interagency program. The Committee
strongly urges continuation of this partnership because it
sponsors use of farm animals as dual purpose models to better
understand developmental origins of disease, fat regulation and
obesity, stem cell biology, assisted reproductive technologies,
and infectious disease which directly benefits both agriculture
and biomedicine. This program also strengthens ties between
human medicine, veterinary medicine, and animal sciences, which
is key to success of the One Health Initiative.
Fragile X [FX].--The Committee commends NICHD for leading
the effort to map the molecular, physiological, biological, and
genetic connections between FX, the fragile X protein, and
autism. 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 NIH to explore ways to encourage investigator-initiated
research applications 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 IDDRC toward understanding why child
development goes awry, discovering ways to prevent
developmental disabilities, and discovering treatments and
interventions to improve the lives of people with developmental
disabilities and their families. The Committee is particularly
pleased with the IDDRC contributions in the areas of autism,
fragile X syndrome, Down syndrome, and other genetic and
environmentally induced disorders. These Centers have greatly
improved our understanding of the causes of developmental
disabilities and have developed effective treatments consistent
with their translational science mission. The Committee urges
NICHD to provide additional resources, if feasible, to the
IDDRCs for research infrastructure and expansion of cores, so
that they can conduct basic and translational research to
develop effective prevention, treatment, and intervention
strategies for children and adults with developmental
disabilities.
Maternal Morbidity.--Though maternal morbidity rates are
rising, there are no uniform definitions of severe maternal
morbidity. Having uniform definitions would help Federal,
State, and local agencies and research institutions establish
standardized and interoperable processes for surveillance, data
collection, and research. The collected data could then inform
the development and deployment of targeted, evidence-based
prevention and treatment programs to reduce the incidence of
severe maternal morbidity. The Committee encourages NICHD to
work with research institutions and professional societies to
identify uniform definitions for severe maternal morbidity.
Mother-Infant Relationship.--The Committee applauds the
multidisciplinary, cutting-edge research that NICHD conducts on
child and maternal health and development. The Committee
encourages a continued focus on basic and applied research to
advance our understanding of attachment in mother-infant
relationships and its impact on development. The Committee
urges NICHD to continue support for a robust intramural and
extramural research portfolio identifying and describing the
complex interaction of behavioral, social, environmental, and
genetic factors on health outcomes with the ultimate goal of
improved understanding of and interventions for disorders such
as depression, addiction, and autism.
Pediatric Research Network.--The Committee is aware that
the National Pediatric Research Network Act (Public Law 113-55)
authorizes an innovative model to accelerate research through
infrastructure consortia across the Nation's pediatric research
institutions. The Committee has provided sufficient funds to
explore how to carry out the provisions of the act, as
feasible.
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 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.
Reading Disability and Genetic Screening.--The failure to
identify learning disabilities early, as well as the failure to
optimally match a specific intervention program to an
individual child, can have a significant detrimental impact on
the lives of individuals, cost of education, and the economy
more broadly. This is especially harmful in the case of reading
disabilities, such as Dyslexia, as we know from The Nation's
Report Card report in 2013, which revealed that over 55 percent
of fourth graders still fail to reach proficiency on
standardized tests. While NICHD funds a number of Intellectual
and Developmental Disabilities Research Centers, they do not
focus specifically on research on the genetic and epigenetic
predictors of reading disability. The Committee encourages
NICHD to support research to increase our ability to identify
the risk, including the role of genetic analyses, early
detection, and optimal educational interventions for reading
disabilities. The Committee urges NICHD to explore additional
ways to encourage and sustain research to achieve meaningful
interventions and therapies to help those with reading
disabilities.
Vulvodynia.--The Committee encourages NICHD to implement
the recommendations from the May 2013 NICHD workshop to develop
research diagnostic criteria and common data elements to
standardize vulvodynia research efforts. The Committee is
pleased with NICHD's involvement in the Trans-NIH effort to
advance research on chronic overlapping pain conditions and
encourages the Institute's continued and expanded involvement.
NATIONAL EYE INSTITUTE
Appropriations, 2015.................................... $676,764,000
Budget estimate, 2016................................... 695,154,000
Committee recommendation................................ 709,549,000
The Committee recommendation includes $709,549,000 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. It
acknowledges that NEI's AMD Gene Consortium has discovered
seven new regions of the human genome, called loci, associated
with increased risk of AMD and confirmed 12 loci identified in
previous studies. Further, it recognizes that three NEI-funded
studies have solidified a link between AMD and genes encoding
the complement system--a set of proteins that plays a central
part in immune responses and inflammation--and that initial
research suggests that a class of medications used to treat the
Human Immunodeficiency Virus called nucleoside reverse
transcriptase inhibitors shows promise to treat AMD, and may be
repurposed to treat other inflammatory disorders.
Audacious Goals Initiative.--The Committee commends NEI's
leadership through its Audacious Goals Initiative, the goal of
which is 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
formed a Steering Committee, which is identifying knowledge
gaps and the scientific expertise need to bridge them, and is
awarding the first cycle of grants addressing the technical
needs and opportunities for imaging the visual system.
Dry Eye.--The Committee is pleased that NEI's Small
Business Innovation Grant Program has supported research into
dry eye, which is one of the most common of all eye conditions
affecting adults 45 years and older. This research has resulted
in the launch of a FDA-approved Phase I clinical trial that is
testing the safety and efficacy of a novel drug targeting a
unique mechanism involved in maintaining moisture in the eye.
Glaucoma.--The Committee recognizes that NEI's Glaucoma
Human Genetics Collaboration has identified five regions of the
genome that are strongly associated with primary open-angle
glaucoma, the most common form of the disease. It acknowledges
new research that suggests that mutations in the myocilin gene
can affect development of the myelin sheath that protects the
optic nerve, leading to glaucoma, especially the juvenile-onset
form of the disease. It is hopeful about new research into a
contact lens that releases intraocular pressure-reducing drugs
at a steady rate, facilitating better treatment for glaucoma.
The Committee requests an update on this research in the fiscal
year 2017 CJ.
Usher Syndrome.--The Committee urges NEI to continue to
prioritize research on Usher syndrome, the leading cause of
deaf-blindness.
NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES
Appropriations, 2015.................................... $667,333,000
Budget estimate, 2016................................... 681,782,000
Committee recommendation................................ 695,900,000
The Committee recommendation includes $695,900,000 for the
National Institute of Environmental Health Sciences [NIEHS].
Autism Spectrum Disorder [ASD].--The Committee encourages
NIEHS to continue its collaboration with NICHD and NIMH to fund
new opportunities for research on ASD. The Committee urges
NIEHS to enhance its support for research, including
experimental and observational research, on potential
environmental risk factors that may play a role in the
initiation or promotion of ASD at any life stage. Further, with
respect to regressive autism, NIEHS is encouraged to focus
research on the susceptibility of subpopulations to
environmental risk factors and consider approaches to the
mitigation of environmental risks associated with ASD.
Healthy Housing.--The Committee encourages NIEHS to
consider study of the impact healthy housing has on reducing
environmental exposures that lead to health risks like asthma
and lead poisoning.
NATIONAL INSTITUTE ON AGING
Appropriations, 2015.................................... $1,197,523,000
Budget estimate, 2016................................... 1,267,078,000
Committee recommendation................................ 1,548,494,000
The Committee recommendation includes $1,548,494,000 for
the National Institute on Aging [NIA].
Alzheimer's Disease.--In keeping with long-standing
tradition, the Committee has not earmarked funding for research
on specific diseases. However, the Committee has included a
$350,971,000 increase for the NIA and expects that a
significant portion will be dedicated to 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. The Committee looks forward to receiving a report in the
fiscal year 2017 CJ that outlines research conducted on
Alzheimer's disease relative to the milestones established in
the National Plan, as well as the professional judgement budget
for Alzheimer's disease for fiscal year 2017. Further, the
Committee directs NIA to continue support for existing well-
characterized, longitudinal, population-based cohort studies
aimed at providing new insights into disease prevention,
particularly among minority populations where disease burden is
greatest. 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.
Atrial Fibrillation [AFib].--The NIA has undertaken an
important national initiative focused on preventing falls in
older adults. Unfortunately, misunderstanding about the impact
of falls risk in older adults with AFib plays a
disproportionate role in treatment decision-making, often
leading to underuse of oral anticoagulation therapies that
reduce the risk of stroke. As such, the Committee strongly
urges the NIA to work with NHLBI, NINDS, and other relevant NIH
Institutes, Centers, and offices to communicate the results of
this falls prevention study widely, when available, to inform
healthcare providers and patients who are making treatment
decisions about AFib-related stroke in older persons.
Population Research.--NIA-supported research confirms that
by 2030, there will be 72 million Americans aged 65 and older.
The Institute's current investment in population aging research
and surveys, including the Demography and Economics of Aging,
Roybal Centers for Translational Research, and the Health and
Retirement Study, is essential to understanding the
implications of an increasing older population. To accelerate
current understanding, the Committee urges NIA to continue
investing in large-scale longitudinal studies that explore how
genetic, behavioral, and psychosocial factors, including
socioeconomic status, interpersonal relationships, and social
environments, affect health and well-being. The Committee is
pleased NIA is developing an initiative to explore why other
industrialized countries surpass the United States in health at
older ages and longevity--especially in light of new NIA-
supported research findings that more than half of premature
deaths are due to social and behavioral issues.
NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES
Appropriations, 2015.................................... $521,528,000
Budget estimate, 2016................................... 533,232,000
Committee recommendation................................ 544,274,000
The Committee recommendation includes $544,274,000 for the
National Institute of Arthritis and Musculoskeletal and Skin
Diseases [NIAMS].
Atopic Dermatitis [AD].--The Committee understands that AD
is the most severe and long-lasting form of eczema which can
cause significant limitations in everyday activities due to
sleep disturbances, fatigue, and psychological distress. The
Committee recognizes that AD is a potentially debilitating
condition that can severely compromise quality of life. The
Committee understands that for the 17,800,000 people who have
the disease, there are a lack of quality measures and clinical
guidelines to support appropriate treatment of AD. The
Committee encourages NIAMS to support research into clinical
tools to diagnose and assess the severity of AD.
Heritable Connective Tissue Disorders.--The Committee
appreciates the leadership role that NIAMS has taken in
investigating heritable connective tissue disorders. The
Committee encourages NIAMS to continue to support these
important activities moving forward.
Lupus Research Plan.--The Committee commends the Institute
for leading the NIH effort to review the current state of the
science, evaluate progress on the existing lupus research
plan--The Future Directions of Lupus Research, originally
issued in 2007--and develop a new action plan for lupus
research. Significant advances in the understanding of disease
mechanisms and drug discovery make this an appropriate time for
re-evaluation of the science. The Committee applauds the broad
solicitation of input from across NIH and the greater research
and advocacy community, and supports the inclusion of input
from researchers, clinicians, patients, and other stakeholders
in this process, and urges special attention for efforts to
fully engage patient volunteers in the full continuum of future
research.
Scleroderma.--The Committee notes that while meaningful
scientific progress has been made through NIAMS-led scleroderma
research, there remains no cure and treatment options are
limited. NIAMS is encouraged to consider advancing research
projects to improve the understanding of the mechanisms of this
disease.
NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS
Appropriations, 2015.................................... $405,207,000
Budget estimate, 2016................................... 416,241,000
Committee recommendation................................ 424,860,000
The Committee recommendation includes $424,860,000 for the
National Institute on Deafness and Other Communication
Disorders [NIDCD].
NATIONAL INSTITUTE OF NURSING RESEARCH
Appropriations, 2015.................................... $140,852,000
Budget estimate, 2016................................... 144,515,000
Committee recommendation................................ 147,508,000
The Committee recommendation includes $147,508,000 for the
National Institute of Nursing Research [NINR].
NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM
Appropriations, 2015.................................... $447,153,000
Budget estimate, 2016................................... 459,833,000
Committee recommendation................................ 469,355,000
The Committee recommendation includes $469,355,000 for the
National Institute on Alcohol Abuse and Alcoholism [NIAAA].
Genomic Research and Alcohol Dependence.--The Committee
commends the NIAAA for its research efforts to increase
understanding of the genetic and neurobiological mechanisms
underlying alcohol use disorder [AUD]. Research shows that
genes contribute 40-60 percent of the risk for developing AUD.
Factors such as stress may make individuals who carry genomic
variations associated with increased risk for AUD more
vulnerable to developing the disorder. NIAAA-supported studies
have identified several genes that contribute to susceptibility
to AUD and many others that show some evidence of involvement;
and these research findings are paving the way for new
opportunities in prevention and treatment. The Committee
encourages the NIAAA to capitalize on advances in genomic
science and ``big data,'' and explore collaborative
opportunities to gain additional insight into the genetics of
AUD, including its relationship to related problems such as
post-traumatic stress disorder in military personnel and
veterans.
NATIONAL INSTITUTE ON DRUG ABUSE
Appropriations, 2015.................................... $1,015,705,000
Budget estimate, 2016................................... 1,047,397,000
Committee recommendation................................ 1,069,086,000
The Committee recommendation includes $1,069,086,000 for
the National Institute on Drug Abuse [NIDA].
NATIONAL INSTITUTE OF MENTAL HEALTH
Appropriations, 2015.................................... $1,433,651,000
Budget estimate, 2016................................... 1,489,417,000
Committee recommendation................................ 1,520,260,000
The Committee recommendation includes $1,520,260,000 for
the National Institute of Mental Health [NIMH].
NATIONAL HUMAN GENOME RESEARCH INSTITUTE
Appropriations, 2015.................................... $498,677,000
Budget estimate, 2016................................... 515,491,000
Committee recommendation................................ 526,166,000
The Committee recommendation includes $526,166,000 for the
National Human Genome Research Institute [NHGRI].
NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING
Appropriations, 2015.................................... $327,243,000
Budget estimate, 2016................................... 337,314,000
Committee recommendation................................ 344,299,000
The Committee recommendation includes $344,299,000 for the
National Institute of Biomedical Imaging and Bioengineering
[NIBIB].
NATIONAL CENTER FOR COMPLEMENTARY AND INTEGRATIVE HEALTH
Appropriations, 2015.................................... $124,062,000
Budget estimate, 2016................................... 127,521,000
Committee recommendation................................ 130,162,000
The Committee recommendation includes $130,162,000 for the
National Center for Complementary and Integrative Health
[NCCIH].
Pain Research.--The Committee is encouraged by NCCIH and
NIDA's collaboration with the Department of Veteran's Affairs
[VA] on a new initiative funding 13 studies examining non-
pharmacological management of pain and other symptoms
experienced by military personnel and veterans. 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 that we support research on
complementary and integrative health approaches to ensure the
best quality of care for our Nation's veterans, and urges the
NIH and VA to continue this vital research.
NATIONAL INSTITUTE ON MINORITY HEALTH AND HEALTH DISPARITIES
Appropriations, 2015.................................... $270,969,000
Budget estimate, 2016................................... 281,549,000
Committee recommendation................................ 287,379,000
The Committee recommendation includes $287,379,000 for the
National Institute on Minority Health and Health Disparities
[NIMHD].
Minority Enrollment in Cohort Studies.--The Committee is
aware of novel efforts underway in racially and ethnically
diverse urban, low-income neighborhoods to enroll households
for participation in future neighborhood cohort studies. Under
these approaches, families are interviewed, consented, and then
provided information on a range of medical and socioeconomic
issues for inclusion in a growing database of such household
information. These families can then be re-contacted for
participation, as appropriate, in future clinical trials and
other research. The Committee believes that the NIMHD should
support the development of this type of research infrastructure
through its community-based participatory research program.
NIMHD Report.--The Committee requests that NIH and NIMHD
provide a report to the Committees on Appropriations of the
House of Representatives and the Senate within 6 months of
enactment on the implementation of the law establishing the
NIMHD.
Research Centers in Minority Institutions [RCMI].--The
Committee continues to recognize the critical role played by
minority institutions, especially at the graduate level, in
addressing the health research and training needs of minority
populations. In particular, the RCMI program fosters the
development of new generations of minority scientists for the
Nation and provides support for crucial gaps in the biomedical
workforce pipeline, with each dollar invested being leveraged
to generate an additional five to six dollars in competitive
research funding. The Committee requests that NIH maintains the
RCMI program in its current form and funds it at no less than
last year's level.
JOHN E. FOGARTY INTERNATIONAL CENTER FOR ADVANCED STUDY IN THE HEALTH
SCIENCES
Appropriations, 2015.................................... $67,634,000
Budget estimate, 2016................................... 69,505,000
Committee recommendation................................ 70,944,000
The Committee recommendation includes $70,944,000 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 though health diplomacy in their
countries.
NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES
Appropriations, 2015.................................... $632,710,000
Budget estimate, 2016................................... 660,131,000
Committee recommendation................................ 699,319,000
The Committee recommendation includes $699,319,000 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, to be used for
the Cures Acceleration Network [CAN]. The fiscal year 2015
funding level for CAN is $9,835,000.
Academic Partnerships to Support Clinical Development.--The
Committee recognizes the importance of public-private-academic
models and partnerships to translate discoveries into
treatments and cures. To speed the pace of discoveries, the
Committee encourages NCATS to seek out and support partnerships
between academic-based entities and NCATS' intramural program,
which has a strong record of expertise and resources for
identifying opportunities, validating leads, and developing the
necessary data to build the basis for clinical development.
Such partnerships should seek to connect intramural research
ideas and discoveries to specific development efforts, and to
assist with the interaction with the pharmaceutical and
biotechnology industries.
Clinical and Translational Science Awards [CTSA].--The
Committee supports the goals of the CTSA program and believes
the principles that serve as the foundation of NCATS--public-
private partnerships, community outreach, faster access to
clinical trials, and distributed patient cohorts--have
tremendous potential for addressing the long-standing
scientific and operational problems associated with getting
treatments to patients, including those with health
disparities. Recognizing the value and importance of supporting
the full spectrum of medical research, the Committee encourages
NCATS to build meaningful relationships between clinical and
translational research programs and the various Institutes and
Centers. NCATS is encouraged to work closely with the CTSA
community and related stakeholders moving forward to continue
to identify emerging opportunities and areas for programmatic
improvement. Further, the Committee encourages NIH to fund
CTSAs with a history of serving health disparity populations,
as well as CTSAs that address the unmet needs associated with
rare diseases, so that research funding provided through the
various Institutes can be leveraged to address the clinical and
translational research challenges associated with those
populations.
The Committee provides $499,746,000 for the CTSA program,
an increase of $25,000,000 above the fiscal year 2015 level for
NCATS to implement the recommendations from the 2013 Institute
of Medicine report on the CTSA program. In particular, the
Committee supports the goal of the CTSA program to build
networking capacity and innovative collaborative projects.
Additional funding is included to allow the program to retain
its merit-based CTSA funding to institutions while expanding
the network capacity to conduct multi-site clinical studies and
collaborative projects.
Full Spectrum of Medical Research.--The Committee supports
the progress of clinical and translational research activities,
including the CTSA program. The Committee is pleased to see
NCATS working on treatments for some infectious diseases,
including malaria and Lassa fever, and encourages NCATS to
focus on additional neglected diseases through the Therapeutics
for Rare and Neglected Diseases program. Additionally, the
Committee requests that NCATS' contributions to neglected
disease research be included in the joint CDC, FDA, and NIH
global health strategy describing coordination and
prioritization of global health research activities within the
three agencies.
Minority Populations.--The Committee encourages NCATS to
consider clinical research efforts in areas that are
characterized by geographically interspersed minority
populations. Clinical and translational research with such
populations can reveal clinically significant differences that
drive improvements in diagnosis and treatment.
NATIONAL LIBRARY OF MEDICINE
Appropriations, 2015.................................... $337,324,000
Budget estimate, 2016................................... 394,090,000
Committee recommendation................................ 402,251,000
The Committee recommends $402,251,000 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, 2017.
National Center for Biotechnology Information [NCBI].--The
Committee recommendation includes funding directly to NLM for
NCBI to meet the challenge of collecting, organizing,
analyzing, and disseminating the increasing amounts of data
related to research in molecular biology and genomics, and to
support the deposit of manuscripts in PubMed Central under the
NIH Public Access Policy. Providing the increase specifically
to NLM, as opposed to previous years where NLM received funding
from individual Institutes and Centers for these activities,
increases funding transparency and enhances NCBI's ability to
provide an integrated, genomic resource for biomedical
researches at NIH and around the globe.
OFFICE OF THE DIRECTOR
Appropriations, 2015.................................... $1,413,734,000
Budget estimate, 2016................................... 1,442,628,000
Committee recommendation................................ 1,523,537,000
The Committee recommendation includes $1,523,537,000 for
the Office of the Director [OD]. Within this total,
$544,077,000 is provided for the Common Fund.
Aging Lungs.--The Committee notes that as the population in
the United States ages, there is a need for more research data
on how the aging process affects the lung. The Committee
encourages NHLBI and NIA to collaborate research efforts in
this area.
Amyloidosis.--The Committee encourages NIH to continue its
research efforts into amyloidosis, a group of rare diseases
characterized by abnormally folded protein deposits in tissues.
Current methods of treatment are risky and unsuitable for many
patients. The Committee asks NIH to keep the Committee informed
on the steps taken to increase the understanding of the causes
of amyloidosis and the measures taken to improve the diagnosis
and treatment of this devastating group of diseases. The
Committee requests an update in the fiscal year 2017 CJ.
Angiogenesis.--The Committee commends the NIH for holding
the Trans-NIH Angiogenesis Workshop and understands that
recommendations based on the findings of that conference are
forthcoming. The Committee urges NIH to implement the
recommendations to further angiogenesis research. The Committee
understands, as noted in the fiscal year 2015 NIH CJ, that a
collection of biomarkers needs to be assessed to determine a
predictive value and to identify responder characteristics for
anti-angiogenic and pro-angiogenic therapies. The Committee
urges the NIH to consider the development of a collection of
biomarkers to study their correlation with age, sex, ethnicity,
and various angiogenesis modifying interventions.
Basic Research.--The Committee urges the Director to
continue the NIH's historical focus on the funding and support
of basic biomedical research. Basic biomedical research is a
critical investment in the future health, wealth, and
international competitiveness of our Nation and plays a vital
role in the Nation's economy. Without continued support for
this early scientific investigation, future development of
treatments and cures will be impossible. The Committee believes
that basic biomedical research must remain a key component of
both the intramural and extramural research portfolio at the
NIH.
Brain Research through Application of Innovative Neuro-
technologies [BRAIN] Initiative.--The Committee continues to
strongly support the BRAIN initiative. The bill provides the
full President's request of $135,381,000, an increase of
$70,000,000 above fiscal year 2015, to be pooled from various
ICs.
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. 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.
Cannabidiol Research.--The Committee recognizes the
potential therapeutic benefits that marijuana and its
components may bring to patients with serious medical
conditions, including seizures, multiple sclerosis, Parkinson's
disease, Alzheimer's, substance use disorders, and neuropathic
and cancer pain. The Committee encourages NIH to coordinate a
multi-Institute approach to increase research related to
potential therapeutic benefits of marijuana and its components,
specifically cannabidiol. The Committee requests an update in
the fiscal year 2017 congressional justification on the status
of research related to this topic.
Doctors of Veterinary Medicine [DVMs] and Loan Repayment
Programs.--The Committee recognizes the important role that
DVMs play in the biomedical research enterprise because of
their background and training in disease processes across all
animals, including cross-species virus transmission, and animal
models. DVMs participate on clinical research teams and are
eligible in that capacity for loan repayments under the
Clinical Research and Clinical Research for Individuals from
Disadvantaged Backgrounds loan repayment programs. NIH is
encouraged to make this information more widely known to
potential applicants.
Emergency Care Research.--The Committee encourages NIH to
give greater consideration to the significance of traumatic
injury, which is the leading cause of death under age 45.
Trauma care, at $56,000,000,000 annually, is now the most
costly medical condition to treat under age 65 in the United
States. While the Committee appreciates the establishment of an
Office of Emergency Care Research [OECR] within NIGMS, with a
mission to coordinate and foster clinical and translational
research and research training for the emergency setting, that
office does not directly fund research grants, but must instead
work to coordinate and catalyze efforts within other
Institutes. The Committee encourages the Director of NIH to
help the OECR effectively promote an expanded NIH-wide research
agenda on emergency and trauma care.
Fibrotic Diseases.--The Committee encourages NIH to
continue to support research into fibrotic diseases affecting
different organs, including the lung, liver, kidney, heart, and
skin, and to ensure appropriation coordination between its
Institutes as they conduct single organ or cross-organ fibrotic
disease research.
Gabriella Miller Kids First Research Act.--The bill
provides the administration's full request of $12,600,000. The
Committee asks that NIH provide information on how it has
disbursed the fiscal year 2015 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 2015. Further, the Committee strongly
encourages the NIH to prioritize research projects relating to
childhood cancer within the program in fiscal year 2016.
Genetic Discoveries.--The Committee continues to support
NIH biomedical research in the area of precision medicine. The
Committee encourages NIH to explore the best ways to utilize
existing large databases, such as those that include large
families or are tied to genealogical, public health, and
medical records. The Committee is particularly interested in
the practical application of genetic discoveries, including the
development of appropriate data analytic tools to make
discoveries using genetic data and the discovery of potentially
pivotal pathways involved in chronic diseases for which novel
medicines could be developed.
Gestational Diabetes.--The Committee recognizes the
importance of research funded by the NIH related to gestational
diabetes, a disease affecting 18 percent of all pregnant women.
Given that both women with gestational diabetes and their
babies face long-term health consequences as a result of this
disease, such as increased risk of developing type 2 diabetes,
the Committee urges NIH to explore additional opportunities for
research on gestational diabetes.
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 2017 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.
Hereditary Hemorrhagic Telangiectasia [HHT].--HHT is a
genetic disorder that can result in life-threatening strokes
and other complications, but if diagnosed in time is very
treatable and manageable. The Committee encourages multiple NIH
Institutes and Centers, including NINDS, NHLBI, NICHD, NHGRI,
NIDDK, NIBIB, and NCATS, to explore collaborative research
opportunities into improvements for diagnosis and early
intervention of HHT and treatment of its manifestations.
Interstitial Cystitis [IC].--IC disproportionately impacts
women and is prevalent in approximately 6 percent of women in
the United States. The Committee commends the Office of Women's
Health for supporting research on IC and encourages ORWH to
continue to prioritize IC research.
Lymphatic Research and Disease.--The Committee once again
commends the trans-NIH Coordinating Committee for Lymphatic
Research. The Committee encourages NIH to consider supporting
extramural interdisciplinary research training programs
relevant to the lymphatic system in health and disease, and
opportunities to incorporate reviewer expertise in lymphatic
biology/disease in the pertinent standing and special study
sections within the Center for Scientific Review.
Minority Research.--The Committee applauds the NIH
Director's efforts to reverse the trend of underrepresentation
of researchers from ethnically diverse backgrounds. The
Committee encourages NIH to continue newly established programs
to enhance NIH-funded workforce diversity.
Mitochondrial Diseases.--Mitochondrial Diseases are now
recognized by most clinicians as a major health issue given the
essential role of impaired mitochondrial function in aging and
degenerative diseases such as Parkinson's, diabetes, and
hearing loss. It is recognized that research into Mitochondrial
Disease provides a window into understanding and treating many
conditions that afflict large segments of the population. The
Committee believes that the NIH might advance research in this
field through the following steps: (1) implement, as feasible
the recommendations contained in the White Paper developed by
the March 2012 workshop on Translational Research in
Mitochondrial Disease; (2) maintain sustained support for the
North American Mitochondrial Disease Consortium; (3) support
investigator-initiated and collaborative pharmaceutical
clinical trials on an increasing cadre of candidate drugs that
meet funding paylines; and (4) follow up on the December 2014
workshop on dietary supplements and medical foods in the
treatment of primary mitochondrial disorders by supporting
research on novel, safe, and effective nutritional
interventions for mitochondrial disease.
Muscular Dystrophy.--The Committee is aware that amendments
to the Muscular Dystrophy CARE Act were enacted into law in
2014 and requests an update from NIH on the implementation of
the updated provisions, particularly a plan to expand research
into bone health and endocrine-functioning. The Committee also
requests that NIH provide an update on its plans to finalize
and implement an updated Action Plan for the Muscular
Dystrophies.
National Children's Study [NCS].--In December 2014, the NIH
Director, following the advice of the Advisory Committee to the
Director, ended the NCS--a longitudinal study that would have
followed 100,000 children from before birth to age 21. The
decision came after $1.3 billion in Federal investment, and was
based on the Advisory Committee's conclusion that the NCS, as
planned, was not feasible and unlikely to achieve its goals,
findings the Committee considers deeply troubling. The NCS was
authorized to (1) gather data from birth to adulthood to
evaluate environmental influences on diverse populations of
children; (2) consider health disparities among children; and
(3) incorporate behavioral, emotional, educational, and
contextual consequences to enable complete assessments of the
physical, chemical, biological, and psychosocial environmental
influences on children's well-being. The discontinuation of the
NCS is a significant setback as the NCS had the potential to
add substantially to scientific knowledge about the impact of
environmental exposures on children's health and development in
the United States. The Committee urges NIH to recalibrate and
realign the investment already made in the NCS to initiate new
and focus existing longitudinal studies to address the
objectives identified for the NCS. The NIH should rely upon a
formal scientific advisory mechanism to coordinate efforts
across studies. The research efforts should incorporate
expertise in population health and environmental epidemiology,
integrate basic science, and leverage maternal/infant cohorts.
For example, it is important to thoroughly examine pathways
linking chronic and intermittent exposures to the physical and
social environments to adverse health and developmental
outcomes in children. It is also important to study the
intertwined biological, behavioral, and social transmission of
obesity and obesity-related risk factors across generations and
to test intergenerational, exposure-disease associations by
linking maternal and infant/child data.
Neurofibromatosis [NF].--The Committee supports efforts to
enhance research for NF at multiple NIH Institutes, including
NCI, NINDS, NIDCD, NHLBI, NICHD, and NEI. Children and adults
with NF are at significant risk for the development of many
forms of cancer; the Committee encourages NCI to continue its
NF research efforts in fundamental basic science, translational
research, and clinical trials focused on NF. The Committee also
encourages the NCI to continue to support the development of NF
preclinical mouse models and NF-associated tumor sequencing
efforts. Since NF2 accounts for approximately 5 percent of
genetic forms of deafness, and NF1 can cause vision loss due to
optic gliomas, the Committee encourages NIDCD and NEI to expand
their investment in NF1 and NF2 basic and clinical research.
Next Generation Research Initiative.--The National Academy
of Sciences [NAS] will conduct an evaluation of the
legislative, administrative, educational, and cultural barriers
to providing for a successful next generation of researchers to
be completed no later than 1 year after the date of enactment
of this act. The Committee appropriates $1,200,000 for this
purpose. The Committee directs the NAS to submit to the
Director of NIH and the Committees on Appropriations of the
House and Senate the results of the study which shall include:
(A) an evaluation of the legislative, administrative,
educational, and cultural barriers faced by the next generation
of researchers; (B) an evaluation of the impact of Federal
budget constraints on the next generation of researchers; and
(C) recommendations for the implementation of policies to
incentivize, improve entry into, and sustain careers in
research for the next generation of researchers, including
proposed policies for agencies and academic institutions.
Non-Recurring 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 including information technology and facilities
infrastructure. Unfortunately, the Department has chosen to use
the majority of NEF funding over the past several years to
supplement funding for the Affordable Care Act. Therefore, the
Committee includes modified bill language directing funding
from the NEF to be expended only by the NIH for carrying out
section 301 and title IV of the PHS Act with respect to
biomedical research. According to the Department and past
expenditures of the NEF, approximately $650,000,000 should be
available in fiscal year 2016. NEF funding shall be transferred
to and merged with the accounts for the various Institutes and
Centers and the Office of the Director in proportion to their
shares of total NIH appropriations made by this act. The NIH
shall provide in the fiscal year 2017 CJ actual expenditures
from the NEF in fiscal year 2016.
Pediatric Research Data Collection.--The inclusion of
children and older populations in clinical research is
essential to ensure that these groups benefit from important
scientific advances. The Committee is aware that NIH has had a
formal policy mandating the inclusion of children in research
relevant to child health since 1998. The Committee recognizes
that without a better understanding of age in clinical
research, Congress is unable to fully exercise its oversight
role and researchers are unable to determine whether children
as a whole, particular pediatric subpopulations, or older
populations, are underrepresented in federally funded
biomedical research. Using data systems available, the
Committee directs NIH to collect, assess, and report publicly
information about the inclusion of individuals from appropriate
age groups throughout the lifespan and on relevant gaps in
pediatric and older population involvement in the NIH portfolio
of clinical research.
Pharmaceutical Development Section [PDS].--The Committee is
concerned about recent reports of unsafe manufacturing
practices and quality control procedures at NIH's PDS that were
first brought to light by a whistleblower. To its credit, as
soon as it became aware of the problems in PDS, the NIH
Director acted quickly to suspend the section's operations and
determine whether any patients were harmed. The agency is
investigating further the section's practices, as well as
assessing whether it should continue to provide these services
in-house or through contracts with outside vendors. The
Committee will continue to closely monitor NIH's next steps as
it continues its analysis.
Phelan-McDermid Syndrome.--The Committee is pleased that
the NIH convened a multi-Institute meeting earlier this year to
discuss collaborative research efforts into gaining a better
understanding of Phelan-McDermid Syndrome, a genetic disorder
that can lead to autism, epilepsy, and other neurological
conditions. The Committee supports similar future discussions
which may advance research into this disorder and other
``shankopathies'' that result in the deletions, duplications,
and mutations of the SHANK1, SHANK2, and SHANK3 genes. Research
into the SHANK genes holds great promise for gaining a better
understanding of more prevalent conditions, including
intellectual and developmental disorders, autism, ADHD,
schizophrenia, bipolar disorder, epilepsy, and dementia.
Physician-Scientist Workforce Report Implementation.--Last
year the Physician-Scientist Workforce Working Group, which was
charged with analyzing the current composition and size of the
physician-scientist biomedical workforce and to make
recommendations to sustain and strengthen this group, released
its report with specific recommendations that impact
veterinarian-scientists. A committee has been convened to
determine how this report's recommendations should be
implemented at NIH. The Committee would like NIH to report on
the implementation status of this report's recommendations in
the fiscal year 2017 CJ.
Precision Medicine.--The Committee recommendation strongly
supports the new Precision Medicine Initiative and has provided
$70,000,000 to NCI and $130,000,000 to various Institutes and
Centers in support of this Initiative. The Committee looks
forward to NIH providing further details and information on the
Initiative as the Working Group of the Advisory Committee to
the NIH Director reports in September 2015. In particular, as
further details are developed, the Committee remains
particularly interested in short and long-term milestones of
the program and expects these milestones to be specified in the
fiscal year 2017 CJ.
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, researchers must have access to
appropriate research facilities. $50,000,000 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.
Science Education.--The Science Education Partnership
Awards [SEPA] foster 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 last year's level.
Sickle Cell Disease [SCD].--SCD is an inherited disorder
affecting red blood cells that impacts approximately 100,000
individuals, the great majority of whom are African American.
Currently, there is only one FDA-approved medication for
treatment and there is no universal cure. The Committee
encourages the NIH to create a Trans-NIH program focusing on
SCD and fund interdisciplinary research initiatives at
hospitals and universities experienced in treating SCD
patients.
Sleep and Circadian Disorders.--The Committee recognizes
the immense public health burden of sleep and circadian
disorders and encourages the Office of the Director to foster
collaboration on sleep and circadian research across ICs and to
support NCSDR efforts to coordinate this important research.
Small Business Innovation Research.--The Committee
encourages NIH to consider new clinical indications that
leverage developed devices when soliciting proposals and
awarding funds through competitive grant programs, including
the Small Business Innovation Research program.
Spina Bifida.--The Committee encourages NIDDK, NICHD, and
NINDS to study the causes and care of the neurogenic bladder
and kidney disease to support research to address issues
related to the treatment and management of Spina Bifida and
associated secondary conditions, such as hydrocephalus; and to
understand the myriad co-morbid conditions experienced by
children with Spina Bifida, including those associated with
both paralysis and developmental delay.
Temporomandibular Disorders [TMD].--Temporomandibular
Disorders affect approximately 35 million Americans; the
majority affected are women in their childbearing years. The
Committee encourages NIBIB, NIAMS, and NIDCR to consider the
recommendations that resulted from their jointly sponsored
Roundtable on the Temporomandibular Joint in Health and Disease
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. The Committee commends NIDCR
for its ongoing support for the OPPERA program, which is
yielding valuable information on many physiological aspects,
not only of temporomandibular disorders, but of other pain
conditions that overlap with TMD. To capitalize on the research
to continue the momentum gained from OPPERA, the Committee
urges NIH to continue research of this caliber and direction,
and to consider measures to encourage NIH-funded investigators
from related fields to include TMD and comorbid conditions in
their studies.
Tuberous Sclerosis Complex [TSC].--The Committee continues
to encourage NIH to coordinate a multi-Institute approach to
finding a cure for TSC. NINDS and NCATS should play leading
roles, given the promising translational potential of new
therapeutics for treating the neurological conditions of TSC,
including autism and epilepsy. The Committee encourages NINDS
to lead the development of NIH programs to implement consensus
recommendations developed at the NIH-sponsored TSC workshop,
``Unlocking Treatments for TSC: 2015 Strategic Plan.''
Usher Syndrome.--As the most common cause of combined
deafness and blindness, Usher syndrome is an important research
area for multiple NIH Institutes. The Committee commends NIH
for including Usher syndrome on the Estimates of Funding for
Various Research, Condition, and Disease Categories list to
track the annual support level of this rare disease. The
Committee urges NIH to prioritize Usher syndrome research at
NIDCD and NEI. The Committee requests an update in the fiscal
year 2017 CJ on the planned and on-going activities related to
this syndrome, including the manner in which various ICs
coordinate on common goals and objectives.
BUILDINGS AND FACILITIES
Appropriations, 2015.................................... $128,863,000
Budget estimate, 2016................................... 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 budget request proposes making
the funding available until expended.
Substance Abuse and Mental Health Services Administration
The Committee recommends $3,460,484,000 for the Substance
Abuse and Mental Health Services Administration [SAMHSA]. The
recommendation includes $133,667,000 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.
Furthermore, racial and ethnic minorities continue to have
higher rates of HIV/AIDS compared to the overall U.S.
population. Therefore, the Committee urges SAMHSA to continue
to prioritize all HIV/AIDS funding to target racial and ethnic
minority communities.
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 2016, as was done prior to fiscal year 2012.
MENTAL HEALTH
Appropriations, 2015.................................... $1,078,975,000
Budget estimate, 2016................................... 1,077,667,000
Committee recommendation................................ 1,054,340,000
The Committee recommends $1,054,340,000 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 Individual with Mental Illness
[PAIMI].
SAMHSA is the lead HHS agency responsible for the Federal
Government's efforts in combating mental health issues.
According to SAMHSA, 43,800,000 adults in the United States
suffered from a mental illness in 2013, 10,000,000 of these
adults suffered from a serious mental illness. The Committee is
disappointed and deeply concerned about the findings in two
recent GAO reports (GAO-15-113 and GAO-15-405) issued in
February and May of 2015, respectively, regarding SAMHSA'
mental health programs. The reports detailed many critical
failures at SAMSHA in leading and overseeing our Nation's
mental health programs.
The February report specifically highlighted the lack of
high-level coordination between agency leaders that operate
mental health programs and the absence of oversight in ensuring
the evaluations of these programs. Without proper coordination
at the leadership level, taxpayers are funding a mixture of
mental health programs across several agencies with no overall
objective. These programs are ultimately duplicative,
fragmented, or overlapping with each other's activities.
In the May GAO report, SAMHSA failed to document how it
applied its own grant criteria before making awards to
grantees, and the report stated that SAMSHA was missing various
pieces of documentation used to oversee the programs. Without
the proper grant documentation, SAMSHA cannot provide proper
oversight of its programs to ensure that they are effective and
beneficial to individuals with a mental illness. However, the
most concerning issue pointed out by GAO is that SAMHSA
acknowledged they followed the Department's grants manual. The
Committee is concerned that SAMHSA either may not fully
understand the Department's grants manual, or there is a
serious lack of training among SAMSHA's grants staff.
The Committee directs the administrator of SAMHSA to work
with GAO in implementing the recommendations provided in the
GAO reports. The Committee expects a detailed update and
timeline on the progress of these recommendations 90 days after
enactment of this act. Furthermore, the Committee directs
SAMHSA to develop a grants compliance plan that will ensure
that SAMSHA's grants process is in accordance with the
Department's grants manual. The compliance plan shall include
periodic, and random, internal audits of grant files to confirm
all the necessary documentation are accounted for and that the
compliance plan is meeting its objectives. Furthermore, SAMHSA
shall provide any additional grants training necessary to
prevent these issues from arising in the future.
Programs of Regional and National Significance
The Committee recommends $378,597,000 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 2015 Fiscal year 2016 Committee
Budget activity appropriation request recommendation
----------------------------------------------------------------------------------------------------------------
CAPACITY:
Seclusion & Restraint................................. 1,147 1,147 1,147
Youth Violence Prevention............................. 23,099 23,099 23,099
Project AWARE State Grants............................ 39,902 39,902 39,902
Mental Health First Aid............................... 14,963 14,963 14,963
Mental Health First Aid for Veterans' Families........ ................ 4,000 ................
Healthy Transitions................................... 19,951 19,951 19,951
National Traumatic Stress Network..................... 45,887 45,887 45,887
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 34,555
Primary and Behavioral Health Care Integration........ 49,877 26,004 49,877
National Strategy for Suicide Prevention.............. 2,000 4,000 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.............................. 4,988 15,000 4,988
Minority AIDS......................................... 9,224 15,935 9,224
Grants for Adult Treatment, Screening, and ................ 2,896 ................
BriefPResponse.......................................
Crisis Systems........................................ ................ 5,000 ................
Criminal and Juvenile Justice Programs................ 4,269 4,269 4,269
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 1,996 1,991
Consumer & Consumer Support TA Centers................ 1,918 1,918 1,918
Minority Fellowship Program........................... 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
----------------------------------------------------------------------------------------------------------------
Access to Mental Health Services for Veterans.--The
Committee is aware of the success achieved in localities that
use locally customized web portals to assist veterans
struggling with mental and substance use issues. These portals
provide veterans with a directory of local mental health
providers and services in addition to all military and VA
funded programs. They also provide quick access to local crisis
intervention and emergency care programs; comprehensive job
search and support; a peer social networking platform, and
personal health records. The Committee encourages SAMHSA to
expand and maintain the capacity of locally customized
internet-based Web portals nationwide.
Primary and Behavioral Healthcare Integration.--The
Committee provides funding for this program through budget
authority rather than through transfers from the PPH Fund as
requested by the administration. The Committee continues to
direct SAMHSA to ensure that new Integration grants awarded for
fiscal year 2016 are funded under the authorities in section
520K of the PHS Act.
Community Mental Health Services Block Grant
The Committee recommends $482,571,000 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 5 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 targets 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 2017 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 $117,026,000 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.
Projects for Assistance in Transition From Homelessness
The Committee recommends $40,000,000 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, 2015.................................... $2,183,858,000
Budget estimate, 2016................................... 2,140,557,000
Committee recommendation................................ 2,054,116,000
The Committee recommends $2,054,116,000 for substance abuse
treatment programs, including programs of regional and national
significance and the substance abuse prevention and treatment
block grant to the States. The recommendation includes
$81,200,000 in transfers available under section 241 of the PHS
Act.
Programs of Regional and National Significance
The Committee recommends $284,260,000 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.
Programs of regional and national significance include
activities to increase capacity by implementing service
improvements using proven evidence-based approaches as well as
science-to-services activities that promote the identification
of practices thought to have potential for broad service
improvement.
Within the total provided for PRNS, the Committee
recommendation includes funding for the following activities:
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year 2015 Fiscal year 2016 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 30,000
Target Capacity Expansion............................. 23,223 36,303 29,223
Medicated Assisted Treatment for Prescription Drug 12,000 25,000 18,000
and Opioid Addiction (non-add)...................
Pregnant & Postpartum Women........................... 15,931 15,931 15,134
Strengthening Treatment Access and Retention.......... 1,000 1,000 ................
Recovery Community Services Program................... 2,434 2,434 2,312
Access to Recovery.................................... 38,223 ................ ................
Primary Care and Addiction Services Integration....... ................ 20,000 ................
Children and Families................................. 29,605 29,605 28,125
Treatment Systems for Homeless........................ 41,386 41,386 39,317
Minority AIDS......................................... 65,570 58,859 58,859
Criminal Justice Activities........................... 78,000 61,946 61,946
SCIENCE AND SERVICE:
Addiction Technology Transfer Centers................. 9,046 8,081 8,081
Crisis Systems........................................ ................ 5,000 ................
Minority Fellowship Program........................... 2,539 ................ 2,539
Special Initiatives/Outreach.......................... 1,432 1,432 ................
----------------------------------------------------------------------------------------------------------------
Access to Recovery.--The Committee eliminates the Access to
Recovery program as proposed by the administration. Activities
related to wrap-around treatment services, such as
transportation, housing, and job support are available through
other funding sources, including SAMHSA's Substance Abuse
Prevention and Treatment block grants.
Oral Fluid Guidelines.--The Committee commends SAMSHA for
the progress made on issuing oral fluid guidelines for the
Federal Workplace Drug Testing Programs and supports the
development of oral fluid as an alternative specimen for drug
testing. The Committee urges SAMSHA to publish the guidelines
expeditiously and to implement the guidelines in partnership
with stakeholders.
Viral Hepatitis Screening.--The Committee applauds SAMSHA
for encouraging grantees to screen for viral hepatitis,
including the use of innovative strategies like rapid testing
and urges SAMSHA to continue these efforts.
Addiction Technology Transfer Centers [ATTCs].--The
Committee continues to direct SAMHSA to ensure that ATTCs
maintain a primary focus on addiction treatment and recovery
services.
Combating Opioid Abuse.--Of the amount provided for
Targeted Capacity Expansion, the Committee recommendation
includes $18,000,000 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
rates of admissions and that have demonstrated a dramatic
increase in admissions for the treatment of opioid use
disorders.
Drug Treatment Courts.--The Committee continues to direct
SAMHSA to ensure that all funding appropriated for Drug
Treatment Courts is allocated to serve people diagnosed with a
substance use disorder as their primary condition. The
Committee expects CSAT to ensure that non-State substance abuse
agency applicants for any drug treatment court grant in its
portfolio continue to demonstrate extensive evidence of working
directly and extensively with the corresponding State substance
abuse agency in the planning, implementation, and evaluation of
the grant.
Screening, Brief Intervention, and Referral to Treatment
[SBIRT].--The Committee continues to direct SAMHSA to ensure
that funds provided for SBIRT are used for existing evidence-
based models of providing early intervention and treatment
services to those at risk of developing substance abuse
disorders.
Substance Abuse Prevention and Treatment Block Grant
The Committee recommends $1,769,856,000 for the SAPT block
grant. The recommendation includes $79,200,000 in transfers
available under section 241 of the PHS Act. The block grant
provides funds to States to support alcohol and drug abuse
prevention, treatment, and rehabilitation services. Funds are
allocated to States according to a formula.
Formula Evaluation.--The Committee understands that States
are having difficulty interpreting the sources of data used in
the current formula for the Substance Abuse Prevention and
Treatment block grant program. In addition, the formula has not
been adjusted since 1997 and is overly confusing. States cannot
defend their positions when SAMHSA does not inform them of the
origin of the data used for the formula. To increase
transparency, the Committee directs SAMHSA to include in their
fiscal year 2017 CJ details on where SAMSHA acquires the data
used for the formula and how SAMHSA utilizes this information
to make funding level determinations. It is imperative that
SAMHSA uses the most recent and accurate data available and
should work with States to better understand the best sources
for this information. SAMHSA shall also include an evaluation
on whether the current formula should be updated in the future.
SUBSTANCE ABUSE PREVENTION
Appropriations, 2015.................................... $175,219,000
Budget estimate, 2016................................... 210,918,000
Committee recommendation................................ 182,731,000
The Committee recommends $182,731,000 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 directs that all of the money appropriated
explicitly for substance abuse prevention purposes both in
CSAP's PRNS lines as well as the funding from the 20 percent
prevention set-aside in the SAPT Block Grant be used only for
bona fide substance abuse prevention programs and strategies
and not for any other purposes.
Programs of Regional and National Significance
The Committee provides $182,731,000 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 2015 Fiscal year 2016 Committee
Budget activity appropriation request recommendation
----------------------------------------------------------------------------------------------------------------
CAPACITY:
Strategic Prevention Framework/Partnership for Success 109,484 118,254 114,984
Strategic Prevention Framework Rx (non-add)....... ................ 10,000 5,500
Grants to Prevent Prescription Drug/Opioid Overdose... ................ 12,000 6,000
Mandatory Drug Testing................................ 4,894 4,894 4,894
Minority AIDS......................................... 41,205 41,205 39,145
Sober Truth on Preventing Underage Drinking (STOP Act) 7,000 7,000 6,650
National Adult-Oriented Media Public Service 1,000 1,000 950
Campaign.........................................
Community-based Coalition Enhancement Grants...... 5,000 5,000 4,750
ICCPUD............................................ 1,000 1,000 950
Tribal Behavioral Health Grants....................... ................ 15,000 ................
SCIENCE AND SERVICE:
Fetal Alcohol Spectrum Disorder....................... 1,000 1,000 ................
Center for the Application of Prevention Technologies. 7,493 7,493 7,119
Science and Service Program Coordination.............. 4,072 4,072 3,868
Minority Fellowship Program........................... 71 ................ 71
----------------------------------------------------------------------------------------------------------------
Combating Opioid Abuse.--The Committee provides $6,000,000
for grants to prevent opioid overdose related deaths. As part
of the new initiative to Combat Opioid Abuse, this new program
will help States equip and train first responders with the use
of devices that rapidly reverse the effects of opioids. 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 $5,500,000 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, 2015.................................... $181,660,000
Budget estimate, 2016................................... 235,145,000
Committee recommendation................................ 169,297,000
The Committee recommends $169,297,000 for Health
Surveillance and Program Support activities. The recommendation
includes $31,428,000 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 2015 Fiscal year 2016 Committee
Budget activity appropriation request recommendation
----------------------------------------------------------------------------------------------------------------
Health Surveillance....................................... 47,258 49,428 44,895
Program Management........................................ 72,002 79,559 68,402
Performance & Quality Information Systems................. 12,918 12,918 10,000
Public Awareness and Support.............................. 13,482 15,571 10,000
Peer Professional Workforce Development................... ................ 10,000 ................
Behavioral Health Workforce Education and Training Program 35,000 56,000 35,000
Minority Fellowship Program............................... ................ 10,669 ................
Behavioral Health Workforce Data.......................... 1,000 1,000 1,000
----------------------------------------------------------------------------------------------------------------
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.
Behavioral Health Workforce Education and Training.--The
Committee is concerned about the uneven distribution of funds
among specialties resulting from the initial grant competition
in 2014. Therefore, the Committee directs SAMHSA and HRSA to
ensure that funding is distributed relatively equally among the
participating health professions, including paraprofessionals,
master's level social workers, counselors, marriage and family
therapists, and doctoral psychology interns. The Committee
directs SAMHSA and HRSA to consider other strategies to achieve
this relative distribution such as issuing separate funding
opportunity announcements for each participating health
profession. In addition, the Committee directs SAMHSA and HRSA
to include doctoral psychology schools in the funding
opportunities to support doctoral level students completing
their practicums which are necessary to move on to internships.
SAMHSA and HRSA shall award meritorious applications for
doctoral psychology interns first, before doctoral psychology
schools applying to support practicums.
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 are
reflected in the tables for each of the centers.
Agency for Healthcare Research and Quality
Appropriations, 2015.................................... $363,698,000
Budget estimate, 2016................................... 363,698,000
Committee recommendation................................ 236,001,000
The Committee provides $236,001,000 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 $151,428,000 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 2015 Fiscal year 2016 Committee
Budget activity appropriation request recommendation
----------------------------------------------------------------------------------------------------------------
Prevention/Care Management................................ 11,590 11,649 8,113
Health Information Technology............................. 28,170 22,877 19,719
Patient Safety Research................................... 76,584 75,977 65,096
Health Services Research, Data and Dissemination.......... 112,207 112,274 58,500
----------------------------------------------------------------------------------------------------------------
Central-Line Associated Bloodstream Infections [CLABSI].--
The Committee notes that while much research on preventing
CLASBI has been dedicated to the exploration of proper line
insertion techniques and line management, little attention has
been given to the relationship between the connectors utilized
in central lines and rates of infection. The Committee urges
AHRQ to examine whether neutral fluid displacement needleless
connectors have the potential to reduce the incidence of CLABSI
as compared to positive fluid displacement needleless
connectors. AHRQ is encouraged to provide a best practice
recommendation for the use of such connectors in hospital
settings.
Consumer Assessment of Healthcare Providers and Systems
[CAHPS].--The CAHPS program supports and promotes the
assessment of consumers' experiences with healthcare. Patient
experience data in maternity care is currently not regularly
and systematically collected. The Committee urges AHRQ to
expand its current set of surveys and develop a CAHPS survey
for maternity care.
Health IT Safety.--The Committee recommendation includes
$4,000,000 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 $34,000,000, the same
level as in fiscal year 2015, 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 recommendation includes $8,000,000 for
the Healthcare Delivery Systems grants, which apply systems
engineering methods to improve patient safety and reduce waste
in healthcare.
Immunotherapy and Asthma.--The Committee is pleased that
AHRQ has joined NIH in co-sponsoring a workshop on
immunotherapy effectiveness. The Committee requests an update
from AHRQ in the fiscal year 2017 CJ on research that will be
undertaken pursuant to the workshop with the goal of
identifying patient, healthcare provider, and systems barriers
to initiation and adherence to allergy immunotherapy and
developing interventions to address these problems. This report
should include information on planned AHRQ initiatives
pertaining to the utilization of allergy immunotherapy to
reduce the prevalence of asthma.
Investigator-Initiated Research.--The Committee believes
that investigator-initiated research is important and AHRQ has
the ability to improve healthcare with creative, groundbreaking
approaches to ongoing and emerging healthcare issues through
this mechanism. Within the Health Services Research, Data and
Dissemination portfolio, the Committee provides $45,882,000 the
same level as in fiscal year 2015, for investigator-initiated
research. The Committee believes that investigator-initiated
research should not be targeted to any specific area of health
services research to generate the best unsolicited ideas from
the research community about a wide variety of topics.
Malnutrition.--The Committee is aware that several studies
suggest that malnourished hospitalized patients have a
significantly higher incidence of infection, are at increased
risk of mortality, have longer median lengths of stay, and are
more likely to be readmitted. The Committee requests that AHRQ
assess the prevalence of malnutrition in U.S. hospitals and
report back to the Committee in its fiscal year 2017 CJ.
Training Grants.--The Committee appreciates AHRQ's
commitment to providing research training and career
development grants for young investigators. AHRQ is urged to
maintain a strong training and career development pipeline for
talented researchers.
MEDICAL EXPENDITURES PANEL SURVEYS
The Committee provides $39,268,000 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 $45,305,000 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, 2015
$234,608,916,000
Budget estimate, 2016
243,545,410,000
Committee recommendation
243,545,410,000
The Committee recommends $243,545,410,000 in mandatory
funding for Grants to States for Medicaid.
The fiscal year 2016 recommendation excludes
$113,272,140,000 in fiscal year 2015 advance appropriations for
fiscal year 2016. As requested by the administration,
$115,582,502,000 is provided for the first quarter of fiscal
year 2017.
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, 2015
$259,212,000,000
Budget estimate, 2016
283,171,800,000
Committee recommendation
283,171,800,000
The Committee recommends $283,171,800,000 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 $198,530,000,000 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 $82,453,000,000 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 $691,000,000 to
be transferred to the Supplementary Insurance Trust Fund as the
general fund share of part D administrative expenses. The
Committee recommendation includes $291,000,000 in
reimbursements to the HCFAC fund, which reflects the portion of
the HCFAC spending to be reimbursed by the General Fund.
PROGRAM MANAGEMENT
Appropriations, 2015.................................... $3,669,744,000
Budget estimate, 2016................................... 4,245,186,000
Committee recommendation................................ 3,027,590,000
The Committee recommends $3,027,590,000 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 $6,900,000 for research,
demonstrations, and evaluation activities. The Committee does
not provide funding for the Medicare Current Beneficiary Survey
[MCBS] but includes the administration request for the other
activities funded by this account, such as the Chronic
Condition Warehouse and the Research Data Assistance Center.
The administration requested a total of $24,000,000 to
support the MCBS and expected this to be provided evenly from
this account and the Center for Medicare and Medicaid
Innovation [CMMI] established under the ACA. However, the
Committee is aware that the ACA provided the CMMI
$10,000,000,000 in mandatory funds and that almost
$7,000,000,000 still remains unobligated. Due to budgetary
constraints, the Committee supports funding the MCBS through
the CMMI.
Program Operations
The Committee recommends $1,890,823,000 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.
The Committee continues to be concerned funds are diverted
by the administration from CMS' core mission and function--
maintaining the essential operations for the Medicare,
Medicaid, and Children's Health Insurance Program--to implement
ACA activities. Specifically, with almost 75 million Americans
in the baby boom generation and approximately 10,000 of them
turning 65 years old every day, funding for CMS' Program
Management account is even more crucial than in previous years
to support the growing infrastructure necessary to accommodate
this generation. In fiscal year 2016, CMS expects Medicare
enrollees to total over 57 million, from 19 million in 1966.
Year after year, CMS has requested increases in funding for
core activities such as ongoing operational costs and
beneficiary outreach to keep up with the growing aging
population. However, the Committee could not provide funding
increases because the administration would reallocate funds to
implement the ACA, including to shore up the failing
Healthcare.gov.
With tight budgetary constraints, the Committee made
difficult choices to reduce funding for programs that were not
part of core activities. Additionally, CMS expects to collect
$1,560,000,000 in ACA user fees for fiscal year 2016, almost
double the amount obtained for the previous fiscal year.
Therefore, the Committee eliminates the budget authority the
Department diverted in previous fiscal years to implement and
operate ACA activities. Existing funding will maintain CMS'
core mission while bill language included will further prevent
the diversion of discretionary funds for ACA activities.
Specifically, the Committee includes bill language to
proactively prohibit the administration from using any
discretionary dollars in this bill from making payments for the
Risk Corridor program or propping up failing State-based
Exchanges.
ACA Internal Controls.--The Committee is deeply concerned
about the findings in the recent HHS Office of Inspector
General [OIG] report (A-02-14-02006) on CMS' lack of oversight
over the payments made to insurance companies. The OIG reported
that CMS failed to implement adequate internal controls to
check the accuracy of $2,800,000,000 worth of payments made to
health insurers for the advance premium tax credits and cost-
sharing reductions for enrollees. This amount only represents
the first payment that covered January to April of 2014 and is
only a tiny fraction of the vast amounts of money at risk.
Based on the current internal controls, the OIG concluded that
CMS could not make correct payments to providers resulting in
improper payments and jeopardizing taxpayer funds. The
Committee is specifically concerned that CMS relied primarily
on health insurers' attestations and that CMS does not plan on
reconciling payments until 2016, 2 years after payments were
made. The Committee directs CMS to work with the OIG to adopt
all the recommendations and expeditiously implement a permanent
process that automates enrollment and payment data on a more
accurate enrollee-by-enrollee basis. As the OIG pointed out in
the report, CMS has the authority to recoup improper payments
and offset them against future payments. The Committee expects
CMS to use this authority after reconciling payments.
ACA Notifications.--The Committee is disappointed that the
administration still cannot provide timely Congressional
notification for ACA enrollment figures even though the
Committee included report language in fiscal year 2015
requiring such notifications. The Committee continued to
receive enrollment data minutes before or even after the
administration's public announcement. The Committee includes
new 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.
Alzheimer's Disease and Dementia Care.--The National Plan
to Address Alzheimer's Disease includes the goal of enhancing
care quality and efficiency and expanding supports for people
with Alzheimer's disease and their families. The Committee is
aware of promising evidence-based interventions, including the
VA's Resources for Enhancing Alzheimer's Caregiver Health
program and the New York University Caregiver Initiative that
have been demonstrated to improve the health outcomes and
quality of life of persons with Alzheimer's and other causes of
dementia and their caregivers and to have delayed placement of
the patient in an institutional care setting. The Committee
encourages CMS to evaluate the impact of such interventions in
improving health outcomes of Medicare beneficiaries with
Alzheimer's and related dementias, including reducing or
delaying the use of institutional care services.
Annual Wellness Exam and Cognitive Impairment.--The
Committee is aware that the Annual Wellness Exam is required to
include an assessment of any cognitive impairment in the
Medicare beneficiary. The Committee is concerned about the
extent such assessments are occurring within the exams and
directs the CMS to report in their fiscal year 2017 CJ the rate
of provider compliance, including impediments for not
conducting the assessment, and to develop a strategy to
increase compliance.
Collection Claims.--The Medicare Secondary Payer program
provides CMS the ability to recover payments it made for
beneficiary healthcare costs from third parties which are later
found responsible for those costs. CMS is encouraged to review
its debt collection process to ensure the agency is providing
accurate and complete information about past-due and legally
enforceable claims, so that the U.S. Department of Treasury can
appropriately identify and adjudicate any appeals.
Complex Rehabilitation Equipment.--CMS issued Final Rule
1614-F detailing how CMS will use data from the Medicare
Competitive Bidding Program [CBP] for durable medical equipment
[DME] to adjust the Medicare fee schedule for DME items in non-
competitive bidding areas beginning in 2016. The Committee is
concerned that this will harm Medicare beneficiaries who will
not have access to specialized rehabilitation equipment,
including adjustable seat cushions, and unnecessarily increase
program costs. The Committee directs CMS to provide a report
within 60 days of enactment of this act to the Committees on
Appropriations of the House of Representatives and the Senate
detailing how the application of the CBP pricing from 2009 and
data from only nine metropolitan areas are appropriate, why CMS
did not include all scenarios in which an adjustable seat
cushion are currently furnished, and also examine the health
outcomes of such changes for patients who have pressure ulcers
or who are at high risk for developing pressure ulcers.
Continuous Glucose Monitors.--Diabetes technologies known
as continuous glucose monitors [CGM] have been shown in
clinical trials to improve health outcomes for people with type
1 diabetes and reduce the risk of low blood sugar emergencies
which can lead to hospitalizations and additional expenses to
CMS. These technologies are recommended by national diabetes
guidelines and covered by 95 percent of private health plans.
The Committee urges CMS to modernize its policies to cover CGM
technologies to ensure access for those seniors with type 1
diabetes or those entering Medicare who have benefitted from
the technology under their prior health plan.
Coordinated Pharmacist Services.--The Committee encourages
CMS to expand efforts that incorporate health information
technology to provide integrated pharmacist services across
care settings and to improve medication reconciliation and
management that has been demonstrated to improve outcomes,
reduce adverse events, lower costs, and prevent readmissions.
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 from April 2015 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.
Dental Plans.--The Committee directs CMS to include in its
Exchange enrollment reports data on children (ages 0 through 18
years) enrolled or who have re-enrolled in dental coverage
through the Exchange for both stand-alone dental plans and
qualified health plans that include pediatric dental benefits.
These reports shall include data for each State-based,
federally facilitated, and partnership Exchanges.
Future of CMS.--The Committee is concerned that the
physical infrastructure of CMS is insufficient to properly
accommodate oversight of the coming demographic growth within
its programs. The Committee directs CMS to provide a master
plan within 180 days after enactment of this act to the
Committees on Appropriations of the House of Representatives
and the Senate with four interdependent parts that cover the
needs of the agency over the next 5 years: physical
infrastructure; workforce planning; claims data IT systems; and
overall IT structure and security.
Health Insurance Exchange Transparency.--The Committee
continues to include bill language in section 226 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 2017.
Healthcare Fraud Prevention Partnership.--The Healthcare
Fraud Prevention Partnership is a new fraud prevention
initiative that includes law enforcement, Federal and State
government agencies, private health insurers, and other private
organizations. The Partnership has shown successes in
preventing improper payments, but recently reported improper
payment levels clearly indicate the need for stronger action.
The Committee urges CMS to work with its partners in expanding
and strengthening the current partnerships and directs CMS to
provide an update in the fiscal year 2017 CJ outlining its plan
for the next 2 years including any legislative barriers for
achieving these goals.
Healthcare.gov Data Privacy.--The Committee is disappointed
that CMS allowed third party vendors to access unencrypted
consumer information such as age, smoking status, zip code,
pregnancy status, and income through Healthcare.gov. The
Committee directs CMS to encrypt and prevent further sharing of
consumer information, to review its current security and
privacy guidelines for this type of data, and to implement
appropriate security measures. Furthermore, CMS shall include
in the fiscal year 2017 CJ an update on these efforts including
a timeline for when these activities will be completed.
Home Health.--CMS identified the implementation of new home
health documentation requirements as a major contributing
factor in the fiscal year 2013 Medicare improper payment rate.
As a result, CMS proposed modifications which became effective
in January of 2015, but these changes will not be reflected in
the improper payment rate until the fiscal year 2017
measurement. The Committee therefore directs CMS to report, no
later than 60 days after the enactment of this act to the
Committees on Appropriations of the House of Representatives
and the Senate, an interim update on the improper payment rate
regarding the home health documentation requirements.
Hospice.--In its March 2015 report to Congress, MedPAC
notes that CMS expressed concern that some hospice providers
may not have the capacity to provide all four of the levels of
care, which is required by the Medicare hospice Conditions of
Participation. CMS makes clear that if the patient's condition
needs it, hospices are required to provide intensive around-
the-clock nursing and other skilled hospice care as necessary,
with the goal of having the patient remain in their home if at
all possible. Therefore, all hospice providers must have the
capacity of providing such care. The Committee directs CMS to
ensure that all hospices are complying with the Conditions of
Participation and have the capacity to provide all specified
hospice services on a 24 hour, 7 days a week basis.
IT Modernization.--Rapid advances in analytical and
information technology provide opportunities for CMS to
modernize, consolidate, and improve operations with greater
efficiency and cost savings over time. CMS has already
implemented several such advances, including the Predictive
Modeling program, the Healthcare General Ledger Accounting
System, and the Unified Case Management System. The Committee
encourages CMS to continue to modernize, consolidate, and
improve analytics and information technology programs to
achieve maximum efficiency and cost savings.
Medicare Advantage.--The Committee is aware 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
and a relatively large proportion of Medicare beneficiaries
without part B coverage, Medicare Advantage reimbursement rates
may be better based on the per capita cost of coverage to
beneficiaries enrolled in both Medicare part A and B. The
Committee urges CMS to consider more accurate adjustments as
soon as practicable in order to include potential changes in
its 2016 draft Call Letter.
Medication Synchronization.--Programs that promote
Medication Synchronization and the Appointment Based Model are
an emerging trend in pharmacy practice that improves adherence
rates for patients taking multiple medications while reducing
unnecessary visits to the doctor. The Committee encourages CMS
to consider ways to increase participation in these types of
programs and move towards greater adherence to medications.
Mental Health Services.--The Committee recognizes the need
for improved access to mental healthcare services and directs
the CMS to identify potential payment-related barriers to the
integration of mental healthcare services into the primary care
context in both traditional fee-for-service Medicare and
alternative payment models. Specifically, CMS is directed to
identify potential payment-related barriers to the adoption of
a collaborative care model in which primary care providers
treat patients with common mental health disorders, such as
depression or anxiety, with help from a care manager and a
psychiatrist who acts as a consultant. The Committee directs
CMS to provide a report within 180 days after enactment of this
act to the Committees on Appropriations of the House of
Representatives and the Senate with its findings, as well as a
proposed plan to address the identified barriers and facilitate
more widespread integration of mental healthcare services into
the primary care context. The report shall also include
recommendations for any legislative changes.
Pediatric Dental Reporting.--Although CMS has released
guidance on CHIP dental reporting, the data from States are
unreliable and incomplete. Without consistent, reliable data,
it is difficult to evaluate the impact of CHIP dental benefits.
The Committee directs CMS to include in the fiscal year 2017 CJ
a plan to collect quality reporting data from States regarding
their dental benefit.
Psychotropic Drugs and Children.--The Committee is aware of
the Department's efforts to reduce the inappropriate use of
psychotropic medications with children and adolescents in
foster care. In addition to the potential for serious long-term
health and developmental problems for children, this alarming
pattern has dramatically increased Medicaid costs. The
Committee urges CMS to encourage States to provide evidence-
based psychosocial interventions to children and youth in
foster care to reduce reliance on psychotropic medications.
Furthermore, the Committee urges CMS to include in the fiscal
year 2017 CJ the reasons for this disparity, including whether
current reimbursement policy incentivizes reliance on
medication rather than evidence-based psychosocial therapies
instead of, or in combination with, psychotropic medications.
Quality Improvement.--The Department recently announced
payment reform goals that identify a timetable for moving away
from Medicare fee-for-service payment. The Committee directs
CMS to include in their fiscal year 2017 CJ the quality
improvement goals for Medicare.
Recovery Audit Contractors [RAC].--The Committee expects
the next round of RAC contracts containing the new RAC
requirements to be executed and operational as quickly as
possible. CMS should work expeditiously to resolve any pending
issues. The Committee appreciates the report submitted by the
intra-agency working group as requested in fiscal year 2015 and
directs the group to continue to monitor the process, provide
recommendations, and evaluate the outcomes. The intra-agency
working group shall provide an update in the fiscal year 2017
CJ. Furthermore, the Committee directs the 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.
Recovery Audit Data Warehouse.--The Committee is
disappointed that CMS is not properly utilizing the Recovery
Audit Data Warehouse [RADW] as highlighted in the GAO report
titled, Medicare Program Integrity: Increased Oversight and
Guidance Could Improve Effectiveness and Efficiency of
Postpayment Claims Reviews. CMS developed the RADW to prevent
RACs from duplicating audits of the other three contractors'
responsible for reviewing postpayment claims. By not taking
advantage of the RADW, duplicative RAC audits are causing
unnecssary burden on providers and wasting Federal resources.
The Committee directs CMS to implement all the recommendations
provided by GAO and to provide an update including a timeline
on these efforts in the fiscal year 2017 CJ.
Relative Values under the Medicare Physician Fee
Schedule.--The Committee encourages CMS to increase the
representation of primary care physicians who are board
certified and actively practicing in family medicine, general
internal medicine, general pediatrics, preventive medicine,
obstetrics and gynecology, or psychiatry on any advisory board
or work group that formulates recommendations regarding any
annual updates to the physician work relative values.
Risk Corridor Program.--The Committee continues to include
bill language preventing CMS from using Program Management
accounts to support the Risk Corridor Program. The Committee
directs CMS to provide a report within 60 days after enactment
of this act 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, the
transfer calculation used for distributing the payments, and a
timeline for these activities for plan year 2014 and 2015.
Robotic Stereotactic Surgery.--The Committee is encouraged
by CMS' decision in the calendar year 2015 Medicare Physician
Fee Schedule Final Rule (79 Fed. Reg. 67548) to maintain G
codes and contractor pricing for robotic stereotactic
radiosurgery procedures performed in a freestanding setting.
The Committee encourages CMS to maintain the current coding and
payment methodology for at least 3 years to provide stability
while determining the most appropriate policy moving forward.
Rural Health.--According to the National Rural Health
Association, 41 percent of Critical Access Hospitals operate at
a loss, and since 2010, 51 rural hospitals have closed while
283 hospitals are in dire financial shape. Almost a quarter of
the U.S. population lives in rural areas. The majority of rural
residents are older, poorer, and less likely to have employer
sponsored health plans. As a result of hospitals closing in
rural communities, 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, miss
out on routine preventative care, and will end up costing
taxpayers much more in the long run. The Committee directs CMS
to work with HRSA's Office of Rural Health to alleviate the
disproportionate impact of regulations, reimbursement cuts, and
workforce issues on rural hospitals.
State-Based Exchanges [SBEs].--The Committee is
disappointed that SBEs may have used and might continue to use
section 1311 funds for operational expenses, which is
specifically prohibited by law. Section 1311 of the Patient
Protection and Affordable Care Act provides funding for States
to design, develop, and implement SBEs. However, these SBEs
were expected to be self-sustaining by 2015 and were
specifically prohibited from using the section 1311 funds for
operational costs after January 1, 2015. The Committee directs
CMS to implement the recommendations put forth by the HHS
Office of Inspector General [OIG] in their Early Alert
Memorandum (A-01-14-02509) issued on April 27, 2015, and
expects an update on the efforts in the fiscal year 2017 CJ.
The Committee expects CMS and the OIG to immediately notify the
Committee of any unauthorized use of section 1311 funds along
with a detailed report which shall include how CMS plans to
recoup those funds from the State. To prevent diverting
discretionary funds intended to support the operations for CMS,
the Committee includes a new general provision prohibiting the
use of funds to support operational costs of SBEs.
Traumatic Injury.--The Committee is concerned that CMS has
not addressed the need to reform the Medicare reimbursement
system for hospital trauma care services. Since CMS withdrew a
proposal to bundle all Emergency Department [ED] outpatient
reimbursement codes 2 years ago, there has been no progress on
modeling alternative value-based reforms--such as a proposal to
create three ED outpatient facility codes that would
incorporate the trauma activation fee. The Committee directs
CMS to include in the fiscal year 2017 CJ a detailed evaluation
analyzing alternative value-based reforms such as creating ED
outpatient facility codes and other potential approaches that
could reimburse facilities for life-threatening, time-dependent
traumatic injuries based on a facility's readiness level and
the nature of the injury.
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 develop and
implement a plan to remove Social Security numbers from
Medicare cards and to have this process completed by the end of
fiscal year 2018. The Committee directs CMS to provide an
update on the progress of this initiative in their fiscal year
2017 CJ.
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, 2015.................................... $672,000,000
Budget estimate, 2016................................... 706,000,000
Committee recommendation................................ 706,000,000
The Committee recommends $706,000,000, to be transferred
from the Medicare trust funds, for Health Care Fraud and Abuse
Control [HCFAC] activities. The latest data demonstrates for
every $1 spent on fraud and abuse, $8.10 is recovered by the
Treasury. By utilizing the cap adjustment provided in the
Budget Control Act, the Committee recommendation will create
over $5,718,000,000 in savings to the U.S. Treasury.
The Committee recommendation includes a base amount of
$311,000,000 and an additional $395,000,000 through a budget
cap adjustment authorized by section 251(b) of the Balanced
Budget and Emergency Deficit Control Act of 1985.
Administration for Children and Families
PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY SUPPORT
PROGRAMS
Appropriations, 2015.................................... $2,438,523,000
Budget estimate, 2016................................... 2,944,906,000
Committee recommendation................................ 2,944,906,000
The Committee recommendation includes $2,944,906,000 in
fiscal year 2016 mandatory funds for Child Support Enforcement
and Family Support programs. In addition, the Committee
recommends $1,300,000,000 in advance funding for the first
quarter of fiscal year 2017.
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, 2015.................................... $3,390,304,000
Budget estimate, 2016................................... 3,390,304,000
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.
The Committee recommendation provides the full amount under
the State formula grant. The budget request included
$3,190,304,000 for the State formula grant, and $200,000,000
for a new Utility Innovation Fund.
Within the total, the Committee recommendation includes up
to $2,988,000 for program integrity and oversight efforts, the
same as the fiscal year 2015 level.
Since fiscal year 2009 appropriations language has modified
the statutory formula for allocating funds to States. As a
result, the vast majority of funding is allocated based on
historical allocation levels, and a much smaller amount based
on dynamic factors such as the number of low-income households
and home heating and cooling costs by State. The Committee
directs the Secretary to submit a report within 90 days of
enactment of this act to the Committees on Appropriations of
the House of Representatives and the Senate on the average home
heating and cooling costs of low-income households by State and
the average LIHEAP assistance payment to households by State.
Further, HHS should include in future budget justifications
estimated State allocations as proposed in the budget request,
and, if different, based on the underlying statutory formula.
REFUGEE AND ENTRANT ASSISTANCE
Appropriations, 2015.................................... $1,559,884,000
Budget estimate, 2016................................... 1,624,612,000
Committee recommendation................................ 1,405,367,000
The Committee recommends $1,405,367,000 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 $426,749,000 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.
Within the total for TAMS, the Committee strongly supports
Office of Refugee Resettlement's plan to increase funding for
the Voluntary Agency Matching Grant program. This program
provides grants to resettlement agencies to support
comprehensive services--including case management, basic job
training, job placement, and interim housing and cash
assistance--for arriving refugees with the goal of refugees
becoming self-sufficient within their first 4 months in the
United States. Many resettlement agencies exhaust their
matching grant slots well before the end of the year. While
this program may not be appropriate for many arriving refugees,
the fact that many agencies quickly use up funds provided
through this program indicates there is more demand than
available resources. Expanding the matching grant program could
improve overall services available to refugees in their first
few months in the United States while saving money elsewhere in
the TAMS budget.
Victims of Trafficking
The Committee recommendation includes $15,755,000 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
$2,755,000 to improve services available for U.S. citizens and
legal permanent residents, the same as the fiscal year 2015
funding levels. Victims and individuals at risk of becoming
victims of trafficking are likely to come into contact with a
variety of different service providers at the local level,
including runaway and homeless youth shelters, child welfare
organizations, and schools. The Committee supports efforts to
improve the coordination of services for victims of trafficking
across ACF and HHS programs, and across the Federal government
consistent with the Federal Strategic Action Plan on human
trafficking.
Social Services
The Committee recommendation includes $149,927,000 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.
The Committee notes that, due to a reprogramming of funds
to address a sudden need for resources elsewhere in ORR, the
timing of Social Services grants was modified in fiscal year
2012. This has created administrative challenges for local
organizations carrying out social services programs for
refugees. The Committee strongly supports efforts to reduce
unnecessary administrative burdens associated with the timing
of these grants and will work with ACF on possible solutions.
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 $750,000,000 for the
Unaccompanied Children [UC] program. The budget request is
$948,000,000 in base funding plus up to an additional
$400,000,000 in contingency funding. 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.
In the spring and summer of fiscal year 2014, the number of
unaccompanied children coming to the United States from Central
America, and apprehended by DHS, dramatically increased. This
followed a trend of consistent increases starting in fiscal
year 2012. In June 2014 alone almost 10,200 children were
apprehended and transferred to HHS' care, more than four times
the number of children as June 2013. However, just as sudden as
the increase, the number of children coming to the United
States significantly decreased starting in July 2014. In the
first 6 months of fiscal year 2015 the number of children
transferred to HHS' care was approximately half the level
through the comparable period in 2014.
In addition, HHS' actual costs of providing emergency
shelter and related services for children in fiscal year 2014
were significantly lower than originally estimated. As a result
of this sudden decrease in children and lower than estimated
costs HHS ended fiscal year 2014 with approximately
$197,000,000 in unexpended balances that is available for
obligation through fiscal year 2016. In addition, if current
trends continue, HHS will not need the full fiscal year 2015
appropriation and will carry over additional unobligated
balances into fiscal year 2016. Therefore, the Committee
recommendation rescinds $250,000,000 of prior-year unobligated
balances in this account. In total, the Committee
recommendation provides adequate resources for HHS to provide
temporary shelter and services to children transferred to their
care in fiscal years 2015 and 2016.
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, 2015.................................... $2,435,000,000
Budget estimate, 2016................................... 2,805,149,000
Committee recommendation................................ 2,585,000,000
The Committee recommends $2,585,000,000, an increase of
$150,000,000 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.
Last year, Congress overwhelmingly passed the
reauthorization of the Child Care and Development Block Grant
Act. This reauthorization includes many important reforms to
the program, including requiring States to strengthen health
and safety standards and implement policies focused on
promoting the healthy development of young children and
supporting working parents. The Committee recommendation
provides an increase for CCDBG to help States implement these
key reforms, and improve working families access to quality
child care. The total provided for CCDBG is consistent with
CBO's estimate of the discretionary portion of costs to
implement the law in the first year after enactment. At the
same time, the Committee notes that discretionary funding for
CCDBG represents only about 27 percent of total expenditures
from the Child Care and Development Fund [CCDF], for which
CCDBG Act governs the use of funds. Funding for CCDF also comes
from the mandatory Child Care Entitlement program, TANF, and
State-matching funds.
The Committee recommendation supports several existing set-
asides within CCDBG, including for resource and referral
activities; a toll-free referral line and Web site; additional
funding for quality improvement activities, including a
specific amount for improving the quality of infant and toddler
care; and research, demonstration, and evaluation activities.
The CCDBG Act reauthorization incorporated these set-asides,
previously created and carried through appropriations language,
into the authorizing statute. The Committee bill language does
not include those set-asides now provided for in the
authorizing statute. The Committee maintains bill language
specifying an additional amount for improving the quality of
infant and toddler care because the set-aside in statute does
not take effect until fiscal year 2017. The Committee
recommendation also includes a technical correction regarding
the availability of funding for technical assistance and
research, demonstration, and evaluation activities.
SOCIAL SERVICES BLOCK GRANT
Appropriations, 2015.................................... $1,700,000,000
Budget estimate, 2016................................... 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, 2015.................................... $10,346,115,000
Budget estimate, 2016................................... 11,911,242,000
Committee recommendation................................ 10,388,620,000
The Committee recommends $10,388,620,000 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.
Head Start
The Committee recommendation includes $8,698,095,000 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.
Within the total for Head Start, in addition to funds
otherwise available for Early Head Start, the Committee
recommendation includes a total of $600,000,000, an increase of
$100,000,000 over the fiscal year 2015 level, to support Early
Head Start expansion grants, including Early Head Start-Child
Care Partnerships.
Early Head Start, which provides services to children and
their families from before birth to age 3, currently serves
less than 5 percent of eligible children, yet research
increasingly supports the importance and benefits of high-
quality early childhood education beginning at birth, including
for families before birth. HHS should allocate these additional
funds to States by considering the number of young children
from families whose income is below the poverty line. Further,
HHS shall reserve no less than 3 percent for Indian Head Start
programs and no less than 4.5 percent for migrant and seasonal
Head Start programs, consistent with the Head Start Act.
In awarding fiscal year 2016 funds, HHS should give equal
priority to grantees proposing to provide more traditional
Early Head Start services and those proposing to form child
care partnerships. The Committee supports this partnership
model but such partnerships will not be viable in every
community and in many places it may be more appropriate to
simply expand traditional Early Head Start, either through
current or new grantees.
Within the total for Head Start, the Committee
recommendation also includes up to $25,000,000, the same as the
comparable fiscal year 2015 level and the budget request, for
transition-related costs associated with the Head Start DRS.
The Committee is encouraged that HHS plans to evaluate the DRS
in the coming year to ensure it meets the goals of
transparency, validity, reliability, and program improvement--
goals that have not yet been met. 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.
Consolidated Runaway and Homeless Youth Program
The Committee recommendation includes $99,000,000 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.
Within the total, the Committee recommendation includes
$2,000,000 for the ``Prevalence, Needs and Characteristics of
Homeless Youth,'' study as requested by the administration.
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 $28,744,000 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.
Abandoned Infants Assistance
The Committee recommendation does not include funding for
this program. The budget request proposes significantly
changing the focus of this program as part of a reauthorization
proposal. The Abandoned Infants Assistance program was created
in 1988 as a response to an acute child welfare crisis
associated with the crack cocaine and HIV/AIDS epidemics of the
1980s. Specifically, the program funded demonstration projects
to prevent the abandonment of infants and young children
impacted by substance abuse and HIV. As the budget request
discusses, over the last several decades, in part because of
these demonstration projects, States have implemented more
effective community responses to infants and families in these
circumstances, the goal of these demonstration projects.
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 $13,984,000 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.
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 $5,762,000 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 $46,520,000 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. In addition, the Committee
directs ACF to coordinate with the Department of Education in
administering these funds.
Community Services Block Grant
The Committee recommendation includes $674,000,000 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 includes $12,000,000 for the
Assets for Independence [AFI] program. The AFI program provides
discretionary grants to organizations to support individual
development accounts that encourage low-income individuals to
create savings accounts for dedicated purposes, such as buying
a home, paying for college, or starting a business.
The Committee remains concerned that grantees have been
unable to expend all of their funding under this program, which
has resulted in a significant amount of funding lapsing.
Grantees have 5 years to expend funds but some have struggled
to encourage enough savings or to provide a sufficient match to
be able to expend their full grant during that time.
National Domestic Violence Hotline
The Committee recommendation includes $4,500,000 for the
National Domestic Violence Hotline. This national, toll-free
hotline provides critical emergency assistance and information
to victims of domestic violence 24 hours a day.
Family Violence Prevention and Services
The Committee recommendation includes $135,000,000 for
Family Violence Prevention and Services programs. These funds
support programs to prevent family violence and provide
immediate shelter and related assistance for victims of
domestic violence and their dependents.
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 $197,901,000 for the
Federal costs of administering ACF programs.
PROMOTING SAFE AND STABLE FAMILIES
Appropriations, 2015.................................... $404,765,000
Budget estimate, 2016................................... 434,765,000
Committee recommendation................................ 404,765,000
The Committee recommends $404,765,000 for the Promoting
Safe and Stable Families program. The Committee recommendation
includes $345,000,000 in mandatory funds authorized by the
Social Security Act and $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.
PAYMENTS FOR FOSTER CARE AND PERMANENCY
Appropriations, 2015.................................... $4,832,000,000
Budget estimate, 2016................................... 5,298,000,000
Committee recommendation................................ 5,298,000,000
The Committee recommends $5,298,000,000 in mandatory funds
for Payments for Foster Care and Permanency. In addition, the
Committee recommends $2,300,000,000 in advance mandatory
funding for the first quarter of fiscal year 2017. 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 continues to strongly support efforts to
improve the coordination and availability of child welfare and
housing services for children aging out, or who have recently
aged out, of the foster care system. Children aging out of
foster care face an abrupt transition, and improving the
quality of services available to them, and particularly the
coordination of child welfare and housing services, can help
improve outcomes for these particularly vulnerable youth and
reduce total costs to the Government. The Committee strongly
encourages HHS to work with the Department of Housing and Urban
Development to improve the coordination of child welfare and
housing services at the Federal and local level.
Administration for Community Living
AGING AND DISABILITY SERVICES PROGRAMS
Appropriations, 2015.................................... $1,700,956,000
Budget estimate, 2016................................... 2,123,355,000
Committee recommendation................................ 1,888,139,000
The Committee recommends an appropriation of
$1,888,139,000, for the Administration for Community Living
[ACL], which includes $30,000,000 in Medicare Trust Funds. The
Committee recommendation also includes $27,050,000 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.
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 $145,586,000 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 $6,031,000 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 $438,191,000
for congregate nutrition services and $216,397,000 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.
Healthier Foods.--The Committee encourages ACL to partner
with organizations to review, identify, and disseminate best
practices to provide healthier foods and menu options for
seniors. These practices could include better food product
procurement, preparation techniques, and improved menu planning
and recipe documentation to facilitate changes that support
healthier meals. Coalitions of manufacturers, food service
providers, and food service distributors could also be
developed to explore ways to promote best practices and provide
a more appropriate selection of healthier ready-to-use
ingredients.
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 $24,850,000 for grants to Native
Americans. This program provides grants to eligible tribal
organizations for the delivery of nutrition and supportive
services to Native Americans.
Tribal Advisory Council.--The Committee encourages ACL to
continue with their plans to establish a Tribal Advisory
Council focusing on issues that affect the aging Indian
population. ACL shall continue to participate in the broader
Secretary-level Tribal Advisory Council to present their latest
efforts, provide advice with respect to policies and services
that affect the older Indian population, help in identifying
priorities, and coordinating strategies across the Tribal,
regional, or national levels.
Aging Network Support Activities
The Committee recommends $7,088,000 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.
Alzheimer's Disease Demonstration Grants to States
The Committee recommendation includes $3,800,000 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 $2,242,000 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 $7,600,000 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 $4,750,000 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.
Senior Medicare Patrol
Due to budget constraints, the Committee recommendation
does not include funding for the Senior Medicare Patrol
program. The Committee recommendation utilizes the budget cap
adjustment for HCFAC and supports this program and other
activities to combat fraud and abuse in the Medicare program
through that funding mechanism.
Elder Rights Support Activities
The Committee recommends $7,874,000 for Elder Rights
Support activities. 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. The Committee includes the same
level as in fiscal year 2015 for the Elder Justice Initiative.
Aging and Disability Resource Centers
The Committee recommendation includes $5,813,000 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
The Committee recommendation includes $30,000,000 for State
Health Insurance Assistance Programs, which provide accurate
and understandable health insurance information to Medicare
beneficiaries and their families.
Paralysis Resource Center
The Committee recommendation includes $6,365,000 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 $2,660,000 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.
Developmental Disabilities State Councils
The Committee recommendation includes $68,107,000 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 $36,797,000 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 $4,715,000 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 $8,414,000 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.
University Centers for Excellence in Developmental Disabilities
The Committee recommendation includes $35,790,000 for
University Centers for Excellence in Developmental Disabilities
[UCEDDs]. The UCEDD program supports 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. These Centers assist
States initiate collaborative research, education, training,
and service efforts to assist youth with disabilities to
successfully transition from school to postsecondary education,
and/or integrated employment. The funding will also allow the
Centers to continue to address critical and emerging national
needs, such as addressing the needs of the rising numbers of
individuals on the autism spectrum; demonstrating cost
effective long term services and supports for adults with
disabilities and those aging with disabilities; supporting
returning veterans; and providing technical assistance to
strengthen and support the national network of Centers and to
disseminate research and best practices nationwide. Within the
amount appropriated for UCEDD, the Committee provides no less
than the fiscal year 2015 level for technical assistance for
the UCEDD network.
Independent Living
The Committee recommendation includes $96,124,000 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. The
Committee includes new bill language providing the necessary
authorities for this program as part of the transfer that
occurred in fiscal year 2015.
National Institute on Disability, Independent Living, and
Rehabilitation Research
The Committee recommendation includes $98,772,000 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
includes new bill language providing the necessary authorities
for this program as part of the transfer that occurred in
fiscal year 2015.
Assistive Technology
The Committee recommendation includes $31,350,000 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 includes new bill
language providing the necessary authorities for this program
as part of the transfer that occurred in fiscal year 2015.
Program Administration
The Committee recommends $35,824,000 for program
administration at ACL. These funds support salaries and related
expenses for program management and oversight activities.
Business Acumen Learning Collaborative.--The Committee
supports ACL in the development of the Business Acumen Learning
Collaborative and the successful partnerships between its
network of home and community-based services organizations. The
collaborative aims to reduce hospital admissions and
readmissions, improve care coordination, improve access to
social services and supports, and lower overall healthcare
expenditures in the future. The Committee urges ACL to continue
these efforts and collaborate with CMS to maximize further cost
savings.
Muscular Dystrophy.--Since ACL was recently added to the
Muscular Dystrophy Coordinating Committee, the Committee
requests an update in the fiscal year 2017 CJ on all programs
relevant to the Duchenne population, particularly those focused
on supporting transitions of persons with Duchenne into
adulthood. This report shall include 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, 2015.................................... $512,862,000
Budget estimate, 2016................................... 558,594,000
Committee recommendation................................ 348,262,000
The Committee recommends $348,262,000 for General
Departmental Management [GDM]. The recommendation includes
$46,762,000 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.
Breast Cancer Patient Education Campaign.-- Since 1998,
health plans that offer breast cancer coverage have been
required to provide for breast reconstruction and prostheses.
Published studies report that an overwhelming majority of women
eligible for breast reconstruction following breast cancer are
not informed of their care options. This is especially
problematic for members of racial and ethnic minority groups,
who are even less likely to be informed but have a greater
chance of getting breast cancer. According to the American
Society of Plastic Surgeons, only 33 percent of eligible women
with breast cancer undergo breast reconstruction and published
research reports that nearly 70 percent of women are not
informed of their care options by their general surgeon. The
Committee directs the Secretary to plan and implement an
education campaign 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. The campaign shall include
dissemination of the following information: (A) Breast
reconstruction is possible at the time of breast cancer
surgery, or at a later time. (B) Prostheses or breast forms may
be available. (C) Federal law mandates both public and private
health plans to include coverage of breast reconstruction and
prostheses. (D) The patient has a right to choose a provider of
reconstructive care, including the potential transfer of care
to a surgeon that provides breast reconstructive care. (E) The
patient may opt to undergo breast reconstruction sometime after
the time of breast cancer surgery for personal or medical
reasons, during treatment or after completion of all other
breast cancer treatments. (F) Other information as the
Secretary determines appropriate. The information required to
be disseminated shall be posted on the Web sites of relevant
Federal agencies, including the Office of Women's Health, the
Office of Minority Health, and the Office of Rural Health
Policy. The campaign shall not specify, or be designed to serve
as a tool to limit, the healthcare providers available to
patients. In developing the information to be disseminated, the
Secretary shall consult with appropriate medical societies and
patient advocates related to breast cancer, breast
reconstructive surgery, breast prostheses, and breast forms and
with patient advocates representing racial and ethnic minority
groups with a special emphasis on African-American and Hispanic
populations. The Committee directs the Secretary to provide an
annual update in the CJ 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.
Breast Density.--The Committee encourages the Secretary to
continue the activities of the Department conducting or
supporting applied research on breast density; research on the
cost-effectiveness and feasibility of reimbursement models for
supplemental imaging relating to breast density; and research
in support of clinical guidelines and best practices concerning
use of mammograms and supplemental screening for women with
dense breast tissue.
Center for Faith-Based and Neighborhood Partnerships.--The
Committee recognizes the realignment of the Center for Faith-
Based and Neighborhood Partnerships from ACF to the Secretary's
Office of Intergovernmental and External Affairs. To complete
this realignment, the Committee transfers the Center for Faith-
Based and Neighborhood Partnerships' budget of $1,299,000 from
ACF to the GDM account as requested in the administration's
budget.
Cerebral Cavernous Angioma.--The Committee encourages the
Secretary to coordinate efforts by agencies and patient
advocacy organizations to increase the efficiency and
effectiveness of the research and clinical drug trials effort.
Children in Poverty.--The Committee encourages the U.S.
Surgeon General to issue a report within 180 days after
enactment of this act to the Committees on Appropriations of
the House of Representatives and the Senate on improving the
health of America's children. Too many children still live in
poverty, compromising their ability to be healthy, to succeed
in school and to raise healthy families themselves. This report
can increase awareness and generate additional efforts on
ameliorating this public health problem.
Conference Attendance.--The Committee remains concerned
that Congress and the administration have implemented
unnecessary barriers to scientific research and collaboration
through various requirements on administrative tasks,
particularly the approval process for conference travel. The
NIH reports that they spend approximately $14,000,000 annually
to comply with this provision and CDC dedicates approximately
1,000 FTE staff hours and 375 contractor support hours per week
for travel approval and oversight. The Department is directed
to provide the Committees on Appropriations of the House of
Representatives and the Senate recommendations to help
streamline administrative commitments, particularly relating to
travel, within 90 days of enactment of this act.
Dietary Guidelines.--The Committee is concerned that the
advisory committee for the 2015 Dietary Guidelines for
Americans considered issues outside of the nutritional focus of
the panel. The advisory committee included agriculture
production practices and environmental factors into their
criteria for establishing the next dietary recommendations. The
Committee directs the Secretary to ensure that the advisory
committee focuses on nutrient and dietary recommendations based
upon only a preponderance of nutritional and dietary scientific
evidence. Furthermore, the Committee includes new bill language
directing the Secretary to only include nutrition and dietary
information, not extraneous factors, in the final 2015 Dietary
Guidelines for Americans.
E-Health and Telemedicine.--The Committee urges the
Department to increase collaboration and coordination across
relevant Federal agencies on E-health and telemedicine to
assess current efforts, needs, barriers, standards, goals,
eliminate duplication and incompatibility, and ultimately
improve health quality, effectiveness, and outcomes. The
Department shall provide a report within 180 days after
enactment of this act to the Committees on Appropriations of
the House of Representatives and the Senate with its analysis,
including any recommendations on improving the existing E-
health and telemedicine efforts.
Integrative Health.--The Committee commends the Council,
which is chaired by the Surgeon General and includes senior
representatives of twenty executive departments and agencies,
for its efforts to guide the prevention, health promotion and
public health policies and priorities of participating Federal
agencies. However, the overriding focus of the Council remains
substantially tobacco use and obesity. The Committee encourages
the Department of HHS and the Surgeon General to guide the
Council to more uniformly address across all Federal agencies
each of the National Prevention Strategy's other priorities,
including active, injury and violence free living, and mental
and emotional wellbeing.
IT Efficiency.--The Committee encourages the Department to
perform periodic inventories of software licenses in use across
HHS. HHS should compare those usage numbers to its purchased
licenses and seek to increase cost savings and efficiencies by
using this information to obtain HHS-wide acquisitions as
opposed to component-specific purchases of licenses.
National Strategy for Combating Antibiotic Resistant
Bacteria [CARB].--The Committee supports the CARB initiative
that will strengthen efforts to prevent, detect, and control
illness and deaths related to infections caused by antibiotic
resistant bacteria. The Committee directs the Department 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. This should include such data as
geographic information system coordinates describing where the
bacteria were isolated to monitor emerging antibiotic resistant
bacteria, assess their threat to public health, and develop
mitigation strategies. The Department shall include in the
fiscal year 2017 CJ a detailed update on the progress being
made to implement the CARB national strategy initiative.
Necrotizing Enterocolitis [NEC].--The Committee directs the
Secretary to coordinate the Department's efforts on NEC,
including disseminating best practices and successful
interventions for the prevention of NEC, particularly in
premature infants.
Open Access to Federal Research.--The Committee continues
to support the Office of Science and Technology Policy's [OSTP]
development and implementation of policies to increase public
access to federally funded scientific research. The Committee
is pleased by the progress being made for Departments and
Agencies funded under this bill, and supports OSTP's
requirement for Agencies to have their public access and data
management plan requirements in place for grants, contracts,
and intramural research projects by January 1, 2016. Agencies
funded in this bill are instructed to continue with their
quarterly reporting requirements to the Senate Committee on
Appropriations to keep Congress apprised of the remaining
progress that needs to be made in making federally funded
research accessible to the public as expeditiously as possible.
Prenatal Opioid Abuse and Neonatal Abstinence Syndrome.--
The Committee directs the Secretary to lead a review of
planning and coordination within the Department related to
prenatal opioid use and neonatal abstinence syndrome. In
carrying out the review of the planning and coordination
efforts, the Secretary shall develop a strategy to address
research and program gaps, including such gaps identified in
findings made by reports of the Government Accountability
Office. Such strategy shall address: (1) gaps in research,
including with respect to the most appropriate treatment of
pregnant women with opioid use disorders; the most appropriate
treatment and management of infants with neonatal abstinence
syndrome; and the long-term effects of prenatal opioid exposure
on children; and (2) gaps in programs, including--the
availability of treatment programs for pregnant and postpartum
women and for newborns with neonatal abstinence syndrome; and
guidance and coordination in Federal efforts to address
prenatal opioid use or neonatal abstinence syndrome. No later
than 1 year after the date of enactment of this act, the
Secretary shall submit a report to the Committees on
Appropriations of the House of Representatives and the Senate
on the findings of the review of planning and coordination
efforts at the Department and the strategy developed to address
any research and program gaps. Furthermore, the Committee
directs the Secretary to conduct a study and develop
recommendations for preventing and treating prenatal opioid
abuse and neonatal abstinence syndrome, soliciting input from
nongovernmental entities, including organizations representing
patients, healthcare providers, hospitals, other treatment
facilities, and other entities, as appropriate. The Secretary
shall publish on the appropriate Web sites a report on the
study and recommendations no later than 1 year after the date
of enactment of this act. The study and report shall include:
(1) a comprehensive assessment of existing research with
respect to the prevention, identification, treatment, and long-
term outcomes of neonatal abstinence syndrome, including the
identification and treatment of pregnant women or women who may
become pregnant who use opioids or other drugs; (2) an
evaluation of: (A) the causes of and risk factors for opioid
use disorders among women of reproductive age, including
pregnant women; (B) the barriers to identifying and treating
opioid use disorders among women of reproductive age, including
pregnant and postpartum women and women with young children;
(C) current practices in the healthcare system to respond to
and treat pregnant women with opioid use disorders and infants
born with neonatal abstinence syndrome; (D) medically indicated
use of opioids during pregnancy; (E) access to treatment for
opioid use disorders in pregnant and postpartum women; and (F)
access to treatment for infants with neonatal abstinence
syndrome; and (3) recommendations on: (A) preventing,
identifying, and treating neonatal abstinence syndrome in
infants; (B) treating pregnant women who are dependent on
opioids; and (C) preventing opioid dependence among women of
reproductive age, including pregnant women, who may be at risk
of developing opioid dependence.
Prescription Drugs on Infants.--Little is known about the
effects of most drugs on the mother and her child or the ways
in which pregnancy and lactation alter the metabolism and
effect of medication. The Committee encourages the Department
to coordinate all activities in this area and requests an
update in the fiscal year 2017 CJ on the progress made on the
safety and efficacy of drugs in this population, as well as
potential projects related to data gathering and other relevant
initiatives underway related to this issue.
Reducing Health Disparities.--The Committee encourages the
Secretary to coordinate the capabilities of HHS agencies and
partner with NIH to improve recruitment and training of health
professionals and biomedical researchers to meet the needs of
minority and underserved populations and to reduce health
disparities in local communities.
Seafood Sustainability.--The Committee prohibits the
Department from using or recommending third party,
nongovernmental certification for seafood sustainability.
Severe Wounds.--The Committee directs the Secretary, in
consultation with relevant stakeholders, to conduct a study on
the treatment needs of individuals entitled to benefits under
part A, or enrolled under part B, of Medicare, requiring
specialized wound care, and the cost, for such individuals and
the Medicare program, of treating severe wounds in rural and
urban areas. The study shall include an assessment of: (A)
access of such individuals to appropriate levels of care for
such cases; (B) the potential impact that section
1886(m)(6)(A)(i) of the Social Security Act (42 U.S.C.
1395ww(m)(6)(A)(i)) will have on the access, quality, and cost
of care for such individuals; and (C) how to appropriately pay
for such care under the Medicare program. The Secretary shall
submit the report within 1 year after enactment of this act to
the Committees on Appropriations of the House of
Representatives and the Senate with recommendations for such
legislation and administrative actions as the Secretary
determines appropriate.
Sickle Cell Disease [SCD].--The Committee recognizes the
Department's efforts in addressing the burden of SCD and
continues to support a multi-disciplinary approach to identify
new methods to disease management, supportive care, and
reducing the burden of care and premature death. The Committee
urges the Secretary to continue coordinating the Department's
activities through the Interagency Working Group on SCD.
Technical Assistance for Priority Areas.--The Committee
notes that the Medicare Access and CHIP Reauthorization Act of
2015 authorizes the Secretary to provide technical assistance
on the Merit-based Incentive Payment System to eligible
professionals with a priority given to practices located in
rural, medically underserved, or health professional shortage
areas. Due to their extensive experience working with providers
in rural and underserved areas, the Committee highlights the
significance of the State Offices of Rural Health and their
ability to provide this type of guidance.
Transparency in Health Plans.--The Committee is aware of
the additional guidance issued to qualified health plans to
ensure greater consistency and full transparency of coverage
options included in health insurance plans prior to selecting
them on the Exchanges during the enrollment process. The
Committee expects the Secretary to ensure this guidance is
followed.
United States-Mexico Border Health Commission.--The border
between the United States and Mexico is one of the busiest
transit points in the world. Therefore, the Committee urges the
Secretary to continue supporting the United States-Mexico
Border Health Commission and to focus on infection disease
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.
Viral Hepatitis Action Plan.--The Committee continues to be
concerned by the viral hepatitis epidemic and recognizes that
much needs to be done to identify the millions of Americans
with hepatitis before they reach end stage liver disease. The
Committee urges the Secretary to continue to implement the
Viral Hepatitis Action Plan and requests a report on spending
by HHS agencies to implement the Action Plan in the fiscal year
2017 CJ. The report should include descriptions of public
private partnerships that will enhance Federal efforts to
combat viral hepatitis.
Teen Pregnancy Prevention
The Committee recommendation includes $20,000,000 for the
Teen Pregnancy Prevention program. This program supports
competitive grants to public and private entities to replicate
evidence-based teen pregnancy prevention approaches.
Office of Minority Health
The Committee recommends $36,000,000 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.
The Lupus Initiative.--The Committee continues to provide
$2,000,000 for Lupus activities at the OMH. The Committee
commends the successes of the National Health Education program
on Lupus for healthcare providers that started in fiscal year
2009. Within the funding provided for Lupus activities, the
Committee includes $1,000,000 to complete the implementation of
the health education program in fiscal year 2016 to transition
to another priority in the Lupus community. The Committee
recognizes that clinical trial education and successful
recruitment of minorities into trials is a significant
challenge in the drug development for Lupus. Therefore, the
Committee directs OMH to initiate a program to develop a
clinical trial education action plan for Lupus and begin
preliminary steps towards implementation of the action plan.
OMH shall work with the relevant Lupus stakeholders in this
effort. The Committee includes the remaining $1,000,000 for
this new initiative, and it should focus on developing public-
private and community partnerships, evaluate current minority
clinical trial education and participation programs, and
development of a research plan for creating new clinical trial
education models in lupus. OMH shall update the Committee on
the progress of this new initiative in the fiscal year 2017 CJ.
Abstinence Education
The Committee recommends $20,000,000 for abstinence
education. This is a competitive grant program that funds
evidenced based abstinence models for adolescents.
Office of Women's Health
The Committee recommends $29,500,000 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
the 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.
HIV/AIDS in Minority Communities
Due to budget constraints, the Committee recommendation
does not include funding for this program. The Secretary's
Minority AIDS Fund [SMAIF] supplements core HIV/AIDS funding
provided to other HHS agencies. The majority of SMAIF
activities supported prevention, treatment, outreach, and
education activities focused on minority populations. The
Committee notes that core HIV/AIDS activities such as CDC's HIV
Prevention with Health Department program and HRSA's Ryan White
programs provide the same services to the same population. In
addition, SAMHSA also provides similar services but targeted to
individuals with co-occurring mental health or substance abuse
disorders.
Embryo Donation and Adoption
The Committee recommends $1,000,000 for Embryo Donation and
Adoption.
OFFICE OF MEDICARE HEARINGS AND APPEALS
Appropriations, 2015.................................... $87,381,000
Budget estimate, 2016................................... 140,000,000
Committee recommendation................................ 97,381,000
The Committee provides $97,381,000 for the Office of
Medicare Hearings and Appeals [OMHA]. This Office is
responsible for hearing Medicare appeals at the administrative
law judge level, which is the third level of Medicare claims
appeals. OMHA ensures that Medicare beneficiaries who are
dissatisfied with the initial decisions about their benefits or
eligibility can appeal and exercise their right to a hearing in
front of an administrative law judge.
Appeals Backlog.--The Committee continues to be concerned
over the substantial backlog in the number of cases pending
before the administrative law judges at OMHA. 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. OMHA shall also provide an update
in the fiscal year 2017 CJ on the pilot programs implemented in
2014, including the global settlement offer, statistical
sampling, and mediation strategies.
OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION TECHNOLOGY
Appropriations, 2015.................................... $60,367,000
Budget estimate, 2016................................... 91,800,000
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, rather than through both budget authority and
transfers available under section 241 of the PHS Act. ONC is
responsible for promoting the use of electronic health records
in clinical practice, coordinating Federal health information
systems, and collaborating with the private sector to develop
standards for a nationwide interoperable health information
technology infrastructure.
Precision Medicine.--The Committee recommendation includes
$5,000,000 for the coordination and development of data
standards necessary to advance the Precision Medicine
initiative. ONC will engage appropriate stakeholders to
identify the standards and policy required to protect user
privacy.
OFFICE OF INSPECTOR GENERAL
Appropriations, 2015.................................... $71,000,000
Budget estimate, 2016................................... 83,000,000
Committee recommendation................................ 71,000,000
The Committee recommends an appropriation of $71,000,000
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 $333,893,000 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, 2015.................................... $38,798,000
Budget estimate, 2016................................... 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. However, since September 2014, three
Weldon Amendment cases have been filed with OCR without
resolution. The OCR process is the only recourse for plaintiffs
in these cases. 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, 2015.................................... $562,241,000
Budget estimate, 2016................................... 586,188,000
Committee recommendation................................ 586,188,000
The Committee provides an estimated $586,188,000 in
mandatory funds for Retirement Pay and Medical Benefits for
Commissioned Officers of the U.S. Public Health Service [PHS].
This account provides for retirement payments to PHS officers
who are retired due to age, disability, or length of service;
payments to survivors of deceased officers; and medical care to
Active Duty and retired officers, as well as their dependents.
PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND
Appropriations, 2015.................................... $1,175,069,000
Budget estimate, 2016................................... 1,909,981,000
Committee recommendation................................ 1,227,277,000
The Committee recommends $1,227,277,000 for the Public
Health and Social Services Emergency Fund. 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.
Office of the Assistant Secretary for Preparedness and Response
The Committee recommendation includes $1,102,928,000 for
activities administered by the Assistant Secretary for
Preparedness and Response [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 includes
new bill language providing coverage under the Federal
Employees Compensation Act for National Disaster Medical System
intermittent employees who are activated for training or
deployment.
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
believes this funding should 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.
Allocation of Funds.--The Committee urges ASPR and State
grantees to be strategic about allocation of HPP funds. Under
current structures, States may allocate funds to as many
healthcare coalitions as they deem appropriate. ASPR is
encouraged to communicate to grantees the minimum standards a
healthcare coalition must meet to be qualified under the
program. ASPR should also provide oversight and technical
assistance to ensure coalitions are meeting those standards and
States are subgranting funds appropriately.
Geographic Variation in Mass Casualty Traumatic Injury
Treatment Capacity.--The Committee is aware that the present
geographic distribution of trauma and burn centers and other
similar response capabilities are heavily skewed toward urban
locations and vary significantly among different urban
settings. The Committee is concerned that there are
vulnerabilities in the Nation's emergency response system for
areas not equipped to deal with mass casualty incidents with
traumatic injuries. According to the CDC, 45 million Americans
lack access to Level I trauma centers within the so-called
``golden hour'' during which outcomes dramatically improve.
Similarly, just 25 percent of the U.S. population lives within
1 hour by ground transport of a verified burn center.
Therefore, the Committee directs ASPR to provide a detailed
report that analyzes the ability of our current infrastructure
to respond to a large scale (greater than 20 casualties)
traumatic injury event that may occur in a rural, exurban,
suburban, and urban locations that are relatively underserved
by the Nation's trauma system. The report should include
recommendations on capacity building approaches including the
use of the HPP address these capacity shortfalls.
Local Health Departments.--The Committee requests more
detailed information in the fiscal year 2017 CJ on how State
HPP funding is distributed at the local level. ASPR is
encouraged to require States to report how much Federal HPP
funding is being allocated to local health departments and what
basis or formula each State is using to make such allocations.
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.
Emergency System for Advance Registration of Volunteer Health
Professionals [ESAR VHP]
The Committee recommendation does not include funding for
the ESAR VHP program, consistent with the administration's
request. Past funding supported technical assistance to States,
but any future request for support will be covered by other
ASPR resources. This program established a national network of
health professionals who provide assistance during an
emergency.
Biomedical Advanced Research and Development
The Committee recommendation includes $473,000,000 for
advanced research and development. The Committee recommendation
includes $143,000,000 for BARDA's Broad Spectrum Antimicrobials
program as part of the Department-wide CARB initiative. The
Committee directs BARDA to collaborate with NIH, CDC, AHRQ,
FDA, VA, DOD, and USDA to leverage existing resources to
increase capacities for research aimed at developing
therapeutic treatments. The Committee appreciates the work of
BARDA to combat antibiotic resistant bacteria through expansion
of public-private partnerships that invest in the development
of new antibiotic therapies. The Committee expects BARDA to
continue to use its other transactional authority, as granted
by PAHPA, to the maximum extent possible to further its work in
this area.
Medical Countermeasure Dispensing
The Committee recommendation does not include funding for
the Medical Countermeasure Dispensing program, consistent with
the administration's request. The Committee notes that prior
year balances exist to support any remaining program costs in
fiscal year 2016.
Project BioShield Special Reserve Fund
The Committee recommendation includes $255,000,000 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 $41,125,000 for information
technology cybersecurity in the Office of the Assistant
Secretary for Administration. These funds provide for
continuous monitoring and security incident response
coordination for the Department's computer systems and
networks.
Office of the Assistant Secretary for Health/Medical Reserve Corps
The Committee recommendation includes $3,839,000 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 $79,385,000 for
activities within the Office of the Secretary.
Pandemic Influenza Preparedness
The Committee recommendation includes $71,915,000 for
Pandemic Influenza Preparedness. Of the total, $32,009,000 is
provided in annual funding and $39,906,000 in no-year funding.
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 2016, the level transferred from the fund
after accounting for sequestration is $932,000,000. The
Committee includes bill language in section 224 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:
[In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
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 7,600
Services Programs. Management.
ACL.................................... Aging and Disability Falls Prevention......... 4,750
Services Programs.
CDC.................................... Immunization and Section 317 Immunization 210,300
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 156,650
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 Nutrition, Physical 35,000
and Health Promotion. Activity, & Obesity Base
Activities.
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 Cancer Prevention & 104,000
and Health Promotion. Control.
CDC.................................... Chronic Disease Prevention Early Care Collaboratives 4,000
and Health Promotion.
CDC.................................... Environmental Health...... Lead Poisoning Prevention 13,000
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 Committee recommendation continues a
provision restricting the Secretary's use of taps for program
evaluation activities unless a report is submitted to the
Appropriations Committees of the House of Representatives and
the Senate on the proposed use of funds.
Section 204. The Committee recommendation continues a
provision authorizing the transfer of up to 2.5 percent of PHS
Act funds for evaluation activities.
Section 205. The Committee recommendation 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 retains a general provision allowing
National Health Service Corps contracts to be canceled up to 60
days after award.
Section 207. The Committee recommendation continues a
provision regarding requirements for family planning
applicants.
Section 208. The Committee recommendation retains language
which states that no provider services under title X of the PHS
Act may be exempt from State laws regarding child abuse.
Section 209. The Committee recommendation retains language
which restricts the use of funds to carry out the Medicare
Advantage Program if the Secretary denies participation to an
otherwise eligible entity.
Section 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 Committee recommendation retains a
provision which facilitates the expenditure of funds for
international health activities.
Section 213. The Committee continues a provision that
permits CDC and the Agency for Toxic Substances and Disease
Registry to transfer funds that are available for Individual
Learning Accounts.
Section 214. The Committee recommendation continues a
provision permitting the transfer of up to 3 percent of AIDS
funds among ICs by the Director of NIH and the Director of the
Office of AIDS Research at NIH.
Section 215. The Committee recommendation retains language
which requires that the use of AIDS research funds be
determined jointly by the Director of NIH and the Director of
the Office of AIDS Research and that those funds be allocated
directly to the Office of AIDS Research for distribution to the
ICs consistent with the AIDS research plan.
Section 216. The Committee recommendation continues a
provision authorizing the Director of NIH to enter into certain
transactions to carry out research in support of the NIH Common
Fund.
Section 217. The Committee recommendation continues a
provision permitting NIH to use up to $3,500,000 per project
for improvements and repairs of facilities.
Section 218. The Committee recommendation retains a
provision that transfers funds from NIH to HRSA and AHRQ, to be
used for National Research Service Awards.
Section 219. The bill includes a new provision related to
the NIH IDeA program.
Section 220. The bill includes a new provision related to
the NEF.
Section 221. The bill retains a provision related to third
party payments to NIH.
Section 222. The Committee recommendation retains 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 223. The Committee recommendation continues a
provision requiring a publicly available Web site that details
expenditures from the PPH Fund.
Section 224. The Committee recommendation 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 225. The Committee recommendation retains a
provision requiring CJs to include certain FTE information with
respect to ACA.
Section 226. The bill includes a modified provision related
to ACA exchange funding transparency.
Section 227. The bill includes a new provision related to
ACA enrollment notifications.
Section 228. The bill continues a provision prohibiting
funds for the Risk Corridor program.
Section 229. The bill includes a new provision prohibiting
funds for the State-Based Exchanges.
Section 230. The bill includes a new provision prohibiting
the use of funds for implementing the Dietary Guidelines.
Section 231. The bill includes a new provision cancelling
unobligated balances at HRSA.
Section 232. The bill includes a new provision rescinding
unobligated carry-over balances from previous appropriations
acts for CDC's Individual Learning Accounts.
Section 233. The bill includes a new general provision
rescinding $250,000,000 in unobligated prior year balances from
the unaccompanied children program.
TITLE III
DEPARTMENT OF EDUCATION
Education for the Disadvantaged
Appropriations, 2015.................................... $15,536,107,000
Budget estimate, 2016................................... 16,592,546,000
Committee recommendation................................ 15,455,802,000
The Committee recommends an appropriation of
$15,455,802,000 for education for the disadvantaged.
The programs in the Education for the Disadvantaged account
help ensure that poor and low-achieving children are not left
behind in the Nation's effort to raise the academic performance
of all children and youth. Funds appropriated in this account
primarily support activities in the 2016-2017 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 $14,559,802,000 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, 2015 for transfer to the Census Bureau for poverty updates;
$3,714,641,000 will become available on July 1, 2016; and
$10,841,177,000 will become available on October 1, 2016. The
funds that become available on July 1, 2016, and October 1,
2016, will remain available for obligation through September
30, 2017.
The Committee recommendation includes a new general
provision affirming that the Department of Education cannot
require or incentivize, including requiring as a condition of
waiver under the Elementary and Secondary Education Act [ESEA],
the adoption of any specific instructional content, academic
standards, academic assessments, or curriculum.
School Improvement Grants
The Committee recommendation includes $450,000,000 for the
School Improvement Grants [SIG] program.
The Committee continues authorities provided by prior
appropriations acts that address several issues, including:
expanding the number of schools that may receive funds through
the program, which allows schools to be eligible for SIG if
they are eligible for title I and have not made adequate yearly
progress for at least 2 years or are in the State's lowest
quintile of performance based on proficiency rates; allowing
States to make subgrants of up to $2,000,000 to each
participating school for an award period of 5 years, increasing
the amount and length of grant awards; allowing the Department
to set-aside up to 5 percent of the SIG appropriation for
national activities; providing flexibility from the
prescriptive school improvement strategies previously required
by the Department, by allowing LEAs to implement a whole-school
reform strategy based on at least a moderate level of evidence
that it will improve student outcomes or an alternative State-
determined school improvement strategy established by the State
and approved by the Secretary; and allowing LEAs eligible under
the Rural Education Achievement program to modify one element
of a SIG model.
The Committee notes that SIG funds may be used for the
coordination and provision of integrated student supports that
address the non-academic needs of students.
The Committee is aware of effective and innovative models
for school-wide reading improvement in rural communities. These
models use highly individualized approaches to improving early
literacy, and further focus on integrating and aligning out of
school interventions, supplementing the traditional school day
with aligned afterschool, summer, and parental engagement
programs. The Committee encourages the Department to consider
such interventions, particularly in rural communities, as part
of efforts to improve low-performing schools and student
outcomes.
Striving Readers Comprehensive Literacy Program
Due to budget constraints, the Committee recommendation
does not include funding for the Striving Readers Comprehensive
Literacy program. Fiscal year 2015 funding supported the fifth
year of 5-year grants under this program. The Committee looks
forward to results from this round of grants in considering
future funding requests.
Migrant Education Program
The Committee recommends $365,000,000 for the title I
Migrant Education program.
This funding supports grants to State Education Agencies
[SEAs] for programs to meet the special educational needs of
the children of migrant agricultural workers and fishermen.
Funding also supports activities to improve interstate and
intrastate coordination of migrant education programs, as well
as identify and improve services to the migrant student
population.
Neglected and Delinquent
The Committee recommends $46,000,000 for the title I
Neglected and Delinquent program.
This program provides financial assistance to SEAs for
education services to neglected and delinquent children and
youth in State-run institutions and for juveniles in adult
correctional institutions. States are authorized to set aside
at least 15 percent, but not more than 30 percent, of their
Neglected and Delinquent funds to help students in State-
operated institutions make the transition into locally operated
programs and to support the successful reentry of youth
offenders who are age 20 or younger and have received a
secondary school diploma or its recognized equivalent.
Evaluation
The Committee recommendation does not include specific
funding for evaluation, as requested by the administration.
Instead, the Committee recommendation continues a general
provision that clarifies the Department's authority to reserve
up to 0.5 percent of each ESEA appropriation in the bill,
except for titles I and III of the ESEA, for evaluation of ESEA
programs funded in this act. The Department is required to
provide the Committees on Appropriations of the House of
Representatives and the Senate, the Senate HELP Committee, and
the House Education and Workforce Committee an operating plan
describing the proposed uses of this evaluation authority as
well as the source appropriation for such activities. In
addition, not later than 45 days prior to the submission of the
required operating plan, the Department shall brief the
Committees above on the programs and activities being
considered for inclusion in the plan. Further, the Committee
expects the Department to continue to include in future CJs a
discussion of its planned use of this authority.
Evaluation funds are used to support large-scale national
surveys that examine how the title I program is contributing to
student academic achievement. Funds also are used to evaluate
State assessment and accountability systems and analyze the
effectiveness of educational programs supported with title I
funds.
Special Programs for Migrant Students
The Committee recommends $35,000,000 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, 2015.................................... $1,288,603,000
Budget estimate, 2016................................... 1,288,603,000
Committee recommendation................................ 1,288,603,000
The Committee recommends $1,288,603,000 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
$1,151,233,000 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.
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,
2017, as requested by the administration.
Payments for Federal Property.--The Committee recommends
$66,813,000 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 rejects this elimination and notes
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, 2015.................................... $4,402,671,000
Budget estimate, 2016................................... 4,693,171,000
Committee recommendation................................ 4,134,746,000
The Committee recommendation includes $4,134,746,000 for
the School Improvement Programs account.
State Grants for Improving Teacher Quality
The Committee recommends $2,246,441,000 for State Grants
for Improving Teacher Quality.
The appropriation for this program primarily supports
activities associated with the 2016-2017 academic year. Of the
funds provided, $565,000,000 will become available on July 1,
2016, and $1,681,441,000 will become available on October 1,
2016. These funds will remain available for obligation through
September 30, 2017.
States and LEAs may use funds for a range of activities
related to the certification, recruitment, professional
development, and support of teachers and administrators.
Activities may include reforming teacher certification and
licensure requirements, addressing alternative routes to State
certification of teachers, recruiting teachers and principals,
and implementing teacher mentoring systems, teacher testing,
merit pay, and merit-based performance systems. These funds may
also be used by districts to hire teachers to reduce class
sizes.
The Committee recommendation increases the set-aside within
this program for the Supporting Effective Educator Development
[SEED] program from 2.3 percent to 5 percent, as requested by
the administration. The SEED program provides competitive
grants to national not-for-profit organizations for recruiting,
training, or providing professional enhancement activities for
teachers and school leaders, particularly for high-need schools
most likely to face shortages in these areas. These funds may
be used to support such activities in civic learning. Up to 10
percent of the set-aside funds may be used for related
research, outreach, evaluation, dissemination, and technical
assistance.
The Committee continues to note that, based on a recent
report by the Department of Education, only approximately 4
percent of funding under the Teacher Quality State Grants
program is used for the professional development of school
principals. The Committee strongly encourages the Department to
provide guidance to SEAs about the availability of funding for
such activities, including technical assistance on best
practices in this area.
Mathematics and Science Partnerships
The Committee recommends $141,299,000 for the Mathematics
and Science Partnerships program.
At the recommended funding level, the ESEA requires the
Department to award grants by formula to States for competitive
awards to eligible partnerships, which must include an
engineering, math, or science department of an institution of
higher education and a high-need LEA. Partnerships will seek to
improve the performance of students in the areas of math and
science, including engineering, by bringing math and science
teachers in elementary and secondary schools together with
scientists, mathematicians, and engineers to increase the
teachers' subject-matter knowledge and improve their teaching
skills.
The Committee notes that investments in non-traditional
STEM teaching activities, including robotics competitions, are
a means to engage and inspire students to pursue further study
or careers in STEM education.
Education Technology State Grants
The Committee recommendation does not include funding for
Education Technology State Grants. Funding for this program was
eliminated in fiscal year 2011. The budget request included
$200,000,000 for this activity.
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 $1,035,000,000
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 directs the Department to submit a report to
the Committees on Appropriations of the House of
Representatives and the Senate within 90 days of enactment of
this act on how States and local school districts are using
waiver authority under this program, an optional waiver as part
of the broader ESEA flexibility waivers, and what specific
activities schools are funding with 21st CCLC funding under
this authority.
The Committee recognizes that foster youth face unique
hardships and challenges in completing their high school
education and fully participating in the student experience.
The Committee strongly encourages the Secretary to provide
guidance and technical assistance to states to help them
develop extracurricular programs specifically targeting foster
youth.
State Assessments and Enhanced Assessment Instruments
The Committee recommends $350,000,000 for the State
Assessments and Enhanced Assessment Instruments program.
This program provides formula grants to States for
developing and implementing standards and assessments required
by the ESEA, and competitive grants to States, including
consortia of States, to improve the quality, validity, and
reliability of academic assessments. The Committee
recommendation includes the full amount for State formula
grants and due to budget constraints does not include funding
for competitive grants.
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 $65,042,000.
This program provides assistance to each State to support
an office of the coordinator of education for homeless children
and youth, to develop and implement State plans for educating
homeless children, and to make subgrants to LEAs to support the
education of those children. Grants are made to States based on
the total that each State receives in title I grants to LEAs.
Under the McKinney-Vento Homeless Children and Youth
Program, SEAs must ensure that homeless children and youth have
equal access to the same free public education, including a
public preschool education, as is provided to other children
and youth.
The Committee bill also maintains language under the
Education for the Disadvantaged account clarifying the
availability of title I funds for services to homeless children
and youths.
Training and Advisory Services
For Training and Advisory Services authorized by title IV
of the Civil Rights Act, the Committee recommends $6,575,000.
The funds provided will support awards to operate the 10
regional equity assistance centers [EACs]. Each EAC provides
services to school districts upon request. Activities include
disseminating information on successful practices and legal
requirements related to nondiscrimination on the basis of race,
color, sex, or national origin in education programs.
Education for Native Hawaiians
For programs for the education of Native Hawaiians, the
Committee recommends $32,397,000.
The Committee bill continues a provision that allows
funding provided by this program to be used for construction.
Alaska Native Educational Equity
The Committee recommends $31,453,000 for the Alaska Native
Educational Equity Assistance program.
These funds address the severe educational handicaps of
Alaska Native schoolchildren. Funds are used for the
development of supplemental educational programs to benefit
Alaska Natives. The Committee bill continues language that
allows funding provided by this program to be used for
construction. The Committee bill also includes language
overriding the authorizing statute's requirement to make
noncompetitive awards to certain organizations.
In awarding funds under this program, the Committee directs
the Department to ensure the maximum participation of Alaska
Native organizations and other required Alaska Native partners,
ensure that all grantees have meaningful plans for consultation
with Alaska Native leaders, and make every effort to ensure
that Alaska Natives and Alaskans represent a significant
proportion of peer reviewers for grant applications.
Rural Education
The Committee recommends $169,840,000 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 $40,000,000 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.
Due to budget restraints the Committee recommendation
includes a decrease in funding for this program. However, the
Committee strongly supports the establishment of a
comprehensive center on students at risk of not attaining full
literacy skills due to a disability. Such a center should
identify or develop free or low cost evidence-based assessment
tools for identifying students at-risk of not attaining full
literacy skills due to a disability, including dyslexia
impacting reading and writing, or developmental delay impacting
reading, writing, language processing, comprehension, or
executive function; identify evidence-based literacy
instruction, strategies, and accommodations; identify or
develop evidence-based professional development for teachers,
paraprofessionals, principals, other school leaders, and
specialized instructional support personnel to understand early
indicators of students at risk of not attaining full literacy
skills; and disseminate the products to regionally diverse
state educational agencies, local educational agencies,
regional educational agencies, and schools. The Committee looks
forward to working with the Department in establishing a
comprehensive center on this issue.
Indian Education
Appropriations, 2015.................................... $123,939,000
Budget estimate, 2016................................... 173,939,000
Committee recommendation................................ 123,939,000
The Committee recommends $123,939,000 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 $17,993,000 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.
The Committee urges the Department to focus available
resources on Native American language preservation and youth
education activities. The Committee believes that Native
language education programs are essential for tribal self,-
determination and improving educational outcomes for Native
youth.
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.
Innovation and Improvement
Appropriations, 2015.................................... $1,102,111,000
Budget estimate, 2016................................... 1,601,559,000
Committee recommendation................................ 694,616,000
The Committee recommends $694,616,000 for programs within
the Innovation and Improvement account.
The Committee remains concerned that competitive grant
programs often leave out rural areas and other high-need
communities that sometimes simply do not have the capacity to
compete against better resourced or national organizations for
limited funding. The Committee directs the Department to ensure
that competitive grant programs, including but not limited to
the Charter Schools, Innovative Approaches to Literacy, Arts in
Education, and SEED, support activities in rural communities.
Investing in Innovation
The Committee recommendation does not include funding for
the Investing in Innovation [i3] program. The i3 program, which
was established in the Recovery Act and has never been
authorized, provides funding for replicating education programs
that meet the highest level of evidence; expanding those with
significant levels of evidence; and supporting promising
practices for which there is some level of appropriate
research. The Committee supports such evidence-based approaches
to improve student outcomes but due to budget constraints has
not included funding for this program and instead focused
funding to core education formula grant programs. The Committee
will consider future funding requests pending authorization of
the program.
High School Redesign
The Committee recommendation does not include funding for a
new High School Redesign program. The budget request included
$125,000,000 for this new activity.
Teacher and Principal Pathways
The Committee recommendation does not include funding for a
new Teacher and Principal Pathways program. The budget request
proposed to consolidate several teacher and school leadership
programs into this new program.
Transition to Teaching
The Committee recommendation does not include funding for
the Transition to Teaching program which provides grants to
help support efforts to recruit, train, and place
nontraditional teaching candidates into teaching positions and
to support them during their first years in the classroom.
Instead, the Committee recommendation includes an increase in
the SEED set-aside within the Teacher Quality State Grants
program, which similarly provides competitive grants for
recruiting, training, or providing professional enhancement
activities for teachers and school leaders, particularly in
high-need LEAs.
School Leadership
The Committee recommendation does not include funding for
the School Leadership program. The program provides competitive
grants to assist high-need LEAs to recruit and train principals
and assistant principals through activities such as
professional development and training programs. Instead, the
Committee recommendation includes an increase in the SEED set-
aside within the Teacher Quality State Grants program, which
similarly provides competitive grants for recruiting, training,
or providing professional enhancement activities for teachers
and school leaders, particularly in high-need LEAs.
Charter Schools
The Committee recommends a total of $273,172,000, an
increase of $20,000,000 above fiscal year 2015 for the support
of charter schools.
Within the total, the Committee recommendation includes
$155,000,000 for SEA grants, including non-SEA eligible
applicant grants; $85,000,000 for grants to make multiple
awards to charter management organizations and other entities
for the replication and expansion of successful charter school
models; up to $9,000,000 for State Facilities incentives; not
less than $13,000,000 for the Credit Enhancement for Charter
Schools Facilities program; and not less than $11,000,000 for
national activities designed to support local, State, and
national efforts to increase the number of high-quality charter
schools.
Charter Schools Grants support the planning, development,
and initial implementation of charter schools. SEAs that have
authority under State law to approve charter schools that are
eligible to compete for grants. If an eligible SEA does not
participate, charter schools from the State may apply directly
to the Secretary.
Under the State facilities program, the Department awards
5-year competitive grants to States that operate per-pupil
facilities aid programs for charters schools. Federal funds are
used to match State-funded programs to provide charter schools
with additional resources for charter school facilities
financing.
The credit enhancement program provides assistance to help
charter schools meet their facility needs. Funds are provided
on a competitive basis to public and nonprofit entities to
leverage non-Federal funds that help charter schools obtain
school facilities through purchase, lease, renovation, and
construction.
The Committee bill continues language that allows charter
school funds to be used for preschool programs in charter
schools.
Magnet Schools Assistance
The Committee recommends $85,000,000 for the Magnet Schools
Assistance program.
This program supports grants to LEAs to establish and
operate magnet schools that are part of a court-ordered or
federally approved voluntary desegregation plan. Magnet schools
are designed to attract substantial numbers of students from
different social, economic, ethnic, and racial backgrounds.
Grantees may use funds for planning and promotional materials,
salaries of instructional staff, and the purchase of
technology, educational materials, and equipment.
Fund for the Improvement of Education
The Committee recommends an appropriation of $62,815,000
for FIE.
Preschool Development Grants.--The Committee recommendation
does not include funding for Preschool Development Grants,
which have never been authorized. This program was funded under
FIE in fiscal year 2015; the budget request included
$750,000,000, funded within a new account. This program, first
funded in fiscal year 2014, provides competitive grants to
States to develop or expand preschool programs for 4-year-olds.
The Committee is concerned that funding another discretionary
competitive grant program to provide early childhood education
contributes to an already complicated system of early childhood
care and education programs at the local level. This bill alone
provides funding for Head Start and the Child Care and
Development Fund, which itself includes funds from TANF and
SSBG, which provide early childhood care and education for
children from birth to age 5. States themselves spend
approximately $5.5 billion on State-funded preschool programs.
These programs are administered by different agencies and
levels of government, and each come with their own eligibility
and reporting requirements. The Committee continues to support
funding for these core early childhood care and education
programs, and efforts to better coordinate these existing
programs.
In 2012, a Government Accountability Office report (GAO-12-
342SP) identified 45 Federal programs that provide or may
support related services to children from birth through age 5,
as well as five tax provisions that subsidize private
expenditures in this area. The Child Care and Development Block
Grant Act of 2014 requires the Secretaries of HHS and Education
to conduct an interdepartmental review of all early learning
programs, develop a plan for eliminating duplicative programs,
and make recommendation to Congress for streamlining such
programs. The Committee looks forward to this report and
believes the administration should complete this review before
considering funding relatively new programs in this area.
Innovative Approaches to Literacy.--Within programs of
national significance, the Committee includes $25,000,000 for
the Innovative Approaches to Literacy program, the same as the
fiscal year 2015 funding level. The budget request does not
include funding for this program. 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 expect that no less than 50 percent of these funds
to be awarded to school libraries proposing high-quality
projects for increasing access to a wide range of print and
electronic resources that provide learning opportunities to all
students, but particularly those less likely to have access to
such materials at home.
The Committee directs the Department to include in future
CJs program performance information for this program covering
all applicable years, consistent with data provided for other
similar programs.
Arts in Education.--Within the amount for FIE, the
Committee includes $25,000,000 for the Arts in Education
program, the same as the fiscal year 2015 funding level and the
budget request. The funding is used for competitive awards for
national nonprofit organizations engaged in arts education,
professional development activities, and model arts education
programs. Funds also are used for evaluation and dissemination
activities, as well as to support a partnership with the
National Endowment for the Arts.
Javits Gifted and Talented Students.--Within FIE, the
Committee also recommends $11,000,000, an increase of
$1,000,000 above fiscal year 2015, for the Javits Gifted and
Talented Students Education program. The budget request
included $9,650,000. 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 training activities designed to enhance the
capability of elementary and secondary schools to meet the
special educational needs of gifted and talented students,
including those from disadvantaged and underrepresented
populations.
Presidential and Congressional History Teaching
Academies.--Within the total for FIE, the Committee
recommendation includes $1,815,000 for Presidential and
Congressional History Teaching Academies, as authorized by the
American History and Civics Education Act of 2004. This
supports summer residential academies to help teachers and
outstanding students learn more about these important subjects
and share their knowledge with students and classmates.
Extended Learning Time.--The Committee encourages the
Department to consider funding for programs that include
extended learning time, specifically year-round education, as
an innovative approach to improving student achievement.
Teacher Incentive Fund
The Committee recommendation includes $225,000,000 for TIF.
The goals of TIF are to improve student achievement by
increasing teacher and principal effectiveness; reform
compensation systems to reward gains in student achievement;
increase the number of effective teachers teaching low-income,
minority, and disadvantaged students, and students in hard-to-
staff subjects; and other activities designed to increase the
effectiveness of teachers, principals, and other personnel in
high-need schools.
Ready-To-Learn Television
The Committee recommendation includes $25,741,000 for the
Ready-to-Learn Television program.
This program is intended to use the power and reach of
public television to help prepare children, especially
disadvantaged children, enter and succeed in school.
Advanced Placement
The Committee recommends $22,888,000 for Advanced Placement
[AP] programs.
Funds have supported two programs: the AP Test Fee program
and the AP Incentive [API] program. The purpose of both is to
aid State and local efforts to increase access to AP and
International Baccalaureate [IB] classes and tests for low-
income students. Under the test fee program, the Department
makes awards to SEAs to enable them to cover part or all of the
cost of test fees of low-income students who are enrolled in an
AP or IB class and plan to take an AP or IB test. Under the API
program, the Department makes 3-year competitive awards to
SEAs, LEAs, or national nonprofit educational entities to
expand access for low-income individuals to AP programs through
activities including teacher training; development of pre-
advanced placement courses; coordination and articulation
between grade levels to prepare students for academic
achievement in AP or IB courses; books and supplies; and
participation in online AP or IB courses. Under the authorizing
statute, the Department must give priority to funding the test
fee program.
Safe Schools and Citizenship Education
Appropriations, 2015.................................... $223,315,000
Budget estimate, 2016................................... 349,561,000
Committee recommendation................................ 120,314,000
The Committee recommends a total of $120,314,000 for
activities to promote safe schools, healthy students, and
citizenship education.
Promise Neighborhoods
The Committee recommendation includes $37,000,000 for the
Promise Neighborhoods program. This funding should be used to
support the continuation costs of current grantees.
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 Department has awarded 1-year planning grants to
develop and plan for providing a continuum of services and
supports for the children and youth in a particular
neighborhood, and multiple-year implementation grants to
organizations with feasible plans for achieving the goals of
the program. The Committee recommendation will support the
continuation costs of the seven remaining implementation
grants.
The Committee continues to note that at least one
implementation grantee has included college savings accounts as
part of its plan for providing a high-quality continuum of
integrated cradle to college career services. The Committee is
interested in understanding the number of grantees that have
included college savings accounts in their plans and the impact
the use of college savings accounts is having on the college-
going behavior of participating students.
Safe and Drug-Free National Activities
The Committee recommendation includes $60,000,000 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 being the victim of violence
and other root causes of unhealthy school climates.
Elementary and Secondary School Counseling
The Committee recommendation includes $23,314,000 for
elementary and secondary school counseling. The Committee
recommendation will help support the continuation costs of
current grantees.
Carol M. White Physical Education for Progress Program
Due to budget constraints the Committee recommendation does
not include funding for the physical education program.
Instead, the Committee has focused funding on core and flexible
funding streams, such as title I, that allow States, LEAs, and
local schools to determine how to best use limited resources.
English Language Acquisition
Appropriations, 2015.................................... $737,400,000
Budget estimate, 2016................................... 773,400,000
Committee recommendation................................ 712,021,000
The Committee recommends an appropriation of $712,021,000
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; and evaluation activities.
National activities funds shall be available for 2 years.
The Committee bill continues language that requires the
Secretary to use a 3-year average of the most recent data
available from the American Community Survey for calculating
allocations to all States under this program.
The Committee recommendation represents a decrease from the
fiscal year 2015 funding level, in part, because it does not
include $14,000,000 provided in fiscal year 2015 specifically
to address costs associated with a significant increase in
unaccompanied children during fiscal year 2015. The budget
request did not include funding for this activity.
Special Education
Appropriations, 2015.................................... $12,522,358,000
Budget estimate, 2016................................... 12,822,358,000
Committee recommendation................................ 12,636,817,000
The Committee recommends an appropriation of
$12,636,817,000 for special education programs.
Grants to States
The Committee recommendation includes $11,597,848,000 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 2016-2017 academic year. Of the
funds available for this program, $2,314,465,000 will become
available on July 1, 2016, and $9,283,383,000 will become
available on October 1, 2016. These funds will remain available
for obligation through September 30, 2017.
As requested by the administration, the Committee continues
bill language capping the Department of the Interior set-aside
at the prior year level, adjusted by the lower of the increase
in inflation or the change in the appropriation for grants to
States. This provision also would prevent a decrease in the
amount to be transferred in case the funding for this program
decreases or does not change. The bill also continues language
included in prior year appropriations acts, and requested by
the administration, clarifying several provisions of the IDEA,
and providing authority concerning certain maintenance of
effort [MOE] requirements.
Preschool Grants
The Committee recommends $363,238,000 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 $453,556,000 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 statewide systems for
providing early intervention services to all children with
disabilities, ages 2 and younger, and their families. The IDEA
also gives States the option of extending eligibility for part
C services to children 3 and older if they were previously
served under part C and will continue to be served until
entrance to kindergarten.
State Personnel Development
The Committee recommends $35,000,000 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 $51,928,000 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
$9,500,000, an increase of $1,917,000 above the fiscal year
2015 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 $81,700,000 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 $26,500,000 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 $27,047,000 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 progress made with tools and
services provided under the Technology and Media Services
program that have allowed more than 320,000 students free
access to more than 280,000 books in multiple digitally
accessible formats. The Committee continues to support these
activities funded within this account, and the expansion of
these activities to reach additional students, with a focus on
underserved areas.
Rehabilitation Services and Disability Research
Appropriations, 2015.................................... $3,709,853,000
Budget estimate, 2016................................... 3,532,109,000
Committee recommendation................................ 3,487,864,000
The Workforce Investment and Opportunity Act [WIOA] of 2014
moved several programs within Rehabilitation Services and
Disability Research from the Department of Education to the
Administration for Community Living at the Department of HHS.
The Committee recommendation supports this reorganization.
Vocational Rehabilitation State Grants
The Committee recommends $3,391,770,000 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.
Client Assistance State Grants
The Committee recommends $12,000,000 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 in order to
receive VR State Grant funds.
Training
The Committee recommends $24,000,000 for training
rehabilitation personnel. This program supports grants to
provide training to new VR staff, or upgrade the qualifications
of existing staff. The Committee recommendation will support
the continuation of current grants.
Demonstration and Training Programs
The Committee recommendation does not include funding for
demonstration and training. This program provides grants to
States and nonprofit organizations to develop innovative
methods and comprehensive services to help individuals with
disabilities achieve satisfactory vocational outcomes. Instead,
the Committee continues bill language allowing the Department
to use unobligated VR State Grant funds for innovative
approaches to improve outcomes for individuals with
disabilities. From fiscal year 2012 to 2014 approximately
$216,000,000 has been made available for such activities under
that authority.
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 does not include funding for
the Supported Employment State Grants Program. The fiscal year
2015 budget request proposed eliminating this program because
supported employment activities funded under this program had
become an integral part of the larger VR State Grants program,
funded in large part with mandatory funding, and eliminating
this program would reduce unnecessary administration burden at
the national, State and local levels. Despite changes to the
Supported Employment State Grants program in WIOA, the
Committee supports this consolidation and notes that funding
for the VR State Grants programs, which can be and is used for
the same purposes, will increase by $56,696,000 in fiscal year
2016. The Committee directs the Department to help ensure that
State agencies continue to invest appropriate levels of their
resources in supported employment, and particularly extended
services to youth with the most significant disabilities,
consistent with the changes in WIOA.
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 $9,127,000 for the Helen Keller
National Center for Deaf-Blind Youth and Adults.
The Helen Keller National Center consists of a national
headquarters in Sands Point, New York, with a residential
training and rehabilitation facility where deaf-blind persons
receive intensive specialized services; a network of 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, 2015.................................... $24,931,000
Budget estimate, 2016................................... 24,931,000
Committee recommendation................................ 24,931,000
The Committee recommends $24,931,000 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 72 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 continues to recognize that students who are
blind or have a vision loss must have equal access to the same
education content and should receive that information at the
same time as their sighted peers if they are to achieve
academically. Accordingly, the Committee continues to support
implementation of APHs Resources with Enhanced Accessibility
for Learning [REAL] plan, and includes no less than $475,000
for such activities, the same as the fiscal year 2015 level.
The REAL plan supports new advances in software and hardware
technology to ensure that students with vision loss receive
high-quality educational material in a timely manner and in the
appropriate formats required to meet individual student
learning needs.
NATIONAL TECHNICAL INSTITUTE FOR THE DEAF
Appropriations, 2015.................................... $67,016,000
Budget estimate, 2016................................... 67,016,000
Committee recommendation................................ 69,016,000
The Committee recommends $69,016,000 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 to
establish a formal regional partnership with at least one
organization to expand the geographic reach of activities and
services supported by NTID for individuals who are deaf or hard
of hearing, leveraging NTIDs expertise in this area. This
should include a focus on promoting training and post-secondary
preparation in STEM fields, which could include a focus on
exposing students to intense training in targeted subjects;
working with NTID faculty to develop and deliver post-secondary
preparation programs for students; providing professional
development for teachers; and developing partnerships with
business and industry to promote employment opportunities.
GALLAUDET UNIVERSITY
Appropriations, 2015.................................... $120,275,000
Budget estimate, 2016................................... 120,275,000
Committee recommendation................................ 120,275,000
The Committee recommends $120,275,000 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, 2015.................................... $1,707,686,000
Budget estimate, 2016................................... 1,915,686,000
Committee recommendation................................ 1,669,731,000
Career and Technical Education
The Committee recommends $1,122,019,000 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
$200,000,000 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 that 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, 2016, and $791,000,000 will become
available on October 1, 2016. These funds will remain available
for obligation until September 30, 2017.
National Programs.--The Committee recommends $4,421,000 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 $547,712,000 for Adult Education
programs.
Adult Education State Grants.--The Committee recommendation
includes $540,000,000 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
$7,712,000 for adult education national leadership activities.
Student Financial Assistance
Appropriations, 2015.................................... $24,198,210,000
Budget estimate, 2016................................... 24,198,210,000
Committee recommendation................................ 24,129,352,000
The Committee recommends an appropriation of
$24,129,352,000 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 recommendation is more than sufficient to
support an increase in the maximum Pell grant award, from
$5,775 for the 2015-16 school year to an estimated $5,915 for
the 2016-17 school year. The Pell grant program is funded
partly through the discretionary appropriations process and
partly through mandatory funding. As long as the discretionary
portion of funding is sufficient to support $4,860 of the
maximum award, mandatory funding supports an increase in the
overall maximum award based on changes in the Consumer Price
Index [CPI]. The Department will determine the exact amount of
the maximum award next year based on CPI data available at the
end of the 2015 calendar year.
The Committee notes that CBOs current estimates of Pell
Grant program costs are significantly lower than their 2014
baseline used in developing the fiscal year 2015 appropriations
bill. As a result, the Department is expected to carry over
significantly more funding into fiscal year 2016 than estimated
last year. Specifically, actual fiscal year 2014 costs were
$554,000,000 lower than estimated, meaning additional
unobligated balances were carried into fiscal year 2015 than
was expected last year, and current fiscal year 2015 estimated
costs are $848,000,000 lower than estimated last year. Based on
these updated estimates for fiscal year 2014 and 2015, the
Committee recommendation rescinds $300,000,000 in unobligated
balances from fiscal year 2015.
The Pell scoring rule, section 406 of H. Con. Res. 95,
requires the Committee to fully fund the Pell grant program
based on the Congressional Budget Office's [CBO] program cost
estimate for the upcoming award year. Including estimated
unobligated balances carried forward from fiscal year 2015 to
2016, the Committee recommendation provides $1,788,000,000 in
additional funding above what is required to support estimated
discretionary program costs in fiscal year 2016. This surplus
funding will not be used in fiscal year 2016 for the 2016-17
school year and will be carried over to be used to support
program costs in the 2017-18 school year.
Federal Supplemental Educational Opportunity Grant Program
The Committee recommends $704,000,000 for the Supplemental
Educational Opportunity Grant [SEOG] program.
The SEOG program provides funds to approximately 3,800
postsecondary institutions for need-based grants to more than
1.6 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 $950,000,000 for the Federal
Work-Study [FWS] program.
This program provides grants to approximately 3,400
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, 2015.................................... $1,396,924,000
Budget estimate, 2016................................... 1,581,854,000
Committee recommendation................................ 1,361,700,000
The Committee recommends $1,361,700,000 for the Student Aid
Administration account. These funds are available until
September 30, 2017, and support the Department's student aid
management expenses.
The Committee recommendation includes $640,000,000 for
administrative costs and $721,700,000 for loan servicing
activities.
The Bipartisan Budget Act of 2013 eliminated mandatory
funding that supported the Not-for-Profit [NFP] servicer
program and two of the TIVAS contracts. To avoid disrupting
student borrowers whose loan servicing was supported with that
mandatory funding, Congress provided a total increase of
approximately $396,000,000 for student loan servicing
activities in fiscal years 2014 and 2015, the vast majority of
which is due to the elimination of this mandatory funding
source. The Committee notes that this elimination does not
reduce the Federal responsibility to service student loans but
only shifts the costs from mandatory funding to discretionary
funding subject to discretionary spending caps.
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.
Not-for-Profit Servicers [NFPs].--The Committee includes
new bill language requiring the Department to allocate no less
than 50 percent of new student loan borrower accounts to NFPs.
The Committee commends the Department for developing a single,
common set of performance metrics for evaluating the
performance of the 11 Federal loan servicers. However, the
Department only recently began allocating new accounts, limited
to 25 percent of new accounts, to NFPs. The Committee strongly
supports the allocation of new student loan accounts based
purely on the performance and capacity of servicers, to help
ensure high-quality service for borrowers. Until the Department
awards a new student loan servicing contract, the Committee
believes allocating no less than 50 percent of new loans, and
more if warranted by the performance and capacity of servicers,
to NFPs will ensure more comparable portfolios across all
servicers, consistent with the stated plan of the Department.
Similarly, the Committee is also concerned that the Department
has unnecessarily restricted consumer choice by only permitting
student and parent loan borrowers to select from among the four
TIVA servicers when choosing a servicer for their consolidation
loans. The Committee directs the Department to permit borrowers
to choose from among all 11 Federal loan servicers. Finally,
the Committee directs the Department to brief the Committees on
Appropriations of the House of Representatives and the Senate
within 30 days of enactment of this act on how they are
carrying out these directives, and how they plan to ensure that
student loan allocations, including consolidations, are awarded
based on performance and capacity, including innovative small
business subcontracting methods, across all eligible servicers
as part of future contracts.
Higher Education Regulations.--The Committee recommendation
includes bill language prohibiting funding in this act for
several recent regulations, until the Higher Education Act
[HEA] is reauthorized, including: developing a post-secondary
institution rating system; administratively defining the phrase
``gainful employment'' included in the HEA; establishing
requirements governing the State authorization process for
higher education programs; establishing a Federal definition of
the term ``credit hour''; and establishing a Federal framework
for evaluating teacher preparation programs. The Committee
supports many of the goals of these regulations, but each
represents a significant expansion of administrative authority,
and in the case of the post-secondary institution ratings
system, a misguided use of limited resources. The Committee
strongly believes the issues addressed by these regulations
should part of the normal legislative and authorization
process. Accordingly, the Committee prohibits the Department
from moving forward with these administrative regulations and
actions until the HEA is reauthorized.
Taskforce on Higher Education Regulations.--In 2013, a
bipartisan group of Senators commissioned a Task Force on
Government Regulation of Higher Education to examine the burden
of Federal regulations on colleges and universities. In
February 2015 the task force issued a final report concluding
that many regulations are unnecessarily long and ambiguous; the
cost of compliance has become particularly burdensome; many
regulations are unrelated to education, student safety, or
stewardship of Federal funds; and they can be a barrier to
access, and innovation in higher education. The Committee urges
the Department of Education to minimize the costs imposed both
directly and indirectly on higher education through Federal
rules and regulations as it seeks to address the problems
associated with college access and affordability. The Committee
further encourages the Department of Education to review and
implement those recommendations identified in the Task Force
report that could be addressed through administrative action to
alleviate the unnecessary financial burden placed on colleges
and universities and improve the overall Federal regulatory
process.
Post-Secondary Compliance Calendar.--The Committee is
concerned that the Department of Education has failed to
implement section 482(e) of the Higher Education Act, as
amended by the Higher Education Opportunity Act of 2008, which
directs the Secretary to annually produce a compliance calendar
with a schedule of all the reporting and disclosure
requirements for colleges and universities. Publication and
distribution of this calendar will greatly help colleges and
universities understand, plan for, and meet their Federal
compliance obligations and requirements. The Committee
therefore strongly encourages the Secretary to produce a
compliance calendar within 60 days of enactment of this act.
Higher Education
Appropriations, 2015.................................... $1,924,839,000
Budget estimate, 2016................................... 2,072,045,000
Committee recommendation................................ 1,783,510,000
The Committee recommends an appropriation of $1,783,510,000
for higher education programs.
Aid for Institutional Development
The Committee recommends $514,114,000 for Aid for
Institutional Development.
Strengthening Institutions.--The Committee bill recommends
$78,048,000 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 $97,224,000 for competitive grants to institutions
at which Hispanic students make up at least 25 percent of
enrollment. Funds may be used for acquisition, rental, or lease
of scientific or laboratory equipment; renovation of
instructional facilities; development of faculty; support for
academic programs; institutional management; and purchase of
educational materials. In addition to the Committee-recommended
level, the HCERA provides $100,000,000 in mandatory funding in
each fiscal year through 2019 to support HSIs in the
development of STEM and articulation programs.
Promoting Postbaccalaureate Opportunities for Hispanic
Americans.--The Committee recommends $8,722,000 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 $220,698,000 for the
Strengthening HBCUs program. The program makes formula grants
to HBCUs that may be used to purchase equipment; construct and
renovate facilities; develop faculty; support academic
programs; strengthen institutional management; enhance
fundraising activities; provide tutoring and counseling
services to students; and conduct outreach to elementary and
secondary school students. In addition to the Committee-
recommended level, this program will receive $85,000,000 in
mandatory funding through the HCERA in each fiscal year through
2019.
Strengthening Historically Black Graduate Institutions
[HBGIs].--The Committee recommends $57,075,000 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 $8,967,000 for the Strengthening PBIs
program. This program provides 5-year grants to PBIs to plan
and implement programs to enhance the institutions' capacity to
serve more low- and middle-income Black American students. In
addition to the Committee-recommended level, the HCERA provides
$15,000,000 in mandatory funding in each fiscal year through
2019 to support programs at PBIs in the areas of STEM; health
education; internationalization or globalization; teacher
preparation; and improving the educational outcomes of African-
American males.
Strengthening Asian American and Native American Pacific
Islander-Serving Institutions [AANAPISIs].--The Committee
recommends $3,020,000 for competitive grants to AANAPISIs that
have an enrollment of undergraduate students that is at least
10 percent Asian American or Native American Pacific Islander
students. Grants may be used to improve their capacity to serve
Asian American and Native American Pacific Islander students
and low-income individuals. In addition to the Committee-
recommended level, AANAPISIs will receive $5,000,000 in
mandatory funding through the HCERA in each fiscal year through
2019 to develop faculty; strengthen academic programs; improve
institutional management; expand student services; and
construct classrooms, libraries, laboratories, and other
instructional facilities.
Strengthening Alaska Native and Native Hawaiian-Serving
Institutions [ANNHs].--The Committee recommends $12,448,000 for
the Strengthening ANNHs program. In addition to the Committee
recommended level, these institutions receive $15,000,000 in
mandatory funding through the HCERA in each fiscal year through
2019.
The purpose of this program is to improve and expand the
capacity of institutions serving Alaska Native and Native
Hawaiian students and low-income individuals. Funds may be used
to plan, develop, and implement activities that encourage
faculty and curriculum development; improve administrative
management; renovate educational facilities; enhance student
services; purchase library and other educational materials;
and, provide education or counseling services designed to
improve the financial and economic literacy of students or
their families.
Strengthening Native American-Serving Non-Tribal
Institutions.--The Committee recommends $3,020,000 for this
program, which serves institutions that enroll at least 10
percent Native American students and at least 50 percent low-
income students. In addition to the Committee recommended
level, these institutions receive $5,000,000 in mandatory
funding through the HCERA in each fiscal year through 2019 to
help institutions plan, develop, and implement activities that
encourage faculty and curriculum development; improve
administrative management; renovate educational facilities;
enhance student services; and purchase library and other
educational materials.
Strengthening Tribally Controlled Colleges and
Universities.--The Committee recommends $24,892,000 for this
program. Tribal colleges and universities rely on a portion of
the funds provided to address developmental needs, including
faculty development, curriculum, and student services. In
addition to the Committee recommended level, this program
receives $30,000,000 in mandatory funding through the HCERA in
each fiscal year through 2019.
International Education and Foreign Language Studies
The bill includes a total of $46,945,000 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 $43,445,000
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 $3,500,000 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
[FIPSE].
First in the World.--The budget request included
$200,000,000, the full amount requested under FIPSE, for First
in the World. The Committee recommendation does not include
funding for this program and instead focuses funding on
preserving funding for Pell grants, the core program funded in
this bill aimed at improving college access and affordability.
First in the World is a competitive grant program to identify
innovative solutions to persistent and wide-spread challenges
facing students in completing post-secondary education.
Model Comprehensive Transition and Postsecondary Programs for Students
With Intellectual Disabilities
The Committee recommendation includes $10,384,000 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 $8,971,000 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 $7,705,000 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 $839,752,000 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.
Gaining Early Awareness and Readiness for Undergraduate Programs
The Committee recommends $301,639,000 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 $20,000,000 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 $34,000,000 for the Teacher
Quality Partnership program. The budget request consolidates
activities supported by this program into a proposed new
Teacher and Principals Pathways program. The Teacher Quality
Partnership Program helps improve the quality of teachers
working in high-need schools and early childhood education
programs by creating model teacher preparation and residency
programs.
Child Care Access Means Parents in Schools
Due to budget constraints, the Committee recommendation
does not include funding for the Child Care Access Means
Parents in School program. Instead of funding this small
targeted child care program, the Committee focuses funding on
core early childhood care and education programs at the
Department of HHS, including CCDBG and Head Start.
GPRA Data/Higher Education Act Program Evaluation
The Committee recommendation does not include funding for
GPRA Data/HEA Program Evaluation. No funding for this program
was provided in fiscal year 2015. The budget request included
$30,000,000 in new funding for higher education evaluation
activities.
Howard University
Appropriations, 2015.................................... $221,821,000
Budget estimate, 2016................................... 221,821,000
Committee recommendation................................ 219,500,000
The Committee recommends an appropriation of $219,500,000
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 $3,350,000 for the endowment
program.
Howard University Hospital.--Within the funds provided, the
Committee recommends $26,500,000 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, 2015.................................... $435,000
Budget estimate, 2016................................... 450,000
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, 2015.................................... $19,430,000
Budget estimate, 2016................................... 19,436,000
Committee recommendation................................ 19,430,000
The Committee recommends $19,430,000 for the HBCU Capital
Financing Program.
The Committee recommendation includes $19,096,000 to pay
the loan subsidy costs in guaranteed loan authority under this
program. This amount will support an estimated $286,000,000 in
new loan volume in fiscal year 2016. 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 for Education Sciences
Appropriations, 2015.................................... $573,935,000
Budget estimate, 2016................................... 675,883,000
Committee recommendation................................ 562,978,000
The Committee recommends $562,978,000 for the Institute for
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.
RESEARCH, DEVELOPMENT, AND DISSEMINATION
The Committee recommends $177,860,000 for education
research, development, and national dissemination activities.
Funds are available for obligation for 2 fiscal years. These
funds support activities that are aimed at expanding
fundamental knowledge of education and promoting the use of
research and development findings in the design of efforts to
improve education.
STATISTICS
The Committee recommends $102,060,000 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 $53,823,000 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 $48,000,000 for research and
innovation in special education conducted by the National
Center for Special Education Research [NCSER].
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 $10,500,000 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 $33,500,000 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 $137,235,000 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
$8,235,000 for the National Assessment Governing Board [NAGB],
which is responsible for formulating policy for NAEP.
The Committee is pleased that the NAGB has 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. Due to budget constraints the Committee
recommendation includes the same level of funding to support
NAEP as in fiscal year 2015. Howerver, the Committee encourages
the NAGB to continue administering the assessments in these
three areas at least every 4 years, in accordance with the
current NAEP schedule. According to this schedule, the next
administration will be in 2018. In addition, the Committee
supports NAEP's proposals to move the math and reading
assessments to a digital based platform and expand the Trial
Urban District Assessments to 10 more urban school districts.
The Committee notes that the NAGB has scheduled the NAEP
arts assessment for 2016. The Committee encourages the
Department to ensure that the arts assessment is completed on
time and that it measures creating, performing, and responding
to art in the disciplines of dance, theatre, music, and visual
arts.
Departmental Management
PROGRAM ADMINISTRATION
Appropriations, 2015.................................... $411,000,000
Budget estimate, 2016................................... 474,089,000
Committee recommendation................................ 391,326,000
The Committee recommends $391,326,000 for program
administration. The fiscal year 2015 level represents the
enacted level, prior to the transfer of funds and
administration of certain programs to ACL in WIOA.
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 remains concerned that State and local
education agencies often submit the exact same data elements to
various principal offices within the Department. This
duplicative reporting diverts important State and local
resources to filling out paperwork rather than to providing
direct services to students. Therefore, the Committee directs
the Department to review the reporting requirements across
principal offices and determine ways to reduce confusion and
duplication across offices in order to streamline reporting
requirements in accordance with the Paperwork Reduction Act.
Performance Partnerships.--The Committee supports the
continuation of the Performance Partnerships for Disconnected
Youth. The Performance Partnerships Pilots will allow States
and localities to identify better ways of improving outcomes
for disconnected youth by giving them additional flexibility in
using discretionary funds available through multiple Federal
programs. The Committee includes a new provision this year to
focus activities towards communities that have recently faced
civil unrest. Recent 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 requests the administration provide it with
annual reports containing the following information: a detailed
summary of all involved pilot programs, an overview of how
pilots were selected, a summary of findings from the various
pilots, and recommendations for Congress on how to apply best
practices more broadly.
The Committee is concerned that the Department took
approximately 18 months for its appeal of an administrative law
judge's decision that Central Kitsap school district is
eligible for payments under the Heavily Impact Aid program in
fiscal year 2010. The Committee believes that such delays
create avoidable hardship for school districts and the students
they serve. The Committee directs the Department to provide a
report not later than 30 days after enactment of this act
identifying specific steps going forward that the Department
will take to prevent any other school district or institution
from having to endure such avoidable delays.
OFFICE FOR CIVIL RIGHTS
Appropriations, 2015.................................... $100,000,000
Budget estimate, 2016................................... 130,691,000
Committee recommendation................................ 100,000,000
The Committee recommends $100,000,000 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 THE INSPECTOR GENERAL
Appropriations, 2015.................................... $57,791,000
Budget estimate, 2016................................... 59,256,000
Committee recommendation................................ 57,791,000
The Committee recommends $57,791,000 for OIG.
OIG has the authority to investigate all departmental
programs and administrative activities, including those under
contract or grant, to prevent and detect fraud and abuse, and
to ensure the quality and integrity of those programs. The
Office investigates alleged misuse of Federal funds and
conducts audits to determine compliance with laws and
regulations, efficiency of operations, and effectiveness in
achieving program goals.
General Provisions
Section 301. The bill continues a provision prohibiting the
use of funds for the transportation of students or teachers in
order to overcome racial imbalance.
Section 302. The bill continues a provision prohibiting the
involuntary transportation of students other than to the school
nearest to the student's home.
Section 303. The bill continues a provision prohibiting the
use of funds to prevent the implementation of programs of
voluntary prayer and meditation in public schools.
Section 304. The bill continues a provision giving the
Secretary authority to transfer up to 1 percent of any
discretionary funds between appropriations.
Section 305. The bill continues a provision that allows the
outlying areas to consolidate funds under title V of the ESEA.
Section 306. The bill continues a provision that allows the
Republic of Palau to receive certain Federal funds.
Section 307. The bill continues a provision that clarifies
the Department's authority to reserve up to 0.5 percent of each
ESEA appropriation in the bill for evaluation of ESEA programs
funded in this act. These resources are in addition to any
funds specifically provided for evaluation purposes.
Section 308. The bill modifies a general provision allowing
certain institutions to continue to use endowment income for
student scholarships.
Section 309. The bill includes a new general provision
rescinding $300,000,000 in prior year discretionary unobligated
balances from the Pell grant program.
Section 310. The bill includes a new general provision
prohibiting funding for the development, implementation, and
enforcement of several higher education administrative
regulations until the HEA is reauthorized.
Section 311. The bill includes a new general provision
affirming that the Department cannot mandate or incentivize
States, LEAs, or schools to adopt any specific set of standards
or assessments.
Section 312. The bill includes a new general provision
modifying the changes made in division G of Public Law 113-235
concerning career pathways programs.
TITLE IV
RELATED AGENCIES
Committee for Purchase From People Who Are Blind or Severely Disabled
SALARIES AND EXPENSES
Appropriations, 2015.................................... $5,362,000
Budget estimate, 2016................................... 5,441,000
Committee recommendation................................ 5,362,000
The Committee recommends $5,362,000 for the Committee for
Purchase from People Who Are Blind or Severely Disabled.
The AbilityOne program provides about 47,000 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 concerned about issues identified by both
stakeholders and the Government Accountability Office [GAO]
stemming from the limited authority of the Commission to
oversee fully the Central Nonprofit Agencies [CNAs], the
independent contracted organizations which administer the
program. As noted by the GAO, the AbilityOne Commission cannot
directly control how CNAs spend funds, set performance goals,
compensate their executives, or assess whether they meet the
statutory requirement that 75 percent of the involved workforce
consist of people with severe disabilities. To enhance the
Commission's ability to manage the CNAs more fully, the
Committee directs the Commission to implement the
recommendations of the GAO in its May 2013 report as
expeditiously as possible. The Committee also directs the
Commission to report to the Committees on Appropriations of the
House of Representatives and the Senate within 120 days of
enactment of this act on its progress addressing these concerns
and recommendations.
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 $844,325,000.
OPERATING EXPENSES
Appropriations, 2015.................................... $758,349,000
Budget estimate, 2016................................... 855,208,000
Committee recommendation................................ 614,075,000
The Committee recommends $614,075,000 for the operating
expenses of CNCS.
Volunteers in Service to America [VISTA]
The Committee recommends $90,000,000 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 $196,637,000 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 $270,000,000 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 Committee strongly encourages CNCS to provide
AmeriCorps grants to support communities that have recently
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.
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 $7,400,000 for
innovation, demonstration, and assistance activities.
Social Innovation Fund [SIF].--Due to budget constraints
the Committee recommendation does not include funding for the
Social Innovation Fund.
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 2015 funding level.
Evaluation
The Committee recommendation includes $4,000,000 for CNCS
evaluation activities.
State Commission Grants
The Committee recommendation includes $16,038,000 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, 2015.................................... $209,618,000
Budget estimate, 2016................................... 237,077,000
Committee recommendation................................ 145,000,000
The Committee recommends an appropriation of $145,000,000
for making payments to the National Service Trust.
The National Service Trust makes payments of Segal
education awards, pays interest that accrues on qualified
student loans for AmeriCorps participants during terms of
service in approved national service positions, and makes other
payments entitled to members who serve in the programs of CNCS.
SALARIES AND EXPENSES
Appropriations, 2015.................................... $81,737,000
Budget estimate, 2016................................... 86,176,000
Committee recommendation................................ 80,000,000
The Committee recommends an appropriation of $80,000,000
for CNCS salaries and expenses. The salaries and expenses
appropriation provides funds for staff salaries, benefits,
travel, training, rent, equipment, and other operating expenses
necessary for management of CNCS programs and activities.
OFFICE OF INSPECTOR GENERAL
Appropriations, 2015.................................... $5,250,000
Budget estimate, 2016................................... 6,000,000
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 2015
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, 2017.................................... $445,000,000
Budget estimate, 2018................................... 445,000,000
Committee recommendation, 2018.......................... 445,000,000
The Committee recommends $445,000,000 for Corporation for
Public Broadcasting [CPB] as an advance appropriation for
fiscal year 2018.
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 has not provided the additional $40,000,000
in fiscal year 2016 requested for the first phase of replacing
and upgrading the public television interconnection system due
to budget constraints. However, language in the bill provides
authority to the CPB, at its discretion, to obligate up to
$40,000,000 of fiscal year 2016 funds for this purpose
notwithstanding the statutory formula distribution. The CPB may
utilize the amount up to $40,000,000 only for the purpose of
beginning the interconnection project in fiscal year 2016 as
requested.
Federal Mediation and Conciliation Service
SALARIES AND EXPENSES
Appropriations, 2015.................................... $45,666,000
Budget estimate, 2016................................... 48,748,000
Committee recommendation................................ 47,823,000
The Committee recommends $47,823,000 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 $400,000 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.
The Committee recognizes the FMCS must incur costs
associated with relocating its offices in fiscal year 2016. The
Committee provides an increase to FMCS to address this need to
reduce the amount which must come from within the Service's
base funds for relocation costs.
Federal Mine Safety and Health Review Commission
SALARIES AND EXPENSES
Appropriations, 2015.................................... $16,751,000
Budget estimate, 2016................................... 17,085,000
Committee recommendation................................ 15,950,000
The Committee recommends $15,950,000 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.
Institute of Museum and Library Services
OFFICE OF MUSEUM AND LIBRARIES: GRANTS AND ADMINISTRATION
Appropriations, 2015.................................... $227,860,000
Budget estimate, 2016................................... 237,428,000
Committee recommendation................................ 227,860,000
The Committee recommends $227,860,000 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
Budget activity 2015 Fiscal year Committee
appropriation 2016 request recommendation
----------------------------------------------------------------------------------------------------------------
Library Services Technology Act:
Grants to States............................................ 154,848 154,500 154,848
Native American Library Services............................ 3,861 4,063 3,861
National Leadership: Libraries.............................. 12,200 17,500 13,092
Laura Bush 21st Century Librarian........................... 10,000 10,500 10,000
-----------------------------------------------
Subtotal, LSTA............................................ 180,909 186,563 181,801
-----------------------------------------------
Museum Services Act:
Museums for America......................................... 20,200 21,457 20,200
Native American/Hawaiian Museum Services.................... 924 972 924
National Leadership: Museums................................ 7,600 11,168 7,741
-----------------------------------------------
Subtotal, MSA............................................. 28,724 33,597 28,865
-----------------------------------------------
African American History and Culture Act........................ 1,407 1,481 1,407
Administration.................................................. 15,000 14,000 14,000
Policy, Research, Program Evaluation, and Statistics............ 1,820 1,787 1,787
----------------------------------------------------------------------------------------------------------------
Medicaid and CHIP Payment and Access Commission
SALARIES AND EXPENSES
Appropriations, 2015.................................... $7,650,000
Budget estimate, 2016................................... 8,700,000
Committee recommendation................................ 7,250,000
The Committee recommends $7,250,000 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, 2015.................................... $11,749,000
Budget estimate, 2016................................... 12,100,000
Committee recommendation................................ 11,100,000
The Committee recommends $11,100,000 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, 2015.................................... $3,250,000
Budget estimate, 2016................................... 3,432,000
Committee recommendation................................ 3,075,000
The Committee recommends $3,075,000 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, 2015.................................... $274,224,000
Budget estimate, 2016................................... 278,000,000
Committee recommendation................................ 246,802,000
The Committee recommends $246,802,000 for the National
Labor Relations Board [NLRB], which administers and enforces
the National Labor Relations Act and protects employee and
employer rights provided under that act.
The Committee is deeply concerned by the Board's aggressive
regulatory agenda as well as its departure from long-standing
policy and precedent on a variety of matters. The Committee has
included new provisions in the bill and reduced the Board's
budget authority to constrain its unacceptable overreach.
The Committee notes that the Board's fiscal year 2016 CJ
contains insufficient detail about its workload, performance,
and administrative plans and priorities. The submission
contains far less information to support the request than in
past years. The Board is directed to provide justification for
its fiscal year 2017 request, including at least as much detail
as it has traditionally provided prior to fiscal year 2016.
The Committee is concerned that the NLRB has sought in some
cases to exercise jurisdiction over Indian-owned businesses
within tribal territories. Under the National Labor Relations
Act of 1935 [NLRA], Federal, State, and local governments are
exempted explicitly from the NLRB's jurisdiction. In the recent
Chickasaw Nation case, the NLRB recognized tribal sovereignty
for purposes of the NLRA for tribes with formal treaties. The
Committee believes that Indian governments without formal
treaties should be treated no differently with respect to the
jurisdiction of the NLRB.
ADMINISTRATIVE PROVISIONS
The Committee maintains language from the fiscal year 2015
appropriations act concerning one administrative provision
restricting the use of electronic voting (section 406) and
includes three new provisions: prohibiting enforcement of a new
representation case procedure rule (section 407); prohibiting
any change in the interpretation or application of a standard
to determine whether entities are ``joint employers'' (section
408); and prohibiting any form of implementation of a new
standard for initial bargaining unit determinations that
conflicts with the standard articulated in the majority opinion
in Wheeling Island Gaming Inc. and United Food and Commercial
Workers International Union, Local 23 (section 409).
National Mediation Board
SALARIES AND EXPENSES
Appropriations, 2015.................................... $13,227,000
Budget estimate, 2016................................... 13,230,000
Committee recommendation................................ 12,600,000
The Committee recommends $12,600,000 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.
Occupational Safety and Health Review Commission
SALARIES AND EXPENSES
Appropriations, 2015.................................... $11,639,000
Budget estimate, 2016................................... 13,212,000
Committee recommendation................................ 11,100,000
The Committee recommends $11,100,000 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, 2015.................................... $34,000,000
Budget estimate, 2016................................... 29,000,000
Committee recommendation................................ 29,000,000
The Committee recommends $29,000,000 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 ACCOUNT
Appropriations, 2015.................................... $150,000
Budget estimate, 2016................................... 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, 2015.................................... $111,225,000
Budget estimate, 2016................................... 119,918,000
Committee recommendation................................ 111,225,000
The Committee recommends $111,225,000 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, 2015.................................... $8,437,000
Budget estimate, 2016................................... 9,450,000
Committee recommendation................................ 8,437,000
The Committee recommends $8,437,000 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, 2015.................................... $16,400,000
Budget estimate, 2016................................... 20,400,000
Committee recommendation................................ 20,400,000
The Committee recommends $20,400,000 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, 2015.................................... $41,232,978,000
Budget estimate, 2016................................... 46,422,000,000
Committee recommendation................................ 46,110,777,000
The Committee recommends $46,110,777,000 in fiscal year
2016 mandatory funds for the SSI program. This is in addition
to the $19,200,000,000 provided in the fiscal year 2015
appropriations act for the first quarter of fiscal year 2016.
In addition, the Committee recommends $14,500,000,000 in
advance funding for the first quarter of fiscal year 2017. Due
to the timing of benefit payments, which are made on the first
of the month unless the first falls on a weekend or Federal
holiday in which case it's made on the previous business day,
there will be 13 monthly benefit payments in fiscal year 2016,
compared to 12 in fiscal year 2015. The SSI program guarantees
a minimum level of income to individuals who are disabled,
blind, or older than age 65, and meet certain income and
resource limitations.
Federal Benefit Payments
The Committee recommendation includes a fiscal year 2016
program level of $60,683,000,000 for Federal benefit payments.
This will support an average monthly benefit of approximately
$565 for 8.2 million recipients.
Beneficiary Services
The Committee recommendation includes $70,000,000 in new
mandatory budget authority for beneficiary services. Including
carryover of prior year unobligated balances this will fund a
total estimated fiscal year 2016 program level of $86,000,000.
These funds reimburse VR agencies for successfully
rehabilitating disabled SSI recipients by helping them achieve
and sustain productive, self-supporting work activity. Funds
also support the Ticket to Work program that provides SSI
recipients with a ticket to offer employment networks [ENs],
including VR agencies, in exchange for employment and support
services. Instead of reimbursing ENs for specific services, the
Ticket to Work program pays ENs based on recipients achieving
certain milestones and outcomes.
Research and Demonstration
The Committee recommendation includes $101,000,000 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.
Administrative Expenses
The Committee recommendation includes $4,453,777,000 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, 2015.................................... $11,805,945,000
Budget estimate, 2016................................... 12,512,000,000
Committee recommendation................................ 11,620,945,000
The Committee recommends $11,620,945,000 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.
Continuing Disability Reviews and SSI Redeterminations.--
The Committee recommendation includes $1,439,000,000 for CDRs
and SSI redeterminations of non-medical eligibility. This
includes $273,000,000 in base funding and $1,166,000,000 in cap
adjustment funding allowed under the Budget Control Act [BCA]
of 2011. The Committee recommendation is a $43,000,000 increase
over the fiscal year 2015 funding level, as specified in the
BCA. Combined these activities are estimated to save
approximately $10,000,000,000 for the Social Security,
Medicare, and Medicaid programs by preventing waste, fraud,
abuse, and improper payments.
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 2015 levels respectively. These programs provide
valuable services to help Social Security disability
beneficiaries return to work.
Representative Payee Oversight.--SSA assigns representative
payees when beneficiaries are unable to financially manage
their own benefit payments. The Committee continues to strongly
encourage SSA to continue to pursue efforts to improve
representative payee oversight, including continuing to partner
with outside organizations to identify, investigate, and
prevent fraud and abuse.
Medical Improvement Review Standard.--The Committee
commends SSA for its work to improve program integrity.
However, the Committee is concerned about GAO's testimony to
Congress that confusion still exists about the Medical
Improvement Review Standard [MIRS] and its exceptions. The
Committee directs SSA to submit a report no later than 60 days
after the enactment of this act to the Committees on
Appropriations of the House of Representatives and the Senate,
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.
Disability Hearing Pilot Program.--The Committee notes that
SSA has made positive statements to Congress about its pilot
program in Region I that requires administrative law judges to
give claimants a 75 day notice before their hearing and
requires claimants to submit all evidence 5 days before the
hearing subject to good cause exception (also known as ``soft''
closing of the record). This policy promotes a smoother hearing
process, reducing the time it take to hear and adjudicate
disability appeals, while still providing assurances that
individuals are able to provide all evidence in support of
their case. The Committee directs SSA to provide to the
Committees on Appropriations of the House of Representatives
and the Senate, no later than 60 days after the enactment of
this act, an update on this pilot program and any plans to
expand the pilot to other regions.
Medical Vocational Guidelines.--The Committee is encouraged
that SSA plans to issue an Advanced Notice of Proposed
Rulemaking on the need to update the medical-vocational
guidelines, including seeking input from the Disability
Research Consortium; the Institute of Medicine; and other
medical, aging, employment, and disability experts. These
guidelines play a key role in SSA's disability determination
process but have not been updated since they were established
in 1978. The Committee directs SSA to provide a report to the
Committees on Appropriations of the House of Representatives
and the Senate, no later than 60 days after the enactment of
this act, on its plan for updating the medical vocational
guidelines.
Vocational Experts [VE].--The Committee notes that SSA's
OIG has recommended that SSA periodically determine whether VE
fees are appropriate to obtain the required level of VE
service, which could include benchmark studies with VE fees
paid in the national economy or elsewhere by government
entities. The Committee strongly encourages SSA to conduct such
a review, including comparing fees paid by SSA to those paid by
other governmental and non-governmental organizations. The
Committee directs SSA to brief the Committees on Appropriations
of the House of Representatives and the Senate on its plan to
comply with these OIG recommendations.
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.
User Fees.--Within the total for LAE, the Committee
recommendation includes up to $137,000,000 for administrative
activities funded from user fees. This includes $136,000,000 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.
Within the total for LAE, the Committee recommendation
includes up to $11,900,000 for the planning and design of the
renovation and modernization of SSA facilities.
OFFICE OF THE INSPECTOR GENERAL
Appropriations, 2015.................................... $103,350,000
Budget estimate, 2016................................... 109,795,000
Committee recommendation................................ 103,350,000
The Committee recommends $103,350,000 for SSA's OIG. This
includes $74,521,000 funded from the OASI and DI trust funds
for those programs' share of OIG's expenses and $28,829,000
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 general 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 general provision
prohibiting SSA from establishing a totalization agreement with
Mexico.
Section 520. The bill includes a modified 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 includes a new provision related to
advertisement costs. In response to Federal agencies spending
millions of taxpayer dollars on advertising campaigns, the
Committee includes language requiring Federal agencies funded
in this bill to disclose when taxpayer dollars are used to pay
for government advertising. On any advertisements, including,
but not limited to, emails, television, radio, or Internet
postings, the Committee requires the agency to disclose within
the advertisement itself, that it was produced and disseminated
with taxpayer dollars. Further, the Committee expects each
agency to include in their fiscal year 2017 CJ information
detailing how much funding was spent on advertising in fiscal
year 2016.
Section 525. The bill includes 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 related to
the National Disaster Medical System employees.
Section 528. The bill includes a new provision designed to
ensure compliance with the ``public charge'' inadmissibility
grounds present in the Immigration and Nationality Act.
Section 529. The bill modifies a provision rescinding funds
from the Independent Payment Advisory Board.
Section. 530. The bill includes a new provision rescinding
funds from the Consumer Operated and Oriented Plans.
Section 531. The bill modifies a provision rescinding funds
from the Children's Health Insurance Program performance bonus
fund.
Section 532. The bill includes a provision rescinding funds
from section 532 of the Children's Health Insurance Program.
Section 533. The bill includes a new provision rescinding
carryover funds from Community Health Centers.
COMPLIANCE WITH PARAGRAPH 7, RULE XVI, OF THE STANDING RULES OF THE
SENATE
Paragraph 7 of rule XVI requires that Committee reports on
general appropriations bills identify each Committee amendment
to the House bill ``which proposes an item of appropriation
which is not made to carry out the provisions of an existing
law, a treaty stipulation, or an act or resolution previously
passed by the Senate during that session.''
The Committee is filing an original bill, which is not
covered under this rule, but reports this information in the
spirit of full disclosure.
The Committee recommends funding for the following programs
and activities which currently lack authorization: Elementary
and Secondary Education Act; Institute of Education Sciences;
parts C and D of the Individuals with Disabilities Education
Act; Special Olympics Sport and Empowerment Act of 2004; 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 25, 2015,
the Committee ordered favorably reported an original bill
making appropriations for the Departments of Labor, Health and
Human Services, and Education, and related agencies for the
fiscal year ending September 30, 2016, and for other purposes,
provided, that the bill be subject to amendment and that the
bill be consistent with its budget allocation, by a recorded
vote of 16-14, a quorum being present. The vote was as follows:
Yeas Nays
Chairman Cochran Ms. Mikulski
Mr. McConnell Mr. Leahy
Mr. Shelby Mrs. Murray
Mr. Alexander Mrs. Feinstein
Ms. Collins Mr. Durbin
Ms. Murkowski Mr. Reed
Mr. Graham Mr. Tester
Mr. Kirk Mr. Udall
Mr. Blunt Mrs. Shaheen
Mr. Moran Mr. Merkley
Mr. Hoeven Mr. Coons
Mr. Boozman Mr. Schatz
Mrs. Capito Ms. Baldwin
Mr. Cassidy Mr. Murphy
Mr. Lankford
Mr. Daines
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 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) * * *
(2)(A) The amount of the Federal Pell Grant for a student
eligible under this part shall be--
(i) the maximum Federal Pell Grant, as specified in
the last enacted appropriation Act applicable to that
award year, plus
(ii) the amount of the increase calculated under
paragraph (7)(B) for that year [except that a student
eligible only under 1091(d)(1)(A) of this title who
first enrolls in an eligible program of study on or
after July 1, 2015 shall not be eligible for the amount
of the increase calculated under paragraph (7)(B)],
less
* * * * * * *
Part F--General Provisions Relating to Student Assistance Programs
Sec. 1091. Student eligibility
(a) In general
* * * * * * *
(d) Students who are not high school graduates
(1) Student eligibilty
* * * * * * *
[(2) Eligible career pathway program
In this subsection, the term ``eligible career pathway
program'' means a program that--
(A) concurrently enrolls participants in connected
adult education and eligible postsecondary programs;
(B) provides counseling and supportive services to
identify and attain academic and career goals;
(C) provides structured course sequences that-
(i) are articulated and contextualized; and
(ii) allow students to advance to higher
levels of education and employment;
(D) provides opportunities for acceleration to
attain recognized postsecondary credentials, including
degrees, industry relevant certifications, and
certificates of completion of apprenticeship programs;
(E) is organized to meet the needs of adults;
(F) is aligned with the education and skill needs
of the regional economy; and
(G) has been developed and implemented in
collaboration with partners in business, workforce
development, and economic development.]
(2) Eligible Career Pathway Program.-- In this subsection,
the term ``eligible career pathway program'' means a program
that combines rigorous and high-quality education, training,
and other services that--
(A) aligns with the skill needs of industries in
the economy of the State or regional economy involved;
(B) prepares an individual to be successful in any
of a full range of secondary or postsecondary education
options, including apprenticeships registered under the
Act of August 16, 1937 (commonly known as the
``National Apprenticeship Act''; 50 Stat. 664, chapter
663; 29 U.S.C. 50 et seq.) (referred to individually in
this Act as an ``apprenticeship'', except in section
171);
(C) includes counseling to support an individual in
achieving the individual's education and career goals;
(D) includes, as appropriate, education offered
concurrently with and in the same context as workforce
preparation activities and training for a specific
occupation or occupational cluster;
(E) organizes education, training, and other
services to meet the particular needs of an individual
in a manner that accelerates the educational and career
advancement of the individual to the extent
practicable;
(F) enables an individual to attain a secondary
school diploma or its recognized equivalent, and at
least 1 recognized postsecondary credential; and
(G) helps an individual enter or advance within a
specific occupation or occupational cluster.
------
TITLE 29--LABOR
CHAPTER 8--FAIR LABOR STANDARDS
Sec. 207. Maximum hours
(a) Employees engaged in interstate commerce; additional
applicability to employees pursuant to subsequent
amendatory provisions
* * * * * * *
(r) Reasonable break time for nursing mothers
(1) * * *
* * * * * * *
(4) Nothing in this subsection shall preempt a State law that
provides greater protections to employees than the protections
provided for under this subsection.
(s)(1) The provisions of this section shall not apply for a
period of 2 years after the occurrence of a major disaster, as
defined herein, to any employee--
(A) employed to adjust or evaluate claims resulting
from or relating to such major disaster, by an employer
not engaged, directly or through an affiliate, in
underwriting, selling, or marketing property, casualty,
or liability insurance policies or contracts;
(B) who receives on average weekly compensation of
not less than $591.00 per week or any minimum weekly
amount established by the Secretary, whichever is
greater, over the number of weeks such employee is
engaged in any of the activities described in
subparagraph (C); and
(C) whose duties include any of the following:
(i) interviewing insured individuals,
individuals who suffered injuries or other
damages or losses arising from or relating to a
disaster, witnesses, or physicians;
(ii) inspecting property damage or
reviewing factual information to prepare damage
estimates;
(iii) evaluating and making recommendations
regarding coverage or compensability of claims
or determining liability or value aspects of
claims;
(iv) negotiating settlements; or
(v) making recommendations regarding
litigation.
(2) Notwithstanding any other provision of section 18, in
the event of a major disaster, this Act exclusively shall
govern the payment of overtime to all employees described in
paragraph (1) above, and shall supersede any other Federal,
State, or local law, regulation, or order.
(3) The exemption in this subsection shall not affect the
exemption provided by section 13(a)(1).
(4) For purposes of this subsection--
(A) the term ``major disaster'' means any disaster
or catastrophe declared or designated by any State or
Federal agency or department;
(B) the term ``employee employed to adjust or
evaluate claims resulting from or relating to such
major disaster'' means an individual who timely secured
or secures a license required by applicable law to
engage in and perform any of the activities described
in clauses (i) through (v) of paragraph (1)(C) relating
to a major disaster, and is employed by an employer
that maintains worker compensation insurance coverage
or protection for its employees, if required by
applicable law, and withholds applicable Federal,
State, and local income and payroll taxes from the
wages, salaries and any benefits of such employees; and
(C) the term ``affiliate'' means a company that, by
reason of ownership or control of percent or more of
the outstanding shares of any class of voting
securities of one or more companies, directly or
indirectly, controls, is controlled by, or is under
common control with, another company.
------
TITLE 42--THE PUBLIC HEALTH AND WELFARE
Chapter 6A--Public Health Service
SUBCHAPTER II--NATIONAL RESEARCH INSTITUTES
Part C--Specific Provisions Respecting National Research Institutes
SUBPART 11--NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES
Sec. 285k. National Institute of General Medical Sciences
(a) General purpose
* * * * * * *
(b) Institutional development award program
(1)(A) In the case of entities described in subparagraph
(B), the Director of NIH, acting through the Director of the
National Institute of General Medical Sciences, shall establish
a program to enhance the competitiveness of such entities in
obtaining funds from the national research institutes for
conducting biomedical and behavioral research.
(B) The entities referred to in subparagraph (A) are
entities that conduct biomedical [and behavioral research and
are located in a State in which the aggregate success rate for
applications to the national research institutes for assistance
for such research by the entities in the State has historically
constituted a low success rate of obtaining such funds,
relative to such aggregate rate for such entities in other
States.] or behavioral research and are located in a State that
is at or below the median of all States with respect to the
aggregate NIH funding received by entities in that State.
(C) With respect to enhancing competitiveness for purposes
of subparagraph (A), the Director of NIH, in carrying out the
program established under such subparagraph, may--
(i) provide technical assistance to the entities
involved, including technical assistance in the
preparation of applications for obtaining funds from
the national research institutes;
(ii) assist the entities in developing a plan for
biomedical or behavioral research proposals; and
(iii) assist the entities in implementing such
plan.
(D) Entities that are designated as Primarily Undergraduate
Institutions and that are not eligible for funding under the
Individuals with Disabilities Education Act, but that have been
eligible for participation in the National Science Foundation
Experimental Program to Stimulate Competitive Research (EPSCoR)
program for the past 2 consecutive years, may apply to an
entity that currently holds an IDeA Networks of Biomedical
Research Excellence award for inclusion in their Network.
* * * * * * *
SUBCHAPTER XXVI--NATIONAL ALL-HAZARDS PREPAREDNESS FOR PUBLIC HEALTH
EMERGENCIES
Part B--All-Hazards Emergency Preparedness and Response
Sec. 300hh-11. National Disaster Medical System
(a) National Disaster Medical System
* * * * * * *
(d) Certain employment issues regarding intermittent
appointments
* * * * * * *
(1) Intermittent disaster-response appointee
* * * * * * *
(2) Compensation for work injuries
[An] (A) In general.--An intermittent disaster-
response appointee shall, while acting in the scope of
such appointment, be considered to be an employee of
the Public Health Service performing medical, surgical,
dental, or related functions, and an injury sustained
by such an individual shall be deemed ``in the
performance of duty'', for purposes of chapter 81 of
title 5 pertaining to compensation for work injuries.
[With] (B) Application to training programs.--With
respect to the participation of individuals appointed
under subsection (c) of this section in training
programs authorized by the Assistant Secretary for
Preparedness and Response or a comparable official of
any Federal agency specified in subsection (a)(2)(B) of
this section, injuries sustained by such an individual,
while acting within the scope of such participation,
also shall be deemed ``in the performance of duty'' for
purposes of chapter 81 of title 5 (regardless of
whether the individuals receive compensation for such
participation).
[In] (C) Responsibility of labor secretary.--In the
event of an injury to such an intermittent disaster-
response appointee, the Secretary of Labor shall be
responsible for making determinations as to whether the
claimant is entitled to compensation or other benefits
in accordance with chapter 81 of title 5.
(D) Computation of pay.--In the event of an injury
to such an intermittent disaster response appointee,
the position of the employee shall be deemed to be
``one which would have afforded employment for
substantially a whole year'', for purposes of section
8114(d)(2) of such title.
(E) Continuation of pay.--The weekly pay of such an
employee shall be deemed to be the hourly pay in effect
on the date of the injury multiplied by 40, for
purposes of computing benefits under section 8118 of
such title.
* * * * * * *
Chapter 43--Department of Health and Human Services
SUBCHAPTER I--GENERAL PROVISIONS
Sec. 3514A. Nonrecurring expenses fund
There is hereby established in the Treasury of the United
States a fund to be known as the ``Nonrecurring expenses fund''
(the Fund): Provided, That unobligated balances of expired
discretionary funds appropriated in this or any succeeding
fiscal year from the General Fund of the Treasury to the
Department of Health and Human Services by this or any other
Act may be transferred (not later than the end of the fifth
fiscal year after the last fiscal year for which such funds are
available for the purposes for which appropriated) into the
Fund: Provided further, That amounts deposited in the Fund
shall be available to the Office of the Director, National
Institutes of Health until expended, and in addition to such
other funds as may be available for [such purposes, for capital
acquisition necessary for the operation of the Department,
including facilities infrastructure and information technology
infrastructure] all necessary expenses related to carrying out
section 301 and title IV of the Public Health Service Act,
subject to approval by the Office of Management and Budget:
Provided further, That amounts in the Fund may be obligated
only after the Committees on Appropriations of the House of
Representatives and the Senate are notified at least 15 days in
advance of the planned use of funds.
------
TITLE 48--TERRITORIES AND INSULAR POSSESSIONS
Chapter 18--Micronesia, Marshall Islands, and Palau
SUBCHAPTER I--MICRONESIA AND MARSHALL ISLANDS
Part B--Approval and Implementation of Compacts, As Amended
Sec. 1921d. Supplemental provisions
(a) Domestic program requirements
* * * * * * *
(f) Continuing programs and laws
(1) Federated States of Micronesia and Republic of the
Marshall Islands
* * * * * * *
(A) Emergency and disaster assistance
* * * * * * *
(B) Treatment of additional programs
(i) Consultation
* * * * * * *
(ix) Applicability
The government, institutions, and
people of Palau shall remain eligible
for appropriations and to receive
grants under the provisions of law
specified in clauses (ii) and (iii)
until the end of fiscal year [2009]
2016, to the extent the government,
institutions, and people of Palau were
so eligible under such provisions in
fiscal year 2003.
------
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 2016.--Federal agencies may use Federal discretionary
funds that are made available in this Act to carry out up to 10
Performance Partnership Pilots. Such Pilots shall:
* * * * * * *
(c) Performance Partnership Agreements.--Federal agencies
may use Federal discretionary funds, as authorized in
subsection (b), to participate in a Performance Partnership
Pilot only in accordance with the terms of a Performance
Partnership Agreement that--
(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, 2020);
* * * * * * *
(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,
2020.
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 2016: Subcommittee on Labor, HHS, Education,
and Related Agencies:
Mandatory............................................... 726,685 726,685 726,379 \1\726,379
Discretionary........................................... 153,188 154,749 165,342 \1\166,674
Security............................................ ........... ........... NA NA
Nonsecurity......................................... 153,188 154,749 NA NA
Overseas Contingency Operations/Global War on Terrorism. ........... ........... ........... ...........
Projections of outlays associated with the recommendation:
2016.................................................... ........... ........... ........... \2\795,519
2017.................................................... ........... ........... ........... 67,098
2018.................................................... ........... ........... ........... 14,527
2019.................................................... ........... ........... ........... 2,902
2020 and future years................................... ........... ........... ........... 811
Financial assistance to State and local governments for 2016 NA 412,900 NA \2\395,879
----------------------------------------------------------------------------------------------------------------
\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
$1,561,000,000 in budget authority plus associated outlays.
COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2015 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL FOR FISCAL
YEAR 2016
[In thousands of dollars]
--------------------------------------------------------------------------------------------------------------------------------------------------------
Senate Committee recommendation
compared with (+ or -)
Item 2015 Budget estimate Committee -----------------------------------
appropriation recommendation 2015
appropriation Budget estimate
--------------------------------------------------------------------------------------------------------------------------------------------------------
TITLE I -- DEPARTMENT OF LABOR
EMPLOYMENT AND TRAINING ADMINISTRATION
Training and Employment Services
Grants to States:
Adult Training, current year.............................. 64,736 103,556 25,000 -39,736 -78,556
Advance from prior year............................... (712,000) (712,000) (712,000) ................ ................
Fiscal year 2017...................................... 712,000 712,000 712,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal............................................ 776,736 815,556 737,000 -39,736 -78,556
Youth Training............................................ 831,842 873,416 790,000 -41,842 -83,416
Dislocated Worker Assistance, current year................ 155,530 160,860 105,000 -50,530 -55,860
Advance from prior year............................... (860,000) (860,000) (860,000) ................ ................
Fiscal year 2017...................................... 860,000 860,000 860,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal............................................ 1,015,530 1,020,860 965,000 -50,530 -55,860
-----------------------------------------------------------------------------------------
Subtotal, Grants to States.......................... 2,624,108 2,709,832 2,492,000 -132,108 -217,832
Current Year...................................... (1,052,108) (1,137,832) (920,000) (-132,108) (-217,832)
Fiscal year 2017.................................. (1,572,000) (1,572,000) (1,572,000) ................ ................
Federally Administered Programs:
Dislocated Worker Assistance National Reserve:
Current year.......................................... 20,859 40,859 ................ -20,859 -40,859
Advance from prior year............................... (200,000) (200,000) (200,000) ................ ................
Fiscal year 2017...................................... 200,000 200,000 200,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal............................................ 220,859 240,859 200,000 -20,859 -40,859
-----------------------------------------------------------------------------------------
Subtotal, Dislocated Worker Assistance.............. 1,236,389 1,261,719 1,165,000 -71,389 -96,719
Native American Programs.................................. 46,082 50,000 40,500 -5,582 -9,500
Disability Employment Programs............................ ................ ................ 23,750 +23,750 +23,750
Migrant and Seasonal Farmworker programs.................. 81,896 81,896 73,000 -8,896 -8,896
Technical Assistance...................................... ................ 3,232 1,000 +1,000 -2,232
Women in Apprenticeship................................... 994 ................ ................ -994 ................
YouthBuild activities..................................... 79,689 84,534 79,689 ................ -4,845
-----------------------------------------------------------------------------------------
Subtotal, Federally Administered Programs [FAP]......... 429,520 460,521 417,939 -11,581 -42,582
Current Year........................................ (229,520) (260,521) (217,939) (-11,581) (-42,582)
Fiscal year 2017.................................... (200,000) (200,000) (200,000) ................ ................
National Activities:
Reintegration of Ex-Offenders......................... 82,078 95,078 22,305 -59,773 -72,773
Workforce Data Quality Initiative..................... 4,000 37,000 4,000 ................ -33,000
Apprenticeship programs............................... ................ 100,000 ................ ................ -100,000
-----------------------------------------------------------------------------------------
Subtotal............................................ 86,078 235,310 26,305 -59,773 -209,005
-----------------------------------------------------------------------------------------
Total, Training and Employment Services [TES]....... 3,139,706 3,405,663 2,936,244 -203,462 -469,419
Current Year...................................... (1,367,706) (1,633,663) (1,164,244) (-203,462) (-469,419)
Fiscal year 2017.................................. (1,772,000) (1,772,000) (1,772,000) ................ ................
=========================================================================================
Office of Job Corps
Administration................................................ 32,330 43,119 31,147 -1,183 -11,972
Operations.................................................... 1,580,825 1,597,825 1,578,008 -2,817 -19,817
Construction, Rehabilitation and Acquisition.................. 75,000 75,000 74,000 -1,000 -1,000
-----------------------------------------------------------------------------------------
Total, Office of Job Corps.............................. 1,688,155 1,715,944 1,683,155 -5,000 -32,789
Current Year........................................ (1,688,155) (1,715,944) (1,683,155) (-5,000) (-32,789)
=========================================================================================
Community Service Employment For Older Americans.............. 434,371 434,371 400,000 -34,371 -34,371
Federal Unemployment Benefits and Allowances.................. 710,600 664,200 664,200 -46,400 ................
STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS
Unemployment Compensation [UI]:
State Operations.......................................... 2,777,793 2,883,450 2,725,550 -52,243 -157,900
National Activities....................................... 12,892 14,547 12,892 ................ -1,655
-----------------------------------------------------------------------------------------
Subtotal, Unemployment Compensation..................... 2,790,685 2,897,997 2,738,442 -52,243 -159,555
Employment Service [ES]:
Allotments to States:
Federal Funds......................................... 21,413 21,413 20,775 -638 -638
Trust Funds........................................... 642,771 642,771 614,000 -28,771 -28,771
Supplemental grants............................... ................ 400,000 ................ ................ -400,000
-----------------------------------------------------------------------------------------
Subtotal, Trust Funds........................... 642,771 1,042,771 614,000 -28,771 -428,771
-----------------------------------------------------------------------------------------
Subtotal, Allotments to States.................. 664,184 1,064,184 634,775 -29,409 -429,409
ES National Activities.................................... 19,818 19,818 19,000 -818 -818
-----------------------------------------------------------------------------------------
Subtotal, Employment Service............................ 684,002 1,084,002 653,775 -30,227 -430,227
Federal Funds................................. (21,413) (21,413) (20,775) (-638) (-638)
Trust Funds................................... (662,589) (1,062,589) (633,000) (-29,589) (-429,589)
Foreign Labor Certification:
Federal Administration.................................... 48,028 61,589 47,691 -337 -13,898
Grants to States.......................................... 14,282 14,282 14,000 -282 -282
-----------------------------------------------------------------------------------------
Subtotal, Foreign Labor Certification................... 62,310 75,871 61,691 -619 -14,180
One-Stop Career Centers/Labor Market Information.............. 60,153 80,153 65,653 +5,500 -14,500
-----------------------------------------------------------------------------------------
Total, State UI and ES.................................. 3,597,150 4,138,023 3,519,561 -77,589 -618,462
Federal Funds....................................... (81,566) (101,566) (86,428) (+4,862) (-15,138)
Trust Funds......................................... (3,515,584) (4,036,457) (3,433,133) (-82,451) (-603,324)
=========================================================================================
State Paid Leave Fund......................................... ................ 35,000 ................ ................ -35,000
Program Administration
Training and Employment....................................... 60,074 73,158 56,568 -3,506 -16,590
Trust Funds............................................... 8,639 10,846 7,991 -648 -2,855
Employment Security........................................... 3,469 3,664 3,209 -260 -455
Trust Funds............................................... 39,264 40,828 36,319 -2,945 -4,509
Apprenticeship Services....................................... 34,000 36,734 31,450 -2,550 -5,284
Executive Direction........................................... 7,034 9,204 6,506 -528 -2,698
Trust Funds............................................... 2,079 2,130 1,974 -105 -156
-----------------------------------------------------------------------------------------
Total, Program Administration........................... 154,559 176,564 144,017 -10,542 -32,547
Federal Funds....................................... (104,577) (122,760) (97,733) (-6,844) (-25,027)
Trust Funds......................................... (49,982) (53,804) (46,284) (-3,698) (-7,520)
=========================================================================================
Total, Employment and Training Administration........... 9,724,541 10,569,765 9,347,177 -377,364 -1,222,588
Federal Funds....................................... 6,158,975 6,479,504 5,867,760 -291,215 -611,744
Current Year.................................. (4,386,975) (4,707,504) (4,095,760) (-291,215) (-611,744)
Fiscal year 2017.............................. (1,772,000) (1,772,000) (1,772,000) ................ ................
Trust Funds......................................... 3,565,566 4,090,261 3,479,417 -86,149 -610,844
=========================================================================================
EMPLOYEE BENEFITS SECURITY ADMINISTRATION [EBSA]
Salaries and Expenses
Enforcement and Participant Assistance........................ 147,400 166,362 137,000 -10,400 -29,362
Policy and Compliance Assistance.............................. 26,901 34,258 25,901 -1,000 -8,357
Executive Leadership, Program Oversight and Administration.... 6,699 6,835 6,029 -670 -806
-----------------------------------------------------------------------------------------
Total, EBSA............................................. 181,000 207,455 168,930 -12,070 -38,525
=========================================================================================
PENSION BENEFIT GUARANTY CORPORATION [PBGC]
Pension Benefit Guaranty Corporation Fund
Pension Insurance Activities.................................. ................ (431,799) (431,799) (+431,799) ................
Pension Insurance Activities.................................. (79,526) ................ ................ (-79,526) ................
Pension Plan Termination...................................... (179,230) ................ ................ (-179,230) ................
Operational Support........................................... (156,638) ................ ................ (-156,638) ................
-----------------------------------------------------------------------------------------
Total, PBGC (program level)............................. (415,394) (431,799) (431,799) (+16,405) ................
=========================================================================================
WAGE AND HOUR DIVISION, Salaries and expenses................. 227,500 277,100 210,000 -17,500 -67,100
OFFICE OF LABOR-MANAGEMENT STANDARDS, Salaries and expenses... 39,129 46,981 36,000 -3,129 -10,981
OFFICE OF FEDERAL CONTRACT COMPLIANCE PROGRAMS, Salaries and 106,476 113,687 96,000 -10,476 -17,687
expenses.....................................................
OFFICE OF WORKERS' COMPENSATION PROGRAMS
Salaries and Expenses......................................... 110,823 117,397 107,500 -3,323 -9,897
Trust Funds............................................... 2,177 2,177 2,177 ................ ................
-----------------------------------------------------------------------------------------
Total, Salaries and Expenses............................ 113,000 119,574 109,677 -3,323 -9,897
Federal Funds....................................... (110,823) (117,397) (107,500) (-3,323) (-9,897)
Trust Funds......................................... (2,177) (2,177) (2,177) ................ ................
=========================================================================================
Special Benefits
Federal Employees' Compensation Benefits...................... 207,000 207,000 207,000 ................ ................
Longshore and Harbor Workers' Benefits........................ 3,000 3,000 3,000 ................ ................
-----------------------------------------------------------------------------------------
Total, Special Benefits................................. 210,000 210,000 210,000 ................ ................
=========================================================================================
Special Benefits for Disabled Coal Miners
Benefit Payments.............................................. 96,000 85,040 85,000 -11,000 -40
Administration................................................ 5,262 5,262 5,302 +40 +40
-----------------------------------------------------------------------------------------
Subtotal, Fiscal year 2016 program level................ 101,262 90,302 90,302 -10,960 ................
Less funds advanced in prior year..................... -24,000 -21,000 -21,000 +3,000 ................
-----------------------------------------------------------------------------------------
Total, Current Year................................. 77,262 69,302 69,302 -7,960 ................
New advances, 1st quarter, fiscal year 2017....... 21,000 19,000 19,000 -2,000 ................
-----------------------------------------------------------------------------------------
Total, Special Benefits for Disabled Coal Miners........ 98,262 88,302 88,302 -9,960 ................
=========================================================================================
Energy Employees Occupational Illness Compensation Fund
Administrative Expenses....................................... 56,406 58,552 58,552 +2,146 ................
Black Lung Disability Trust Fund
Benefit Payments and Interest on Advances..................... 261,548 275,261 275,261 +13,713 ................
Workers' Compensation Programs, Salaries and Expenses......... 33,321 35,244 35,244 +1,923 ................
Departmental Management, Salaries and Expenses................ 30,403 30,279 30,279 -124 ................
Departmental Management, Inspector General.................... 327 327 327 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Black Lung Disability......................... 325,599 341,111 341,111 +15,512 ................
Treasury Department Administrative Costs...................... 356 356 356 ................ ................
-----------------------------------------------------------------------------------------
Total, Black Lung Disability Trust Fund................. 325,955 341,467 341,467 +15,512 ................
=========================================================================================
Total, Workers' Compensation Programs................... 803,623 817,895 807,998 +4,375 -9,897
Federal Funds......................................... 801,446 815,718 805,821 +4,375 -9,897
Current year........................................ (780,446) (796,718) (786,821) (+6,375) (-9,897)
Fiscal year 2017.................................... (21,000) (19,000) (19,000) (-2,000) ................
Trust Funds........................................... 2,177 2,177 2,177 ................ ................
OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION [OSHA]
Salaries and Expenses
Safety and Health Standards................................... 20,000 23,306 17,000 -3,000 -6,306
Federal Enforcement........................................... 208,000 225,608 194,000 -14,000 -31,608
Whistleblower enforcement..................................... 17,500 22,628 15,750 -1,750 -6,878
State Programs................................................ 100,850 104,337 98,746 -2,104 -5,591
Technical Support............................................. 24,469 24,614 24,000 -469 -614
Compliance Assistance:
Federal Assistance........................................ 68,433 73,044 66,500 -1,933 -6,544
State Consultation Grants................................. 57,775 57,775 56,500 -1,275 -1,275
Training Grants........................................... 10,537 10,687 10,149 -388 -538
-----------------------------------------------------------------------------------------
Subtotal, Compliance Assistance......................... 136,745 141,506 133,149 -3,596 -8,357
Safety and Health Statistics.................................. 34,250 38,763 31,681 -2,569 -7,082
Executive Direction and Administration........................ 10,973 11,309 10,150 -823 -1,159
-----------------------------------------------------------------------------------------
Total, OSHA............................................. 552,787 592,071 524,476 -28,311 -67,595
=========================================================================================
MINE SAFETY AND HEALTH ADMINISTRATION
Salaries and Expenses
Coal Enforcement.............................................. 167,859 175,769 158,052 -9,807 -17,717
Metal/Non-Metal Enforcement................................... 91,697 93,841 87,000 -4,697 -6,841
Standards Development......................................... 5,416 6,070 4,500 -916 -1,570
Assessments................................................... 6,976 8,122 6,627 -349 -1,495
Educational Policy and Development............................ 36,320 40,448 35,412 -908 -5,036
Technical Support............................................. 33,791 34,583 33,546 -245 -1,037
Program Evaluation and Information Resources [PEIR]........... 17,990 19,783 17,091 -899 -2,692
Program Administration........................................ 15,838 16,316 14,650 -1,188 -1,666
-----------------------------------------------------------------------------------------
Total, Mine Safety and Health Administration............ 375,887 394,932 356,878 -19,009 -38,054
=========================================================================================
Total, Worker Protection Agencies....................... 1,595,779 1,751,800 1,501,961 -93,818 -249,839
Federal Funds......................................... (1,593,602) (1,749,623) (1,499,784) (-93,818) (-249,839)
Trust Funds........................................... (2,177) (2,177) (2,177) ................ ................
=========================================================================================
BUREAU OF LABOR STATISTICS
Salaries and Expenses
Employment and Unemployment Statistics........................ 204,788 219,129 200,383 -4,405 -18,746
Labor Market Information...................................... 65,000 65,000 63,700 -1,300 -1,300
Prices and Cost of Living..................................... 200,000 216,048 196,000 -4,000 -20,048
Compensation and Working Conditions........................... 78,000 85,793 76,000 -2,000 -9,793
Productivity and Technology................................... 11,424 10,795 10,627 -797 -168
Executive Direction and Staff Services........................ 33,000 35,972 32,484 -516 -3,488
-----------------------------------------------------------------------------------------
Total, Bureau of Labor Statistics....................... 592,212 632,737 579,194 -13,018 -53,543
Federal Funds....................................... 527,212 567,737 515,494 -11,718 -52,243
Trust Funds......................................... 65,000 65,000 63,700 -1,300 -1,300
=========================================================================================
OFFICE OF DISABILITY EMPLOYMENT POLICY
Salaries and Expenses......................................... 38,500 38,203 ................ -38,500 -38,203
DEPARTMENTAL MANAGEMENT
Salaries and Expenses
Executive Direction........................................... 31,010 35,302 28,684 -2,326 -6,618
Departmental Program Evaluation............................... 8,040 9,500 7,236 -804 -2,264
Legal Services................................................ 126,136 139,680 116,000 -10,136 -23,680
Trust Funds............................................... 308 308 293 -15 -15
International Labor Affairs................................... 91,125 94,517 30,000 -61,125 -64,517
Administration and Management................................. 28,413 35,835 27,750 -663 -8,085
Adjudication.................................................. 29,420 35,854 28,500 -920 -7,354
Women's Bureau................................................ 11,536 11,788 9,465 -2,071 -2,323
Civil Rights Activities....................................... 6,880 7,996 6,192 -688 -1,804
Chief Financial Officer....................................... 5,061 5,205 4,900 -161 -305
-----------------------------------------------------------------------------------------
Total, Departmental Management.......................... 337,929 375,985 259,020 -78,909 -116,965
Federal Funds....................................... (337,621) (375,677) (258,727) (-78,894) (-116,950)
Trust Funds......................................... (308) (308) (293) (-15) (-15)
=========================================================================================
Veterans Employment and Training
State Administration, Grants.................................. 175,000 175,000 175,000 ................ ................
Transition Assistance Program................................. 14,000 14,100 14,000 ................ -100
Federal Administration........................................ 39,458 40,487 39,458 ................ -1,029
National Veterans Training Institute.......................... 3,414 3,414 3,414 ................ ................
Homeless Veterans Program..................................... 38,109 38,109 38,109 ................ ................
-----------------------------------------------------------------------------------------
Total, Veterans Employment and Training................. 269,981 271,110 269,981 ................ -1,129
Federal Funds....................................... 38,109 38,109 38,109 ................ ................
Trust Funds......................................... 231,872 233,001 231,872 ................ -1,129
=========================================================================================
IT Modernization
Departmental support systems.................................. 4,898 4,898 4,898 ................ ................
Infrastructure technology modernization....................... 10,496 53,880 8,000 -2,496 -45,880
Digital Government Integrated Platform........................ ................ 60,824 ................ ................ -60,824
-----------------------------------------------------------------------------------------
Total, IT Modernization................................. 15,394 119,602 12,898 -2,496 -106,704
=========================================================================================
Office of Inspector General
Program Activities............................................ 76,000 82,325 73,721 -2,279 -8,604
Trust Funds............................................... 5,590 5,660 5,590 ................ -70
-----------------------------------------------------------------------------------------
Total, Office of Inspector General...................... 81,590 87,985 79,311 -2,279 -8,674
=========================================================================================
Total, Departmental Management.......................... 704,894 854,682 621,210 -83,684 -233,472
Federal Funds....................................... 467,124 615,713 383,455 -83,669 -232,258
Current Year........................................ (467,124) (615,713) (383,455) (-83,669) (-232,258)
Trust Funds......................................... 237,770 238,969 237,755 -15 -1,214
=========================================================================================
Total, Workforce Investment Act Programs................ 4,826,867 5,121,607 4,619,399 -207,468 -502,208
Current Year........................................ (3,054,867) (3,349,607) (2,847,399) (-207,468) (-502,208)
Fiscal year 2017.................................... (1,772,000) (1,772,000) (1,772,000) ................ ................
=========================================================================================
Total, Title I, Department of Labor..................... 13,346,549 14,545,508 12,747,863 -598,686 -1,797,645
Federal Funds......................................... 9,476,036 10,149,101 8,964,814 -511,222 -1,184,287
Current Year........................................ (7,683,036) (8,358,101) (7,173,814) (-509,222) (-1,184,287)
Fiscal year 2017.................................... (1,793,000) (1,791,000) (1,791,000) (-2,000) ................
Trust Funds........................................... 3,870,513 4,396,407 3,783,049 -87,464 -613,358
=========================================================================================
TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES
HEALTH RESOURCES AND SERVICES ADMINISTRATION [HRSA]
HEALTH RESOURCES AND SERVICES
Primary Health Care
Community Health Centers...................................... 1,491,422 1,491,422 1,491,422 ................ ................
Free Clinics Medical Malpractice.............................. 100 100 100 ................ ................
-----------------------------------------------------------------------------------------
Total, Primary Health Care.............................. 1,491,522 1,491,522 1,491,522 ................ ................
=========================================================================================
Health Workforce
National Health Service Corps................................. ................ 287,370 ................ ................ -287,370
Training for Diversity:
Centers of Excellence..................................... 21,711 25,000 21,711 ................ -3,289
Health Careers Opportunity Program........................ 14,189 ................ ................ -14,189 ................
Faculty Loan Repayment.................................... 1,190 1,190 1,190 ................ ................
Scholarships for Disadvantaged Students................... 45,970 45,970 50,970 +5,000 +5,000
Health workforce diversity................................ ................ 14,000 ................ ................ -14,000
-----------------------------------------------------------------------------------------
Subtotal, Training for Diversity........................ 83,060 86,160 73,871 -9,189 -12,289
Training in Primary Care Medicine............................. 38,924 38,924 36,831 -2,093 -2,093
Rural Physician Training Grants............................... ................ 4,000 ................ ................ -4,000
Oral Health Training.......................................... 33,928 33,928 32,000 -1,928 -1,928
-----------------------------------------------------------------------------------------
Subtotal, Oral Health programs.......................... 33,928 33,928 32,000 -1,928 -1,928
Interdisciplinary Community-Based Linkages:
Area Health Education Centers............................. 30,250 ................ 31,000 +750 +31,000
Geriatric Programs........................................ 34,237 34,237 35,076 +839 +839
Clinical Training in Interprofessional Practice....... ................ 10,000 ................ ................ -10,000
Mental and Behavorial Health.............................. 8,916 8,916 8,916 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Interdisciplinary Community Linkages.......... 73,403 53,153 74,992 +1,589 +21,839
-----------------------------------------------------------------------------------------
Total, Interdisciplinary Community Linkages............. 73,403 53,153 74,992 +1,589 +21,839
=========================================================================================
Workforce Information and Analysis............................ 4,663 4,663 2,782 -1,881 -1,881
Public Health and Preventive Medicine programs................ 21,000 17,000 9,864 -11,136 -7,136
-----------------------------------------------------------------------------------------
Subtotal................................................ 21,000 17,000 9,864 -11,136 -7,136
Nursing Programs:
Advanced Education Nursing................................ 63,581 63,581 61,089 -2,492 -2,492
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.................... 81,785 81,785 79,785 -2,000 -2,000
Comprehensive Geriatric Education......................... 4,500 4,500 ................ -4,500 -4,500
Nursing Faculty Loan Program.............................. 26,500 26,500 24,500 -2,000 -2,000
-----------------------------------------------------------------------------------------
Total, Nursing programs................................. 231,622 231,622 220,630 -10,992 -10,992
=========================================================================================
Children's Hospitals Graduate Medical Education............... 265,000 100,000 270,000 +5,000 +170,000
National Practitioner Data Bank............................... 18,814 19,728 18,814 ................ -914
User Fees................................................. -18,814 -19,728 -18,814 ................ +914
-----------------------------------------------------------------------------------------
Total, Health Workforce................................. 751,600 856,820 720,970 -30,630 -135,850
=========================================================================================
Maternal and Child Health
Maternal and Child Health Block Grant......................... 637,000 637,000 615,276 -21,724 -21,724
Sickle Cell Anemia Demonstration Program...................... 4,455 4,455 4,455 ................ ................
Traumatic Brain Injury........................................ 9,321 9,321 9,321 ................ ................
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................................................. 102,000 102,000 102,000 ................ ................
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........................ 851,738 851,738 828,014 -23,724 -23,724
=========================================================================================
Ryan White HIV/AIDS
Ryan White HIV/AIDS:
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................................ 201,079 280,167 201,079 ................ -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 ................ -25,000 -25,000
-----------------------------------------------------------------------------------------
Total, Ryan White HIV/AIDS program level................ (2,318,781) (2,322,781) (2,293,781) (-25,000) (-29,000)
=========================================================================================
Health Care Systems
Organ Transplantation......................................... 23,549 23,549 23,549 ................ ................
National Cord Blood Inventory................................. 11,266 11,266 11,266 ................ ................
Bone Marrow Program........................................... 22,109 22,109 22,109 ................ ................
Office of Pharmacy Affairs.................................... 10,238 17,238 10,238 ................ -7,000
340B Drug Pricing User Fees................................... ................ 7,500 7,500 +7,500 ................
User Fees................................................. ................ -7,500 -7,500 -7,500 ................
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 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Health Care Systems........................... 103,193 110,193 103,193 ................ -7,000
Rural Health
Rural Outreach Grants......................................... 59,000 59,000 63,500 +4,500 +4,500
Rural Health Research/Policy Development...................... 9,351 9,351 9,351 ................ ................
Rural Hospital Flexibility Grants............................. 41,609 26,200 41,609 ................ +15,409
Rural and Community Access to Emergency Devices............... 4,500 ................ ................ -4,500 ................
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.................................................... 14,900 14,900 18,000 +3,100 +3,100
-----------------------------------------------------------------------------------------
Total, Rural Health..................................... 147,471 127,562 150,571 +3,100 +23,009
=========================================================================================
Family Planning............................................... 286,479 300,000 257,832 -28,647 -42,168
Program Management............................................ 154,000 157,061 151,000 -3,000 -6,061
Vaccine Injury Compensation Program Trust Fund
Post-fiscal year 1988 Claims.................................. 235,000 237,000 237,000 +2,000 ................
HRSA Administration........................................... 7,500 7,500 7,500 ................ ................
-----------------------------------------------------------------------------------------
Total, Vaccine Injury Compensation Trust Fund........... 242,500 244,500 244,500 +2,000 ................
=========================================================================================
Total, Health Resources & Services Administration....... 6,347,284 6,462,177 6,241,383 -105,901 -220,794
=========================================================================================
CENTERS FOR DISEASE CONTROL AND PREVENTION
Immunization and Respiratory Diseases......................... 573,105 537,766 573,105 ................ +35,339
Pandemic Flu balances (Public Law 111-32)................. (15,000) ................ (15,000) ................ (+15,000)
Prevention and Public Health Fund\1\...................... (210,300) (210,300) (210,300) ................ ................
-----------------------------------------------------------------------------------------
Subtotal................................................ (798,405) (748,066) (798,405) ................ (+50,339)
HIV/AIDS, Viral Hepatitis, STD, and TB Prevention............. 1,117,609 1,161,747 1,090,609 -27,000 -71,138
Emerging and Zoonotic Infectious Diseases..................... 352,990 644,687 388,590 +35,600 -256,097
Prevention and Public Health Fund\1\...................... (52,000) (54,580) (52,000) ................ (-2,580)
-----------------------------------------------------------------------------------------
Subtotal................................................ 404,990 699,267 440,590 +35,600 -258,677
-----------------------------------------------------------------------------------------
Subtotal, Emerging and Zoonotic Infectious.............. 352,990 644,687 388,590 +35,600 -256,097
Subtotal, Prevention and Public Health Fund\1\.......... (52,000) (54,580) (52,000) ................ (-2,580)
-----------------------------------------------------------------------------------------
Total................................................... 404,990 699,267 440,590 +35,600 -258,677
=========================================================================================
Chronic Disease Prevention and Health Promotion............... 747,220 577,854 595,272 -151,948 +17,418
Prevention and Public Health Fund\1\...................... (452,000) (480,204) (457,650) (+5,650) (-22,554)
-----------------------------------------------------------------------------------------
Subtotal................................................ 1,199,220 1,058,058 1,052,922 -146,298 -5,136
Birth Defects, Developmental Disabilities, Disabilities, and 131,781 63,815 132,781 +1,000 +68,966
Health.......................................................
Prevention and Public Health Fund\1\...................... ................ (67,966) ................ ................ (-67,966)
-----------------------------------------------------------------------------------------
Subtotal................................................ 131,781 131,781 132,781 +1,000 +1,000
Public Health Scientific Services............................. 481,061 474,559 471,061 -10,000 -3,498
Prevention and Public Health Fund\1\...................... ................ (64,250) ................ ................ (-64,250)
-----------------------------------------------------------------------------------------
Subtotal................................................ (481,061) (538,809) (471,061) (-10,000) (-67,748)
Environmental Health.......................................... 166,404 141,500 132,286 -34,118 -9,214
Prevention and Public Health Fund\1\...................... (13,000) (37,000) (13,000) ................ (-24,000)
-----------------------------------------------------------------------------------------
Subtotal................................................ 179,404 178,500 145,286 -34,118 -33,214
Injury Prevention and Control................................. 170,447 256,977 187,947 +17,500 -69,030
National Institute for Occupational Safety & Health\1\........ 334,863 283,418 305,887 -28,976 +22,469
Evaluation Tap Funding.................................... ................ ................ ................ ................ ................
-----------------------------------------------------------------------------------------
Subtotal................................................ (334,863) (283,418) (305,887) (-28,976) (+22,469)
Energy Employees Occupational Illness Compensation Program.... 55,358 55,358 55,358 ................ ................
Global Health................................................. 416,517 448,092 411,758 -4,759 -36,334
Ebola funding (Public Law 113-164)........................ (30,000) ................ ................ (-30,000) ................
-----------------------------------------------------------------------------------------
Subtotal................................................ (446,517) (448,092) (411,758) (-34,759) (-36,334)
Public Health Preparedness and Response....................... 1,352,551 1,381,818 1,340,118 -12,433 -41,700
Buildings and Facilities...................................... 10,000 10,000 10,000 ................ ................
CDC-wide Activities and Program Support
Prevention and Public Health Fund\1\.......................... (160,000) ................ (160,000) ................ (+160,000)
Office of the Director........................................ 113,570 113,570 107,892 -5,678 -5,678
Title VI Ebola funding........................................ (1,771,000) ................ ................ (-1,771,000) ................
-----------------------------------------------------------------------------------------
Subtotal, CDC-Wide Activities........................... (273,570) (113,570) (267,892) (-5,678) (+154,322)
=========================================================================================
Total, Centers for Disease Control...................... 6,023,476 6,151,161 5,802,664 -220,812 -348,497
Discretionary....................................... 5,968,118 6,095,803 5,747,306 -220,812 -348,497
Pandemic Flu balances (Public Law 111-32)........... (15,000) ................ (15,000) ................ (+15,000)
Prevention and Public Health Fund\1\................ (887,300) (914,300) (892,950) (+5,650) (-21,350)
Title VI Ebola funding.............................. (1,771,000) ................ ................ (-1,771,000) ................
-----------------------------------------------------------------------------------------
Total, Centers for Disease Control Program Level.. (6,925,776) (7,065,461) (6,710,614) (-215,162) (-354,847)
=========================================================================================
NATIONAL INSTITUTES OF HEALTH
National Cancer Institute..................................... 4,953,028 5,098,479 5,204,058 +251,030 +105,579
National Heart, Lung, and Blood Institute..................... 2,995,865 3,071,906 3,135,519 +139,654 +63,613
National Institute of Dental & Craniofacial Research.......... 397,700 406,746 415,169 +17,469 +8,423
National Institute of Diabetes and Digestive and Kidney 1,749,140 1,788,133 1,825,162 +76,022 +37,029
Diseases [NIDDK].............................................
Juvenile Diabetes (mandatory)............................. (150,000) (150,000) (150,000) ................ ................
-----------------------------------------------------------------------------------------
Subtotal, NIDDK program level........................... 1,899,140 1,938,133 1,975,162 +76,022 +37,029
National Institute of Neurological Disorders & Stroke......... 1,604,607 1,660,375 1,694,758 +90,151 +34,383
National Institute of Allergy and Infectious Diseases......... 4,417,558 4,614,779 4,710,342 +292,784 +95,563
Title VI Ebola funding........................................ (238,000) ................ ................ (-238,000) ................
National Institute of General Medical Sciences................ 1,657,301 1,586,291 1,571,431 -85,870 -14,860
Evaluation Tap Funding.................................... (715,000) (847,489) (940,000) (+225,000) (+92,511)
-----------------------------------------------------------------------------------------
Subtotal, NGMS program level............................ 2,372,301 2,433,780 2,511,431 +139,130 +77,651
Eunice Kennedy Shriver National Institute of Child Health & 1,286,869 1,318,061 1,345,355 +58,486 +27,294
Human Development............................................
National Eye Institute........................................ 676,764 695,154 709,549 +32,785 +14,395
National Institute of Environmental Health Sciences........... 667,333 681,782 695,900 +28,567 +14,118
National Institute on Aging................................... 1,197,523 1,267,078 1,548,494 +350,971 +281,416
National Institute of Arthritis and Musculoskeletal and Skin 521,528 533,232 544,274 +22,746 +11,042
Diseases.....................................................
National Institute on Deafness and Other Communication 405,207 416,241 424,860 +19,653 +8,619
Disorders....................................................
National Institute of Nursing Research........................ 140,852 144,515 147,508 +6,656 +2,993
National Institute on Alcohol Abuse and Alcoholism............ 447,153 459,833 469,355 +22,202 +9,522
National Institute on Drug Abuse.............................. 1,015,705 1,047,397 1,069,086 +53,381 +21,689
National Institute of Mental Health........................... 1,433,651 1,489,417 1,520,260 +86,609 +30,843
National Human Genome Research Institute...................... 498,677 515,491 526,166 +27,489 +10,675
National Institute of Biomedical Imaging and Bioengineering... 327,243 337,314 344,299 +17,056 +6,985
National Center for Complementary and Integrative Health...... 124,062 127,521 130,162 +6,100 +2,641
National Institute on Minority Health and Health Disparities.. 270,969 281,549 287,379 +16,410 +5,830
John E. Fogarty International Center.......................... 67,634 69,505 70,944 +3,310 +1,439
National Center for Advancing Translational Sciences.......... 632,710 660,131 699,319 +66,609 +39,188
National Library of Medicine [NLM]............................ 337,324 394,090 402,251 +64,927 +8,161
Office of the Director........................................ 1,401,134 1,430,028 860,937 -540,197 -569,091
Common Fund (non-add)..................................... (533,039) (544,077) (544,077) (+11,038) ................
Gabriella Miller Kids First Research Act (Common Fund non- 12,600 12,600 12,600 ................ ................
add).....................................................
Transfers from non-recurring expenses fund................ ................ ................ (650,000) (+650,000) (+650,000)
-----------------------------------------------------------------------------------------
Subtotal................................................ 1,413,734 1,442,628 1,523,537 +109,803 +80,909
Buildings and Facilities...................................... 128,863 128,863 128,863 ................ ................
-----------------------------------------------------------------------------------------
Total, National Institutes of Health [NIH].............. 29,369,000 30,236,511 30,494,000 +1,125,000 +257,489
(Evaluation Tap Funding)................................ (715,000) (847,489) (940,000) (+225,000) (+92,511)
(Transfers from non-recurring expenses fund)............ ................ ................ (650,000) (+650,000) (+650,000)
(Title VI Ebola funding)................................ (238,000) ................ ................ (-238,000) ................
Total, NIH Program Level................................ (30,084,000) (31,084,000) (32,084,000) (+2,000,000) (+1,000,000)
=========================================================================================
SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION
[SAMHSA]
Mental Health
Programs of Regional and National Significance................ 366,597 334,289 366,597 ................ +32,308
Evaluation Tap Funding.................................... ................ (5,000) ................ ................ (-5,000)
Prevention and Public Health Fund\1\...................... (12,000) (38,000) (12,000) ................ (-26,000)
-----------------------------------------------------------------------------------------
Subtotal................................................ 378,597 377,289 378,597 ................ +1,308
Mental Health block grant..................................... 461,532 461,532 461,532 ................ ................
Evaluation Tap Funding.................................... (21,039) (21,039) (21,039) ................ ................
-----------------------------------------------------------------------------------------
Subtotal................................................ (482,571) (482,571) (482,571) ................ ................
Children's Mental Health...................................... 117,026 117,026 117,026 ................ ................
Grants to States for the Homeless (PATH)...................... 64,635 64,635 40,000 -24,635 -24,635
Protection and Advocacy....................................... 36,146 36,146 36,146 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Mental Health................................. 1,045,936 1,013,628 1,021,301 -24,635 +7,673
(Evaluation Tap Funding)............................ (21,039) (26,039) (21,039) ................ (-5,000)
(Prevention and Public Health Fund\1\).............. (12,000) (38,000) (12,000) ................ (-26,000)
-----------------------------------------------------------------------------------------
Subtotal, Mental Health program level............. (1,078,975) (1,077,667) (1,054,340) (-24,635) (-23,327)
Substance Abuse Treatment
Programs of Regional and National Significance................ 362,002 290,701 282,260 -79,742 -8,441
Evaluation Tap Funding.................................... (2,000) (30,000) (2,000) ................ (-28,000)
-----------------------------------------------------------------------------------------
Subtotal................................................ (364,002) (320,701) (284,260) (-79,742) (-36,441)
Substance Abuse block grant................................... 1,740,656 1,740,656 1,690,656 -50,000 -50,000
Evaluation Tap Funding.................................... (79,200) (79,200) (79,200) ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Block grant................................... (1,819,856) (1,819,856) (1,769,856) (-50,000) (-50,000)
-----------------------------------------------------------------------------------------
Subtotal, Substance Abuse Treatment..................... 2,102,658 2,031,357 1,972,916 -129,742 -58,441
(Evaluation Tap Funding).............................. (81,200) (109,200) (81,200) ................ (-28,000)
Subtotal, Program level............................. (2,183,858) (2,140,557) (2,054,116) (-129,742) (-86,441)
Substance Abuse Prevention
Programs of Regional and National Significance................ 175,219 194,450 182,731 +7,512 -11,719
Evaluation Tap Funding.................................... ................ (16,468) ................ ................ (-16,468)
-----------------------------------------------------------------------------------------
Subtotal................................................ 175,219 210,918 182,731 +7,512 -28,187
Health Surveillance and Program Support....................... 150,232 156,228 137,869 -12,363 -18,359
Evaluation Tap Funding (NA)............................... (31,428) (58,917) (31,428) ................ (-27,489)
Prevention and Public Health Fund\1\...................... ................ (20,000) ................ ................ (-20,000)
-----------------------------------------------------------------------------------------
Subtotal................................................ 181,660 235,145 169,297 -12,363 -65,848
=========================================================================================
Total, SAMHSA........................................... 3,474,045 3,395,663 3,314,817 -159,228 -80,846
(Evaluation Tap Funding)............................ (133,667) (210,624) (133,667) ................ (-76,957)
(Prevention and Public Health Fund\1\).............. (12,000) (58,000) (12,000) ................ (-46,000)
-----------------------------------------------------------------------------------------
Total, SAMHSA Program Level....................... (3,619,712) (3,664,287) (3,460,484) (-159,228) (-203,803)
=========================================================================================
AGENCY FOR HEALTHCARE RESEARCH AND QUALITY [AHRQ]
Healthcare Research and Quality
Research on Health Costs, Quality, and Outcomes:
Federal Funds................................................. 228,551 134,889 151,428 -77,123 +16,539
Evaluation Tap funding................................ ................ (87,888) ................ ................ (-87,888)
Patient-Centered Outcomes Research transfer........... ................ (115,636) ................ ................ (-115,636)
Preventive/Care Management (NA)........................... ................ (203,524) ................ ................ (-203,524)
-----------------------------------------------------------------------------------------
Subtotal, Health Costs, Quality, and Outcomes........... (228,551) (338,413) (151,428) (-77,123) (-186,985)
(Evaluation Tap Funding)............................ ................ (87,888) ................ ................ (-87,888)
Medical Expenditures Panel Surveys:
Federal Funds............................................. 65,447 68,877 39,268 -26,179 -29,609
Evaluation Tap Funding (NA)............................... ................ ................ ................ ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Medical Expenditures Panel Surveys............ (65,447) (68,877) (39,268) (-26,179) (-29,609)
Program Support:
Federal Funds............................................. 69,700 72,044 45,305 -24,395 -26,739
-----------------------------------------------------------------------------------------
Total, AHRQ Program Level............................... (363,698) (363,698) (236,001) (-127,697) (-127,697)
Federal funds....................................... (363,698) (275,810) (236,001) (-127,697) (-39,809)
(Evaluation Tap Funding)............................ ................ (87,888) ................ ................ (-87,888)
=========================================================================================
Total, Public Health Service (PHS) appropriation........ 45,577,503 46,521,322 46,088,865 +511,362 -432,457
Total, Public Health Service Program Level (excluding (49,111,470) (48,755,259) (48,732,482) (-378,988) (-22,777)
Ebola funding).........................................
=========================================================================================
CENTERS FOR MEDICARE AND MEDICAID SERVICES
Grants to States for Medicaid
Medicaid Current Law Benefits................................. 315,238,600 334,936,328 334,936,328 +19,697,728 ................
State and Local Administration................................ 18,766,022 17,771,915 17,771,915 -994,107 ................
Vaccines for Children......................................... 4,076,617 4,109,307 4,109,307 +32,690 ................
-----------------------------------------------------------------------------------------
Subtotal, Medicaid Program Level........................ 338,081,239 356,817,550 356,817,550 +18,736,311 ................
Less funds advanced in prior year................... -103,472,323 -113,272,140 -113,272,140 -9,799,817 ................
-----------------------------------------------------------------------------------------
Total, Grants to States for Medicaid.............. 234,608,916 243,545,410 243,545,410 +8,936,494 ................
New advance, 1st quarter, fiscal year 2017........ 113,272,140 115,582,502 115,582,502 +2,310,362 ................
=========================================================================================
Payments to Health Care Trust Funds
Supplemental Medical Insurance................................ 194,343,000 198,530,000 198,530,000 +4,187,000 ................
Federal Uninsured Payment..................................... 187,000 158,000 158,000 -29,000 ................
Program Management............................................ 763,000 1,044,000 1,044,000 +281,000 ................
General Revenue for Part D Benefit............................ 63,342,000 82,453,000 82,453,000 +19,111,000 ................
General Revenue for Part D Administration..................... 418,000 691,000 691,000 +273,000 ................
HCFAC Reimbursement........................................... 153,000 291,000 291,000 +138,000 ................
State Low-Income Determination for Part D..................... 6,000 4,800 4,800 -1,200 ................
-----------------------------------------------------------------------------------------
Total, Payments to Trust Funds, Program Level........... 259,212,000 283,171,800 283,171,800 +23,959,800 ................
=========================================================================================
Program Management
Research, Demonstration, Evaluation........................... 20,054 ................ 6,900 -13,154 +6,900
Program Operations............................................ 2,519,823 3,024,386 1,890,823 -629,000 -1,133,563
State Survey and Certification................................ 397,334 437,200 397,334 ................ -39,866
Federal Administration........................................ 732,533 783,600 732,533 ................ -51,067
-----------------------------------------------------------------------------------------
Total, Program management............................... 3,669,744 4,245,186 3,027,590 -642,154 -1,217,596
=========================================================================================
Health Care Fraud and Abuse Control Account
Centers for Medicare and Medicaid Services.................... 477,120 474,175 474,175 -2,945 ................
HHS Office of Inspector General............................... 67,200 118,631 77,275 +10,075 -41,356
Medicaid/CHIP................................................. 67,200 ................ 77,275 +10,075 +77,275
Department of Justice......................................... 60,480 113,194 77,275 +16,795 -35,919
-----------------------------------------------------------------------------------------
Total, Health Care Fraud and Abuse Control.............. 672,000 706,000 706,000 +34,000 ................
=========================================================================================
Total, Centers for Medicare and Medicaid Services....... 611,434,800 647,250,898 646,033,302 +34,598,502 -1,217,596
Federal funds......................................... 607,093,056 642,299,712 642,299,712 +35,206,656 ................
Current year........................................ (493,820,916) (526,717,210) (526,717,210) (+32,896,294) ................
New advance, fiscal year 2017....................... (113,272,140) (115,582,502) (115,582,502) (+2,310,362) ................
Trust Funds........................................... 4,341,744 4,951,186 3,733,590 -608,154 -1,217,596
=========================================================================================
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............................ 3,117,555 3,541,359 3,541,359 +423,804 ................
Federal Incentive Payments................................ 526,968 519,547 519,547 -7,421 ................
Access and Visitation..................................... 10,000 10,000 10,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Child Support Enforcement..................... 3,654,523 4,070,906 4,070,906 +416,383 ................
-----------------------------------------------------------------------------------------
Total, Family Support Payments Program Level............ 3,688,523 4,104,906 4,104,906 +416,383 ................
Less funds advanced in previous years............... -1,250,000 -1,160,000 -1,160,000 +90,000 ................
=========================================================================================
Total, Family Support Payments, current year............ 2,438,523 2,944,906 2,944,906 +506,383 ................
New advance, 1st quarter, fiscal year 2017.......... 1,160,000 1,300,000 1,300,000 +140,000 ................
=========================================================================================
Low Income Home Energy Assistance [LIHEAP]
Formula Grants................................................ 3,390,304 3,190,304 3,390,304 ................ +200,000
Utility Innovation Fund....................................... ................ 200,000 ................ ................ -200,000
-----------------------------------------------------------------------------------------
Total, LIHEAP, Program Level............................ 3,390,304 3,390,304 3,390,304 ................ ................
=========================================================================================
Refugee and Entrant Assistance
Transitional and Medical Services............................. 383,266 426,749 426,749 +43,483 ................
Victims of Trafficking........................................ 15,755 22,000 15,755 ................ -6,245
Social Services............................................... 149,927 149,927 149,927 ................ ................
Preventive Health............................................. 4,600 4,600 4,600 ................ ................
Targeted Assistance........................................... 47,601 47,601 47,601 ................ ................
Unaccompanied Minors.......................................... 948,000 948,000 750,000 -198,000 -198,000
Unaccompanied Minors Contingency Fund (CBO estimate).......... ................ 15,000 ................ ................ -15,000
Victims of Torture............................................ 10,735 10,735 10,735 ................ ................
-----------------------------------------------------------------------------------------
Total, Refugee and Entrant Assistance................... 1,559,884 1,624,612 1,405,367 -154,517 -219,245
=========================================================================================
Payments to States for the Child Care and Development Block 2,435,000 2,805,149 2,585,000 +150,000 -220,149
Grant........................................................
Social Services Block Grant (Title XX)........................ 1,700,000 1,700,000 1,700,000 ................ ................
Children and Families Services Programs
Programs for Children, Youth and Families:
Head Start, current funded................................ 8,598,095 10,117,706 8,698,095 +100,000 -1,419,611
Consolidated Runaway, Homeless Youth Program.............. 97,000 105,980 99,000 +2,000 -6,980
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...................... 28,744 48,744 28,744 ................ -20,000
Community Based Child Abuse Prevention.................... 39,764 39,764 39,764 ................ ................
Abandoned Infants Assistance.............................. 11,063 11,063 ................ -11,063 -11,063
Child Welfare Services.................................... 268,735 268,735 268,735 ................ ................
Child Welfare Training, Research, or Demonstration 15,984 15,984 13,984 -2,000 -2,000
projects.................................................
Adoption Opportunities.................................... 39,100 42,622 39,100 ................ -3,522
Adoption Incentive........................................ 37,943 37,943 37,943 ................ ................
Social Services and Income Maintenance Research............... 5,762 17,762 5,762 ................ -12,000
Native American Programs...................................... 46,520 50,000 46,520 ................ -3,480
Community Services:
Community Services Block Grant Act programs:
Grants to States for Community Services............... 674,000 674,000 674,000 ................ ................
Economic Development.................................. 29,883 ................ ................ -29,883 ................
Rural Community Facilities............................ 6,500 ................ ................ -6,500 ................
-----------------------------------------------------------------------------------------
Subtotal............................................ 710,383 674,000 674,000 -36,383 ................
Individual Development Account Initiative............. 18,950 18,950 12,000 -6,950 -6,950
-----------------------------------------------------------------------------------------
Subtotal, Community Services........................ 729,333 692,950 686,000 -43,333 -6,950
Domestic Violence Hotline..................................... 4,500 12,300 4,500 ................ -7,800
Family Violence/Battered Women's Shelters..................... 135,000 150,000 135,000 ................ -15,000
Independent Living Training Vouchers.......................... 43,257 43,257 43,257 ................ ................
Faith-Based Center............................................ 1,299 ................ ................ -1,299 ................
Disaster Human Services Case Management....................... 1,864 1,864 1,864 ................ ................
Program Direction............................................. 199,701 211,767 197,901 -1,800 -13,866
-----------------------------------------------------------------------------------------
Total, Children and Families Services Programs.......... 10,346,115 11,911,242 10,388,620 +42,505 -1,522,622
Current Year........................................ (10,346,115) (11,911,242) (10,388,620) (+42,505) (-1,522,622)
Promoting Safe and Stable Families............................ 345,000 345,000 345,000 ................ ................
Discretionary Funds....................................... 59,765 89,765 59,765 ................ -30,000
-----------------------------------------------------------------------------------------
Total, Promoting Safe and Stable Families............... 404,765 434,765 404,765 ................ -30,000
=========================================================================================
Payments for Foster Care and Permanency
Foster Care................................................... 4,289,000 4,772,100 4,772,100 +483,100 ................
Adoption Assistance........................................... 2,504,000 2,562,900 2,562,900 +58,900 ................
Guardianship.................................................. 99,000 123,000 123,000 +24,000 ................
Independent Living............................................ 140,000 140,000 140,000 ................ ................
-----------------------------------------------------------------------------------------
Total, Payments to States............................... 7,032,000 7,598,000 7,598,000 +566,000 ................
Less Advances from Prior Year......................... -2,200,000 -2,300,000 -2,300,000 -100,000 ................
-----------------------------------------------------------------------------------------
Total, payments, current year....................... 4,832,000 5,298,000 5,298,000 +466,000 ................
New Advance, 1st quarter, fiscal year 2017........ 2,300,000 2,300,000 2,300,000 ................ ................
=========================================================================================
Total, ACF.............................................. 30,566,591 33,708,978 31,716,962 +1,150,371 -1,992,016
Current year........................................ (27,106,591) (30,108,978) (28,116,962) (+1,010,371) (-1,992,016)
Fiscal year 2017.................................... (3,460,000) (3,600,000) (3,600,000) (+140,000) ................
(Evaluation Tap Funding).............................. ................ ................ ................ ................ ................
-----------------------------------------------------------------------------------------
Total, ACF Program Level............................ 30,566,591 33,708,978 31,716,962 +1,150,371 -1,992,016
=========================================================================================
ADMINISTRATION FOR COMMUNITY LIVING
Aging and Disability Services Programs
Grants to States:
Home and Community-based Supportive Services.............. 347,724 386,182 347,724 ................ -38,458
Preventive Health......................................... 19,848 19,848 19,848 ................ ................
Protection of Vulnerable Older Americans-Title VII........ 20,658 20,658 20,658 ................ ................
-----------------------------------------------------------------------------------------
Subtotal................................................ 388,230 426,688 388,230 ................ -38,458
Family Support Initiative................................. ................ 15,000 ................ ................ -15,000
Family Caregivers......................................... 145,586 150,586 145,586 ................ -5,000
Native American Caregivers Support........................ 6,031 6,800 6,031 ................ -769
-----------------------------------------------------------------------------------------
Subtotal, Caregivers.................................... 151,617 172,386 151,617 ................ -20,769
Nutrition:
Congregate Meals...................................... 438,191 458,091 438,191 ................ -19,900
Home Delivered Meals.................................. 216,397 236,397 216,397 ................ -20,000
Nutrition Services Incentive Program.................. 160,069 160,069 160,069 ................ ................
Nutrition Initiative.................................. ................ 20,000 ................ ................ -20,000
-----------------------------------------------------------------------------------------
Subtotal............................................ 814,657 874,557 814,657 ................ -59,900
-----------------------------------------------------------------------------------------
Subtotal, Grants to States.......................... 1,354,504 1,473,631 1,354,504 ................ -119,127
Grants for Native Americans................................... 26,158 29,100 24,850 -1,308 -4,250
Aging Network Support Activities.............................. 9,961 9,961 7,088 -2,873 -2,873
Alzheimer's Disease Demonstrations............................ 3,800 3,800 3,800 ................ ................
Prevention and Public Health Fund\1\...................... (14,700) (14,700) (14,700) ................ ................
Lifespan Respite Care......................................... 2,360 5,000 2,242 -118 -2,758
Prevention and Public Health Fund\1\...................... (8,000) (8,000) (7,600) (-400) (-400)
Prevention and Public Health Fund\1\...................... (5,000) (5,000) (4,750) (-250) (-250)
Senior Medicare Patrol Program................................ 8,910 8,910 ................ -8,910 -8,910
Elder Rights Support Activities............................... 7,874 28,874 7,874 ................ -21,000
Aging and Disability Resources................................ 6,119 20,000 5,813 -306 -14,187
State Health Insurance Program................................ 52,115 52,115 30,000 -22,115 -22,115
National Clearinghouse for Long-Term Care Information......... ................ 1,000 ................ ................ -1,000
Paralysis Resource Center..................................... 6,700 6,700 6,365 -335 -335
Limb loss..................................................... 2,800 2,810 2,660 -140 -150
Developmental Disabilities Programs:
State Councils............................................ 71,692 71,692 68,107 -3,585 -3,585
Protection and Advocacy................................... 38,734 38,734 36,797 -1,937 -1,937
Voting Access for Individuals with Disabilities........... 4,963 4,963 4,715 -248 -248
Developmental Disabilities Projects of National 8,857 14,500 8,414 -443 -6,086
Significance.............................................
University Centers for Excellence in Developmental 37,674 38,619 35,790 -1,884 -2,829
Disabilities.............................................
-----------------------------------------------------------------------------------------
Subtotal, Developmental Disabilities Programs........... 161,920 168,508 153,823 -8,097 -14,685
Workforce Innovation and Opportunity Act Independent Living... ................ 106,183 96,124 +96,124 -10,059
National Institute on Disability, Independent Living, and ................ 108,000 98,772 +98,772 -9,228
Rehabilitation Research..................................
Assistive Technology...................................... ................ 31,000 31,350 +31,350 +350
-----------------------------------------------------------------------------------------
Subtotal, Workforce Innovation and Opportunity Act...... ................ 245,183 226,246 +226,246 -18,937
Program Administration........................................ 30,035 40,063 35,824 +5,789 -4,239
=========================================================================================
Total, Administration for Community Living [ACL]........ 1,673,256 2,095,655 1,861,089 +187,833 -234,566
Federal funds....................................... 1,621,141 2,043,540 1,831,089 +209,948 -212,451
Trust Funds......................................... (52,115) (52,115) (30,000) (-22,115) (-22,115)
(Prevention and Public Health Fund\1\).............. (27,700) (27,700) (27,050) (-650) (-650)
-----------------------------------------------------------------------------------------
Total, ACL program level.......................... 1,700,956 2,123,355 1,888,139 +187,183 -235,216
=========================================================================================
OFFICE OF THE SECRETARY
General Departmental Management
General Departmental Management, Federal Funds................ 200,000 225,336 195,000 -5,000 -30,336
-----------------------------------------------------------------------------------------
Subtotal................................................ 200,000 225,336 195,000 -5,000 -30,336
Teen Pregnancy Prevention and Abstinence Education
Community Grant 104,790 20,000 -81,000 -84,790
Evaluation Tap Funding.................................... (6,800) (6,800) ................ (-6,800) (-6,800)
-----------------------------------------------------------------------------------------
Subtotal, Grants........................................ (107,800) (111,590) (20,000) (-87,800) (-91,590)
Abstinence Education.......................................... 5,000 ................ 20,000 +15,000 +20,000
Minority Health............................................... 56,670 56,670 36,000 -20,670 -20,670
Office of Women's Health...................................... 32,140 31,500 29,500 -2,640 -2,000
Minority HIV/AIDS............................................. 52,224 53,900 ................ -52,224 -53,900
Embryo Adoption Awareness Campaign............................ 1,000 ................ 1,000 ................ +1,000
DATA Act activities........................................... ................ 10,320 ................ ................ -10,320
HHS Digital Service Team...................................... ................ 10,000 ................ ................ -10,000
Planning and Evaluation, Evaluation Tap Funding............... (58,028) (59,278) (46,762) (-11,266) (-12,516)
-----------------------------------------------------------------------------------------
Total, General Departmental Management.................. 448,034 492,516 301,500 -146,534 -191,016
Federal Funds....................................... (448,034) (492,516) (301,500) (-146,534) (-191,016)
(Evaluation Tap Funding)............................ (64,828) (66,078) (46,762) (-18,066) (-19,316)
Total, General Departmental Management Program.... 512,862 558,594 348,262 -164,600 -210,332
=========================================================================================
Office of Medicare Hearings and Appeals....................... 87,381 140,000 97,381 +10,000 -42,619
Office of the National Coordinator for Health Information 60,367 ................ 60,367 ................ +60,367
Technology...................................................
Evaluation Tap Funding.................................... ................ (91,800) ................ ................ (-91,800)
-----------------------------------------------------------------------------------------
Total, Program Level.................................... (60,367) (91,800) (60,367) ................ (-31,433)
=========================================================================================
Office of Inspector General
Inspector General Federal Funds............................... 71,000 83,000 71,000 ................ -12,000
HIPAA/HCFAC funding (NA).................................. (240,455) (333,893) (333,893) (+93,438) ................
-----------------------------------------------------------------------------------------
Total, Inspector General Program Level.................. (311,455) (416,893) (404,893) (+93,438) (-12,000)
=========================================================================================
Office for Civil Rights
Federal Funds................................................. 38,798 42,705 38,798 ................ -3,907
Retirement Pay and Medical Benefits for Commissioned Officers
Retirement Payments........................................... 432,177 441,977 441,977 +9,800 ................
Survivors Benefits............................................ 28,186 28,603 28,603 +417 ................
Dependents' Medical Care...................................... 101,878 115,608 115,608 +13,730 ................
-----------------------------------------------------------------------------------------
Total, Medical Benefits for Commissioned Officers....... 562,241 586,188 586,188 +23,947 ................
=========================================================================================
Public Health and Social Services Emergency Fund [PHSSEF]
Assistant Secretary for Preparedness and Response
Operations.................................................... 31,305 30,938 30,938 -367 ................
Preparedness and Emergency Operations......................... 24,789 24,654 24,654 -135 ................
National Disaster Medical System.............................. 50,054 49,904 49,904 -150 ................
Hospital Preparedness Cooperative Agreement Grants:
Formula Grants............................................ 254,555 254,555 254,555 ................ ................
Biomedical Advanced Research and Development Authority [BARDA] 415,000 521,732 473,000 +58,000 -48,732
Ebola funding (Public Law 113-164)........................ (58,000) ................ ................ (-58,000) ................
Title VI Ebola funding........................................ (733,000) ................ ................ (-733,000) ................
Policy and Planning........................................... 14,877 14,877 14,877 ................ ................
Project BioShield............................................. 255,000 646,425 255,000 ................ -391,425
-----------------------------------------------------------------------------------------
Subtotal, Preparedness and Response..................... 1,045,580 1,543,085 1,102,928 +57,348 -440,157
Assistant Secretary for Administration
Assistant Secretary for Administration, Cybersecurity......... 41,125 73,417 41,125 ................ -32,292
Office of Security and Strategic Information.................. 7,470 7,470 7,470 ................ ................
Public Health and Science
Medical Reserve Corps......................................... 8,979 6,000 3,839 -5,140 -2,161
Office of the Secretary
Pandemic Influenza Preparedness............................... 71,915 170,009 71,915 ................ -98,094
Emergency response initiative................................. ................ 110,000 ................ ................ -110,000
Health insurance initiative (PHS evaluation funding).......... ................ (30,000) ................ ................ (-30,000)
-----------------------------------------------------------------------------------------
Subtotal, Non-pandemic flu/BioShield/Parklawn/Other -326,915 -816,434 -326,915 ................ +489,519
construction...........................................
-----------------------------------------------------------------------------------------
Total, PHSSEF........................................... 1,175,069 1,909,981 1,227,277 +52,208 -682,704
=========================================================================================
Total, Office of the Secretary.......................... 2,442,890 3,254,390 2,382,511 -60,379 -871,879
Federal Funds....................................... 2,355,509 3,114,390 2,285,130 -70,379 -829,260
Trust Funds......................................... 87,381 140,000 97,381 +10,000 -42,619
(Evaluation Tap Funding)............................ (64,828) (187,878) (46,762) (-18,066) (-141,116)
(Title VI Ebola funding)............................ (733,000) ................ ................ (-733,000) ................
-----------------------------------------------------------------------------------------
Total, Office of the Secretary Program Level...... 2,507,718 3,442,268 2,429,273 -78,445 -1,012,995
=========================================================================================
Total, Title II, Health and Human Services.............. 691,695,040 732,831,243 728,082,729 +36,387,689 -4,748,514
Federal Funds....................................... 687,213,800 727,687,942 724,221,758 +37,007,958 -3,466,184
Current year.................................. (570,481,660) (608,505,440) (605,039,256) (+34,557,596) (-3,466,184)
Fiscal year 2017.............................. (116,732,140) (119,182,502) (119,182,502) (+2,450,362) ................
Trust Funds......................................... 4,481,240 5,143,301 3,860,971 -620,269 -1,282,330
Pandemic Flu balances (Public Law 111-32)........... (927,000) (1,000,000) (932,000) (+5,000) (-68,000)
-----------------------------------------------------------------------------------------
Total, Prevention and Public Health Fund\1\....... (927,000) (1,000,000) (932,000) (+5,000) (-68,000)
=========================================================================================
TITLE III--DEPARTMENT OF EDUCATION
EDUCATION FOR THE DISADVANTAGED
Grants to Local Educational Agencies [LEAs] Basic Grants:
Advance from prior year............................... (2,915,776) (2,890,776) (2,890,776) (-25,000) ................
Forward funded........................................ 3,564,641 4,568,625 3,714,641 +150,000 -853,984
Current funded........................................ 3,984 ................ 3,984 ................ +3,984
-----------------------------------------------------------------------------------------
Subtotal, Basic grants current year approp.......... 3,568,625 4,568,625 3,718,625 +150,000 -850,000
Subtotal, Basic grants total funds available........ (6,484,401) (7,459,401) (6,609,401) (+125,000) (-850,000)
Basic Grants fiscal year 2017 Advance..................... 2,890,776 1,890,776 2,740,776 -150,000 +850,000
-----------------------------------------------------------------------------------------
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 2017 Advance.............................. 1,362,301 1,362,301 1,362,301 ................ ................
Targeted Grants:
Advance from prior year............................... (3,281,550) (3,294,050) (3,294,050) (+12,500) ................
Fiscal year 2017 Advance.............................. 3,294,050 3,794,050 3,369,050 +75,000 -425,000
-----------------------------------------------------------------------------------------
Subtotal............................................ 3,294,050 3,794,050 3,369,050 +75,000 -425,000
Education Finance Incentive Grants:
Advance from prior year............................... (3,281,550) (3,294,050) (3,294,050) (+12,500) ................
Fiscal year 2017 Advance.............................. 3,294,050 3,794,050 3,369,050 +75,000 -425,000
-----------------------------------------------------------------------------------------
Subtotal............................................ 3,294,050 3,794,050 3,369,050 +75,000 -425,000
=========================================================================================
Subtotal, Grants to LEAs, program level................. 14,409,802 15,409,802 14,559,802 +150,000 -850,000
=========================================================================================
Subtotal, Grants to LEAs, program level................. 14,409,802 15,409,802 14,559,802 +150,000 -850,000
School Improvement Grants..................................... 505,756 555,756 450,000 -55,756 -105,756
Striving Readers.............................................. 160,000 160,000 ................ -160,000 -160,000
State Agency Programs:
Migrant................................................... 374,751 374,751 365,000 -9,751 -9,751
Neglected and Delinquent/High Risk Youth.................. 47,614 47,614 46,000 -1,614 -1,614
-----------------------------------------------------------------------------------------
Subtotal, State Agency programs......................... 422,365 422,365 411,000 -11,365 -11,365
Evaluation.................................................... 710 ................ ................ -710 ................
Migrant Education:
High School Equivalency Program........................... 37,474 44,623 35,000 -2,474 -9,623
=========================================================================================
Total, Education for the disadvantaged.................. 15,536,107 16,592,546 15,455,802 -80,305 -1,136,744
Current Year........................................ (4,694,930) (5,751,369) (4,614,625) (-80,305) (-1,136,744)
Fiscal year 2017.................................... (10,841,177) (10,841,177) (10,841,177) ................ ................
Subtotal, Forward Funded................................ (4,652,762) (5,706,746) (4,575,641) (-77,121) (-1,131,105)
PRESCHOOL DEVELOPMENT GRANTS.................................. ................ 750,000 ................ ................ -750,000
IMPACT AID
Basic Support Payments........................................ 1,151,233 1,151,233 1,151,233 ................ ................
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 ................ 66,813 ................ +66,813
-----------------------------------------------------------------------------------------
Total, Impact aid....................................... 1,288,603 1,288,603 1,288,603 ................ ................
=========================================================================================
SCHOOL IMPROVEMENT PROGRAMS
State Grants for Improving Teacher Quality.................... 668,389 668,389 565,000 -103,389 -103,389
Advance from prior year................................... (1,681,441) (1,681,441) (1,681,441) ................ ................
Fiscal year 2017.......................................... 1,681,441 1,681,441 1,681,441 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, State Grants for Improving Teacher Quality, 2,349,830 2,349,830 2,246,441 -103,389 -103,389
program level..........................................
Mathematics and Science Partnerships.......................... 152,717 202,717 141,299 -11,418 -61,418
Educational Technology State Grants........................... ................ 200,000 ................ ................ -200,000
Supplemental Education Grants................................. 16,699 16,699 16,699 ................ ................
21st Century Community Learning Centers....................... 1,151,673 1,151,673 1,035,000 -116,673 -116,673
State Assessments/Enhanced Assessment Instruments............. 378,000 403,000 350,000 -28,000 -53,000
Education for Homeless Children and Youth..................... 65,042 71,542 65,042 ................ -6,500
Training and Advisory Services (Civil Rights)................. 6,575 6,575 6,575 ................ ................
Education for Native Hawaiians................................ 32,397 33,397 32,397 ................ -1,000
Alaska Native Education Equity................................ 31,453 32,453 31,453 ................ -1,000
Rural Education............................................... 169,840 169,840 169,840 ................ ................
Comprehensive Centers......................................... 48,445 55,445 40,000 -8,445 -15,445
=========================================================================================
Total, School Improvement Programs...................... 4,402,671 4,693,171 4,134,746 -267,925 -558,425
Current Year........................................ (2,721,230) (3,011,730) (2,453,305) (-267,925) (-558,425)
Fiscal year 2017.................................... (1,681,441) (1,681,441) (1,681,441) ................ ................
Subtotal, Forward Funded.......................... (2,585,661) (2,867,161) (2,326,181) (-259,480) (-540,980)
=========================================================================================
INDIAN EDUCATION
Grants to Local Educational Agencies.......................... 100,381 100,381 100,381 ................ ................
Federal Programs:
Special Programs for Indian Children...................... 17,993 67,993 17,993 ................ -50,000
National Activities....................................... 5,565 5,565 5,565 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Federal Programs.............................. 23,558 73,558 23,558 ................ -50,000
-----------------------------------------------------------------------------------------
Total, Indian Education................................. 123,939 173,939 123,939 ................ -50,000
=========================================================================================
INNOVATION AND IMPROVEMENT
Investing in Innovation Fund.................................. 120,000 300,000 ................ -120,000 -300,000
Teacher and Principal Pathways (proposed legislation)......... ................ 138,762 ................ ................ -138,762
Transition to Teaching........................................ 13,700 ................ ................ -13,700 ................
School Leadership............................................. 16,368 ................ ................ -16,368 ................
Charter Schools Grants........................................ 253,172 375,000 273,172 +20,000 -101,828
Magnet Schools Assistance..................................... 91,647 91,647 85,000 -6,647 -6,647
Fund for the Improvement of Education [FIE]................... 323,000 166,926 62,815 -260,185 -104,111
Teacher Incentive Fund (Excellent Educators Grants)........... 230,000 350,000 225,000 -5,000 -125,000
Ready-to-Learn television..................................... 25,741 25,741 25,741 ................ ................
Next Generation High Schools (proposed legislation)........... ................ 125,000 ................ ................ -125,000
Advanced Placement............................................ 28,483 28,483 22,888 -5,595 -5,595
=========================================================================================
Total, Innovation and Improvement....................... 1,102,111 1,601,559 694,616 -407,495 -906,943
Current Year........................................ (1,102,111) (1,601,559) (694,616) (-407,495) (-906,943)
=========================================================================================
SAFE SCHOOLS AND CITIZENSHIP EDUCATION
Promise Neighborhoods......................................... 56,754 150,000 37,000 -19,754 -113,000
National Programs............................................. 70,000 90,000 60,000 -10,000 -30,000
Elementary and Secondary School Counseling.................... 49,561 49,561 23,314 -26,247 -26,247
Carol M. White Physical Education Program..................... 47,000 60,000 ................ -47,000 -60,000
-----------------------------------------------------------------------------------------
Total, Safe Schools and Citizenship Education........... 223,315 349,561 120,314 -103,001 -229,247
=========================================================================================
ENGLISH LANGUAGE ACQUISITION
Current funded................................................ 47,931 50,271 46,281 -1,650 -3,990
Forward funded................................................ 689,469 723,129 665,740 -23,729 -57,389
-----------------------------------------------------------------------------------------
Total, English Language Acquisition..................... 737,400 773,400 712,021 -25,379 -61,379
=========================================================================================
SPECIAL EDUCATION
State Grants:
Grants to States Part B current year...................... 2,214,465 2,389,465 2,314,465 +100,000 -75,000
Part B advance from prior year........................ (9,283,383) (9,283,383) (9,283,383) ................ ................
Grants to States Part B (fiscal year 2017)................ 9,283,383 9,283,383 9,283,383 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, program level................................. 11,497,848 11,672,848 11,597,848 +100,000 -75,000
Preschool Grants.......................................... 353,238 403,238 363,238 +10,000 -40,000
Grants for Infants and Families........................... 438,556 503,556 453,556 +15,000 -50,000
-----------------------------------------------------------------------------------------
Subtotal, program level................................. 12,289,642 12,579,642 12,414,642 +125,000 -165,000
IDEA National Activities (current funded):
State Personnel Development............................... 41,630 41,630 35,000 -6,630 -6,630
Technical Assistance and Dissemination.................... 51,928 61,928 51,928 ................ -10,000
Personnel Preparation..................................... 83,700 83,700 81,700 -2,000 -2,000
Parent Information Centers................................ 27,411 27,411 26,500 -911 -911
Technology and Media Services............................. 28,047 28,047 27,047 -1,000 -1,000
-----------------------------------------------------------------------------------------
Subtotal, IDEA special programs......................... 232,716 242,716 222,175 -10,541 -20,541
=========================================================================================
Total, Special education................................ 12,522,358 12,822,358 12,636,817 +114,459 -185,541
Current Year........................................ (3,238,975) (3,538,975) (3,353,434) (+114,459) (-185,541)
Fiscal year 2017.................................... (9,283,383) (9,283,383) (9,283,383) ................ ................
Subtotal, Forward Funded.......................... (3,006,259) (3,296,259) (3,131,259) (+125,000) (-165,000)
=========================================================================================
REHABILITATION SERVICES AND DISABILITY RESEARCH
Vocational Rehabilitation State Grants........................ 3,295,914 3,350,594 3,350,594 +54,680 ................
Vocational Rehabilitation Grants to Indians................... 39,160 41,176 41,176 +2,016 ................
-----------------------------------------------------------------------------------------
Subtotal, Vocational Rehabilitation Grants program level 3,335,074 3,391,770 3,391,770 +56,696 ................
Client Assistance State grants................................ 13,000 13,000 12,000 -1,000 -1,000
Training...................................................... 30,188 30,188 24,000 -6,188 -6,188
Demonstration and Training programs........................... 5,796 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 -30,548
Independent Living:
State Grants.............................................. 22,878 ................ ................ -22,878 ................
Centers................................................... 78,305 ................ ................ -78,305 ................
Services for Older Blind Individuals...................... 33,317 33,317 33,317 ................ ................
-----------------------------------------------------------------------------------------
Subtotal................................................ 134,500 33,317 33,317 -101,183 ................
Helen Keller National Center for Deaf/Blind Youth and Adults.. 9,127 9,840 9,127 ................ -713
National Inst. Disability and Rehab. Research [NIDRR]......... 103,970 ................ ................ -103,970 ................
Assistive Technology.......................................... 33,000 ................ ................ -33,000 ................
-----------------------------------------------------------------------------------------
Subtotal, Discretionary programs........................ 374,779 140,339 96,094 -278,685 -44,245
-----------------------------------------------------------------------------------------
Total, Rehabilitation services.......................... 3,709,853 3,532,109 3,487,864 -221,989 -44,245
=========================================================================================
SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES
American Printing House for the Blind......................... 24,931 24,931 24,931 ................ ................
National Technical Institute for the Deaf [NTID]:
Operations................................................ 67,016 67,016 69,016 +2,000 +2,000
-----------------------------------------------------------------------------------------
Total, NTID............................................. 67,016 67,016 69,016 +2,000 +2,000
=========================================================================================
Gallaudet University:
Operations................................................ 120,275 120,275 120,275 ................ ................
-----------------------------------------------------------------------------------------
Total, Gallaudet University............................. 120,275 120,275 120,275 ................ ................
=========================================================================================
Total, Special Institutions for Persons with 212,222 212,222 214,222 +2,000 +2,000
Disabilities...........................................
=========================================================================================
CAREER, TECHNICAL, AND ADULT EDUCATION
Career Education:
Basic State Grants/Secondary & Technical Education State 326,598 526,598 326,598 ................ -200,000
Grants, current funded...................................
Advance from prior year............................... (791,000) (791,000) (791,000) ................ ................
Fiscal year 2017...................................... 791,000 791,000 791,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Basic State Grants, program level......... 1,117,598 1,317,598 1,117,598 ................ -200,000
National Programs......................................... 7,421 9,421 4,421 -3,000 -5,000
-----------------------------------------------------------------------------------------
Subtotal, Career Education.............................. 1,125,019 1,327,019 1,122,019 -3,000 -205,000
Adult Education:
State Grants/Adult Basic and Literacy Education:
State Grants, current funded.......................... 568,955 568,955 540,000 -28,955 -28,955
National Leadership Activities................................ 13,712 19,712 7,712 -6,000 -12,000
-----------------------------------------------------------------------------------------
Subtotal, Adult education............................... 582,667 588,667 547,712 -34,955 -40,955
=========================================================================================
Total, Career, Technical, and Adult Education........... 1,707,686 1,915,686 1,669,731 -37,955 -245,955
Current Year........................................ (916,686) (1,124,686) (878,731) (-37,955) (-245,955)
Fiscal year 2017.................................... (791,000) (791,000) (791,000) ................ ................
Subtotal, Forward Funded.......................... (916,686) (1,124,686) (878,731) (-37,955) (-245,955)
=========================================================================================
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........... 733,130 733,130 704,000 -29,130 -29,130
Federal Work Study............................................ 989,728 989,728 950,000 -39,728 -39,728
-----------------------------------------------------------------------------------------
Total, Student Financial Assistance [SFA]............... 24,198,210 24,198,210 24,129,352 -68,858 -68,858
=========================================================================================
STUDENT AID ADMINISTRATION
Salaries and Expenses......................................... 675,224 726,643 640,000 -35,224 -86,643
Servicing Activities.......................................... 721,700 855,211 721,700 ................ -133,511
-----------------------------------------------------------------------------------------
Total, Student Aid Administration....................... 1,396,924 1,581,854 1,361,700 -35,224 -220,154
=========================================================================================
HIGHER EDUCATION
Aid for Institutional Development:
Strengthening Institutions................................ 80,462 80,462 78,048 -2,414 -2,414
Hispanic Serving Institutions............................. 100,231 100,231 97,224 -3,007 -3,007
Promoting Post-Baccalaureate Opportunities for Hispanic 8,992 10,565 8,722 -270 -1,843
Americans................................................
Strengthening Historically Black Colleges [HBCUs]......... 227,524 227,524 220,698 -6,826 -6,826
Strengthening Historically Black Graduate Institutions.... 58,840 58,840 57,075 -1,765 -1,765
Strengthening Predominantly Black Institutions............ 9,244 9,244 8,967 -277 -277
Asian American Pacific Islander........................... 3,113 3,113 3,020 -93 -93
Strengthening Alaska Native and Native Hawaiian-Serving 12,833 12,833 12,448 -385 -385
Institutions.............................................
Strengthening Native American-Serving Nontribal 3,113 3,113 3,020 -93 -93
Institutions.............................................
Strengthening Tribal Colleges............................. 25,662 25,662 24,892 -770 -770
-----------------------------------------------------------------------------------------
Subtotal, Aid for Institutional development............. 530,014 531,587 514,114 -15,900 -17,473
International Education and Foreign Language:
Domestic Programs......................................... 65,103 67,103 43,445 -21,658 -23,658
Overseas Programs......................................... 7,061 9,061 3,500 -3,561 -5,561
-----------------------------------------------------------------------------------------
Subtotal, International Education & Foreign Lang........ 72,164 76,164 46,945 -25,219 -29,219
Fund for the Improvement of Postsec. Ed. [FIPSE].............. 67,775 200,000 ................ -67,775 -200,000
Postsecondary Program for Students with Intellectual 11,800 11,800 10,384 -1,416 -1,416
Disabilities.................................................
Minority Science and Engineering Improvement.................. 8,971 8,971 8,971 ................ ................
Tribally Controlled Postsec Voc/Tech Institutions............. 7,705 7,705 7,705 ................ ................
Federal TRIO Programs......................................... 839,752 859,752 839,752 ................ -20,000
GEAR UP....................................................... 301,639 301,639 301,639 ................ ................
Graduate Assistance in Areas of National Need................. 29,293 29,293 20,000 -9,293 -9,293
Teacher Quality Partnerships.................................. 40,592 ................ 34,000 -6,592 +34,000
Child Care Access Means Parents in School..................... 15,134 15,134 ................ -15,134 -15,134
GPRA Data/HEA Program Evaluation.............................. ................ 30,000 ................ ................ -30,000
-----------------------------------------------------------------------------------------
Total, Higher Education................................. 1,924,839 2,072,045 1,783,510 -141,329 -288,535
=========================================================================================
HOWARD UNIVERSITY
Academic Program.............................................. 191,091 194,496 189,650 -1,441 -4,846
Endowment Program............................................. 3,405 ................ 3,350 -55 +3,350
Howard University Hospital.................................... 27,325 27,325 26,500 -825 -825
-----------------------------------------------------------------------------------------
Total, Howard University................................ 221,821 221,821 219,500 -2,321 -2,321
=========================================================================================
COLLEGE HOUSING AND ACADEMIC FACILITIES LOANS................. 435 450 435 ................ -15
HISTORICALLY BLACK COLLEGE AND UNIVERSITY [HBCU]
CAPITAL FINANCING PROGRAM
HBCU Federal Administration................................... 334 340 334 ................ -6
HBCU Loan Subsidies........................................... 19,096 19,096 19,096 ................ ................
-----------------------------------------------------------------------------------------
Total, HBCU Capital Financing Program................... 19,430 19,436 19,430 ................ -6
=========================================================================================
INSTITUTE OF EDUCATION SCIENCES [IES]
Research, Development and Dissemination....................... 179,860 202,273 177,860 -2,000 -24,413
Statistics.................................................... 103,060 124,744 102,060 -1,000 -22,684
Regional Educational Laboratories............................. 54,423 54,423 53,823 -600 -600
Research in Special Education................................. 54,000 54,000 48,000 -6,000 -6,000
Special Education Studies and Evaluations..................... 10,818 13,000 10,500 -318 -2,500
Statewide Data Systems........................................ 34,539 70,000 33,500 -1,039 -36,500
Assessment:
National Assessment....................................... 129,000 149,616 129,000 ................ -20,616
National Assessment Governing Board....................... 8,235 7,827 8,235 ................ +408
-----------------------------------------------------------------------------------------
Subtotal, Assessment.................................... 137,235 157,443 137,235 ................ -20,208
-----------------------------------------------------------------------------------------
Total, IES.............................................. 573,935 675,883 562,978 -10,957 -112,905
=========================================================================================
DEPARTMENTAL MANAGEMENT
Program Administration:
Salaries and Expenses..................................... 410,000 460,259 390,326 -19,674 -69,933
Building Modernization.................................... 1,000 13,830 1,000 ................ -12,830
-----------------------------------------------------------------------------------------
Total, Program administration........................... 411,000 474,089 391,326 -19,674 -82,763
=========================================================================================
Office for Civil Rights....................................... 100,000 130,691 100,000 ................ -30,691
Office of Inspector General................................... 57,791 59,256 57,791 ................ -1,465
=========================================================================================
Total, Departmental management.......................... 568,791 664,036 549,117 -19,674 -114,919
Total, Title III, Department of Education............... 70,470,650 74,138,889 69,164,697 -1,305,953 -4,974,192
Current Year........................................ (47,873,649) (51,541,888) (46,567,696) (-1,305,953) (-4,974,192)
Fiscal year 2017.................................... (22,597,001) (22,597,001) (22,597,001) ................ ................
=========================================================================================
TITLE IV--RELATED AGENCIES
COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY 5,362 5,441 5,362 ................ -79
DISABLED.....................................................
CORPORATION FOR NATIONAL AND COMMUNITY SERVICE
Operating Expenses
Domestic Volunteer Service Programs:
Volunteers in Service to America [VISTA].................. 92,364 96,885 90,000 -2,364 -6,885
National Senior Volunteer Corps:
Foster Grandparents Program........................... 107,702 107,702 104,781 -2,921 -2,921
Senior Companion Program.............................. 45,512 45,512 44,278 -1,234 -1,234
Retired Senior Volunteer Program...................... 48,903 48,903 47,578 -1,325 -1,325
-----------------------------------------------------------------------------------------
Subtotal, Senior Volunteers......................... 202,117 202,117 196,637 -5,480 -5,480
-----------------------------------------------------------------------------------------
Subtotal, Domestic Volunteer Service................ 294,481 299,002 286,637 -7,844 -12,365
=========================================================================================
National and Community Service Programs:
AmeriCorps State and National Grants...................... 335,430 425,105 270,000 -65,430 -155,105
Innovation, Assistance, and Other Activities.............. 77,400 78,601 7,400 -70,000 -71,201
Evaluation................................................ 5,000 5,000 4,000 -1,000 -1,000
National Civilian Community Corps [NCCC].................. 30,000 30,500 30,000 ................ -500
State Commission Support Grants........................... 16,038 17,000 16,038 ................ -962
-----------------------------------------------------------------------------------------
Subtotal, National and Community Service................ 463,868 556,206 327,438 -136,430 -228,768
-----------------------------------------------------------------------------------------
Total, Operating expenses............................... 758,349 855,208 614,075 -144,274 -241,133
=========================================================================================
National Service Trust........................................ 209,618 237,077 145,000 -64,618 -92,077
Salaries and Expenses......................................... 81,737 86,176 80,000 -1,737 -6,176
Office of Inspector General................................... 5,250 6,000 5,250 ................ -750
-----------------------------------------------------------------------------------------
Total, Corp. for National and Community Service......... 1,054,954 1,184,461 844,325 -210,629 -340,136
=========================================================================================
CORPORATION FOR PUBLIC BROADCASTING:
Fiscal year 2018 (current) with fiscal year 2016 445,000 445,000 445,000 ................ ................
comparable...............................................
Fiscal year 2017 advance with fiscal year 2015 comparable (445,000) (445,000) (445,000) ................ ................
(NA).....................................................
Fiscal year 2016 advance with fiscal year 2014 comparable (445,000) (445,000) (445,000) ................ ................
(NA).....................................................
Public television interconnection system (current)........ ................ 40,000 ................ ................ -40,000
FEDERAL MEDIATION AND CONCILIATION SERVICE.................... 45,666 48,748 47,823 +2,157 -925
FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION.............. 16,751 17,085 15,950 -801 -1,135
INSTITUTE OF MUSEUM AND LIBRARY SERVICES...................... 227,860 237,428 227,860 ................ -9,568
MEDICARE PAYMENT ADVISORY COMMISSION.......................... 11,749 12,100 11,100 -649 -1,000
MEDICAID AND CHIP PAYMENT AND ACCESS COMMISSION............... 7,650 8,700 7,250 -400 -1,450
NATIONAL COUNCIL ON DISABILITY................................ 3,250 3,432 3,075 -175 -357
NATIONAL LABOR RELATIONS BOARD................................ 274,224 278,000 246,802 -27,422 -31,198
NATIONAL MEDIATION BOARD...................................... 13,227 13,230 12,600 -627 -630
OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION.............. 11,639 13,212 11,100 -539 -2,112
RAILROAD RETIREMENT BOARD
Dual Benefits Payments Account................................ 34,000 29,000 29,000 -5,000 ................
Less Income Tax Receipts on Dual Benefits..................... -3,000 -2,000 -2,000 +1,000 ................
-----------------------------------------------------------------------------------------
Subtotal, Dual Benefits................................. 31,000 27,000 27,000 -4,000 ................
Federal Payment to the RR Retirement Accounts................. 150 150 150 ................ ................
Limitation on Administration.................................. 111,225 119,918 111,225 ................ -8,693
Limitation on the Office of Inspector General................. 8,437 9,450 8,437 ................ -1,013
SOCIAL SECURITY ADMINISTRATION
Payments to Social Security Trust Funds....................... 16,400 20,400 20,400 +4,000 ................
Supplemental Security Income Program
Federal Benefit Payments...................................... 56,201,000 60,683,000 60,683,000 +4,482,000 ................
Beneficiary Services.......................................... 70,000 70,000 70,000 ................ ................
Research and Demonstration.................................... 83,000 101,000 101,000 +18,000 ................
Afghanistan Special Immigrant Visa............................ ................ 3,000 3,000 +3,000 ................
Administration................................................ 4,578,978 4,765,000 4,453,777 -125,201 -311,223
-----------------------------------------------------------------------------------------
Subtotal, SSI program level............................. 60,932,978 65,622,000 65,310,777 +4,377,799 -311,223
Less funds advanced in prior year................... -19,700,000 -19,200,000 -19,200,000 +500,000 ................
-----------------------------------------------------------------------------------------
Subtotal, regular SSI current year...................... 41,232,978 46,422,000 46,110,777 +4,877,799 -311,223
New advance, 1st quarter, fiscal year 2017........ 19,200,000 14,500,000 14,500,000 -4,700,000 ................
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Total, SSI program...................................... 60,432,978 60,922,000 60,610,777 +177,799 -311,223
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Limitation on Administrative Expenses
OASI/DI Trust Funds........................................... 4,913,260 5,248,608 4,819,494 -93,766 -429,114
HI/SMI Trust Funds............................................ 1,755,376 1,858,882 1,707,374 -48,002 -151,508
Social Security Advisory Board................................ 2,300 2,400 2,300 ................ -100
SSI........................................................... 3,614,009 3,827,110 3,515,777 -98,232 -311,333
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Subtotal, regular LAE................................... 10,284,945 10,937,000 10,044,945 -240,000 -892,055
User Fees:
SSI User Fee activities................................... 124,000 136,000 136,000 +12,000 ................
SSPA User Fee Activities.................................. 1,000 1,000 1,000 ................ ................
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Subtotal, User fees..................................... 125,000 137,000 137,000 +12,000 ................
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Subtotal, Limitation on administrative expenses......... 10,409,945 11,074,000 10,181,945 -228,000 -892,055
Program Integrity:
OASDI Trust Funds......................................... 431,031 500,580 500,580 +69,549 ................
SSI....................................................... 964,969 938,420 938,420 -26,549 ................
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Subtotal, Program integrity funding..................... 1,396,000 1,439,000 1,439,000 +43,000 ................
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Total, Limitation on Administrative Expenses............ 11,805,945 12,513,000 11,620,945 -185,000 -892,055
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Office of Inspector General
Federal Funds................................................. 28,829 30,000 28,829 ................ -1,171
Trust Funds................................................... 74,521 78,795 74,521 ................ -4,274
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Total, Office of Inspector General...................... 103,350 108,795 103,350 ................ -5,445
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Adjustment: Trust fund transfers from general revenues........ -4,578,978 -4,765,000 -4,453,777 +125,201 +311,223
=========================================================================================
Total, Social Security Administration................... 67,779,695 68,799,195 67,901,695 +122,000 -897,500
Federal funds....................................... 60,603,207 61,109,400 60,797,006 +193,799 -312,394
Current year.................................. (41,403,207) (46,609,400) (46,297,006) (+4,893,799) (-312,394)
New advances, 1st quarter, fiscal year 2017... (19,200,000) (14,500,000) (14,500,000) (-4,700,000) ................
Trust funds......................................... 7,176,488 7,689,795 7,104,689 -71,799 -585,106
=========================================================================================
Total, Title IV, Related Agencies....................... 70,047,839 71,262,550 69,926,754 -121,085 -1,335,796
Federal Funds....................................... 62,739,940 63,431,287 62,691,303 -48,637 -739,984
Current Year.................................. (43,094,940) (48,486,287) (47,746,303) (+4,651,363) (-739,984)
Current Year (emergency)...................... ................ ................ ................ ................ ................
Fiscal year 2017 Advance...................... (19,200,000) (14,500,000) (14,500,000) (-4,700,000) ................
Fiscal year 2018 Advance...................... (445,000) (445,000) (445,000) ................ ................
Trust Funds......................................... 7,307,899 7,831,263 7,235,451 -72,448 -595,812
=========================================================================================
TITLE VI--EBOLA RESPONSE AND PREPAREDNESS (total)....... (1,001,000) ................ ................ (-1,001,000) ................
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Grand Total, current year......................... 845,560,078 892,778,190 879,922,043 +34,361,965 -12,856,147
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\1\Section 4002 of Public Law 111-148.
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