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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   ................
                                                               -----------------------------------------------------------------------------------------
      Total, SSI program......................................       60,432,978        60,922,000        60,610,777          +177,799          -311,223
                                                               =========================================================================================
             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
                                                               -----------------------------------------------------------------------------------------
      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   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, User fees.....................................          125,000           137,000           137,000           +12,000   ................
                                                               -----------------------------------------------------------------------------------------
      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   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Program integrity funding.....................        1,396,000         1,439,000         1,439,000           +43,000   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Limitation on Administrative Expenses............       11,805,945        12,513,000        11,620,945          -185,000          -892,055
                                                               =========================================================================================
                  Office of Inspector General
 
Federal Funds.................................................           28,829            30,000            28,829   ................           -1,171
Trust Funds...................................................           74,521            78,795            74,521   ................           -4,274
                                                               -----------------------------------------------------------------------------------------
      Total, Office of Inspector General......................          103,350           108,795           103,350   ................           -5,445
                                                               =========================================================================================
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)  ................
                                                               -----------------------------------------------------------------------------------------
            Grand Total, current year.........................      845,560,078       892,778,190       879,922,043       +34,361,965       -12,856,147
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\Section 4002 of Public Law 111-148.
 

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