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115th Congress    }                                          {    Report
                        HOUSE OF REPRESENTATIVES
 1st Session      }                                          {   115-244

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



 
  DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND 
               RELATED AGENCIES APPROPRIATIONS BILL, 2018

                                _______
                                

 July 24, 2017.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

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

                              R E P O R T

                             together with

                             MINORITY VIEWS

                        [To accompany H.R. 3358]

    The Committee on Appropriations submits the following 
report in explanation of the accompanying bill making 
appropriations for the Departments of Labor, Health and Human 
Services (except the Food and Drug Administration, the Agency 
for Toxic Substances and Disease Registry and the Indian Health 
Service), Education, Committee for Purchase from People Who Are 
Blind or Severely Disabled, Corporation for National and 
Community Service, Corporation for Public Broadcasting, Federal 
Mediation and Conciliation Service, Federal Mine Safety and 
Health Review Commission, Institute of Museum and Library 
Services, Medicaid and CHIP Payment and Access Commission, 
Medicare Payment Advisory Commission, National Council on 
Disability, National Labor Relations Board, National Mediation 
Board, Occupational Safety and Health Review Commission, 
Railroad Retirement Board, and the Social Security 
Administration for the fiscal year ending September 30, 2018, 
and for other purposes.

                        INDEX TO BILL AND REPORT

_______________________________________________________________________


                                                            Page number

                                                            Bill Report
Summary of Estimates and Appropriation.....................
                                                                      3
General Summary of the Bill................................
                                                                      3
Title I--Department of Labor:
        Employment and Training Administration.............     2
                                                                      5
        Employee Benefits Security Administration..........    15
                                                                     11
        Pension Benefit Guaranty Corporation...............    15
                                                                     11
        Wage and Hour Division.............................    16
                                                                     12
        Office of Labor-Management Standards...............    17
                                                                     12
        Office of Federal Contract Compliance Programs.....    17
                                                                     12
        Office of Workers' Compensation Programs...........    17
                                                                     13
        Occupational Safety and Health Administration......    21
                                                                     14
        Mine Safety and Health Administration..............    24
                                                                     15
        Bureau of Labor Statistics.........................    26
                                                                     16
        Office of Disability Employment Policy.............    26
                                                                     17
        Departmental Management............................    27
                                                                     17
        General Provisions.................................    31
                                                                     19
Title II--Department of Health and Human Services:
        Health Resources and Services Administration.......    42
                                                                     20
        Centers for Disease Control and Prevention.........    46
                                                                     33
        National Institutes of Health......................    52
                                                                     49
        Substance Abuse and Mental Health Services 
            Administration.................................    60
                                                                     74
        Centers for Medicare and Medicaid Services.........    64
                                                                     82
        Administration for Children and Families...........    68
                                                                     88
        Administration on Aging............................
                                                                     93
        Office of Secretary................................    79
                                                                     99
        Office of Inspector General........................    82
                                                                    103
        Public Health and Social Services Emergency Fund...    83
                                                                    104
        General Provisions.................................    85
                                                                    105
Title III--Department of Education:
        Education for the Disadvantaged....................   101
                                                                    108
        Impact Aid.........................................   102
                                                                    110
        School Improvement Programs........................   103
                                                                    111
        Indian Education...................................   104
                                                                    113
        Innovation and Improvement.........................   105
                                                                    115
        Safe Schools and Citizenship Education.............   105
                                                                    117
        English Language Acquisition.......................   105
                                                                    117
        Special Education..................................   106
                                                                    118
        Rehabilitation Services and Disability Research....   109
                                                                    120
        Special Institutions for Persons with Disabilities.   110
                                                                    122
        Career, Technical and Adult Education..............   110
                                                                    123
        Student Financial Assistance.......................   111
                                                                    124
        Student Aid Administration.........................   111
                                                                    125
        Higher Education...................................   111
                                                                    125
        Howard University..................................   112
                                                                    129
        College Housing and Academic Facilities Loans......   113
                                                                    130
        Historically Black College and University Capital 
            Financing......................................   113
                                                                    130
        Institute of Education Sciences....................   114
                                                                    130
        Departmental Management............................   114
                                                                    132
        Office for Civil Rights............................   115
                                                                    134
        Office of the Inspector General....................   115
                                                                    134
        General Provisions.................................   115
                                                                    134
Title IV--Related Agencies:
        Committee for the Purchase from People Who Are 
            Blind or Severely Disabled.....................   118
                                                                    135
        Corporation for National and Community Service.....   119
                                                                    136
        Federal Mediation and Conciliation Service.........   124
                                                                    139
        Federal Mine Safety and Health Review Commission...   125
                                                                    139
        Institute of Museum and Library Services...........   125
                                                                    139
        Medicaid and CHIP Payment and Access Commission....   126
                                                                    140
        Medicare Payment Advisory Commission...............   126
                                                                    140
        National Council on Disability.....................   126
                                                                    140
        National Labor Relations Board.....................   126
                                                                    141
        National Mediation Board...........................   130
                                                                    141
        Occupational Safety and Health Review Commission...   130
                                                                    141
        Railroad Retirement Board..........................   130
                                                                    141
        Social Security Administration.....................   132
                                                                    142
Title V--General Provisions:
        House of Representatives Reporting Requirements....
                                                                    147
        Minority Views.....................................
                                                                    260

                Summary of Estimates and Appropriations

    The following table compares on a summary basis the 
appropriations, including trust funds for fiscal year 2018, the 
budget request for fiscal year 2018, and the Committee 
recommendation for fiscal year 2018 in the accompanying bill.

                                         2018 LABOR, HHS, EDUCATION BILL
                                 [Discretionary funding in thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                   Fiscal Year--                   2018 Committee compared to--
         Budget Activity         -------------------------------------------------------------------------------
                                   2017 Enacted     2018 Budget   2018 Committee   2017 Enacted     2018 Budget
----------------------------------------------------------------------------------------------------------------
Department of Labor.............     $12,088,155     $10,641,329     $10,767,464     (1,320,691)         126,135
Department of Health and Human        78,118,630      63,029,369      77,576,400       (542,230)      14,547,031
 Services.......................
Department of Education.........      68,239,195      62,889,423      65,823,945     (2,415,250)       2,934,522
Related Agencies................      14,885,326      13,682,005      14,715,337       (169,989)       1,033,332
----------------------------------------------------------------------------------------------------------------

                      General Summary of the Bill

    For fiscal year 2018, the Committee recommends a total of 
$157,938,000,000 in current year discretionary funding, 
including offsets and adjustments. The fiscal year 2018 
recommendation is a decrease of $5,047,000,000 below the fiscal 
year 2017 enacted level.
    Within the funds provided, the Committee has focused 
increases on priority areas and reduced funding for programs 
that are no longer authorized, are of limited scope or 
effectiveness, or do not have a clear Federal role.
    First and foremost among these priority areas, the 
Committee continues to build on the investment made last year 
in biomedical research by increasing funding for the National 
Institutes of Health (NIH) by $1,100,000,000. This increase 
builds on the prior $2,000,000,000 increase included in the 
Consolidated Appropriations Act, 2017 and continues funding 
from the 21st Century Cures Act. Within the total increase, the 
Committee provides an increase of $80,000,000 to the Precision 
Medicine Initiative, which holds the promise of designing 
personalized, targeted cures and treatment. The Committee also 
includes an increase of $400,000,000 to help find a cure for 
Alzheimer's disease and an increase of $76,000,000 for the 
BRAIN initiative to help better understand how the brain 
functions and learns.
    The Committee has also placed a high priority on combatting 
opioid addiction by including an additional $500,000,000 for 
grants to States, as outlined in the 21st Century Cures Act. 
The Committee also continues support for programs addressing 
opioid addiction as authorized in the Comprehensive Addiction 
and Recovery Act.
    To protect public health and the Nation in the event of a 
bioterrorism or other pandemic crisis, the Committee 
recommendation also includes increases to the Bioshield and the 
Biomedical Research and Advanced Development Authority (BARDA) 
programs as well as a $178,000,000 increase for detecting and 
preventing a pandemic flu outbreak. The recommendation also 
increases the Strategic National Stockpile by $25,000,000 and 
includes language allowing the Secretary of Health and Human 
Services greater flexibility to respond to an imminent public 
health threat within the public health and social services 
emergency fund.
    In the area of education, the Committee has included an 
increase of $200,000,000 to assist local school districts in 
covering the cost of ensuring all children with disabilities 
have access to a free, appropriate, and public education. The 
Committee provides a total of $500,000,000 for the new Student 
Support Services program created in the Every Student Succeeds 
Act. These funds can be used flexibly by school districts 
across the country to meet local challenges, whether those be 
in the area of counseling, special curriculum services, 
computer science or physical education needs as local demands 
may dictate. The recommendation also includes an increase of 
$28,000,000 for charter schools.
    The Committee includes robust increases for the TRIO, 
$60,000,000, and GEAR UP, $10,246,000, programs to ensure that 
students from disadvantaged backgrounds have access to a 
college program. The bill also provides sufficient funding to 
maintain the maximum Pell grant award at $5,920 in the 2018-
2019 academic year.
    The Head Start program is increased by $21,905,000 and the 
Child Care and Development Block Grant is increased by 
$4,000,000 to continue investments in early childhood 
education. The Committee has also included $250,000,000 within 
the Department of Health and Human Services for the Preschool 
Development Grants program.
    These increases are offset by eliminating funding for 
programs that do not have a clear or effective Federal role, or 
that have large unobligated balances that are not needed in 
this fiscal year.
    The Committee believes that public service is a public 
trust that requires Federal employees to place ethical 
principles above private gain. Federal employees are reminded 
that they shall not advance a personal agenda or give 
preferential treatment to any outside organization or 
individual within the government programs that they administer. 
Information that is received by the employee, including 
information from other employees, offices, or Congress should 
be handled in a professional and confidential manner in 
accordance with Code of Federal Regulations regarding the basic 
obligation of public service (5 CFR 2635.101).
    The Committee directs each of the agencies funded by this 
Act to continue to report any funds derived by the agency from 
non-Federal sources, including user charges and fines, that are 
authorized by law, to be retained and used by the agency or 
credited as an offset in annual budget submissions.
    Paper Reduction Efforts.--The Committee urges each agency 
funded by this Act to work with the Office of Management and 
Budget (OMB) to reduce printing and reproduction costs and 
directs each agency to inform the Committee on what steps have 
been taken to achieve this goal, including identifying how much 
money each agency expects to save by implementing these 
measures.

                      TITLE I--DEPARTMENT OF LABOR


                 Employment and Training Administration


                    TRAINING AND EMPLOYMENT SERVICES

    The Committee recommends $3,042,720,000 for Training and 
Employment Services (TES). TES provides funding for Federal 
government job training and employment service programs 
authorized primarily by the Workforce Innovation and 
Opportunity Act of 2014 (WIOA). This recommendation is 
$295,979,000 less than the fiscal year 2017 enacted level, and 
$988,954,000 more than the fiscal year 2018 budget request.
    Workforce Training.--The Committee continues to be 
concerned by the skills gap. According to Bureau of Labor 
Statistics data, employers are currently reporting over six 
million open positions. Employers are unable to fill many of 
these positions due to a lack of applicants with the required 
skills. The Committee believes this is an enormous missed 
economic opportunity. In the November 2016 Top Management and 
Performance Challenges Facing the U.S. Department of Labor, the 
Department of Labor Office of Inspector General (DOL-OIG) 
states that the Department has been challenged to assure that 
participants in its job training programs receive industry-
recognized credentials and that participants obtain employment 
in the occupations they have been trained for. The Committee 
urges the Department to consider ways that job-training 
programs can be better targeted and improved within existing 
authorities in order to train participants for in-demand jobs 
and reduce the skills gap.
    Governors' Reserve Fund.--The Committee recommendation 
maintains the Governors' Reserve Fund at the level authorized 
by WIOA. The Committee supports efforts by the Department of 
Labor to work with States to ensure that funds are used for 
authorized purposes in a timely manner and to minimize the 
accumulation of balances.
    Apprenticeship.--The Committee provides $35,000,000 for the 
Office of Apprenticeship Services. The Committee urges the 
Employment and Training Administration (ETA) to continue to 
expand apprenticeship options through outreach and increased 
employer engagement in registered apprenticeships. The bill 
provides no new funding for the Apprenticeship Grants program. 
The Committee encourages ETA to work with the authorizing 
committees of jurisdiction to enact an appropriate 
apprenticeship program authorization.
    Licensing.--The Committee continues to support the 
Department's efforts to address ways in which harmonizing 
licensing requirements across States can reduce barriers to 
labor market entry and mobility, including for dislocated 
workers, transitioning service members, and veterans.
    Pay for Performance.--The Pay-for-Performance authority 
provided in WIOA is a promising, innovative approach that 
leverages data, evaluation, and evidence-based performance to 
improve workforce development outcomes. The Committee urges the 
Department to consider how this authority can be used to 
improve training and employment programs across the workforce 
development system.
    Formal Partnerships and Job-Placement Services.--The United 
States is experiencing a shortfall of workers with education 
and training beyond a high school education. At the same time, 
industry surveys show that a lack of qualified workers is a top 
concern for many employers. The Committee urges the Secretary 
of Labor to research and develop strategies for creating formal 
partnerships and job-placement services with industry employers 
and the Adult Employment and Training Activities and Dislocated 
Worker Employment and Training Activities programs authorized 
by WIOA.
    Evaluation.--The Committee supports rigorous evaluation of 
the Department's programs, particularly the workforce training 
programs authorized by WIOA. The Committee provides $8,040,000 
in direct appropriations for program evaluations and continues 
a general provision authorizing the transfer of up to 0.75 
percent of appropriations from specific program accounts for 
purposes of evaluation.
    Evaluations should be targeted in ways that will allow the 
Department to use the findings to improve program delivery and 
results. The Committee urges the Department to follow through 
on evaluation findings with evidence-based Congressional 
justifications.
    Program Integrity.--The Committee continues to be concerned 
by the improper payment rate in the Unemployment Insurance (UI) 
program and urges the Department to use its authority and 
program integrity resources to help address this issue.
    Information Technology (IT) Consortia.--The Committee 
remains concerned that serious challenges threaten the 
viability of the UI IT modernization projects being carried out 
by State consortia. The Committee directs the Department to 
continue to provide annual reports to the Committees on 
Appropriations of the House of Representatives and the Senate 
on the status of all consortia projects and to implement 
appropriate policies and procedures for assessing and funding 
projects by State consortia. In addition, the Committee directs 
the Department to include in the fiscal year 2019 Congressional 
Justification any necessary recommendations for language or 
direction that would be helpful to ensure the long-term 
viability of the consortia projects and ensure that funds being 
used for IT modernization projects are achieving the intended 
results.
    Adult Employment and Training Activities.--For Adult 
Employment and Training Activities, the Committee recommends 
$776,736,000, which is $38,820,000 less than the fiscal year 
2017 enacted level and $286,366,000 more than the fiscal year 
2018 budget request.
    Youth Employment and Training Activities.--For Youth 
Employment and Training Activities, the Committee recommends 
$831,842,000, which is $41,574,000 less than the fiscal year 
2017 enacted level and $308,175,000 more than the fiscal year 
2018 budget request.
    Dislocated Worker Employment and Training Activities.--For 
Dislocated Worker Employment and Training Activities, the 
Committee recommends $1,145,530,000 which is $96,189,000 less 
than the fiscal year 2017 enacted level and $413,045,000 more 
than the fiscal year 2018 budget request.
    Of the total provided for Dislocated Worker Employment and 
Training Activities, $1,015,530,000 is designated for State 
grants that provide core and intensive services, training, and 
supportive services for dislocated workers. In addition, States 
use these funds for rapid response assistance to help workers 
affected by mass layoffs and plant closures.
    The remaining $130,000,000 is available for the Dislocated 
Workers National Reserve (DWNR). The DWNR supports national 
emergency grants, technical assistance and demonstration 
projects as authorized by WIOA. The Committee recommendation 
eliminates advance appropriations for the DWNR by providing 
$130,000,000 in current year funds and rescinding the advance 
provided in fiscal year 2017. No advance is provided for fiscal 
year 2019. The Committee recommendation includes up to 
$66,000,000 to assist dislocated workers in the Appalachian 
region as requested in the fiscal year 2018 budget request. The 
Committee appreciates the Department's efforts to address 
severe dislocations of workers in the coal industry.
    Native Americans.--For the Indian and Native American 
programs, the Committee recommends $50,000,000, which is the 
same as the fiscal year 2017 enacted level and $95,000 more 
than the fiscal year 2018 budget request.
    Migrant and Seasonal Farmworkers.--For the National 
Farmworker Jobs program, the Committee recommends $72,000,000, 
which is $9,896,000 less than the fiscal year 2017 enacted 
level. The fiscal year 2018 budget request proposed no funding 
for this program.
    The Committee encourages the Department to consider ways 
that the Migrant and Seasonal Farmworkers program can be used 
to help address shortages of workers in the agricultural 
sector.
    YouthBuild.--For the YouthBuild program, the Committee 
recommends $84,534,000, which is the same as the fiscal year 
2017 enacted level and $161,000 more than the fiscal year 2018 
budget request.
    Technical Assistance.--The Committee recommends no direct 
funding for technical assistance, which is $2,500,000 less than 
the fiscal year 2017 and $5,226,000 less than the fiscal year 
2018 budget request. WIOA provides the authority to use DWNR 
funds for technical assistance and the Committee maintains a 
provision allowing the set-aside of up to 10 percent of such 
funds for technical assistance activities.
    Reintegration of Ex-Offenders.--The Committee recommends 
$82,078,000 for ex-offender retraining and reintegration 
activities, which is $6,000,000 less than the fiscal year 2017 
enacted level and $4,167,000 more than the fiscal year 2018 
budget request.
    Workforce Data Quality Initiative.--The Committee 
recommends no funding for the Workforce Data Quality 
Initiative, which is $6,000,000 less than the fiscal year 2017 
enacted level and the same as the fiscal year 2018 budget 
request.

                               JOB CORPS

                     (INCLUDING TRANSFER OF FUNDS)

    The Committee recommends $1,688,155,000 for Job Corps, 
which is $16,000,000 less than the fiscal year 2017 enacted 
level and $239,711,000 more than the fiscal year 2018 budget 
request.
    Operations.--For Job Corps Operations, the Committee 
recommends $1,572,886,000, which is $14,439,000 less than the 
fiscal year 2017 enacted level and $231,568,000 more than the 
fiscal year 2018 budget request.
    Construction, Rehabilitation, and Acquisition.--The 
Committee recommends $83,000,000 for construction, 
rehabilitation, and acquisition activities of Job Corps 
centers, which is $1,500,000 less than the fiscal year 2017 
enacted level and $8,143,000 more than the fiscal year 2018 
budget request.
    Administration.--The Committee recommends $32,269,000 for 
the administrative expenses of the Job Corps program, which is 
$61,000 less than the fiscal year 2017 enacted level and the 
same as the fiscal year 2018 budget request.
    Job Corps is a residential education and vocational 
training program that helps young people ages 16 through 24 
improve the quality of their lives through vocational and 
academic training.
    On March 31, 2017, the DOL-OIG issued a report entitled 
Review of Job Corps Center Safety and Security (Report Number 
26-17-001-03-370). The DOL-OIG found that campuses audited had 
significant physical security weaknesses and that center 
management continued to underreport or misclassify incidents of 
student misconduct to Job Corps. The Consolidated 
Appropriations Act, 2017 and the fiscal year 2018 Committee 
recommendation includes additional funds for Job Corps 
construction. The Committee directs the Department to use these 
funds to address physical security weaknesses at Job Corps 
centers. The Committee directs the Department to review and 
make any necessary changes to the collection and processing of 
misconduct reports.
    The Committee continues to be concerned about the safety 
and security of students in the Job Corps program. The 
Committee supports the Department's efforts to improve safety 
and urges ETA to continue to review and implement policies that 
will enhance safety and security on Job Corps campuses 
throughout the country.
    The Committee is concerned that a backlog in the 
procurement of Job Corps operations contracts has resulted in a 
number of unnecessary and costly bridge contracts in recent 
years. The Committee recognizes that fewer bridge contracts 
were reported in the most recent quarter and appreciates the 
efforts the Department has undertaken to reduce the backlog and 
need for such bridge contracts in the future.
    The Committee is aware of challenges with respect to the 
recruitment of women participants in the Job Corps program. The 
Department is directed to submit a report to the Committees on 
Appropriations of the House of Representatives and the Senate 
within 180 days of enactment of this Act providing detail on 
current outreach and recruitment activities, barriers to 
women's participation in the program, and ways that Job Corps 
recruitment policies can better target women. As part of the 
report, the Committee encourages ETA to work with HHS early 
childhood education programs to assess current partnerships and 
develop recommendations to improve or expand upon successful 
partnership models at Job Corps campuses to facilitate the 
participation of women with children.
    The Committee encourages the Department to consider 
establishing a working group of Job Corps administrators, 
industry leaders and other relevant parties to identify ways in 
which the program can be better targeted to support the goals 
of training young Americans for in-demand jobs that benefit 
their communities, the economy, and help reduce poverty.
    The Committee continues to support the policy of closing a 
limited number of chronically underperforming Job Corps centers 
and directs the Department to submit a comprehensive plan to 
the Committees on Appropriations of the House of 
Representatives and the Senate at least 60 days prior to 
initiating the closure of any existing Job Corps centers. The 
plan should identify the centers that will be closed, provide 
the financial and management rationale for closing each center, 
and include a detailed analysis of the costs and anticipated 
savings that will result from the closure.
    Section 106(b) authorizes the Secretary to transfer up to 
0.5 percent of discretionary ETA appropriations to carry out 
program integrity activities within those programs, the 
Committee directs the Department to notify the Committees on 
Appropriations of the House of Representatives and the Senate 
at least 15 days in advance of any such transfer with respect 
to funds appropriated to Job Corps.

            COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS

    The Committee recommends transferring the Community Service 
Employment for Older Americans program to the Administration 
for Community Living at the Department of Health and Human 
Services.

              FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES

    The Committee recommends $790,000,000 for Federal 
Unemployment Benefits and Allowances, which is $59,000,000 less 
than the fiscal year 2017 enacted level and the same as the 
fiscal year 2018 budget request.
    The Trade Adjustment Assistance program (TAA) provides 
assistance to workers adversely affected by international 
trade. TAA provides training, income support, wage subsidies 
for older workers, job search and relocation allowances to 
groups of workers who file a petition and are certified as 
eligible to apply for such benefits due to job losses resulting 
from increases in imports or foreign trade.

     STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS

    The Committee recommends $2,830,903,000 for State 
Unemployment Insurance and Employment Service Operations. The 
total includes $2,760,903,000 from the Employment Security 
Administration Account from the Unemployment Trust Fund and 
$70,000,000 from the General Fund of the Treasury. These funds 
are used to support the administration of Federal and State 
unemployment compensation laws.
    Unemployment Insurance Compensation.--For Unemployment 
Insurance (UI) Compensation, the Committee recommends 
$2,665,775,000, which is $21,825,000 less than the fiscal year 
2017 enacted level and $30,000,000 more than the fiscal year 
2018 budget request. The total includes $2,665,775,000 for 
State Operations and $13,000,000 for National Activities.
    The recommendation for State UI Operations includes 
$160,000,000 to conduct in-person reemployment and eligibility 
assessments (REA), which is $45,000,000 more than the fiscal 
year 2017 enacted level and $30,000,000 more than the fiscal 
year 2018 budget request. The Committee supports the REA 
program as a means to reduce waste, fraud, abuse, to conduct 
eligibility assessments, and to refer beneficiaries to 
appropriate training options.
    As in previous years, the recommendation provides 
contingency funding for increased workloads that States may 
face in the administration of UI. During fiscal year 2018, for 
every 100,000 increase in the total average weekly insured 
unemployment above 2,246,000, an additional $28,600,000 shall 
be made available from the Unemployment Trust Fund.
    Employment Service.--The Committee recommends $19,818,000 
for Employment Service National Activities, which is the same 
as the fiscal year 2017 enacted level and $38,000 more than the 
fiscal year 2018 budget request.
    Foreign Labor Certification.--The Committee recommends 
$62,310,000 for the Foreign Labor Certification (FLC) program, 
which is the same as the fiscal year 2017 enacted level and 
$118,000 more than the fiscal year 2018 budget request. The 
recommendation includes $48,028,000 for Federal administration 
activities and $14,282,000 for grants to States.
    The FLC program administers temporary foreign worker 
programs including the H-2A and the H-2B temporary visa 
programs. These programs are essential to employers in 
industries that have cyclical peaks or that are seasonal in 
nature, including agriculture, tourism, and hospitality.
    The Committee is concerned about previous delays in the 
processing of labor certifications in the H-2A, H-2B, and PERM 
programs. The Department is directed to use all appropriate 
resources and authorities to prevent any backlogs of 
applications in Foreign Labor Certification programs in fiscal 
year 2018.
    The Committee is aware that there continues to be concern 
regarding the methodology for calculating H-2A wage rates 
prescribed in the Final Rule published by the Department of 
Labor on February 12, 2010. The Committee encourages the 
Department to review the wage methodology prescribed in the 
Final Rule and determine whether an alternate methodology could 
reduce disparate impacts on local areas.
    One-Stop Career Centers/Labor Market Information.--The 
Committee recommends $70,000,000 for One-Stop Career Centers 
and Labor Market Information, which is $2,347,000 more than the 
fiscal year 2017 enacted level and $2,476,000 more than the 
fiscal year 2018 budget request. The Committee expects the 
Department to use additional funds to ensure claimants have 
access to timely information on job openings and other 
appropriate labor market information.

        ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS

    The Committee recommends such sums as necessary for 
Advances to the Unemployment Trust Fund and Other Funds. The 
funds are made available to accounts authorized under Federal 
and State unemployment insurance laws and the Black Lung 
Disability Trust Fund when the balances in such accounts are 
insufficient.

                         PROGRAM ADMINISTRATION

    The Committee recommends $156,348,000 for Program 
Administration, which is $2,308,000 less than the fiscal year 
2017 enacted level and $2,083,000 more than the fiscal year 
2018 budget request. The recommendation includes $106,461,000 
from the General Fund of the Treasury and $49,887,000 from the 
Employment Security Administration Account in the Unemployment 
Trust Fund.

               Employee Benefits Security Administration


                         SALARIES AND EXPENSES

    The Committee recommends $175,600,000 for the Employee 
Benefits Security Administration (EBSA). This recommendation is 
$5,400,000 less than the fiscal year 2017 enacted level and 
$8,326,000 less than the fiscal year 2018 budget request. The 
EBSA assures the security of retirement, health and other 
workplace-related benefits of working Americans.
    The Committee understands there is concern regarding the 
amount of time it takes to complete audits of Association 
Health Plans and urges the Department to review its audit 
policies to determine if there are ways to reduce the burdens 
on plan administrators and complete audits in a timely manner.

                  Pension Benefit Guaranty Corporation

    The Committee includes an obligation limitation for 
administrative expenses of $424,417,000 for the Pension Benefit 
Guaranty Corporation (PBGC). The limitation is $95,089,000 less 
than the fiscal year 2017 enacted level and $98,500,000 less 
than the fiscal year 2018 budget request. The recommendation 
includes bill language that defines PBGC's discretionary 
authority to incur additional unforeseen and emergency 
administrative expenses related to its multiemployer plan 
insurance program. Congress established the PBGC to insure the 
defined-benefit pension plans of working Americans.
    The Committee recommendation does not include $98,500,000 
for expenses related to the relocation of headquarters space, 
which was provided in the Consolidated Appropriations Act, 
2017. The Committee expects the fiscal year 2019 budget request 
for PBGC to return to its base funding needs and that the 
consolidation of headquarters space will result in lower 
operating costs for PBGC in the future.
    The Committee directs PBGC to submit a report to the 
Committees on Appropriations of the House of Representatives 
and the Senate within 180 days of enactment of this Act that 
includes an evidence-based review and assessment of the Smaller 
Asset Manager Pilot Program. The report should include 
performance comparisons of pilot participants and non-pilot 
PBGC asset managers, after fees, relative to their portfolio 
benchmarks, and should identify best practices and lessons 
learned that could be applied at PBGC and other Federal pension 
and retirement benefit systems.
    The Committee directs PBGC to submit reports required by 
the Employee Retirement Income Security Act of 1974 and the 
Pension Protection Act of 2006.

                         Wage and Hour Division


                         SALARIES AND EXPENSES

    The Committee recommends $217,500,000 for the Wage and Hour 
Division (WHD), which is $10,000,000 less than the fiscal year 
2017 enacted level and $12,568,000 less than the fiscal year 
2018 budget request.
    The WHD enforces Federal minimum wage, overtime pay, 
recordkeeping, and child labor requirements of the Fair Labor 
Standards Act. WHD also has enforcement and other 
administrative responsibilities related to the Migrant and 
Seasonal Agricultural Worker Protection Act, the Employee 
Polygraph Protection Act, the Family and Medical Leave Act, the 
Davis Bacon Act and the Service Contract Act.
    The Committee continues to be concerned that the 
Establishing a Minimum Wage for Contractors regulation 
published by the Department of Labor in the Federal Register on 
October 7, 2014 (79 Fed. Reg. 60634 et seq.) disproportionately 
affects entities operating seasonal recreational services and 
equipment rental to the general public on Federal property or 
lands.

                  Office of Labor-Management Standards


                         SALARIES AND EXPENSES

    The Committee recommends $41,129,000 for the Office of 
Labor-Management Standards (OLMS), which is $2,942,000 more 
than the fiscal year 2017 enacted level and $5,505,000 less 
than the fiscal year 2018 budget request. The recommendation 
does not include funding for the proposed Electronic Labor 
Organization Reporting System (e.LORS) modernization project.
    OLMS administers the Labor-Management Reporting and 
Disclosure Act, which establishes safeguards for union 
democracy and union financial integrity, and requires public 
disclosure reporting by unions, union officers, employees of 
unions, labor relations consultants, employers, and surety 
companies.

             Office of Federal Contract Compliance Programs


                         SALARIES AND EXPENSES

    The Committee recommends $94,500,000 for the Office of 
Federal Contract Compliance Programs (OFCCP), which is 
$9,976,000 less than the fiscal year 2017 enacted level and 
$6,500,000 more than the fiscal year 2018 budget request. The 
OFCCP ensures equal employment opportunity in the Federal 
contracting community through enforcement, regulatory work, 
outreach and education to workers and their advocates.
    In September 2016, GAO issued a report entitled, ``Equal 
Employment Opportunity: Strengthening Oversight Could Improve 
Federal Contractor Nondiscrimination Compliance'' (GAO-16-750). 
In the report GAO found, among other things, that OFCCP does 
not have reasonable assurance that the methods used for 
selecting contractors for compliance reviews effectively target 
contractors that pose the greatest risk of non-compliance, that 
compliance assistance activities have declined by 30 percent 
since 2012 ``as the agency refocused its activities on 
enforcement,'' and that ``many contractors told GAO they do not 
feel comfortable contacting OFCCP for assistance and hire third 
party support to help comply with federal nondiscrimination and 
affirmative action requirements.''
    The Committee has raised concerns with these issues in 
recent years and appreciates that the Department agreed with 
the six recommendations GAO made in its report. The Committee 
directs OFCCP to submit a report to the Committees on 
Appropriations of the House of Representatives and the Senate 
within 160 days of enactment of this Act on its efforts and the 
status of implementing each of the GAO recommendations.

                Office of Workers' Compensation Programs


                         SALARIES AND EXPENSES

    The Committee recommends $116,550,000 for the Office of 
Workers' Compensation Programs (OWCP), which is $1,051,000 less 
than the fiscal year 2017 enacted level and $1,268,000 more 
than the fiscal year 2018 budget request. The recommendation 
includes $114,377,000 in General Funds from the Treasury and 
the authority to expend $2,173,000 from the Special Fund 
established by the Longshore and Harbor Workers' Compensation 
Act.
    The OWCP administers the Federal Employees' Compensation 
Act, the Longshore and Harbor Workers' Compensation Act, the 
Energy Employees Occupational Illness Compensation Program Act, 
and the Black Lung Benefits Act. These programs provide 
eligible injured and disabled workers and their survivors with 
compensation, medical benefits, and services including 
rehabilitation, supervision of medical care, and technical and 
advisory counseling.
    The Committee supports the efforts of OWCP to reduce fraud 
and abuse related to the prescription of compound 
pharmaceuticals and opioids.
    The Committee remains concerned about backlogs of claims in 
OWCP programs. The Committee directs OWCP to implement policies 
and consider other ways in which processing times can be 
brought more closely into alignment with agency goals.

                            SPECIAL BENEFITS

                     (INCLUDING TRANSFER OF FUNDS)

    The Committee recommends $220,000,000 for Special Benefits, 
which is the same as the fiscal year 2017 enacted level and the 
fiscal year 2018 budget request. These funds provide mandatory 
benefits under the Federal Employees' Compensation Act.

               SPECIAL BENEFITS FOR DISABLED COAL MINERS

    The Committee recommends $54,319,000 for Special Benefits 
for Disabled Coal Miners. This amount is in addition to the 
$16,000,000 appropriated in fiscal year 2017 as an advance for 
the first quarter of fiscal year 2018. The total program level 
recommendation is $70,319,000, which is $10,000,000 less than 
the fiscal year 2017 enacted level and the same as the fiscal 
year 2018 budget request.
    These funds provide mandatory benefits to coal miners 
disabled by black lung disease, to their survivors and eligible 
dependents, and for necessary administrative costs. The 
Committee recommendation also provides $15,000,000 as an 
advance appropriation for the first quarter of fiscal year 
2019. These funds ensure uninterrupted payments to 
beneficiaries.

    ADMINISTRATIVE EXPENSES, ENERGY EMPLOYEES OCCUPATIONAL ILLNESS 
                           COMPENSATION FUND

    The Committee recommends $59,846,000 for the Energy 
Employees Occupational Illness Compensation Program, which is 
the same as the fiscal year 2017 enacted level and the fiscal 
year 2018 budget request.
    These funds provide mandatory benefits to eligible 
employees or survivors of employees of the Department of Energy 
(DOE); its contractors and subcontractors; companies that 
provided beryllium to DOE; atomic weapons employees 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; and uranium workers covered under the Radiation 
Exposure Compensation Act.

                    BLACK LUNG DISABILITY TRUST FUND

                     (INCLUDING TRANSFER OF FUNDS)

    The Committee recommends such sums as necessary for payment 
of benefits and interest on advances for the Black Lung 
Disability Trust Fund. The Committee recommends $414,806,000 
for the Black Lung Disability Trust Fund, which is $42,121,000 
more than the fiscal year 2017 enacted level and the same as 
the fiscal year 2018 budget request.
    The Black Lung Disability Trust Fund pays black lung 
compensation, medical and survivor benefits, and administrative 
expenses when no mine operator can be assigned liability for 
such benefits, or when mine employment ceased prior to 1970. 
The Black Lung Disability Trust Fund is financed by an excise 
tax on coal, reimbursements from responsible mine operators, 
and short-term advances from the Treasury. The Emergency 
Economic Stabilization Act of 2008 authorized a restructuring 
of the Black Lung Disability Trust Fund debt and required that 
annual operating surpluses be used to pay down the debt until 
all remaining obligations are retired.

             Occupational Safety and Health Administration


                         SALARIES AND EXPENSES

    The Committee recommends $531,470,000 for the Occupational 
Safety and Health Administration (OSHA). This recommendation is 
$21,317,000 less than the fiscal year 2017 enacted level and 
$11,787,000 less than the fiscal year 2018 budget request. OSHA 
enforces the Occupational Safety and Health Act of 1970.
    The Committee strongly supports the mission of OSHA to 
promote a safe and healthy workplace and protect workers from 
injury, illness, and death. The Committee supports the efforts 
of OSHA to adopt an approach that more effectively balances 
enforcement with education, training, and compliance 
assistance. Unfortunately, overreliance on enforcement in 
recent years has fostered a toxic environment between the 
agency and employers that is undermining the agency's goals for 
workplace safety and is at odds with Federal policies that 
support economic growth and job creation.
    Safety and Health Standards.--The Committee recommends 
$18,000,000 for Safety and Health Standards.
    Federal Enforcement.--The Committee recommends $194,250,000 
for Federal Enforcement.
    Whistleblower Programs.--The Committee recommends 
$17,500,000 for Whistleblower Programs.
    State Programs.--The Committee recommends $100,850,000 for 
State Programs.
    Technical Support.--The Committee recommends $24,469,000 
for Technical Support.
    Compliance Assistance.--The Committee recommends 
$131,851,000 for Federal and State compliance assistance 
programs. The total includes $72,351,000 for Federal Assistance 
and $59,500,000 for State Consultation Grants.
    Training Grants.--No funding is provided for Training 
Grants.
    Voluntary Protection Program/Safety and Health Achievement 
Recognition Program.--The Committee supports the Voluntary 
Protection Program and the Safety and Health Achievement 
Recognition Program and urges OSHA to expand these vital 
programs as part of a comprehensive strategy realignment that 
focuses more on cooperative safety efforts and less on punitive 
enforcement.
    Whistleblower Provisions.--The Committee directs OSHA to 
issue whistleblower citations consistent with and not to exceed 
the authority provided in section 11(c) of the Occupational 
Safety and Health Act.
    Outreach Training Program.--The Committee directs OSHA to 
conduct a fair and open competition for any new or reissued 
request for proposals for the Outreach Training Program.
    National/Regional/Local Emphasis Programs.--The explanatory 
statement accompanying the fiscal year 2016 Consolidated 
Appropriations Act directed OSHA to notify the Committee on 
Appropriations of the House of Representatives and the Senate 
10 days prior to the announcement of any new National, Regional 
or Local Emphasis Program including the circumstances and data 
used to determine the need for the launch of the new program. 
The Committee directs OSHA to continue to provide such notices 
in fiscal year 2018.

                 Mine Safety and Health Administration


                         SALARIES AND EXPENSES

    The Committee recommends $359,975,000 for the Mine Safety 
and Health Administration (MSHA), which is $13,841,000 less 
than the fiscal year 2017 enacted level and $15,197,000 less 
than the fiscal year 2018 budget request.
    MSHA enforces the Federal Mine Safety and Health Act in 
underground and surface coalmines and metal/non-metal mines.
    The Committee continues bill language designating up to 
$2,000,000 for mine rescue recovery activities, and provides 
for the retention of fees up to $2,499,000 for the testing and 
certification of equipment.
    The Committee includes $10,537,000 for State assistance 
training grants and provides the authority to use such funds 
for the purchase and maintenance of equipment required by the 
```Lowering Miners' Exposure to Respirable Coal Mine Dust, 
Including Continuous Personal Dust Monitors'' regulation.
    The Committee supports the efforts of MSHA to reemphasize 
compliance assistance programs that help mine operators to 
improve safety and comply with regulations without the threat 
of punitive enforcement.
    The Committee appreciates the significant reductions in 
mining injury and illness rates that have been achieved in 
recent decades and remains a strong proponent for vigilant mine 
safety oversight. The Committee notes significant worker 
dislocations and mine closures as a result of economic 
conditions throughout the mining industry, and in coal mining 
in particular. The Committee continues to receive reports of 
inspectors exceeding necessary and appropriate levels of 
oversight to the point of significantly impeding mining 
operations. The Committee questions whether this strategy 
materially improves safety and if the costs outweigh the 
benefits of such additional oversight. The Committee continues 
to support the efforts MSHA has undertaken to realign its 
resources and capacity to match where mining activity is 
currently occurring. MSHA has made progress in recent years but 
must accelerate the process, including reductions in force if 
necessary, in order to ensure sufficient industry oversight 
that meets and does not exceed statutory and regulatory 
requirements.
    The Committee continues to support advances MSHA has made 
in mine rescue technology and communications. The Committee 
directs MSHA to assess its current mine rescue deployment 
capability and strategy and discuss ongoing operational and 
resource needs in the fiscal year 2019 Congressional 
Justification.

                       Bureau of Labor Statistics


                         SALARIES AND EXPENSES

    The Committee recommends $609,000,000 for the Bureau of 
Labor Statistics (BLS), which is the same as the fiscal year 
2017 enacted level and $1,158,000 more than the fiscal year 
2018 budget request. The recommendation includes $544,000,000 
from the General Fund of the Treasury and $65,000,000 from the 
Employment Security Administration Account in the Unemployment 
Trust Fund.
    BLS is an independent national statistical agency that 
collects, processes, analyzes, and disseminates essential 
economic data to the Congress, Federal agencies, State and 
local governments, businesses, and the public. Its principal 
surveys include the Consumer Price Index and the monthly 
unemployment series.
    Employment and Unemployment Statistics.--The Committee 
recommends $203,878,000 for Employment and Unemployment 
Statistics.
    Labor Market Information.--The Committee recommends 
$65,000,000 for Labor Market Information.
    Prices and Cost of Living.--The Committee recommends 
$211,444,000 for Prices and Cost of Living.
    Compensation and Working Conditions.--The Committee 
recommends $82,880,000 for Compensation and Working Conditions.
    Productivity and Technology.--The Committee recommends 
$10,798,000 for Productivity and Technology.
    Executive Direction and Staff Services.--The Committee 
recommends $35,000,000 for Executive Direction and Staff 
Services.

                 Office of Disability Employment Policy


                         SALARIES AND EXPENSES

    The Committee recommends $36,800,000 for the Office of 
Disability Employment Policy (ODEP), which is $1,403,000 less 
than the fiscal year 2017 enacted level and $9,597,000 more 
than the fiscal year 2018 budget request. ODEP provides policy 
guidance and leadership to eliminate employment barriers to 
people with disabilities.

                        Departmental Management


                         SALARIES AND EXPENSES

                     (INCLUDING TRANSFER OF FUNDS)

    The Committee recommends $272,847,000 for Departmental 
Management, which is $61,997,000 less than the fiscal year 2017 
enacted level and $12,989,000 more than the fiscal year 2017 
budget request. The recommendation includes $272,539,000 from 
the General Fund of the Treasury and $308,000 from the 
Employment Security Administration Account in the Unemployment 
Trust Fund. The Departmental Management appropriation provides 
funds for the staff responsible for Departmental operations, 
management, and policy development.
    Program Direction and Support.--The Committee recommends 
$30,250,000 for Program Direction and Support.
    Departmental Program Evaluation.--The Committee recommends 
$8,040,000 for Departmental Program Evaluation.
    Legal Services.--The Committee recommends $122,445,000 for 
Legal Services.
    International Labor Affairs.--The Committee recommends 
$26,500,000 for International Labor Affairs (ILAB). The 
recommendation provides no funding for ILAB grants as requested 
in the fiscal year 2018 budget request and returns ILAB to its 
original mission of research, advocacy, and technical 
assistance.
    Administration and Management.--The Committee recommends 
$23,496,000 for Administration and Management.
    Adjudication.--The Committee recommends $33,561,000 for 
Adjudication.
    Women's Bureau.--The Committee recommends $11,466,000 for 
the Women's Bureau.
    Civil Rights Activities.--The Committee recommends 
$6,867,000 for Civil Rights Activities.
    Chief Financial Officer.--The Committee recommends 
$9,914,000 for the Chief Financial Officer.
    The Committee directs the Department to submit its annual 
Operating Plan to the Committees on Appropriations of the House 
of Representatives and the Senate within the 45-day statutory 
deadline.

                    VETERANS EMPLOYMENT AND TRAINING

    The Committee recommends $284,051,000 for the Veterans 
Employment and Training (VETS) program, which is $5,010,000 
more than the fiscal year 2017 enacted level and $4,456,000 
more than the fiscal year 2018 budget request. The 
recommendation includes $47,537,000 from the General Fund of 
the Treasury and $236,514,000 from the Employment Security 
Administration Account in the Unemployment Trust Fund.
    The VETS program serves America's veterans and separating 
service members by preparing them for meaningful careers, 
providing employment resources and expertise, and protecting 
their employment rights.
    The Committee continues to support the VETS program and 
encourages the Department to pursue opportunities to 
cooperation with other Federal, State and private enterprises 
to help the country better serve its veterans.
    The Committee includes funding for the initiation of the 
HIRE Vets Medallion Program authorized by the Honoring 
Investments in Recruiting and Employing American Military 
Veterans Act of 2017.
    State Grants.--The Committee recommends $175,000,000 for 
State Grants.
    Transition Assistance Program.--The Committee recommends 
$16,073,000 for the Transition Assistance Program.
    Homeless Veterans' Reintegration Program.--The Committee 
recommends $47,537,000 for the Homeless Veterans' Reintegration 
Program.
    Federal Administration.--The Committee recommends 
$42,027,000 for Federal Administration.
    National Veterans' Employment and Training Service 
Institute.--The Committee recommends $3,414,000 for the 
National Veterans' Employment and Training Institute.

                  INFORMATION TECHNOLOGY MODERNIZATION

    The Committee recommends $20,769,000 for Information 
Technology (IT) Modernization, which is $1,991,000 more than 
the fiscal year 2017 enacted level and $8,953,000 less than the 
fiscal year 2018 budget request.
    The Committee directs the Department to establish a multi-
year IT modernization plan consistent with the Department's 
capacity to oversee effectively projects, within available 
appropriations, and to propose the plan and required funding in 
the fiscal year 2019 Congressional Justification.
    The Committee directs the Department to assign a qualified 
project manager that is a full-time employee of the Department 
to each modernization project to ensure the all IT 
modernization projects are executed effectively, according to 
Departmental requirements, on time, and within budget.

                      OFFICE OF INSPECTOR GENERAL

    The Committee recommends $89,147,000 for the Department of 
Labor Office of Inspector General (DOL-OIG), which is 
$1,426,000 more than the fiscal year 2017 enacted level and 
$3,011,000 more than the fiscal year 2018 budget request. The 
recommendation includes $83,487,000 from the General Fund of 
the Treasury and $5,660,000 from the Employment Security 
Administration Account in the Unemployment Trust Fund.
    The DOL-OIG conducts audits of Department programs and 
operations in order to determine that they comply with the 
applicable laws and regulations, that they use resources 
effectively, and that they are achieving their intended 
results.
    The Committee supports the DOL-OIG efforts to reduce 
improper payments in the UI program, and to reduce fraud and 
abuse in the Workers' Compensation programs related to the 
prescription of compound pharmaceuticals and opioids.

                           General Provisions

    Sec. 101. The Committee continues a provision to prohibit 
the use of Job Corps funds for the salary of an individual at a 
rate in excess of Executive Level II.

                          (TRANSFER OF FUNDS)

    Sec. 102. The Committee continues a provision providing the 
Secretary of Labor with the authority to transfer up to one 
percent of discretionary funds between appropriations, provided 
that no appropriation is increased by more than three percent 
by any such transfer.
    Sec. 103. The Committee continues a prohibition on use of 
funds to purchase goods that are in any part produced by 
indentured children.
    Sec. 104. The Committee continues a provision related to 
grants made from funds available to the Department under the 
American Competitiveness and Workforce Improvement Act.
    Sec. 105. The Committee continues a provision to prohibit 
recipients of funds provided to the Employment and Training 
Administration from using such funds for the compensation of 
any individual at a rate in excess of Executive Level II.

                          (TRANSFER OF FUNDS)

    Sec. 106. The Committee continues a provision providing the 
Secretary of Labor with the authority to transfer funds made 
available to the Employment and Training Administration to 
Program Administration for technical assistance and program 
integrity activities.

                          (TRANSFER OF FUNDS)

    Sec. 107. The Committee continues a provision allowing up 
to 0.75 percent of discretionary appropriations provided in 
this Act for specific Department of Labor 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.
    Sec. 108. The Committee continues a provision relating to 
section 147 of the WIOA authorizing competitive procurement of 
certain Job Corps Civilian Conservation Centers.
    Sec. 109. The Committee continues a provision relating to 
the Fair Labor Standards Act and certain insurance personnel 
conducting post-disaster activity.

                              (RESCISSION)

    Sec. 110. The Committee continues a provision rescinding 
advance appropriations in the Dislocated Workers' National 
Reserve account.
    Sec. 111. The Committee continues a provision relating to 
flexibility of H-2B nonimmigrant crossings.
    Sec. 112. The Committee continues a provision relating to 
wage determinations in the H-2B program.
    Sec. 113. The Committee continues a provision relating to 
the administration of the H-2B program.
    Sec. 114. The Committee includes a new provision relating 
to the definition of the term ``fiduciary.''

           TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES


              Health Resources and Services Administration

    The Committee recommends $5,815,727,000 for health 
resources and services programs, which is $397,620,000 below 
the fiscal year 2017 enacted level and $276,893,000 above the 
fiscal year 2018 budget request. The Health Resources and 
Services Administration (HRSA) supports programs that provide 
health services to disadvantaged, medically underserved, and 
special populations; decrease infant mortality rates; assist in 
the education of health professionals; and provide technical 
assistance regarding the utilization of health resources and 
facilities.

                          PRIMARY HEALTH CARE

Health Centers

    The Committee recommends $1,491,422,000 for the Health 
Centers program, which is $900,000 above the fiscal year 2017 
enacted level and $2,835,000 above the fiscal year 2018 budget 
request.
    The Committee includes bill language providing up to 
$99,893,000 for the Federal Tort Claims Act program, which is 
the same as the fiscal year 2017 enacted level and $190,000 
above the fiscal year 2018 budget request. The program provides 
medical malpractice liability protection to Federally supported 
health centers.
    The Committee requests HRSA include an update in the fiscal 
year 2019 Congressional justification on the agency's efforts 
to implement the recommendations described in GAO Report (GAO-
12-546) Health Center Program: Improved Oversight Needed to 
Ensure Grantee Compliance with Requirements.
    In addition, the Committee allocates not less than 
$15,000,000 for the establishment of a Health Center Audit, 
Compliance, and Oversight Office within the Bureau of Primary 
Health Care. The Committee expects the office to perform 
periodic audits and compliance reviews of all health center 
access points, with a goal of conducting a compliance or audit 
review for every access point location every five years. The 
office shall oversee Federally Qualified Health Centers, Health 
Center Program Look-Alikes, and Health Centers receiving a 
grant under section 330 of the Public Health Service Act. The 
office should provide uniform guidance to health center project 
officers, monitor project officer adherence to program 
guidance, and periodically assess whether program guidance is 
meeting program objectives. The office will also conduct 
independent compliance reviews, ensuring all health center 
access points have policies, procedures, and training to comply 
with applicable Federal laws. The office shall submit quarterly 
reports to the Committees on Appropriations of the House of 
Representatives and the Senate containing the results of all 
audits and compliance reviews of health center access points 
and oversight of health center project officers. The Committees 
directs HRSA to provide a briefing within 45 days of enactment 
of this Act on efforts to establish this office.
    Tuberculosis.--The Committee supports the coordination 
between health centers and State and local Tuberculosis (TB) 
control programs to help ensure appropriate identification, 
treatment, and prevention of TB among target populations. The 
Committee encourages HRSA to continue to implement the 
recommendations of the Tuberculosis Action Plan and recommends 
that the agency include an update of its progress in the fiscal 
year 2019 Congressional Justification.

Free Clinics Medical Malpractice

    The Committee recommends $100,000 for carrying out 
responsibilities under the Federal Tort Claims Act. This amount 
is $900,000 below the fiscal year 2017 enacted level and the 
same as the fiscal year 2018 budget request. The program 
provides medical malpractice coverage to individuals involved 
in the operation of free clinics in order to expand access to 
health care services to low-income individuals in medically 
underserved areas. A free clinic must apply, consistent with 
the provisions applicable to community health centers, to have 
those individuals ``deemed'' an employee of the Public Health 
Service, and therefore eligible for coverage.

                            HEALTH WORKFORCE

Health Professions

    The Committee recommends $748,236,000 for the Health 
Professions programs, which is $90,459,000 below the fiscal 
year 2017 enacted level and $365,605,000 above the fiscal year 
2018 budget request. The Health Professions programs support 
grants for the development of the health workforce in fields 
challenged by a high need and insufficient supply of health 
professionals. Given that colleges and universities serve the 
dual role of training students and carrying out a majority of 
Federally-funded biomedical research, the Committee believes 
that they serve as an ideal setting to expose future clinicians 
to the evidence base that underlies their intended profession.
    Within the total for Health Professions, the Committee 
recommends the following amounts:

------------------------------------------------------------------------
                   Budget Activity                     FY 2018 Committee
------------------------------------------------------------------------
Health Professions Training for Diversity
    Centers of Excellence............................         $9,711,000
    Faculty Loan Repayment...........................          1,190,000
    Scholarships for Disadvantaged Students..........         45,970,000
Workforce Information and Analysis...................          4,663,000
Primary Care Training and Enhancement................         38,924,000
Oral Health Training Programs........................         36,673,000
Interdisciplinary, Community-based Linkages
    Area Health Education Centers....................         30,250,000
    Geriatric Programs...............................         34,737,000
    Mental and Behavioral Health.....................          9,916,000
    Behavioral Health Workforce Education and                 25,000,000
     Training........................................
NURSE Corps Scholarship and Loan Repayment...........         83,135,000
Nursing Workforce Development........................        128,067,000
------------------------------------------------------------------------

Training for Diversity

    Centers of Excellence.--The Committee directs HRSA to 
provide continuation grants for activities authorized under 
section 736 of the Public Health Service Act.

Primary Care Training and Enhancement

    Interprofessional Education.--The Committee is aware of the 
growing recognition that interprofessional clinical health 
programs represent the state of the art in health care. The 
Committee believes interprofessional clinical care teams that 
include physicians and physician assistants and other 
disciplines (such as nurses, oral health practitioners, 
behavioral health professionals, and allied health providers) 
can achieve better care, better population health, and lower 
costs. Further, the Committee shares HRSA's belief that health 
organizations and professionals should be trained for a 
contemporary practice environment focused on new and more 
efficient models of care that include interprofessional and 
team-based care. The Committee also believes that 
implementation of interprofessional practice requires health 
students and faculty, as well as staff at the clinic site, be 
prepared effectively to work side-by-side. In carrying out the 
various workforce programs authorized by Title VII and VIII of 
the Public Health Service Act, including the Primary Care 
Training and Enhancement Program, the Committee supports 
efforts by the Bureau of Health Workforce to include 
interprofessional education as a component in funding 
announcements, particularly with respect to programs that 
address student and faculty learning as well as clinical site 
readiness.
    Integration of Primary Care and Oral Health Practice.--The 
Committee is aware that a number of medications (prescription 
drugs, over the counter drugs, and vitamins and minerals) can 
affect oral health. Many medications used to treat chronic 
diseases have adverse effects on oral health that patients and/
or providers might not be aware of. The most common side effect 
is dry mouth, which can be brought on by more than 400 
different prescription medications. Dry mouth raises the risk 
of tooth decay and gum disease. The Committee encourages HRSA 
to address the impact of medication on oral health as part of 
its ongoing efforts to promote oral health and primary care 
integration across the patient lifespan, additional focus would 
feature diabetic patients as a population of interest for 
primary care integration.
    Rare Diseases.--The Committee encourages HRSA to examine 
programs to increase primary care physician's preparedness in 
the diagnosis of rare diseases.

Oral Health Training

    The Committee recommends $36,673,000 for Oral Health 
Training programs, which is the same as the fiscal year 2017 
enacted level and $36,673,000 above the fiscal year 2018 budget 
request. These programs serve to increase the number of medical 
graduates from minority and disadvantaged backgrounds and to 
encourage students and residents to choose primary care fields 
and practice in underserved urban and rural areas.
    Within the funds provided, the Committee includes not less 
than $10,000,000 for General Dentistry Programs and not less 
than $10,000,000 for Pediatric Dentistry programs. The 
Committee directs HRSA to provide continuation funding for pre-
doctoral and postdoctoral training grants initially awarded in 
fiscal year 2015.
    Within the funds provided, the Committee provides not less 
than $1,675,000 for the Dental Faculty Loan Repayment program 
authorized by section 748 of the Public Health Service Act. The 
Committee directs HRSA to provide continuation funding for 
grants initially awarded in fiscal years 2016 and 2017.

Area Health Education Centers

    The Committee strongly supports Area Health Education 
Centers (AHEC) oral health projects that establish primary 
points of service and address the need to help patients find 
treatment outside of hospital emergency rooms. The Committee is 
aware that some State dental associations have already 
initiated programs to refer emergency room patients to dental 
networks. HRSA is encouraged to work with these programs.
    The Committee is pleased with the national work of the AHEC 
program, which has worked to educate primary care health 
providers on emerging public health needs. The Committee 
encourages HRSA to engage additional Federal partners, external 
stakeholders, including current and former grantees of the 
program, to determine how the AHEC network can be used to 
continually educate primary care health professionals, 
especially concerning infectious diseases.

Mental and Behavioral Health

    The Committee recommendation includes $8,916,000 for the 
interprofessional Graduate Psychology Education (GPE) Program 
to increase the number of health service psychologists trained 
to provide integrated services to high-need, underserved 
populations in rural and urban communities. Recognizing the 
growing need for highly trained mental and behavioral health 
professionals to deliver evidence-based services to the rapidly 
aging population, the Committee encourages HRSA to invest in 
geropsychology training programs and to help integrate health 
service psychology trainees at Federally Qualified Health 
Centers. The GPE program is dedicated to the education and 
training of doctoral-level psychologists to provide supervised 
behavioral, mental health services to underserved populations, 
including older adults, children, the chronically ill, and 
veterans. HRSA should build on recent efforts to expand 
training to increase mental, behavioral health services for 
returning service members, veterans, and their families, with 
an emphasis on veterans reintegrating into rural civilian 
communities.

Behavioral Health Workforce Education and Training

    The Committee recommends $25,000,000 for the Behavioral 
Health Workforce Education and Training Grant Program. Eligible 
entities for this program shall include accredited programs 
that train Master's level social workers, psychologists, 
counselors, marriage and family therapists, psychology doctoral 
interns, as well as behavioral health paraprofessionals. The 
Committee directs HRSA to share information concerning pending 
grant opportunity announcements with State licensing 
organizations and all the relevant professional associations.

Nursing Workforce Development

    The Committee recognizes the need for a highly educated 
nursing workforce to reflect the diversity of the populations 
it serves. The recruitment of culturally and economically 
diverse individuals positively impacts the classroom and 
professional practice environments. Exposure to other 
viewpoints and perspectives serves to advance collaboration 
that will translate into improved care delivery. The Title VIII 
Nursing Workforce Development Programs directly bolster this 
effort by supporting students from diverse and underrepresented 
backgrounds in the nursing profession through recruitment and 
retention efforts. For example, in Academic Year 2014-2015, the 
Title VIII Nursing Workforce Diversity (NWD) Grants program 
supported 13,225 students and aspiring students, partnering 
with over 900 clinical training sites. Of these sites, 42 
percent were located in medically-underserved areas. Title VIII 
programs like NWD offer a two-fold benefit: not only are the 
direct recipients provided financial assistance, but they also 
connect these clinicians with communities that vary in 
socioeconomic, racial/ethnic, and geographic backgrounds some 
that experience higher rates of health disparities. The 
Committee requests HRSA include in the fiscal year 2019 
Congressional Justification information on the impact of Title 
VIII programs on workforce diversity.
    The Committee is aware of provider shortages and recognizes 
that training postgraduate Nurse Practitioners in Federally 
Qualified Health Centers could address aspects of the primary 
care provider shortage. The Committee supports efforts to train 
Nurse Practitioners on a model of care consistent with both 
Institute of Medicine principles and the needs of vulnerable 
populations. The Committee believes a focus of the program 
should be training in the integration of primary care and 
behavioral health, since mental health issues and opioid and 
other illegal drug addiction remain healthcare priorities.

Children's Hospitals Graduate Medical Education

    The Committee recommends $300,000,000 for the Children's 
Hospitals Graduate Medical Education Payment program, which is 
the same as the fiscal year 2017 enacted level and $5,000,000 
more than the fiscal year 2018 budget request. The Children's 
Hospitals Graduate Medical Education Payment program helps 
eligible hospitals maintain graduate medical education 
programs, which support the training of residents to care for 
the pediatric population and enhance the supply of primary care 
and pediatric medical and surgical subspecialties.

National Practitioner Data Bank

    The Committee assumes $18,000,000 for the National 
Practitioner Data Bank, which is $814,000 below the fiscal year 
2017 enacted level and the same as the fiscal year 2018 budget 
request. The Committee recommendation and the fiscal year 2018 
budget request assume that the data bank will be self-
supporting. The Committee continues to include bill language to 
ensure that user fee collections cover the full costs of data 
bank operations.

                       MATERNAL AND CHILD HEALTH

Maternal and Child Health Block Grant

    The Committee recommends $641,700,000 for the Maternal and 
Child Health (MCH) Block Grant, which is the same as the fiscal 
year 2017 enacted level and $25,287,000 below the fiscal year 
2018 budget request. States use the block grant to improve 
access to care for mothers, children, and their families; 
reduce infant mortality; provide pre- and post-natal care; 
support screening and health assessments for children; and 
provide systems of care for children with special health care 
needs.
    Maternal Depression.--The Committee recognizes that over 
400,000 women in the United States suffer from postpartum 
depression each year. Postpartum depression can affect mother-
infant bonding and have longer-term effects on the development 
of children. The Committee supports efforts by HRSA to address 
the needs of mothers and children related to maternal 
depression.
    Neonatal Abstinence Syndrome Effects on Maternal and Child 
Health.--The Committee is alarmed by the prevalence of Neonatal 
Abstinence Syndrome (NAS) and the resulting health and 
developmental impacts on children. The Committee requests an 
update in the fiscal year 2019 Congressional Justification on 
efforts undertaken by HRSA to address NAS.
    Prenatal Screening Working Group.--Patient education 
materials related to non-invasive prenatal screening (NIPS) 
often lag behind fast-moving NIPS technological advancements 
and fail to reflect the most current clinical guidance. To 
ensure patients and providers are educated about evidence-based 
practices and their applications, as well as the underlying 
conditions for which a patient may require further diagnostic 
testing based on screening results, the Committee asks the 
Maternal and Child Health Bureau within 120 days of enactment 
of this Act to convene a meeting of Federal and public 
stakeholders representing health care professionals, industry, 
and patient voices to discuss the purposes and definitions of 
NIPS, the status of research regarding the effectiveness of 
various practices regarding NIPS, other factors that should be 
considered in implementing NIPS, provider best practices and 
guidance, and patient and industry needs related to information 
dissemination and standards for screenings. The goal of such a 
meeting is for stakeholders to establish consensus about next 
steps for provider and patient education. Within 120 days after 
the meeting, recommended consensus driven activities will be 
reported from HRSA, along with a plan and timeline for 
implementation of next steps. The Committee expects a report 
outlining consensus recommendations for education of women 
regarding NIPS, and possible methods/timeline for implementing 
an education initiative related to prenatal screening. In 
addition, the working group should recommend to the Secretary a 
process by which materials related to specific conditions are 
created, disseminated, and updated on a routine basis.
    The Committee continues bill language identifying specific 
amounts for Special Projects of Regional and National 
Significance (SPRANS). The Committee provides the following 
within SPRANS:

------------------------------------------------------------------------
                                                            FY 2018
                   Budget Activity                         Committee
------------------------------------------------------------------------
Set-aside for Oral Health............................         $5,250,000
Set-aside for Epilepsy...............................          3,642,000
Set-aside for Sickle Cell Disease....................          3,000,000
Set-aside for Fetal Alcohol Syndrome.................            477,000
------------------------------------------------------------------------

    Set-aside for Oral Health.--The Committee has included 
$250,000 to continue demonstration projects to increase the 
implementation of integrating oral health and primary care 
practice. The projects should model the core clinical oral 
health competencies for non-dental providers that HRSA 
published and initially tested in its 2014 report, Integration 
of Oral Health and Primary Care Practice. The Committee expects 
the Chief Dental Officer to play a key role in the design, 
monitoring, oversight, and implementation of these projects.
    Thalassemia.--HRSA has a long history of supporting 
thalassemia services. The thalassemia program has been 
instrumental in aiding patients with this inherited blood 
disorder, especially as treatments and best practices have 
evolved over time. The Committee encourages HRSA to 
reconstitute this program in order to ensure the continued 
improvement of care and treatment options for patients with 
this complex and debilitating blood disorder.

Maternal and Child Health Programs

    In addition to the Maternal and Child Health Block Grant, 
the Maternal and Child Health Bureau at HRSA supports several 
programs to improve the health of all mothers, children, and 
their families. These programs support activities that develop 
systemic mechanisms for the prevention and treatment of sickle 
cell disease; provide information and research on and promote 
screening of autism and other developmental disorders; provide 
newborn and child screening of heritable disorders; provide 
grants to reduce infant mortality and improve perinatal 
outcomes; fund States to conduct newborn hearing screening; and 
provide grants to improve existing emergency medical services.
    Within the total for Maternal and Child Health Programs, 
the Committee recommends the following amounts:

------------------------------------------------------------------------
                                                            FY 2018
                   Budget Activity                         Committee
------------------------------------------------------------------------
Sickle Cell Anemia Program...........................         $4,455,000
Autism and Other Developmental Disorders.............         47,099,000
Heritable Disorders..................................         13,883,000
Healthy Start........................................        103,500,000
Universal Newborn Hearing............................         17,818,000
Emergency Medical Services for Children..............         20,162,000
------------------------------------------------------------------------

    Birthplace and Seamless Systems for Transfer of Care.--The 
Committee continues to note the rising rates for out of 
hospital births in the United States, and the subsequent 
importance of collaboration within an integrated maternity care 
system in order to achieve optimal mother-baby outcomes. The 
Committee believes that all women and families planning a home 
or birth center birth have a right to respectful, safe, and 
seamless consultation, referral, transport and transfer of care 
when necessary. The Committee encourages HRSA to work with its 
partners, including National organizations representing 
professionals who attend home, birthing center, and hospital 
births, to develop a strategy for facilitating ongoing inter-
professional dialogue and cooperation and universal adoption of 
the Best Practice Guidelines for Transfer from Planned Home 
Birth to Hospital. The goal of this effort should be to achieve 
optimal mother-baby outcomes in all settings and with all 
providers. The Committee requests HRSA include information on 
this effort in the fiscal year 2019 Congressional 
Justification.
    Breastfeeding Support and Safe Sleep Promotion.--The 
Committee is aware that 49 jurisdictions have selected the 
Title V National Performance Measure 4 on Breastfeeding and 
encourages HRSA to ensure incorporation and coordination of 
breastfeeding support within and among the Title V Maternal and 
Child Health Block Grant, the Healthy Start program, and the 
Maternal, Infant and Early Childhood Home Visiting Program. The 
Committee further encourages the integration of breastfeeding 
support and safe sleep promotion activities within these 
programs.
    Vision.--One out of four children in the United States have 
some form of low vision and at least four million 
schoolchildren start the school year not being able to see 
clearly. Most of these cases of poor vision are due to 
refractive error, a condition that is easily corrected. The 
Committee supports efforts at HRSA to assist programs that 
identify and provide prescription eyeglasses to children from 
low-income families.

Autism and Other Developmental Disorders

    The Committee recommends $47,099,000 for Autism and Other 
Developmental Disorders; this funding level is the same as the 
fiscal year 2017 enacted level and $47,099,000 above the fiscal 
year 2018 budget request. These programs seek to improve the 
health and well-being of children and adolescents with autism 
spectrum disorder and other developmental disabilities and to 
advance best practices for the early identification and 
treatment of autism and related developmental disabilities.
    The Committee provides not less than $31,317,485 for the 
Leadership Education in Neurodevelopmental and Related 
Disabilities (LEND) program to maintain the program's capacity 
to train professionals to screen, diagnose, and provide 
evidence-based interventions to individuals with autism 
spectrum disorder and other developmental disabilities as 
authorized by the Autism CARES Act. This funding will also 
enable the LEND network to assist in ongoing developmental 
monitoring, especially for children exposed to lead and other 
environmental toxins and for infants exposed to the Zika virus 
with its resulting complications. LEND programs provide a 
strong community link to services and support these newest 
members of the disability community and their families. In 
addition, the funding will allow these programs to develop 
innovative strategies to integrate and enhance existing 
investments, including translating research findings on 
interventions, development of guidelines, tools, and systems 
management approaches for training settings and promotion of 
life-course considerations, from developmental screening in 
early childhood, to transition to adulthood issues.

Heritable Disorders

    The Committee provides $13,883,000 for the Heritable 
Disorders program, which is the same as the fiscal year 2017 
enacted level and $13,883,000 above the fiscal year 2018 budget 
request. Newborn Screening is a complex public health system 
that relies on coordinated actions by stakeholders, including 
clinicians, hospitals, parents, labs, and public health 
professionals. HRSA's Heritable Disorders Program supports a 
number of activities that strengthen this system to ensure 
infants born in every State receive rapid identification, early 
intervention, and potentially life-saving treatment.
    Pediatric Hospice Care.--The Committee recognizes the 
importance of pediatric hospice care. The Committee understands 
the unique conditions surrounding pediatric hospice care and 
grief support for families including the need to support family 
members, the recognition that child death can have more intense 
and longer grieving periods, and the need for development of 
best practices for counseling, support, medication, and other 
factors impacting the end of life experience for children.
    Recommended Uniform Screening Panel.--The Committee 
encourages HRSA to expand the Heritable Disorders program to 
support States with the implementation, education, and 
awareness of newborn screening for new conditions recently 
added to the Recommended Uniform Screening Panel, including 
Pompe, Mucopolysaccharidosis I, and X-linked 
adrenoleukodystrophy. The program will also disseminate 
National, regional and State education and training resources 
for parents, families and providers.
    Severe Combined Immune Deficiency.--Within the amount for 
Heritable Disorders, the Committee provides $2,000,000 to 
continue efforts to support wider implementation, education, 
and awareness of Newborn Screening for Severe Combined Immune 
Deficiency (SCID). The Committee supports HRSA's efforts to 
address SCID and encourages the agency to continue the program 
in its current form.

Healthy Start

    The Committee recommends $103,500,000 for the Healthy Start 
program, which is the same as the fiscal year 2017 enacted 
level and $24,803,000 below the fiscal year 2018 budget 
request. The program provides discretionary grants to 
communities with high rates of infant mortality to support 
primary and preventive health care services for mothers and 
their infants.
    Within the total for Healthy Start, the Committee directs 
not less than $1,000,000 for screening and treatment for 
maternal depression as authorized in section 10005 of the 21st 
Century Cures Act (P.L. 114-255).
    Fetal Infant Mortality Review.--The Fetal Infant Mortality 
Review (FIMR) program is an important component of many Healthy 
Start and local health department initiatives that provide 
evidence-based interventions crucial to improving infant health 
in high-risk communities. HRSA is encouraged to continue to 
support the FIMR program with Healthy Start funding while 
educating Healthy Start Programs on the successes of FIMR.

                      RYAN WHITE HIV/AIDS PROGRAM

Ryan White HIV/AIDS Program

    The Committee provides $2,318,781,000 for the Ryan White 
HIV/AIDS program, which is the same as the fiscal year 2017 
enacted level and $58,773,000 above the fiscal year 2018 budget 
request.
    The Ryan White HIV/AIDS program funds activities to address 
the care and treatment of persons living with HIV/AIDS who are 
either uninsured or underinsured and need assistance to obtain 
treatment. The program provides grants to States and eligible 
metropolitan areas to improve the quality, availability, and 
coordination of health care and support services to include 
access to HIV-related medications; grants to service providers 
for early intervention outpatient services; grants to 
organizations to provide care to HIV infected women, infants, 
children, and youth; and grants to organizations to support the 
education and training of health care providers.
    Within the total for the Ryan White HIV/AIDS program, the 
Committee provides the following amounts:

------------------------------------------------------------------------
                                                            FY 2018
                   Budget Activity                         Committee
------------------------------------------------------------------------
Emergency Assistance.................................       $655,876,000
Comprehensive Care Programs..........................      1,315,005,000
AIDS Drug Assistance Program.........................        900,313,000
Early Intervention Program...........................        201,079,000
Children, Youth, Women, and Families.................         75,088,000
AIDS Dental Services.................................         13,122,000
Education and Training Centers.......................         33,611,000
Special Projects of National Significance............         25,000,000
------------------------------------------------------------------------

                          HEALTH CARE SYSTEMS

    The Committee recommends $100,518,000 for Health Care 
Systems, which is $3,675,000 below the fiscal year 2017 enacted 
level and $1,167,000 above the fiscal year 2018 budget request. 
The programs within Health Care Systems support National 
activities that enhance health care delivery in the United 
States. Activities include maintaining a National system to 
allocate and distribute donor organs to individuals awaiting 
transplant; building an inventory of cord blood units; 
maintaining a National system for the recruitment of bone 
marrow donors; operating the 340B drug discount program; and 
operating a national toll-free poison control hotline.
    Within the total for Health Care Systems, the Committee 
provides the following amounts:

------------------------------------------------------------------------
                                                            FY 2018
                   Budget Activity                         Committee
------------------------------------------------------------------------
Organ Transplantation................................        $23,549,000
National Cord Blood Inventory........................         12,266,000
C.W. Bill Young Cell Transplantation Program.........         22,109,000
Office of Pharmacy Affairs...........................         10,238,000
Poison Control Centers...............................         18,846,000
National Hansen's Disease Program....................         11,653,000
Hansen's Payment to Hawaii...........................          1,857,000
------------------------------------------------------------------------

Organ Transplantation

    Organ Donation Rates.--The Committee remains aware of the 
insufficient supply of donated organs to meet Nationwide need 
and of the existing variations among local communities in 
donation rates and procurement practices. The Committee directs 
HRSA to develop a comprehensive report with recommendations and 
initiatives that can be pursued to ensure that local 
communities adopt best practices to increase the supply of 
donated organs. The recommendations shall place special 
emphasis on assisting localities with low donation and 
procurement rates. HRSA shall provide this report within 120 
days of enactment of this Act.
    Organ Distribution Proposal.--The Committee understands 
that the Organ Procurement and Transplantation Network (OPTN) 
developed the ``Redesigning Liver Distribution'' proposal and 
released the proposal for public comment in 2016. The Committee 
recognizes that OPTN expects to release for public comment an 
amended proposal in 2017. The Committee urges HRSA to ensure 
that any proposals see a robust and transparent public debate 
on the merits of the proposal. Furthermore, the Committee 
believes that an extended process will allow the transplant 
community and its stakeholders to assess fully the use of 
appropriate supply and demand metrics and the protection of 
programs serving rural and underserved communities. The 
Committee encourages HRSA to ensure that liver redistribution 
proposals go through a transparent process and receive support 
from the transplant community prior to final action.
    Costs of Liver Distribution Proposals.--The Committee is 
aware that OPTN is preparing a revised proposal for redesigning 
the distribution of livers for transplant in the United States. 
The Committee encourages the proposal to include the scope of 
financial costs associated with the proposal, including 
estimates of the direct and indirect costs imposed on the 
Federal government, State governments, local governments, and 
public and private health insurers.
    Positions at Organ Procurement and Transplantation 
Network.--The Committee appreciates the valuable role played by 
individuals in leadership positions and other voting positions 
at OPTN. The Committee expects HRSA to ensure OPTN policymaking 
committees and subcommittees are selected in a manner that 
provides equal representation with unbiased selection.

National Cord Blood Inventory

    The Committee recommends $12,266,000 for the National Cord 
Blood Inventory, which is the same as the fiscal year 2017 
enacted level and $1,021,000 more than the fiscal year 2018 
budget request. The National Cord Blood Inventory program 
builds a genetically and ethnically diverse inventory of high-
quality umbilical cord blood for transplantation.

C.W. Bill Young Cell Transplantation Program

    The Committee recommends $22,109,000 for the C.W. Bill 
Young Cell Transplantation program, which is the same as the 
fiscal year 2017 enacted level and $42,000 more than the fiscal 
year 2018 budget request.
    The Committee continues to support cell transplantation 
through the use of cord blood, bone marrow, and peripheral 
blood stem cells. The Committee appreciates HRSA's efforts to 
increase the diversity of the volunteer 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), which is the same as the fiscal year 
2017 enacted level and $19,000 above the fiscal year 2018 
budget request. The Office of Pharmacy Affairs oversees the 
340B Drug Pricing Program, which requires drug manufacturers to 
provide discounts on outpatient prescription drugs to certain 
safety net health care providers.
    The Committee recognizes that the 340B Drug Pricing program 
was designed to help safety net providers maintain, improve, 
and expand patient access to healthcare services generally. 
Since its enactment in 1992, the 340B program has lowered the 
cost of outpatient drugs to Government funded health clinics, 
as well as nonprofit and public hospitals that serve a 
disproportionate share of low-income patients or rural 
communities.
    The Committee is aware that the 340B statute requires HRSA 
to make 340B ceiling prices available to covered entities 
through a secure website and continues to be concerned that OPA 
has failed to meet deadlines to complete work on the secure 
website. The Committee urges OPA to complete the development of 
a secure website. The Committee directs OPA to include an 
update on the status of the secure website in the fiscal year 
2019 budget request.

Poison Control Centers

    The Committee recommends $18,846,000 for Poison Control 
Centers, which is the same as the fiscal year 2017 enacted 
level and $36,000 above the fiscal year 2018 budget request. 
The Committee recognizes the critical role of this proven 
National public health program and the value of its services to 
all citizens. In 2015, poison control centers managed 2.8 
million calls, which is an average of approximately 8,000 calls 
per day. Of these calls, 47 percent related to exposures to 
children age five and under, and 22 percent came from health 
care facilities. Of the approximate 2.2 million poisonings 
reported in 2015, 67 percent were managed at the site of 
exposure, avoiding unnecessary visits to emergency departments.

                              RURAL HEALTH

    The Committee recommends $156,060,000 for Rural Health 
programs, which is the same as the fiscal year 2017 enacted 
level and $81,665,000 more than the fiscal year 2018 budget 
request. Rural Health programs provide funding to improve 
access, quality, and coordination of care in rural communities; 
for research on rural health issues; for technical assistance 
and recruitment of health care providers; for screening 
activities for individuals affected by the mining, transport, 
and processing of uranium; for the outreach and treatment of 
coal miners and others with occupation-related respiratory and 
pulmonary impairments; and for the expansion of telehealth 
services.
    The Committee requests an update in the fiscal year 2019 
Congressional Justification information on the best practices 
and strategies to attract healthcare practitioners to rural 
clinics and hospitals in areas with healthcare professional 
shortages.
    Within the total for Rural Health activities, the Committee 
provides the following amounts:

------------------------------------------------------------------------
                                                            FY 2018
                   Budget Activity                         Committee
------------------------------------------------------------------------
Rural Outreach Programs..............................        $65,500,000
Rural Health Research................................          9,351,000
Rural Hospital Flexibility Grants....................         43,609,000
State Offices of Rural Health........................         10,000,000
Black Lung Clinics...................................          7,266,000
Radiation Exposure Screening and Education...........          1,834,000
Telehealth...........................................         18,500,000
------------------------------------------------------------------------

    Radiation Safety.--The Committee supports efforts to ensure 
information regarding exposure to radiation is up-to-date on 
all available options to protect surgical/interventional health 
care personnel and patients from radiation exposure.
    Telehealth.--The Committee recognizes the growing 
importance of telehealth in delivering high-quality healthcare 
to medically underserved communities in both rural and urban 
areas. The Committee encourages the Secretary to establish a 
Telehealth Center of Excellence to test the efficacy of 
telehealth services in both urban and rural geographic 
locations.

                            FAMILY PLANNING

    The Committee does not recommend funding for the Family 
Planning program, which is $286,479,000 below the fiscal year 
2017 enacted level and fiscal year 2018 budget request. The 
Family Planning program administers Title X of the Public 
Health Service Act.

                           PROGRAM MANAGEMENT

    The Committee recommends $151,993,000 for the cost of 
Federal staff and related activities to coordinate, direct, and 
manage the programs of HRSA, which is $2,007,000 below the 
fiscal year 2017 enacted level and the same as the fiscal year 
2018 budget request.
    Chief Dental Officer.--The Committee is pleased that HRSA 
has restored the position of Chief Dental Officer (CDO) and 
looks forward to learning how the agency has ensured that the 
CDO is functioning with executive level authority with 
resources to oversee and lead HRSA oral health programs and 
initiatives. The Committee would like an update in the fiscal 
year 2019 Congressional Justification on how the CDO is serving 
as the agency representative on oral health issues to 
international, National, State, and/or local government 
agencies, universities, and oral health stakeholder 
organizations.

             VACCINE INJURY COMPENSATION PROGRAM TRUST FUND

    The Committee estimates that $268,000,000 will be released 
from the Vaccine Injury Compensation Trust Fund, which is 
$28,000,000 more than the fiscal year 2017 enacted level and 
the same as the fiscal year 2018 budget request.
    The National Vaccine Injury Compensation Program provides a 
system of compensation for individuals with vaccine-associated 
injuries or deaths. Funds for claims from vaccines administered 
on or after October 1, 1988 are generated by a per-dose excise 
tax on the sale of selected prescribed vaccines. The Vaccine 
Injury Compensation Trust Fund receives revenues raised by this 
tax. Trust funds made available will support the liability 
costs of vaccines administered after September 30, 1988.
    The Committee recommends $8,250,000 for administration of 
the program, which is $500,000 more than the fiscal year 2017 
enacted level and $950,000 less than the fiscal year 2018 
budget request.

               Centers for Disease Control and Prevention

    The Committee recommends a program level of $7,056,811,000 
for the Centers for Disease Control and Prevention (CDC), which 
is $198,350,000 below the fiscal year 2017 enacted level and 
$1,026,210,000 above the fiscal year 2018 budget request. This 
level includes $6,010,153,000 in discretionary budget 
authority, $55,358,000 in mandatory funds under the terms of 
the Energy Employees Occupational Illness Compensation Program 
Act (EEOICPA), $840,600,000 in transfers from the Prevention 
and Public Health (PPH) Fund, and $150,700,000 in PHS Act 
section 241 evaluation set-aside transfers. CDC works with 
State, local, and Tribal health authorities and other non-
governmental health-related organizations to understand, 
control, and reduce public health problems.

                 IMMUNIZATION AND RESPIRATORY DISEASES

    The Committee recommends $744,350,000 for Immunization and 
Respiratory Diseases (IRD), which includes $470,700,000 in 
discretionary budget authority, and $273,650,000 in transfers 
from the PPH Fund. This level is $50,000,000 below the fiscal 
year 2017 enacted level and $43,522,000 above the fiscal year 
2018 budget request level.
    Immunization grants are awarded to States and local 
agencies for planning, developing, and conducting childhood, 
adolescent, and adult immunization programs, including 
enhancement of the vaccine delivery infrastructure. CDC 
directly maintains a stockpile of vaccines, supports 
consolidated purchase of vaccines for State and local health 
agencies, and conducts surveillance, investigations, and 
research into the safety and efficacy of new and presently-used 
vaccines.
    Within the total for IRD, the Committee recommends the 
following amounts:

------------------------------------------------------------------------
                   Budget Activity                     FY 2018 Committee
------------------------------------------------------------------------
Section 317 Immunization Program.....................       $556,792,000
    National Immunization Survey.....................         12,864,000
Influenza Planning and Response......................        187,558,000
------------------------------------------------------------------------

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

    The Committee recommends $1,117,278,000 for HIV/AIDS, Viral 
Hepatitis, Sexually Transmitted Diseases (STD), and 
Tuberculosis (TB) Prevention, which is the same as the fiscal 
year 2017 enacted level and $183,278,000 above the fiscal year 
2018 budget request.
    CDC provides National leadership and support for HIV 
prevention research and the development, implementation, and 
evaluation of evidence-based HIV prevention programs serving 
persons affected by, or at risk for, HIV infection. Activities 
include surveillance, epidemiologic and laboratory studies, and 
prevention activities. CDC provides funds to State, local, and 
Tribal health departments and community-based organizations to 
develop and implement integrated community prevention plans.
    Within the total for HIV/AIDS, Viral Hepatitis, STD, and TB 
Prevention, the Committee recommends the following amounts:

------------------------------------------------------------------------
                                                            FY 2018
                   Budget Activity                         Committee
------------------------------------------------------------------------
Domestic HIV/AIDS Prevention and Research............       $788,712,000
    HIV Prevention by Health Departments.............        397,161,000
    HIV Surveillance.................................        119,861,000
    Activities to Improve Program Effectiveness......        103,208,000
    National, Regional, Local, Community, and Other          135,401,000
     Organizations...................................
    School Health-HIV................................         33,081,000
Viral Hepatitis......................................         34,000,000
Sexually Transmitted Infections......................        152,310,000
Tuberculosis.........................................        142,256,000
------------------------------------------------------------------------

    Hepatitis B.--The Committee is concerned that even though 
the hepatitis B vaccine is more than 90 percent effective, 
there are over 50,000 new hepatitis B virus (HBV) infections 
each year and more than 10 deaths each day due to this disease 
in the U.S. As a result of the opioid epidemic, infection with 
HBV has spiked in many parts of the nation with, for example, 
acute HBV infections increasing 114 percent from 2006 to 2013 
in three states that have suffered from widespread opioid 
overuse (Kentucky, Tennessee, and West Virginia). The Committee 
notes that the link between HBV infection and primary liver 
cancer is well-established, with up to 60 percent of global 
liver cancer cases caused by HBV. Many of these liver cancer 
cases are preventable with early detection of, treatment of, 
and vaccination for HBV. An innovative public health effort to 
reduce HBV-related disease burden would move the U.S. into a 
global leadership position likely to benefit U.S. relations 
with countries in Asia, Africa, and other global regions where 
HBV infection and its severe complications are endemic.
    Latent TB Infection.--The Committee notes with concern that 
there are up to 13 million individuals in the U.S. with latent 
TB infection. The diagnosis and treatment of individuals with 
latent TB infection at highest risk of progression to active TB 
would prevent future cases of this airborne infectious disease. 
The Committee acknowledges that only by addressing latent TB 
infection can the U.S. achieve TB elimination. The Committee 
recognizes the vital role of CDC's Division of TB Elimination 
to address TB and urges support to ensure that State and local 
TB programs have adequate resources to effectively identify and 
treat latent TB infection cases.
    Liver Health.--The Committee commends CDC for its efforts 
to increase national awareness of viral hepatitis B and C, and 
requests that CDC support liver health and wellness activities 
in an effort to reduce morbidity and mortality for persons 
infected with viral hepatitis who develop liver disease, 
cirrhosis, liver failure, and liver cancer.

               EMERGING AND ZOONOTIC INFECTIOUS DISEASES

    The Committee recommends $551,522,000 for Emerging and 
Zoonotic Infectious Diseases (EZID), which includes 
$499,522,000 in discretionary appropriations and $52,000,000 in 
transfers from the PPH Fund. This level is $33,400,000 below 
the fiscal year 2017 enacted level and $37,522,000 above the 
fiscal year 2018 budget request. The EZID programs support the 
prevention and control of infectious diseases through 
surveillance, outbreak investigation and response, research, 
and prevention.
    Within the total for EZID, the Committee recommends the 
following amounts:

------------------------------------------------------------------------
                                                            FY 2018
                   Budget Activity                         Committee
------------------------------------------------------------------------
Core Infectious Diseases.............................       $362,950,000
    Emerging Infectious Diseases.....................        125,000,000
    Lab Safety and Quality...........................          8,000,000
    Antibiotic Resistance Initiative.................        163,000,000
    All Other Infectious Diseases....................         23,840,000
    Vector-borne Diseases............................         26,410,000
    Lyme Disease.....................................         10,700,000
    Prion Disease....................................          6,000,000
    Chronic Fatigue Syndrome.........................                  0
Food Safety..........................................         54,000,000
National Health Care Safety Network..................         21,000,000
Quarantine...........................................         31,572,000
Advanced Molecular Detection.........................         30,000,000
Epidemiology and Laboratory Capacity.................         40,000,000
Healthcare-Associated Infections.....................         12,000,000
------------------------------------------------------------------------

    Combating Antibiotic-Resistant Bacteria.--The Committee 
recognizes the importance of addressing antibiotic-resistant 
bacteria through a ``One Health'' approach, simultaneously 
combating antibiotic resistance in human, animal, and 
environmental settings. The Committee encourages CDC to develop 
a national capacity to identify and catalog microbial genome 
sequences, paying attention to antibiotic-resistant microbes. 
CDC is encouraged to continue to pursue research opportunities 
in the area of antimicrobial stewardship in diverse healthcare 
settings and encourage regional collaborations to study the 
most effective strategies to improve antibiotic prescribing and 
stewardship.
    Lyme Disease Activities.--Lyme disease can be found in at 
least 80 countries around the globe and is endemic in many 
regions. In the U.S., Lyme disease is the most common disease 
transmitted from animals to humans. CDC estimated in 2013 that 
only 10 percent of Lyme disease cases were being reported 
annually. The Committee encourages CDC to expand activities 
related to developing sensitive and more accurate diagnostic 
tools and tests for Lyme disease and evaluating the development 
of a national reporting system.
    Sepsis.--The Committee encourages CDC to increase its 
public awareness, outreach, and education efforts on sepsis, 
including health provider outreach and other related activities 
to improve diagnosis and treatment of sepsis. The Committee 
requests an update in the fiscal year 2019 Congressional 
Justification on activities to improve public awareness of 
sepsis.
    Tick-Borne Disease Resources and Guide.--The Committee 
encourages CDC to ensure transparency on its website of its 
physician education programs regarding Lyme disease, including 
scientific resources and schedules; to solicit input from the 
treating physician community at large regarding such education 
programs; and to include the broad spectrum of scientific 
viewpoints. The Committee also encourages CDC to provide a 
written rationale for the selection of Lyme and tick-borne 
disease treatment guidelines it displays on its website and to 
intensify surveillance of Borrelia infections in non-endemic/
non-high incidence areas.
    Vector-Borne Diseases.--Vector-borne diseases, such as Lyme 
disease, West Nile Virus, and Zika, have high human 
consequences and are a growing threat to public health. The 
impacts of these diseases and the effectiveness of programs for 
surveillance, prevention, and control should be better gauged 
and understood. Therefore, the Committee directs CDC to include 
goals and performance indicators for each high-priority vector-
borne disease in its annual Congressional Justification. 
Additionally, within 90 days of enactment, the Committee 
directs CDC to submit a report to the Committees on 
Appropriations of the House of Representatives and the Senate, 
that: (1) Compares funding for high priority vector-borne 
diseases to the burden of disease as defined by Disability 
Adjusted Life Years (DALYs), and (2) Includes estimates for the 
burden of each high-priority vector-borne disease on the U.S. 
economy, including direct medical costs, indirect medical 
costs, nonmedical costs, and productivity losses.
    Vector Control Guidelines.--The Committee requests that CDC 
maintain an online guide for use by States and local 
communities with a full scope of vector control options, tools, 
and other factors State and local jurisdictions may consider as 
they develop plans to carry out vector control activities to 
control Zika and other related diseases carried by insects. The 
Committee encourages CDC to update the guidelines annually.
    Zika.--The Committee continues to support CDC's 
preparedness and response efforts to control outbreaks of Zika 
virus infection. The Committee strongly encourages CDC to 
invest in innovative vector control technologies to enhance 
current vector-borne disease control efforts, including those 
discussed by the World Health Organization's Vector Control 
Advisory Group, which outlines new and existing vector control 
tools for use in response to Zika virus outbreaks. The 
Committee also notes CDC's report of research from Brazil 
showing that some infants exposed to Zika who were born without 
microcephaly nevertheless did develop it later or developed 
other neurological problems. Therefore, the Committee expects 
CDC to continue to work closely with the vector control unit in 
Puerto Rico and to address not only basic surveillance and 
research but also the use of new approaches to limit the spread 
of infected Aedes Aegypti mosquitoes through innovative vector 
control technologies which can be effective in environments and 
locations not amenable to traditional pesticides.

            CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION

    The Committee recommends $1,041,646,000 for Chronic Disease 
Prevention and Health Promotion (CDPHP), which includes 
$703,696,000 in discretionary appropriations and $337,950,000 
in transfers from the PPH Fund. This level is $73,950,000 below 
the fiscal year 2017 enacted level and $89,396,000 above the 
fiscal year 2018 budget request level. The CDPHP programs 
provide support for State, Tribal, and community programs on 
surveillance, prevention research, evaluation, and health 
promotion.
    The Committee recommendation for CDPHP maintains most of 
the existing program line items as they were funded in fiscal 
year 2017 and does not provide funding for the America's Health 
Block Grant proposed in the budget request. Chronic diseases, 
such as Alzheimer's disease, diabetes, heart disease, and 
stroke, are the leading causes of death and disability in the 
U.S. and account for 86 cents of every dollar spent on health 
care. Many of these conditions are largely preventable through 
improved nutrition and physical activity. Recent large-scale 
pilots have shown that as much as $2,650 per year per senior 
can be saved by investing in public health programs like the 
National Diabetes Prevention Program and similar studies have 
shown hospitalizations can be reduced and save as much as $945 
per year per adult by scaling programs that control arthritis 
pain through evidence-based physical activity programs. A 
robust investment in in the prevention and control of chronic 
diseases is essential to curb health spending and improve 
health and quality of life for millions of Americans, who are 
at risk of, living with, or have survived a chronic condition.
    Within the total provided, the Committee recommends the 
following amounts:

------------------------------------------------------------------------
                   Budget Activity                     FY 2018 Committee
------------------------------------------------------------------------
Tobacco..............................................       $155,000,000
Nutrition, Physical Activity, and Obesity............         49,920,000
    High Obesity Rate Counties ......................         10,000,000
School Health........................................         15,400,000
Health Promotion.....................................         14,025,000
    Glaucoma.........................................          3,300,000
    Visual Screening Education.......................            525,000
    Alzheimer's Disease..............................          3,500,000
    Inflammatory Bowel Disease ......................            750,000
    Interstitial Cystitis ...........................            850,000
    Excessive Alcohol Use ...........................          3,000,000
    Chronic Kidney Disease...........................          2,100,000
Prevention Research Centers..........................         25,461,000
Heart Disease and Stroke.............................        136,037,000
Diabetes.............................................        144,129,000
National Diabetes Prevention Program ................         25,000,000
Cancer Prevention and Control........................        356,674,000
    Breast and Cervical Cancer ......................        210,000,000
        WISEWOMAN....................................         21,120,000
    Breast Cancer Awareness for Young Women..........          4,960,000
    Cancer Registries ...............................         49,440,000
    Colorectal Cancer ...............................          43,294,00
    Comprehensive Cancer ............................         19,675,000
    Johanna's Law ...................................          5,500,000
    Ovarian Cancer ..................................          8,000,000
    Prostate Cancer .................................         13,205,000
    Skin Cancer .....................................          2,125,000
    Cancer Survivorship Resource Center .............            475,000
Oral Health..........................................         18,500,000
Safe Motherhood/Infant Health........................         44,000,000
    Preterm Birth ...................................          2,000,000
Other Chronic Diseases...............................         25,500,000
    Arthritis........................................         11,000,000
    Epilepsy.........................................          8,500,000
    National Lupus Patient Registry .................          6,000,000
Racial and Ethnic Approaches to Community Health.....                  0
Million Hearts.......................................          4,000,000
National Early Child Care Collaboratives.............          4,000,000
Hospitals Promoting Breastfeeding....................          8,000,000
Good Health and Wellness in Indian Country...........         16,000,000
------------------------------------------------------------------------

    Chronic Obstructive Pulmonary Disease.--The Committee 
understands that chronic obstructive pulmonary disease (COPD) 
is the third leading cause of death in the U.S., leading to the 
death of over 145,000 Americans each year. The Committee 
commends CDC for working with the National Heart, Lung, and 
Blood Institute on the development of the National Action Plan 
for COPD. The Committee expects CDC to implement the public 
health recommendations identified in the plan.
    Chronic Pain.--According to the Institute of Medicine, 100 
million Americans are burdened with chronic pain, which costs 
the U.S. economy more than $560 billion annually in direct 
healthcare costs and lost productivity. Longitudinal 
comparisons of pain data to identify trends, subpopulations at 
risk, and the health consequences of pain in terms of 
morbidity, mortality, and disability are critical in order to 
address this issue. The Committee directs CDC to collect 
epidemiological data to clarify the incidence and prevalence of 
various pain syndromes differentiated by patient age, 
comorbidities, socio-economic status, race, and gender. The 
Committee directs CDC to collect resource utilization data of 
medical and social services; on direct healthcare costs of pain 
treatment, both traditional and alternative; on the 
effectiveness of evidence-based treatment approaches; and on 
indirect costs (i.e., missed work, public and private 
disability, reductions in productivity). Finally, the Committee 
directs CDC to report these pain statistics to Congress and 
publish annually.
    Epilepsy.--Close to three million individuals in the U.S. 
have epilepsy and, while new cases are most common among young 
children, the onset of epilepsy can occur at any age. The 
Committee encourages CDC to support telehealth and educational 
training programs for rural and under-served areas that reach 
school nurses, childcare personnel, first responders, and care 
providers for seniors, to recognize and respond appropriately 
to seizures caused by epilepsy or result from trauma and other 
acute chronic illness.
    Good Health and Wellness in Indian Country.--The Committee 
recommendation includes $16,000,000 for awards to Tribes and 
Tribal Organizations to comprehensively address the leading 
causes of death and associated risk factors while incorporating 
culturally-driven wellness practices under the Good Health and 
Wellness in Indian Country program. The Committee also directs 
CDC to provide funding at not less than the fiscal year 2017 
level within CDPHP for the Comprehensive Approach to Good 
Health and Wellness in Indian Country cooperative agreement.
    Heart Disease and Stroke Prevention.--Largely preventable, 
cardiovascular disease, including heart disease and stroke, 
continues to inflict the highest burden on our Nation's health 
and economy. Yet, effective evidence-based prevention 
initiatives are not fully implemented and death rates are 
starting to rise. The Committee increases support for CDC's 
heart disease and stroke prevention activities within State, 
local, and Tribal public health departments, and for enhanced 
surveillance and research to target high-burden populations and 
guide public health strategies.
    Heart Valve Disease.--The Committee understands that heart 
valve disease can be debilitating and if not treated properly 
can result in heart failure, sudden cardiac arrest, and death. 
The Committee urges CDC to include information on valve disease 
on its website and to help bring public awareness to this 
disease. The Committee encourages CDC to engage with patient 
and research organizations to explore collaborative ways to 
integrate information about the warning signs, symptoms, and 
risk factors of valve disease into CDC's existing programs.
    Inflammatory Bowel Disease.--The Committee commends CDC for 
its commitment to the study of Inflammatory Bowel Disease (IBD) 
epidemiology and is concerned by the results of the recent 
Morbidity and Mortality Weekly Report study ``Prevalence of 
Inflammatory Bowel Disease Among Adults Aged 18 Years'', which 
demonstrates that IBD affects 3.3 million Americans, twice as 
many as originally thought. The Committee is particularly 
concerned that IBD is increasingly recognized in minority and 
underserved communities, yet there are gaps in our knowledge 
about IBD in these populations. The Committee expects CDC to 
include a focus on these groups in its existing IBD 
epidemiology study.
    Johanna's Law.--The Committee strongly encourages 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.
    Million Hearts 2022.--The Committee continues to support 
Million Hearts 2022 to capitalize on the solid foundation, best 
practices, evidence, shared tools, and progress made on this 
public-private initiative to prevent heart attacks and strokes. 
Funding will allow for mobilization of communities and the 
healthcare sector to implement evidence-based interventions to 
prevent heart disease and stroke in areas with the highest 
burden by implementing the ABCS: Aspirin when appropriate, 
Blood pressure control, Cholesterol management, and Smoking 
cessation; supporting innovative strategies to increase 
physical activity; using cardiac rehabilitation; and developing 
innovative, scalable approaches to improve cardiovascular 
health.
    National Early Child Care Collaboratives Program.--The 
Committee recognizes the importance of the early years and 
particularly early child care and education settings in 
promoting healthy habits. The Committee is aware that the 
National Early Child Care Collaboratives (NECCC) program has 
produced statistically significant improvements in adoption of 
best practices for healthy eating, physical activity, reduced 
screen time, and breastfeeding support. The Committee 
encourages CDC to build on the success of the NECCC program to 
provide training and technical assistance to early care and 
education providers to improve healthy eating and physical 
practices, including testing approaches to strengthen family 
engagement. Funds support technical assistance to integrate 
healthy eating and physical activity into State and local 
systems initiatives. The Committee encourages the NECCC to 
service a mix of rural, suburban, and urban areas, including 
areas with high childhood obesity rates.
    National Lupus Patient Registry.--The Committee continues 
to support research efforts under the National Lupus Patient 
Registry program and acknowledges that there has been 
significant progress to understand better the epidemiology of 
lupus. However, the Committee recognizes that challenges still 
remain and encourages CDC to focus on studies related to the 
natural history and pathogenesis of pediatric lupus to 
understand better the lifetime burden of disease in children 
and young adults. The Committee also encourages the continuing 
development of lupus self-management programs by current lupus 
registry cohorts and national voluntary health organizations 
for adults with lupus to improve quality of life and health 
outcomes.
    Oral Health.--The Committee has provided additional funding 
for the Division of Oral Health to continue distributing new 
waterline safety guidelines to dentist offices and clinics, to 
conduct follow up research where needed, and to work with 
professional organizations to educate dentists and dental 
students of such guidelines.
    Outreach to and Study of Obese Populations with Limited 
English Ability.--The Committee is concerned about specific 
obese populations that are overrepresented and medically 
underserved. The Committee encourages CDC to conduct additional 
outreach to and study of these specific populations. CDC is 
additionally encouraged to work with Hispanic-Serving 
Institutions and Historically Black Colleges and Universities 
in this effort.
    Ovarian Cancer.--The Committee continues to support the 
Ovarian Cancer Control Initiative to advance ovarian cancer 
prevention, early detection, risk assessment, and access to 
care. The Committee commends the CDC for its work to evaluate 
existing risk assessment tools, which can be used to help 
identify patients with a genetic predisposition to ovarian and 
other cancers, and identify which of these existing tools are 
valid, reliable, and the most user-friendly for providers and 
patients. The Committee requests that the Secretary of HHS 
present the findings of this review and provide recommendations 
with respect to how CDC can support the deployment of the tools 
found to have the greatest value and utility in the fiscal year 
2019 Congressional Justification.
    Psoriasis and Psoriatic Arthritis.--The Committee 
recognizes the growing body of evidence linking psoriatic 
disease, which impacts more than eight million Americans, to 
other comorbidities such as cardiovascular disease, mental 
health and substance abuse challenges, kidney disease, and 
other conditions. The Committee also recognizes the low rate of 
diagnosis of psoriatic arthritis and the high percentage of 
patients with psoriatic disease who do not treat or who 
undertreat their disease. The Committee directs the CDC to 
develop an action plan not later than 180 days after the 
enactment of this Act as to how it can leverage existing 
programs and resources, including the Prevention Research 
Centers and projects supported by the CDC's Arthritis program, 
to build upon the agency's Public Health Agenda for Psoriasis 
and Psoriatic Arthritis to address diagnosis, treatment and 
public health self-management needs of this patient population.
    Pulmonary Hypertension Program.--The Committee is concerned 
that most Pulmonary Hypertension (PH) patients are not 
diagnosed until the condition has reached a catastrophic stage, 
which leads to significant disability, greatly increased 
mortality, and the need for costly and dramatic medical 
interventions, such as heart-lung transplantation. Considering 
the availability of effective therapies for early-stage PH, CDC 
is encouraged to support education, awareness, and epidemiology 
activities that promote early and accurate diagnosis of PH.
    Safe Motherhood and Infant Health.--The Committee continues 
to support activities within this line related to maternal and 
infant health, such as State-Based Perinatal Collaboratives and 
the Pregnancy Risk Assessment Monitoring System, at the fiscal 
year 2017 enacted level. The Committee recommendation does not 
include funding for the teen pregnancy prevention cooperative 
agreement.
    Type 1 Diabetes and Diabetic Ketoacidosis.--The Committee 
is concerned about the increase in type 1 diabetes and the risk 
of diabetic ketoacidosis, and encourages the CDC to work with 
the States to educate parents, providers, and schools on this 
risk.

              BIRTH DEFECTS AND DEVELOPMENTAL DISABILITIES

    The Committee recommends $137,560,000 for Birth Defects and 
Developmental Disabilities (NCBDDD), which is the same as the 
fiscal year 2017 enacted level and $37,560,000 above the fiscal 
year 2018 budget request. This program supports the prevention 
of and collects, analyzes, and makes available data on the 
incidence and causes of birth defects and developmental 
disabilities.
    Within the total, the Committee recommends the following 
amounts:

------------------------------------------------------------------------
                   Budget Activity                     FY 2018 Committee
------------------------------------------------------------------------
Child Health and Development.........................        $65,800,000
    Birth Defects....................................         19,000,000
    Fetal Death......................................            900,000
    Fetal Alcohol Syndrome...........................         11,000,000
    Folic Acid.......................................          3,150,000
    Infant Health....................................          8,650,000
    Autism...........................................         23,100,000
Health and Development for People with Disabilities..         56,660,000
    Disability & Health incl. Child Development......         24,000,000
    Tourette Syndrome................................          2,000,000
    Early Hearing Detection and Intervention.........         10,760,000
    Muscular Dystrophy...............................          6,000,000
    Attention Deficit Hyperactivity Disorder.........          1,900,000
    Fragile X........................................          2,000,000
    Spina Bifida.....................................          6,000,000
    Congenital Heart Failure.........................          4,000,000
Blood Disorders......................................         15,100,000
    Public Health Approach to Blood Disorders........          4,400,000
    Hemophilia Activities............................          3,500,000
    Hemophilia Treatment Centers.....................          5,100,000
    Thalassemia Blood Disorders......................          2,100,000
------------------------------------------------------------------------

    Blood Safety Monitoring.--Patients who receive regular 
blood transfusions are at increased risk for transmission of 
blood-borne infectious diseases. Facing an increase in 
infectious diseases that have a known or potential risk of 
transmission via blood transfusion, patients with thalassemia, 
anemia, and other diseases that impact blood production often 
face a lack of information about transmission modes and rates 
of infectious diseases, including new or emerging viruses like 
the Zika virus. Given the increased threat to patients who are 
reliant on blood transfusions, and the increased prevalence of 
blood-borne viruses like babesia, the Committee urges CDC to 
provide specific information to assist blood centers in 
responding to emerging infectious diseases that may be 
transmitted by blood transfusion.
    Congenital Heart Disease.--The Committee commends NCBDDD 
for its leadership in addressing Congenital Heart Disease (CHD) 
and adult CHD surveillance efforts and requests a report in the 
fiscal year 2019 Congressional Justification on CDC 
surveillance and research efforts regarding CHD across the 
lifespan, age-specific prevalence, and factors associated with 
those patients who may have dropped out of appropriate 
specialty care.
    Duchenne Muscular Dystrophy.--The Committee expects NCBDDD 
to continue its work to update, evaluate, and disseminate the 
revised Duchenne care standards; to expand surveillance of 
Duchenne via the MD STARnet, to develop a Duchenne newborn 
screening program; and to support refinement of an 
International Classification of Disease (ICD 10) code for 
Duchenne and Becker Muscular Dystrophy.
    Fragile X and Associated Disorders.--The Committee commends 
CDC's efforts to identify and define the population impacted by 
Fragile X (FX) and all conditions associated with the gene 
mutation with the goal of understanding the public health 
impact of these conditions. The Committee acknowledges the 
significant progress made by the NCBDDD Fragile X Clinical and 
Research Consortium in growing its FORWARD Database and Patient 
Registry, and is pleased that a new grant was awarded in 2015 
to continue and expand upon this important work. The Committee 
also notes with approval the public-private partnership meeting 
to set the Public Health Research Agenda and the resulting 
focus on longitudinal data to characterize the natural history 
of Fragile X, to in turn better inform the development of 
outcome measures and biomarkers for new drug treatments under 
development. The Committee believes even more robust natural 
history data will lead to improved outcome measures and urges 
increased focus on this effort. Given the connections among 
Fragile X, the FX protein, and autism, the prospect of targeted 
treatments for both conditions, the overlapping public health 
impacts and current budgetary constraints, the Committee urges 
the NCBDDD to explore cross-divisional funding opportunities to 
accelerate data-driven public health research to reduce the 
public health burdens of both FX and autism.
    Hereditary Hemorrhagic Telangiectasia Pilot.--The Committee 
recommends $100,000 within the Hemophilia Treatment Centers 
line to support the second year of a two-year pilot program 
that enables up to three existing Federally-funded Hemophilia 
Treatment Centers across the country to serve as specialty 
centers for the evaluation and management of Hereditary 
Hemorrhagic Telangiectasia.
    National Spina Bifida Program.--The Committee recognizes 
that Spina Bifida is the most common permanently disabling 
birth defect in the U.S. While Spina Bifida and related neural 
tube defects are largely preventable through education and 
adequate daily folic acid consumption, there are an estimated 
166,000 individuals living with all forms of this complex birth 
defect. The Committee commends the work of the National Spina 
Bifida Program (NSBP) and its support of the Spina Bifida 
Clinical Care Monitoring and Tracking Program, which provides 
input into research priorities for the National Spina Bifida 
Patient Registry. Further, the Committee commends the NSBP for 
serving as a model for programs assisting other individuals 
living with similar complex conditions and encourages the CDC 
to continue to work with a National patient advocacy 
organization that disseminates information to clinicians, 
parents, and families living with Spina Bifida.
    Preterm Birth Perinatal Collaboratives.--Preterm birth 
affects more than 500,000 babies each year in the U.S. and is 
the leading cause of neonatal mortality. The Committee commends 
CDC for funding six State-based Perinatal Collaboratives that 
focus on improving birth outcomes and improving maternal health 
and safety using known prevention strategies such as reducing 
early elective deliveries.
    Tuberous Sclerosis Complex.--The Committee encourages CDC 
to take into consideration tuberous sclerosis complex (TSC) as 
a possible cause of autism, epilepsy, and cardiac rhabdomyomas 
in its surveillance network.

                   PUBLIC HEALTH SCIENTIFIC SERVICES

    The Committee recommends $479,397,000 program level for 
Public Health Scientific Services (PHSS), which includes funds 
for the National Center for Health Statistics. The total 
program level includes $328,697,000 in discretionary budget 
authority and $150,700,000 from PHS Act section 241 evaluation 
set-aside transfers. The Committee recommendation is 
$10,000,000 below the fiscal year 2017 enacted level and 
$19,397,000 above the fiscal year 2018 budget request.
    Within the total, the Committee recommends the following 
amounts:

------------------------------------------------------------------------
                   Budget Activity                     FY 2018 Committee
------------------------------------------------------------------------
Health Statistics....................................       $155,397,000
Surveillance, Epidemiology, and Informatics..........        279,000,000
    Laboratory Training and Oversight................          5,000,000
Public Health Workforce..............................         45,000,000
------------------------------------------------------------------------

    Hydrocephalus.--The Committee encourages CDC to collect 
information on the incidence rates and prevalence of 
hydrocephalus, including available information on children and 
adults, and to identify any changes over time with respect to 
the incidence and prevalence of hydrocephalus.

                          ENVIRONMENTAL HEALTH

    The Committee recommends $159,750,000 for Environmental 
Health (EH), which includes $142,750,000 in discretionary 
appropriations and $17,000,000 in transfers from the PPH Fund. 
This level is $56,000,000 below the fiscal year 2017 enacted 
level and $2,750,000 above the fiscal year 2018 budget request. 
The EH program focuses on preventing disability, disease, and 
death caused by environmental factors through laboratory and 
field research.
    Within the total, the Committee recommends the following 
amounts:

------------------------------------------------------------------------
                   Budget Activity                     FY 2018 Committee
------------------------------------------------------------------------
Environmental Health Laboratory......................        $56,150,000
    Newborn Screening Quality Assurance Program......          8,400,000
    Newborn Screening /Severe Combined                         1,250,000
     Immunodeficiency Diseases.......................
Environmental Health Activities......................         32,600,000
    Environmental Health Activities..................         14,000,000
    Safe Water.......................................          8,600,000
    Amyotrophic Lateral Sclerosis (ALS) Registry.....         10,000,000
    Climate Change...................................                  0
Environmental and Health Outcome Tracking Network....         25,000,000
Asthma...............................................         29,000,000
Childhood Lead Poisoning.............................         17,000,000
------------------------------------------------------------------------

    Harmful Algal Blooms.--The Committee supports the work that 
CDC is doing to conduct surveillance for and report health 
concerns related to harmful algal blooms. The Committee urges 
CDC to continue this work and (1) provide more outreach to 
State and local public health officials to use these 
surveillance and reporting systems, and (2) work with other 
agencies, including EPA, NOAA, and USGS, to integrate disparate 
sets of data to allow for a broader understanding of the 
spatial and temporal dynamics of the environmental and health 
impacts of harmful algal blooms.
    Lead Poisoning Prevention.--The Committee commends CDC for 
funding nearly 60 childhood lead poisoning prevention programs 
to develop, implement, and evaluate lead poisoning prevention 
activities. The Committee encourages CDC to require that States 
receiving funding for lead prevention report all blood tests in 
a standardized format through the National Notifiable Diseases 
Surveillance System.
    National Asthma Control Program.--The Committee continues 
to support the work of the National Asthma Control Program, 
recognizing that asthma is one of the most common and costly 
health conditions in the U.S. Twenty-five million Americans 
have asthma, including six million children. The Committee 
understands that better coordination of public health and 
health systems interventions are necessary to reduce the burden 
caused by asthma, and encourages CDC to continue its 
collaboration with payers and health systems.
    Newborn Screening Quality Assurance Program.--The Committee 
is aware that State laboratories need specialized support to 
begin screening for additional newborn conditions and 
recognizes CDC's expertise in working with laboratories to 
implement accurate newborn screening tests. The Committee 
continues to support State laboratories through the Newborn 
Screening Quality Assurance Program as they implement screening 
for new disorders. This program will also support evaluation of 
testing methods for new conditions, expansion of CDC's quality 
assurance materials, and critical infrastructure and 
development of tests for rare conditions.

                     INJURY PREVENTION AND CONTROL

    The Committee recommends $286,059,000 for Injury Prevention 
and Control, which is the same as the fiscal year 2017 enacted 
level and $69,894,000 above the fiscal year 2018 budget 
request. The program supports intramural research, injury 
control research centers, extramural research grants, and 
technical assistance to State, local, and Tribal health 
departments to prevent premature death and disability and to 
reduce human suffering and medical costs caused by injury and 
violence.
    Within the total, the Committee recommends the following 
amounts:

------------------------------------------------------------------------
                   Budget Activity                     FY 2018 Committee
------------------------------------------------------------------------
Intentional Injury...................................        $97,730,000
    Domestic Violence and Sexual Violence............         32,700,000
        Child Maltreatment...........................          7,250,000
    Youth Violence Prevention........................         15,100,000
    Domestic Violence Community Projects.............          5,500,000
    Rape Prevention..................................         44,430,000
National Violent Death Reporting System..............         16,000,000
Unintentional Injury.................................          8,800,000
    Traumatic Brain Injury...........................          6,750,000
    Elderly Falls....................................          2,050,000
Injury Prevention Activities.........................         28,950,000
Prescription Drug Overdose...........................        112,000,000
Illicit Opioid Use Risk Factors......................         13,579,000
Injury Control Research Centers......................          9,000,000
------------------------------------------------------------------------

    Childhood Lead Poisoning Prevention.--The Committee 
encourages CDC to collaborate with the Department of Education 
to improve awareness of educational intervention strategies for 
children with elevated blood lead levels. The CDC and the 
Department of Education are expected to implement 
prioritization initiatives and provide technical assistance 
that informs educators, parents, and State and local education 
agencies about the severity and symptoms of lead poisoning and 
intervention strategies for children with elevated blood lead 
levels. The Committee requests an update on the CDC's strategy 
and its outcomes on this topic in the fiscal year 2019 
Congressional Justification.
    Gun Research.--The Committee continues a general provision 
to prevent funds from being used to advocate for or promote gun 
control.
    Rape Prevention.--The Committee directs CDC to allocate at 
least 75 percent of funds appropriated to the Rape Prevention 
and Education program to State and territory health departments 
through formula grants that support State and local rape 
prevention activities.
    Using Data to Prevent Opioid-Related Overdosing.--The 
Committee continues to be very concerned about the high rate of 
opioid abuse and overdosing and understands that with data, 
forecasting of overdosing risk by geographic region can be 
provided. The Committee encourages CDC to begin using data to 
provide such forecasts that public health officials can use to 
intervene and prevent overdoses.

         NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH

    The Committee recommends $325,200,000 for the National 
Institute for Occupational Safety and Health (NIOSH), which is 
$10,000,000 below the fiscal year 2017 enacted level and 
$125,200,000 above the fiscal year 2018 budget request. NIOSH 
conducts applied research, develops criteria for occupational 
safety and health standards, and provides technical services to 
government, labor, and industry, including training for the 
prevention of work-related diseases and injuries. This 
appropriation supports surveillance, health hazard evaluations, 
intramural and extramural research, instrument and methods 
development, dissemination, and training grants.
    Within the total for NIOSH, the Committee recommends the 
following amounts:

------------------------------------------------------------------------
                                                            FY 2018
                   Budget Activity                         Committee
------------------------------------------------------------------------
National Occupational Research Agenda................       $116,000,000
    Agricultural, Forestry, and Fishing..............         25,500,000
Education and Research Centers.......................         29,000,000
Personal Protective Technology.......................         20,000,000
Mining Research......................................         59,500,000
National Mesothelioma Registry and Tissue Bank.......          1,100,000
Other Occupational Safety and Health Research........         99,600,000
------------------------------------------------------------------------

    Total Worker Health.--The agreement provides funding in the 
Other Occupational Safety and Health Research line to continue 
to support the Total Worker Health program at no less than the 
fiscal year 2017 level.

       ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM

    The Committee recommends $55,358,000 in mandatory funding 
for CDC to administer the Energy Employees Occupational Illness 
Compensation Program (EEOICPA), which is the same as the fiscal 
year 2017 enacted level and the fiscal year 2018 budget 
request. EEOICPA provides compensation to employees or 
survivors of employees of Department of Energy facilities and 
private contractors who have been diagnosed with a radiation-
related cancer, beryllium-related disease, or chronic silicosis 
as a result of their work. NIOSH estimates occupational 
radiation exposure for cancer cases, considers and issues 
determinations for adding classes of workers to the Special 
Exposure Cohort, and provides administrative support to the 
Advisory Board on Radiation and Worker Health.

                             GLOBAL HEALTH

    The Committee recommends $435,121,000 for Global Health 
(GH), which is the same as the fiscal year 2017 enacted level 
and $85,121,000 above the fiscal year 2018 budget request. 
Through its GH activities, CDC coordinates, cooperates, 
participates with, and provides consultation to other nations, 
Federal agencies, and international organizations to prevent 
and contain diseases and environmental health problems and to 
develop and apply health promotion activities. In cooperation 
with ministries of health and other appropriate organizations, 
CDC tracks and assesses evolving global health issues and 
identifies and develops activities to apply CDC's technical 
expertise to be of maximum public health benefit.
    Within the total, the Committee recommends the following 
amounts:

------------------------------------------------------------------------
                                                            FY 2018
                   Budget Activity                         Committee
------------------------------------------------------------------------
Global AIDS Program..................................       $128,421,000
Global Immunization Program..........................        224,000,000
    Polio Eradication................................        174,000,000
    Other Global/Measles.............................         50,000,000
Parasitic Diseases and Malaria.......................         24,500,000
Global Disease Detection and Emergency Response......         48,400,000
Global Public Health Capacity Development............          9,800,000
------------------------------------------------------------------------

    Global Health Security and Global Health Research.--The 
Committee supports CDC's work to protect American and global 
health security through the Center for Global Health, the 
National Center for Emerging and Zoonotic Infectious Diseases, 
and other programs that detect, prevent, and respond to 
infectious disease and other health threats. As emerging 
infectious diseases like Ebola and Zika represent perpetual 
challenges for our health system, the Committee supports 
continued and enhanced work in health research, innovation, 
capacity building for disease research, detection, and 
surveillance, and robust monitoring and evaluation systems at 
home and abroad.

                PUBLIC HEALTH PREPAREDNESS AND RESPONSE

    The Committee recommends $1,450,000,000 for Public Health 
Preparedness and Response (PHPR), which is $45,000,000 above 
the fiscal year 2017 enacted level and $184,000,000 above the 
fiscal year 2018 budget request. CDC distributes grants to 
State, local, Tribal, and territorial public health agencies. 
The PHPR supports capabilities and infrastructure upgrades to 
respond to all potential hazards, including acts of terrorism, 
infectious disease outbreaks, or natural disasters. Funds are 
used for needs assessments, response planning, support 
training, strengthening epidemiology and surveillance, and 
upgrades for laboratory capacity and communications systems. 
Activities support the establishment of procedures and response 
systems, and build the infrastructure necessary to respond to a 
variety of disaster scenarios.
    Within the total, the Committee recommends the following 
amounts:

------------------------------------------------------------------------
                                                            FY 2018
                   Budget Activity                         Committee
------------------------------------------------------------------------
State and Local Preparedness and Response Capability.       $688,200,000
    Public Health Emergency Preparedness Cooperative         680,000,000
     Agreement.......................................
    Academic Centers for Public Health Preparedness..          8,200,000
CDC Preparedness and Response........................        161,800,000
    BioSense.........................................         23,000,000
    All Other CDC Preparedness and Response..........        138,800,000
Strategic National Stockpile (SNS)...................        600,000,000
------------------------------------------------------------------------

    Procurement of Medical Countermeasures.--The Committee 
continues to have concerns over the consistency in acquisition 
and replenishment of vaccines and medical countermeasures 
(MCMs) that are procured for emergency response under Federal 
contracts. Because these MCMs, in many cases, have few or no 
commercial market applications, procurement requires special 
planning, development, and contract execution so that private 
industry will continue to invest in their development. The 
Committee strongly encourages CDC to take steps to ensure that 
the procurement process for MCMs is efficient, consistent, and 
aligned with the mission of the Strategic National Stockpile.

                        BUILDINGS AND FACILITIES

                     (INCLUDING TRANSFER OF FUNDS)

    The Committee recommends $10,000,000 for CDC buildings and 
facilities, which is the same as the fiscal year 2017 enacted 
level and $10,000,000 below the fiscal year 2018 budget 
request. In addition, the Committee continues the language from 
fiscal year 2017 to allow CDC to retain unobligated funds in 
the Individual Learning Accounts from departed employees to 
support the replacement of the underground and surface coal 
mine safety and health research facility.

                CDC-WIDE ACTIVITIES AND PROGRAM SUPPORT

    The Committee recommends $263,570,000 for CDC-Wide 
Activities and Program Support, which includes $103,570,000 in 
discretionary funds and $160,000,000 in transfers from the PPH 
Fund. This level is $10,000,000 below the fiscal year 2017 
enacted level and $158,570,000 above the fiscal year 2018 
budget request. This activity supports several crosscutting 
areas within CDC. Included is CDC's leadership and management 
function, which funds the CDC Office of the Director.
    Within the total, the Committee recommends the following 
amounts:

------------------------------------------------------------------------
                                                            FY 2018
                   Budget Activity                         Committee
------------------------------------------------------------------------
Preventive Health and Health Services Block Grant....       $160,000,000
Public Health Leadership and Support.................        103,570,000
------------------------------------------------------------------------

    Cross-Border Disease Control.--The Committee requests that 
CDC provide a report in the fiscal year 2019 Congressional 
Justification on how CDC coordinates its various programs with 
State and local public health departments and international 
partners to measure, track, control, and manage cross-border 
infectious disease in high-volume port cities.
    Vector-Borne Disease Centers of Excellence.--The Committee 
encourages CDC to fund an additional university-based vector-
borne disease center of excellence in the West. The Committee 
notes that CDC only awarded centers east of the Rocky 
Mountains, despite the fact that the West is home to densely 
populated areas and is at high risk of importation of vectors 
and vector-borne diseases due to high volumes of travel and 
trade.

Preventive Health and Health Services Block Grant

    The Committee does not concur with the Administration's 
proposed elimination of the Preventive Health and Health 
Services Block Grant and funds this program at the fiscal year 
2017 enacted level of $160,000,000. The Committee expects CDC 
to provide these flexible funds to State public health agencies 
to work with local and Tribal public health agencies to address 
the most critical public health needs.

                     National Institutes of Health

    The Committee recommends $35,184,000,000 for the National 
Institutes of Health (NIH), which is $1,100,000,000 above the 
fiscal year 2017 enacted level and $8,580,443,000 above the 
fiscal year 2018 budget request. This level includes 
$34,359,557,000 in discretionary appropriations and 
$824,443,000,000 in PHS Act section 241 evaluation set-aside 
transfers. Within the total discretionary appropriations, the 
Committee recommendation includes $496,000,000 in budget 
authority authorized in the 21st Century Cures Act.
    The mission of NIH is to seek fundamental knowledge about 
the nature and behavior of living systems and the application 
of that knowledge to enhance health, lengthen life, and reduce 
illness and disability. NIH conducts and supports research to 
understand the basic biology of human health and disease; apply 
this understanding towards designing new approaches for 
preventing, diagnosing, and treating disease and disability; 
and ensure that these approaches are widely available.
    The recommendation provides an increase of $400,000,000 for 
Alzheimer's disease research; an increase of $30,000,000 for 
combating antibiotic-resistant bacteria; an increase of 
$80,000,000 for the ``All of Us'' research program (formerly 
called the Precision Medicine Initiative); an increase of 
$76,000,000 for the Brain Research through Application of 
Innovative Neurotechnologies (BRAIN) Initiative; an increase of 
$8,000,000 for regenerative medicine; and increases to every 
Institute and Center (IC) to support innovative research to 
advance fundamental knowledge and speed the development of new 
therapies and diagnostics to improve the health of all 
Americans. The Committee also continues to support the Cancer 
Moonshot Initiative with a total of $300,000,000 in fiscal year 
2018.
    The Committee expects the 3.2 percent increase of funds 
over the fiscal year 2017 enacted level to support an increase 
in the number of new and competing Research Project Grants 
(RPGs), with a focus on early-stage investigators and 
investigators seeking first-time renewals. The Committee 
encourages NIH to restore extramural support to at least 90 
percent of all NIH funding and to continue to focus on basic 
research. The Committee expects NIH to support an increased 
number of Ruth L. Kirschstein National Research Service Awards 
and to provide a stipend level increase to training grantees 
that is consistent with any fiscal year 2018 Federal employee 
pay raise. The Committee continues to provide in bill language 
specific funding levels for Clinical and Translational Science 
Awards, Institutional Development Awards (IDeA), the Cures 
Acceleration Network, the Common Fund (CF), and the follow-on 
to the National Children's Study.
    While the Committee appreciates the Secretary's efforts to 
find efficiencies in NIH research spending, the 
Administration's proposal to drastically reduce and cap 
reimbursement of facilities and administrative (F&A;) costs to 
research institutions is misguided and would have a devastating 
impact on biomedical research across the country. To ensure 
that NIH can continue supporting both direct and F&A; costs as 
is their current practice, the bill includes a new general 
provision directing NIH to continue reimbursing institutions 
for F&A; costs according to the rules and procedures described 
in 45 CFR 75 (with the exception of existing waivers for 
training grants). This provision also prohibits funds in this 
Act from being used to implement any further caps on F&A; cost 
reimbursements.
    The Committee recognizes that there are opportunities to 
reduce the administrative burden on research institutions 
through legislative, regulatory, and administrative means, so 
that NIH can support more researchers who can in turn spend 
more time on science and less time on paperwork. The National 
Academies of Sciences, Engineering, and Medicine 2016 
publication ``Optimizing the Nation's Investment in Academic 
Research: A New Regulatory Framework for the 21st Century'' put 
forth several recommendations for reducing burden on 
institutions and investigators. The Committee directs NIH to 
identify the most appropriate and potentially impactful 
recommendations and submit a plan to the Committees on 
Appropriations of the House of Representatives and the Senate 
within 90 days of enactment of this Act outlining concrete 
steps to achieving these goals. NIH should consult with 
academic and independent research institutions, investigators 
who receive NIH grants, the HHS Office of Cost Allocation, the 
Office of Management and Budget, and other relevant 
stakeholders in developing this plan.

                    NATIONAL CANCER INSTITUTE (NCI)

    Mission.--NCI conducts and supports basic and applied 
cancer research in early detection, diagnosis, prevention, 
treatment, and rehabilitation. NCI provides training support 
for research scientists, clinicians and educators, and 
maintains a national network of cancer centers, clinical 
cooperative groups, and community clinical oncology programs, 
along with cancer prevention and control initiatives and 
outreach programs to translate rapidly basic research findings 
into clinical practice.
    Cancer Moonshot.--The Committee recommendation directs NIH 
to transfer $300,000,000 from the NIH Innovation Account to NCI 
to support the Cancer Moonshot initiative. These funds were 
authorized in the 21st Century Cures Act.
    Gastric Cancer.--The Committee continues to be concerned 
about the deadly outcomes of gastric cancer, particularly among 
young adults. The five-year survival rate for stomach cancer is 
30 percent. The Committee encourages NCI to consider developing 
a scientific framework, as specified by the Recalcitrant Cancer 
Research Act of 2012, for advancing stomach cancer research.
    Heavy Ion Cancer Therapy and Research.--The Committee 
supports NIH's continued exploration of advanced therapeutic 
cancer research, specifically heavy ion irradiation technology. 
Heavy ion technology will introduce a novel treatment option to 
cancer patients that is currently not available in the U.S. The 
Committee notes that the U.S. stands to be a world leader in 
this advanced research. The Committee encourages NIH to explore 
further the development of a state of the art heavy ion 
research facility in the U.S. Furthermore, the Committee 
encourages NIH to work with the Departments of Defense and 
Energy, and other applicable Federal agencies to equip the 
first U.S. heavy ion research center. The Committee urges NIH 
to capitalize on the expertise and potential of recently 
awarded heavy ion facility planning grant recipients in order 
to foster a multidisciplinary approach and advance heavy ion 
research that would produce novel, cutting edge treatments for 
cancer patients.
    Hepatitis B.--The Committee notes that liver cancer is the 
second deadliest cancer in the U.S., with a five-year survival 
rate less than 18 percent. According to the CDC, unlike other 
cancers, the rates of liver cancer deaths and incidence are 
rising. To increase the five-year survivability of liver 
cancer, the Committee urges that NCI issue targeted calls for 
proposals and create an ad hoc special emphasis panel to review 
liver cancer applications. The Committee also notes that the 
link between hepatitis B infection and primary liver cancer is 
well-established with up to 60 percent of global liver cancer 
cases caused by the hepatitis B virus (HBV) and, therefore, 
urges close collaboration with NIAID and NIDDK on issues 
related to HBV research.
    Immunotherapy for Childhood Cancers.--Recent NIH studies 
demonstrate that a new cancer immunotherapy method to 
specifically attack tumor cells that have mutations unique to a 
patient's cancer could be effective against a wide range of 
cancers. The Committee encourages NCI to continue to explore 
further new interventions, such as immunotherapy, as a 
promising new treatment strategy for children with cancer.
    Glyphosate.--The Committee directs NIH to provide an update 
within 60 days of enactment of this Act on research related to 
whether glyphosate causes cancer in humans.
    Lung Cancer.--The Committee encourages NCI to continue to 
prioritize support for meritorious research for lung cancer 
generally and specifically related to early detection of lung 
cancer and continued advances in treating lung cancer with 
personalized medicine, immunotherapy, and other innovative 
treatments. The Committee requests an update in the fiscal year 
2019 budget request on these efforts.
    Melanoma.--Given the significant advances in melanoma 
research, in biology, molecular profiling, targeted therapies, 
immunology, vaccines, and other areas, and with added 
Congressional support to achieve Cancer Moonshot goals in five 
years, the Committee requests that NCI update the Committee on 
advances in melanoma research in the fiscal year 2019 
Congressional Justification.
    Pancreatic Cancer Research.--In 2016, pancreatic cancer 
rose to become the third leading cause of cancer-related death 
in the U.S., claiming the lives of nearly 42,000 Americans. 
Despite progress in combating other forms of cancer, pancreatic 
cancer remains the only major cancer with a five-year survival 
rate in the single digits, at nine percent, in large part 
because there are no reliable early detection methods or 
effective treatment options. To help turn the tide against this 
deadly cancer, Congress in 2012 passed the Recalcitrant Cancer 
Research Act (P.L. 112-239), calling for the development of a 
scientific framework for certain recalcitrant cancers. The 
Committee requests an update on pancreatic cancer research in 
the fiscal year 2019 Congressional Justification.
    Pediatric Oncology Research.--The Committee encourages NCI 
to continue its important investments in pediatric oncology 
research, including clinical studies for children with brain 
tumors, the important pediatric preclinical testing program 
evaluating new agents for treating pediatric malignancies, and 
development of the novel pediatric Molecular Analysis for 
Therapy Choice (MATCH) study. The Committee requests an update 
in the fiscal year 2019 Congressional Justification on the 
progress of these important programs.
    Precision Oncology.--The Committee recognizes the potential 
for significant advancements in cancer treatments from the NCI 
MATCH trial. It remains the central pillar of precision 
medicine research focused on oncology for cancers that are 
unresponsive to standard interventions. The Committee urges NCI 
to continue to expand precision oncology trials. NCI should 
also continue to focus on launching the important pediatric-
MATCH trial as pediatric oncology mechanisms are very different 
from mutations seen in adults. NCI shall provide an update on 
these activities in the fiscal year 2019 Congressional 
Justification.
    Regional Clinical Trial Networks.--The Committee encourages 
NCI to coordinate with other ICs to leverage existing platforms 
and consider new approaches in conjunction with communities to 
identify clinical research and fosters enhanced participation 
in clinical trials by community members. The Committee 
encourages that the resulting model include robust 
collaboration with industry partners, the identification of 
best practices, and methods to efficiently implement clinical 
studies in the regional networks.

           NATIONAL HEART, LUNG, AND BLOOD INSTITUTE (NHLBI)

    Mission.--NHLBI provides leadership for a national research 
program in diseases of the heart, blood vessels, lungs, and 
blood, in blood resources, and in sleep disorders through 
support of basic, clinical, and population-based research.
    Lung Disease.--Lung disease is the third leading cause of 
death in the U.S., with a rising morbidity and mortality burden 
among all Americans, including older Americans. The Committee 
urges the institute to collaborate with the National Institute 
on Aging to study the impact of the lungs' vulnerability to 
systemic disease and aging.
    Lymphangioleiomyomatosis (LAM).--The Committee remains very 
interested in efforts to find a cure for LAM, a progressive and 
often fatal lung disease in women. The Committee supports both 
intramural and extramural research on LAM and urges NHLBI to 
use all available mechanisms as appropriate, including 
Translational Program Project Grants, to stimulate a broad 
range of clinical and basic research. The Committee commends 
NIH for supporting multicenter LAM trials and encourages 
additional support of such trials.
    Pulmonary Hypertension.--The Committee applauds NHLBI for 
identifying the study of underlying mechanisms of disease of 
Pulmonary Hypertension as one of its areas of focus within its 
recent strategic vision plan for research. The Committee 
encourages NHLBI to continue its focus in this area, 
particularly on idiopathic pulmonary arterial hypertension, so 
that additional gains can be made that benefit patient outcomes 
and further improve survivability for affected individuals.
    Sickle Cell Disease Research.--The Committee understands 
the burden sickle cell disease places on more than 100,000 
Americans. Additionally, Federal research spending on sickle 
cell disease has historically been eclipsed by other medical 
conditions that affect fewer Americans. The Committee 
encourages NHLBI to consider an increased focus on innovation 
in treatment of sickle cell disease and continue support for 
highly meritorious research on sickle cell disease.

     NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH (NIDCR)

    Mission.--The mission of NIDCR is to improve the Nation's 
oral, dental, and craniofacial health through research and 
research training. NIDCR accomplishes its mission by performing 
and supporting basic and clinical research; conducting and 
funding research training and career development programs to 
ensure that there is an adequate number of talented, well 
prepared, and diverse investigators; and coordinating and 
assisting relevant research and research-related activities.
    Biomaterials.--The Committee is pleased that NIDCR is 
exploring approaches to prevent dental caries with probiotic 
therapy, and in the development of biomaterials. The Committee 
encourages NIDCR to increase its investment in the development 
of new and improved biomaterials for use in clinical settings 
to enhance the prevention and treatment of caries.

   NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES 
                                (NIDDK)

    Mission.--NIDDK supports research in three major disease 
categories: diabetes, endocrinology, and metabolic diseases; 
digestive diseases and nutrition; and kidney, urologic, and 
hematologic diseases. NIDDK supports a coordinated program of 
fundamental and clinical research and demonstration projects 
relating to the causes, prevention, diagnosis, and treatment of 
diseases within these categories.
    Glomerular Diseases.--The Committee encourages continued 
support for the Cure Glomerulonephropathy (CureGN) initiative, 
which has enrolled over 1,500 clinical research subjects 
working towards furthering the understanding of rare forms of 
kidney diseases.
    Inflammatory Bowel Disease.--The Committee is pleased by 
NIDDK's support of research into inflammatory bowel disease 
(IBD) and urges the Institute to provide support for research 
on the environmental triggers and epigenetics of IBD as well as 
interventions for the rising prevalence of IBD to both 
pediatric and adult patients.
    Interstitial Cystitis.--The Committee is pleased with the 
evolving research on interstitial cystitis and encourages NIDDK 
to work with stakeholders on a comprehensive state of the 
science conference to examine mechanisms for scientific 
opportunity.
    Multidisciplinary Approach to the Study of Chronic Pelvic 
Pain.--The Committee is pleased with the progress of the 
Multidisciplinary Approach to the Study of Chronic Pelvic Pain 
Research Network and encourages collaborations with 
stakeholders to ensure proper dissemination of information.
    Pediatric Kidney Disease.--The Committee is encouraged by 
the current multicenter pediatric kidney disease research 
funded by NIDDK. While important strides have been made, 
further research is critical to the validation of new 
prognostic indicators, novel diagnostic biomarkers, and 
therapeutics necessary to better understand and treat kidney 
disease as children mature from newborns and ultimately 
transition to adulthood. The Committee urges the NIDDK to work 
collaboratively with other NIH institutes, including the NICHD, 
NHLBI, and NIMHD, to advance further multidisciplinary research 
for children and young adults with kidney disease and its 
complex co-morbidities. The Committee requests that NIDDK 
report back in the fiscal year 2019 Congressional Justification 
on the steps taken to advance this type of collaborative 
research.
    Study of Overrepresented and Medically Underserved 
Populations with Diabetes.--The Committee is concerned about 
specific diabetic populations that are more likely to be 
overrepresented and medically underserved. The Committee 
encourages NIDDK to support research on these specific 
populations. The Committee also encourages NIDDK to work with 
Hispanic-Serving Institutions and Historically Black Colleges 
and Universities in this effort.

    NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE (NINDS)

    Mission.--NINDS supports and conducts basic, translational, 
and clinical neurological research and research training to 
increase understanding of the brain and improve the prevention 
and treatment of neurological and neuromuscular disorders. The 
NINDS mission encompasses over 600 disorders, including stroke, 
head and spinal cord injury, epilepsy, multiple sclerosis, and 
neurodegenerative disorders such as Parkinson's disease.
    BRAIN Initiative.--The Committee recommendation includes 
bill language transferring $43,000,000 from the NIH Innovation 
Account to NINDS to support the BRAIN Initiative. These funds 
were authorized in the 21st Century Cures Act.
    Brain Aneurysm Research.--The Committee is concerned that 
an estimated one out of every 50 individuals in the U.S. has a 
brain aneurysm and an estimated 30,000 Americans suffer a brain 
aneurysm rupture each year, with little to no warning. Ruptured 
brain aneurysms are fatal in about 40 percent of cases. The 
Committee requests a report from NINDS regarding its annual 
funding level for brain aneurysm research funding over the past 
five years, including the types of grants supported.
    Duchenne Muscular Dystrophy.--The Committee is aware of 
stakeholder efforts to achieve validated and qualified 
biomarkers for Duchenne Muscular Dystrophy. The Committee 
supports these activities and urges NINDS to work with other 
Institutes and with the Food and Drug Administration to provide 
the necessary guidance and to assemble a workshop of all 
stakeholders to advance this work. The Committee is also 
concerned about a lack of access to Federally-funded data, such 
as imaging and biomarker data, which could support 
qualification of an MRI imaging biomarker and directs NIH to 
ensure all Federally-funded Duchenne investigators are in full 
compliance with the data sharing requirements included in the 
21st Century Cures Act. The Committee also remains optimistic 
about the potential for additional Duchenne treatments using 
exon skipping splicing and encourages NIH to work with other 
Federal agencies to convene a workshop on exon skipping in 
Duchenne and other neuromuscular diseases.
    Dystonia.--The Committee encourages NINDS to continue to 
expand the dystonia research portfolio. NINDS is encouraged to 
work with stakeholders in support of a comprehensive state of 
the science conference to examine evolving mechanisms for 
scientific opportunities in dystonia research.
    Headache Disorders.--The Committee encourages NIH to 
prioritize fundamental, translational, and clinical research on 
headache disorders over the next decade. The World Health 
Organization has found that migraines are the third most 
prevalent global disorder and the seventh leading cause of 
global disability.
    Hydrocephalus Research.--The Committee encourages NIH, 
under the direction of NINDS, to conduct a scientific workshop 
on hydrocephalus research. The Committee requests that a key 
agenda item of the workshop be a discussion of future needs for 
hydrocephalus research, and that NIH report back to the 
Committee in the fiscal year 2019 Congressional Justification 
on this and other findings and recommendations of the workshop.
    Myotonic Dystrophy.--The Committee recognized there are 
significant gaps in our scientific understanding of the causes 
of myotonic dystrophy and there are still no FDA approved 
treatments for this inherited genetic disorder that can cause 
multiple organ systems to fail or severely disrupt their 
function that affects approximately 100,000 Americans. The 
Committee encourages the NIH to fund efforts to recruit young 
researchers to this field and stimulate more high quality 
research proposals to advance this critical scientific field. 
Myotonic dystrophy research holds significant promise for major 
advances across many neurodegenerative diseases, particularly 
other triplet repeat expansion diseases.
    Peripheral Neuropathies.--The Committee is pleased at the 
progress of ongoing research into Guillain-Barre syndrome 
(GBS), chronic inflammatory demyelinating polyneuropathy, and 
related conditions, and notes the important connection between 
Zika and GBS. The Committee encourages NINDS to continue work 
to advance emerging research in an organized and meaningful 
way.
    Stroke.--The Committee is concerned that stroke continues 
to inflict a massive burden on our Nation's long-term health 
and economic stability and encourages NIH to expand its 
investment commensurate with the impact on public health, the 
economy, and innovative scientific opportunities. NINDS shall 
continue to implement top priorities identified in the 2012 
planning initiative for stroke prevention, treatment and 
recovery research, particularly augmentation of the Stroke 
Clinical Trials Network, including early stroke recovery. The 
Committee lauds the Institute for its leadership in convening a 
workshop on ``Translational Stroke Research: Vision and 
Opportunities'' and directs NINDS to accelerate implementation 
of key recommendations and other findings.
    Traumatic Brain Injury.--The Committee understands 
regenerative medicine research and the use of adult stem cells 
may play an important role in the treatment of Traumatic Brain 
Injury (TBI). The Committee strongly encourages NINDS to work 
with the National Institute of Aging to support a robust and 
coordinated portfolio of TBI research with a focus on how to 
leverage regenerative medicine research and the use of adult 
stem cells in the treatment of TBI. The Committee requests an 
update in the fiscal year 2019 Congressional Justification on 
efforts in these specific areas of TBI research.

     NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES (NIAID)

    Mission.--NIAID supports and conducts basic, applied, and 
clinical research, and research training programs in 
infectious, immunologic, and allergic diseases. NIAID-supported 
research includes research on HIV/AIDS, malaria, tuberculosis, 
sexually transmitted infections, neglected tropical diseases, 
emerging and re-emerging infectious diseases, asthma, allergic 
and autoimmune diseases, and transplantation. The goals of 
NIAID research are to increase the understanding of disease 
pathogenesis and the immune system, to improve disease 
diagnosis, to develop new and improved drugs to treat such 
diseases, and to develop new and improved vaccines and other 
approaches to prevent such diseases, many of which 
significantly affect public health.
    Antimicrobial Resistance.--The Committee recommendation 
includes an increase of $30,000,000 within NIAID for combating 
antimicrobial resistance. The Committee continues to support 
research on mechanisms of drug resistance, bacterial 
pathogenesis, and infection control; developing new or 
repurposing existing antimicrobials; and exploring approaches 
to prevention including bacterial vaccines and other 
strategies. The Committee encourages NIH to coordinate with CDC 
to determine how data in the CDC resistant pathogens database 
can be leveraged to improve future research. The Committee 
requests an update in the fiscal year 2019 Congressional 
Justification on how NIAID is working with CDC and other 
Federal partners in this field of research.
    Autoimmune Neuropathies.--The Committee is pleased that 
NIAID and NINDS are working on a state of the science of 
autoimmune neuropathies research into conditions like Guillain-
Barre syndrome and chronic inflammatory demyelinating 
polyneuropathy, and encourages them to work with stakeholders 
on the importance of the patient perspective.
    Hepatitis B.--The Committee notes that infection with 
hepatitis B virus (HBV) is a serious public health threat and 
is associated with approximately 887,000 deaths each year 
worldwide, making it a leading cause of death in the world. In 
the U.S., one in 20 Americans has been infected with HBV and up 
to 2.2 million are chronically infected. Left undiagnosed and 
untreated, one in four of those with chronic HBV infection will 
die prematurely from cirrhosis, liver failure, and/or liver 
cancer. With hepatitis C now curable and study of the entire 
HBV lifecycle now possible, NIAID is urged to intensify its 
current efforts to find a cure for HBV. To meet this goal, the 
Committee urges NIAID to issue targeted calls for HBV research 
proposals in fiscal year 2018, focused on therapeutic 
development and the many critical research opportunities 
identified by the scientific community.
    Malaria.--The Committee urges NIH to continue its efforts 
to understand the biology of the malaria parasite, and to 
continue its role in developing tools needed for effective and 
sustainable malaria prevention, treatment, and control, 
including vaccines.
    Microbicides.--The Committee recognizes that with NIH and 
United States Agency for International Development (USAID) 
leadership, research has shown the potential for antiretroviral 
(ARV) drugs to prevent HIV infection in women. The Committee 
encourages NIAID to continue coordination with USAID, the State 
Department, and others to advance ARV-based microbicide 
development efforts with the goal of enabling regulatory 
approval of the first safe and effective microbicide for women 
and supporting an active ARV-based microbicide pipeline to 
produce additional solutions to prevent HIV and to help end the 
epidemic.
    Neglected Tropical Diseases.--One-sixth of the world's 
population suffers from one or more neglected tropical diseases 
(NTDs). In the U.S., we have seen Chikungunya, Dengue, and 
Chagas disease emerge. Research conducted by NIH is a key 
component to ensuring there are tools to treat, control, and 
eventually eradicate many neglected diseases. The Committee 
urges NIH to continue its investment in malaria and NTD 
research, including work in late-stage and translational 
research for NTDs, and to work with other agencies to foster 
research and ensure that basic discoveries are translated into 
solutions.
    Tick-Borne Diseases.--The Committee encourages NIH to 
intensify research on Lyme and tick-borne diseases, including 
research that will increase understanding of the full range of 
Lyme disease processes and the physiology of Borrelia 
burgdorferi and Borrelia mayonii, including the mechanisms of 
persistent infection such as persisters and potential treatment 
protocols for identified mechanisms of persistence. The 
Committee also encourages NIH to intensify research efforts 
focused on the development of more sensitive and accurate 
diagnostic tests for Lyme and tick-borne diseases, including 
next generation polymerase chain reaction and new testing 
methodologies such as proteomics and metabolomics.
    Translational Vaccinology.--The Committee notes a very 
promising area in the field of vaccine and immunology is 
translational vaccinology, in which researchers are able to 
translate the science of vaccine design and development into 
the assessment of current and novel, experimental vaccines 
through pre-clinical and clinical trials. The Committee 
strongly encourages NIAID to support a robust portfolio of 
extramural, highly meritorious translational vaccine research 
that focus on an interdisciplinary approach to this research. 
The Committee requests NIAID provide an update in the fiscal 
year 2019 Congressional Justification on expansion 
opportunities for interdisciplinary translational vaccinology 
research.
    Tuberculosis.--According to the World Health Organization 
(WHO), Tuberculosis (TB) is the leading global infectious 
disease killer, accounting for the deaths of 1.8 million people 
annually and the continued spread of drug resistant TB is a 
serious global health problem. There is an urgent need to 
develop faster point-of-care diagnostics; shorter, safer, and 
more tolerable treatments; and effective vaccines for all 
populations, including for drug resistant TB. The Committee 
urges the Institute to prioritize the development of new TB 
diagnostic, treatment, and prevention tools.
    Zika-Related Conditions.--The Committee encourages NIAID 
along with other Institutes and Centers to establish cross-
cutting research activities to combat Zika-related conditions, 
including Guillain-Barre Syndrome.

         NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES (NIGMS)

    Mission.--NIGMS supports research and research training in 
the basic biomedical sciences. Institute grantees, working in 
such fields as cell biology, biophysics, genetics, 
developmental biology, pharmacology, physiology, biological 
chemistry, bioinformatics, and computational biology study 
normal biological processes to better understand what goes 
wrong when disease occurs. In this way, NIGMS supports the 
development of new knowledge, theories, and technologies that 
can then be applied to the disease-targeted studies supported 
by other NIH components. NIGMS-supported basic research 
advances also find applications in the biotechnology and 
pharmaceutical industries. The Institute's training programs 
help develop scientists needed in industry and academia and 
increase the diversity of the biomedical workforce.
    Institutional Development Awards.--The Committee has 
provided $373,641,000 for the IDeA program, $40,000,000 above 
the fiscal year 2017 enacted level. IDeA supports high-quality 
research and investigators throughout the country in States in 
which the success rate for NIH grants has been historically 
low.

  EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN 
                          DEVELOPMENT (NICHD)

    Mission.--The NICHD conducts and supports basic, 
translational, and clinical research on the reproductive, 
developmental, and behavioral processes that determine and 
maintain--and rehabilitation that restores and improves--the 
health and well-being of children, adults, families, and 
populations.
    National Breastfeeding Research Consortium.--The Committee 
is aware of the substantial amount of research showing that 
breastfeeding can contribute significantly to health and the 
prevention of childhood obesity and chronic conditions. The 
Committee supports the Surgeon General's Call to Action to 
Support Breastfeeding and its recommendations for the 
development of a national consortium on breastfeeding research. 
The Committee urges NICHD to convene the national consortium on 
breastfeeding research called for by the Surgeon General.
    Preterm Birth Research.--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.
    Rehabilitation Research.--The Committee recognizes the 
significant challenges faced by patients with neurological 
impairments who live in rural areas, where access to assistive 
devices, medical advice, and community resources can be 
limited. Proper rehabilitation, with the help of patient 
``navigators,'' is critical to improving patients' quality of 
life and preventing further, and more costly, health problems. 
Therefore, the Committee urges the NIH, acting through the 
trans-NIH Rehabilitation Coordinating Committee that is chaired 
by the National Center for Medical Rehabilitation Research at 
NICHD, to provide greater support for research efforts that 
involve the combination of patient navigators and assistive 
health technology, particularly in underserved rural settings.
    Research on the Long-Term and Developmental Health Effects 
of Zika.--The Committee recognizes the unique nature of NICHD 
research into how the Zika virus infection affects pregnancy 
and the long-term and developmental health effects on children 
exposed to the Zika virus. The Committee urges NICHD to 
prioritize investment into long-term and developmental health 
effects of the Zika virus as the fight against the virus 
continues.
    Task Force on Research in Pregnant Women and Lactating 
Women.--The Committee looks forward to an update on the work of 
the Task Force on Research in Pregnant Women and Lactating 
Women, and continues to encourage and support the important 
work of the Task Force to ensure that consumers and health care 
professionals have up-to-date and accurate information on the 
safety and efficacy of drugs that women are taking while 
pregnant or breastfeeding.

                      NATIONAL EYE INSTITUTE (NEI)

    Mission.--NEI conducts and supports basic and clinical 
research, research training, and other programs with respect to 
blinding eye diseases, visual disorders, and mechanisms of 
visual function, preservation of sight, and the special health 
problems and needs of individuals who are visually-impaired or 
blind.
    3-D Retina Organoid Challenge.--The Committee directs NIH 
to provide an update on the 3-D Retina Organoid Challenge 
authorized in the Consolidated Appropriations Act, 2016.
    Blepharospasm.--The Committee encourages NEI to expand 
research on blepharospasm, a form of dystonia.

      NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES (NIEHS)

    Mission.--The mission of NIEHS is to prevent and reduce the 
burden of human illness and disability by understanding how the 
environment influences the development and progression of human 
disease. In addition, NIEHS is responsible for the research of 
the National Toxicology Program whose mission is to coordinate 
toxicity testing across the Federal government and to evaluate 
substances of public health concern.

                   NATIONAL INSTITUTE ON AGING (NIA)

    Mission.--NIA supports and conducts biomedical, social and 
behavioral research with respect to the aging process and the 
diseases and other special problems and needs of older 
Americans.
    Alzheimer's Disease.--In recognition that Alzheimer's 
disease poses a serious threat to the nation's long-term health 
and economic stability, the Committee recommends an increase of 
$400,000,000 within NIA to support a total of at least 
$1,791,000,000 on Alzheimer's disease research. NIA should 
continue to address 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. Additionally, the Committee encourages NIA to continue 
support for additional Alzheimer's Disease Centers in States 
with high patient incidences of Alzheimer's disease. Preference 
shall be given to centers demonstrating collaborative work 
among basic scientists and clinical scientists to expedite new 
treatment protocols, particularly among underrepresented areas.

 NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES 
                                (NIAMS)

    Mission.--NIAMS conducts and supports basic and clinical 
research and on the more than 100 forms of arthritis; 
osteoporosis and other bone diseases; muscle biology and muscle 
diseases; orthopedic disorders, such as back pain and sports 
injuries; and numerous skin diseases.
    Alopecia Areata Research.--The Committee recognizes NIAMS 
for leadership on recent research breakthroughs that could 
potentially lead to effective treatments for alopecia areata 
and related conditions, and encourages NIAMS to continue to 
support research in this area.

   NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS 
                                (NIDCD)

    Mission.--NIDCD funds and conducts research in human 
communication. Included in its program areas are research and 
research training in the normal and disordered mechanisms of 
hearing, balance, smell, taste, voice, speech and language. The 
Institute addresses special biomedical and behavioral problems 
associated with people who have communication impairments or 
disorders. In addition, NIDCD is actively involved in health 
promotion and disease prevention, and supports efforts to 
create devices that substitute for lost and impaired sensory 
and communication functions.
    Spasmodic Dysphonia.--The Committee encourages NIDCD to 
expand research on spasmodic dysphonia, a form of dystonia.

             NATIONAL INSTITUTE OF NURSING RESEARCH (NINR)

    Mission.--NINR supports and conducts scientific research 
and research training to reduce the burden of illness and 
disability; improve health-related quality of life; enhance 
end-of-life and palliative care; and establish better 
approaches to promote health and prevent disease.

       NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM (NIAAA)

    Mission.--NIAAA supports research to generate new knowledge 
to answer crucial questions about why people drink; why some 
individuals are vulnerable to alcohol dependence or alcohol-
related diseases and others are not; the relationship between 
genetic and environmental factors involved in alcoholism; the 
mechanisms whereby alcohol produces its disabling effects, 
including organ damage; how to prevent alcohol abuse and 
associated damage, especially in the underage population; and 
how alcoholism treatment can be improved. NIAAA addresses these 
questions through a program of biomedical, behavioral, and 
epidemiologic research on alcoholism, alcohol abuse, and 
related problems.

                NATIONAL INSTITUTE ON DRUG ABUSE (NIDA)

    Mission.--NIDA-supported science addresses questions about 
drug abuse and addiction, which range from its causes and 
consequences to its prevention and treatment. NIDA research 
explores how drugs of abuse affect the brain and behavior and 
develops effective prevention and treatment strategies.
    Barriers to Research.--The Committee is concerned that 
restrictions associated with Schedule 1 of the Controlled 
Substance Act effectively limit the amount and type of research 
that can be conducted on certain schedule 1 drugs, especially 
marijuana or its component chemicals and certain synthetic 
drugs. At a time when we need as much information as possible 
about these drugs, we should be lowering regulatory and other 
barriers to conducting this research. The Committee directs 
NIDA to provide a short report on the barriers to research that 
result from the classification of drugs and compounds as 
Schedule 1 substances.
    Drug Treatment in the Justice System.--The Committee 
understands that providing evidence-based treatment for 
substance use disorders offers a valuable opportunity to 
interrupt the substance use/criminal justice system cycle for 
people struggling with substance use disorders. Untreated 
substance use disorder renders prior criminal offenders 
particularly vulnerable to recidivism and continued health 
problems, preventing them from being able to find stable 
employment, jeopardizing public health and safety, and taxing 
justice and health system resources. When combined with 
therapy, medication assisted treatment (MAT) has consistently 
been shown to be more effective in treating substance use 
disorder than abstinence. The Committee applauds NIDA's focus 
on adult and juvenile justice populations in its research 
around substance use disorder treatment. The Committee supports 
this important work and asks for a progress report on those 
efforts, including information on the use and success of MAT in 
the juvenile justice system.
    Marijuana Research.--The Committee is concerned that States 
are changing public policies related to marijuana without the 
benefit of scientific research to help guide those decisions. 
NIDA is encouraged to continue supporting a full range of 
research on the effects of marijuana and its components, 
including research focused on policy change and implementation 
across the country.
    Neonatal Abstinence Syndrome.--The Committee recognizes the 
importance of research on prevention, identification, and 
treatment of prenatal opioid exposure and Neonatal Abstinence 
Syndrome. The Committee encourages NIDA to ensure that the 
review process includes appropriate focus on geographic 
locations where the problem is particularly acute. The 
Committee encourages NIH, based on appropriate scientific 
review, to support meritorious research opportunities in 
Appalachia and at institutions that have unique opportunities 
to study innovative care models.
    Opioid Misuse and Addiction.--The Committee continues to be 
extremely concerned about the epidemic of prescription opioids, 
heroin, and synthetic opioid use, addiction, and overdose in 
the U.S. Approximately 144 people die each day in this country 
from opioid overdose, making it one of the most common causes 
of non-disease-related deaths for adolescents and young adults. 
This crisis has been exacerbated by the availability of 
fentanyl and its analogs into many communities. The Committee 
appreciates the important role that research can and should 
play in the various Federal initiatives aimed at this crisis. 
The Committee urges NIDA to (1) continue funding research on 
medication development to alleviate pain, especially the 
development of medications with reduced abuse liability; (2) as 
appropriate, work with private companies to fund innovative 
research into such medications; and (3) report on what is knows 
regarding the transition from opioid analgesics to heroin and 
synthetic opioid abuse and addiction within affected 
populations.
    Raising Awareness and Engaging the Medical Community in 
Drug Abuse and Addiction Prevention and Treatment.--Education 
is a critical component of any effort to curb drug use and 
addiction, and it must target every segment of society, 
including healthcare providers (doctors, nurses, dentists, and 
pharmacists), patients, and families. Medical professionals 
must be in the forefront of efforts to curb the opioid crisis. 
The Committee continues to be pleased with the NIDAMeD 
initiative, targeting physicians-in-training, including medical 
students and resident physicians in primary care specialties 
(e.g., internal medicine, family practice, and pediatrics). 
NIDA should continue its efforts in this space, providing 
physicians and other medical professionals with the tools and 
skills needed to incorporate drug abuse screening and treatment 
into their clinical practices.

               NATIONAL INSTITUTE OF MENTAL HEALTH (NIMH)

    Mission.--NIMH is responsible for basic and clinical 
research to improve diagnosis, treatments, and overall quality 
of care for persons with mental illnesses. Disorders of high 
priority to NIMH include schizophrenia; depression and manic-
depressive illness; obsessive-compulsive disorder; anxiety 
disorders and other mental and behavioral disorders that occur 
across the lifespan, which include childhood mental disorders 
such as autism and attention-deficit/hyperactivity disorder; 
eating disorders; and other illnesses. NIMH supports and 
conducts fundamental research in neuroscience, genetics, and 
behavioral science. In addition to laboratory and controlled 
clinical studies, NIMH supports research on the mental health 
needs of special populations and health services research.
    BRAIN Initiative.--The Committee recommendation includes 
bill language transferring $43,000,000 from the NIH Innovation 
Account to NIMH to support the BRAIN Initiative. These funds 
were authorized in the 21st Century Cures Act.
    Adolescent and Young Adult Brain Development.--The 
Committee recognizes and supports the NIH Adolescent Brain and 
Cognitive Development (ABCD) Study. The Committee recognizes 
that an individual's brain continues to develop into his or her 
mid-twenties. However, little is known about the dramatic brain 
development that takes place during adolescence and how the 
various experiences people are exposed to during this time 
interact with each other and their biology to affect brain 
development and, ultimately, social, behavioral, health, and 
other outcomes. The ABCD study addresses this knowledge gap.
    Improving the Treatment of Mental Illness.--The Committee 
shares the concern of the NIMH National Advisory Mental Health 
Council that over the past decade the NIMH research portfolio 
has increasingly become focused on basic neuroscience research 
at the expense of research focused on finding ways to ease the 
burden of those currently suffering from devastating mental 
conditions. Therefore, the Committee urges NIMH to diversify 
its research portfolio to better balance basic neuroscience and 
applied research to increase the development of more effective 
treatments for people suffering from mental conditions now.

            NATIONAL HUMAN GENOME RESEARCH INSTITUTE (NHGRI)

    Mission.--NHGRI provides leadership for the development of 
resources and technology to accelerate genome research and its 
application to human health. NHGRI-supported activities include 
basic and translational research to understand the sequence and 
function of both human and non-human genomes, human genetic 
variation, and the genetic and environmental basis of disease. 
Also central to NHGRI research goals are training programs and 
a strong focus on the ethical, legal, and social implications 
of genomic science and medicine.

  NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING (NIBIB)

    Mission.--The NIBIB mission is to improve human health by 
leading the development and accelerating the application of 
biomedical technologies. The Institute is committed to 
integrating the engineering and physical sciences with the life 
sciences to advance basic research and medical care.

  NATIONAL INSTITUTE ON MINORITY HEALTH AND HEALTH DISPARITIES (NIMHD)

    Mission.--NIMHD conducts and supports research, training, 
and other programs aimed at reducing the disproportionately 
high incidence and prevalence of disease, burden of illness and 
mortality experienced by certain American populations, 
including racial and ethnic minorities and other groups, such 
as the urban and rural poor, with disparate health status.
    Focal Segmental Glomerulosclerosis (FSGS) Research.--The 
Committee encourages NIMHD to continue research collaboration 
with NIDDK to address the connection between the APOL1 gene and 
the onset of FSGS.
    Health Disparities and Pediatric Kidney Disease.--The 
Committee recognizes that health disparities play a significant 
role in kidney disease in children, from the incidence and 
progression of kidney disease in children, to the long-term 
health outcomes, such as access to kidney transplant, access to 
living donors and disparate transplant survival. Children of 
minority populations are disproportionately impacted by kidney 
disease, and NIMHD's work in this area is critical to defining 
the basis for these health disparities and developing 
mechanisms to address them. The Committee requests that NIMHD 
catalog the research being conducted in this area and report 
back on the research currently underway and research gaps in 
this area of study in the fiscal year 2019 Congressional 
Justification.

   NATIONAL CENTER FOR COMPLEMENTARY AND ALTERNATIVE MEDICINE (NCCAM)

    Mission.--NCCAM was established to stimulate, develop, and 
support rigorous and relevant research of high quality and 
open, objective inquiry into the safety and effectiveness of 
complementary and alternative medicine (CAM) practices and to 
train individuals to apply the tools of exacting science to CAM 
systems and modalities in order to provide health care 
professionals and the American public with reliable information 
about these practices.

      NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES (NCATS)

    Mission.--NCATS was established to advance translational 
sciences, coordinating and developing resources that leverage 
basic research in support of translational science and 
developing partnerships and working cooperatively to foster 
synergy in ways that do not create duplication, redundancy, and 
competition with industry activities. NCATS also includes the 
Office of Rare Disease Research (ORD) that was established in 
recognition of the need to provide a focal point of attention 
and coordination at NIH for research on rare diseases. ORD 
works within the authorized mission of NCATS to provide an 
increased focus on rare disease research and orphan product 
development; develop a centralized database on rare diseases 
research; and stimulate rare disease research by supporting 
scientific workshops and symposia to identify research 
opportunities.
    Clinical and Translational Science Awards.--The Committee 
remains deeply concerned over the broad utilization of 
resources it specifically allocated for the Clinical and 
Translational Science Awards (CTSA) hubs and has provided NCATS 
with direct instructions regarding the number of awards. As 
investment in the CTSA program continues, NCATS is directed to 
ensure the level of support for CTSA institutions is maintained 
to appropriately reflect the additional resources provided by 
the Committee. Further, NCATS is directed to maintain the 
number of CTSA hubs at no fewer than 64 institutions.
    Hereditary Angioedema.--The Committee applauds the Office 
of Rare Diseases Research for their efforts to facilitate 
research into Hereditary Angioedema (HAE) and encourages 
continued collaboration with other Institutes and Centers (ICs) 
to advance our scientific understanding and spur the further 
development of innovative treatment options for patients.
    Pediatric Rare Diseases.--The Committee is encouraged by 
the work of the Rare Diseases Clinical Research Network (RDCRN) 
across a range of rare diseases. The burden of pediatric rare 
diseases is especially difficult for families navigating 
multiple research opportunities and clinical service needs. The 
Committee encourages NCATS to work with RDCRN members to create 
a pediatric rare disease center of excellence model.

               JOHN E. FOGARTY INTERNATIONAL CENTER (FIC)

    Mission.--FIC was established to improve the health of the 
people of the U.S. and other nations through international 
collaborations in the biomedical sciences. In support of this 
mission, the FIC pursues the following four goals: (1) mobilize 
international research efforts against global health threats; 
(2) advance science through international cooperation; (3) 
develop human resources to meet global research challenges; and 
(4) provide leadership in international science policy and 
research strategies.
    Recent disease outbreaks such as Ebola, Zika, and Dengue 
have shown the importance of the Center's essential role in 
global infectious disease health research training and health 
system strengthening to help developing countries to eventually 
advance their own research and health solutions and tools. FIC 
has developed important partnerships in countries, including 
countries unfriendly to the U.S., to not only fight malaria, 
neglected tropical diseases, and other infectious diseases, but 
also to have the capabilities to help the U.S. detect and treat 
infectious diseases that are not endemic to the U.S. before 
they travel to the U.S., thus protecting Americans here at 
home. The Committee urges FIC to continue this important work 
building relationships with scientists abroad to foster a 
stronger and more effective science workforce and health 
capacity on the ground, helping to detect infectious diseases 
and building the capacity to confront those diseases while 
improving the image of the U.S. though health diplomacy in 
their countries.

                   NATIONAL LIBRARY OF MEDICINE (NLM)

    Mission.--The NLM collects and organizes information 
important to biomedicine; serves as a national information 
resource for medical education, research, and health service 
activities; enhances access to biomedical literature through 
electronic services; serves the public by providing electronic 
access to reliable health information for consumers; supports 
and directs the national network of libraries of medicine; 
provides grants for research in biomedical communications, 
medical library development, and training health information 
specialists; conducts and supports research in biomedical 
informatics and computational biology; and creates information 
resources for genomics, molecular biology, toxicology, medical 
images, environmental health, emergency preparedness and 
response, and health services research.

                      OFFICE OF THE DIRECTOR (OD)

    Mission.--The OD provides leadership to the NIH research 
enterprise and coordinates and directs initiatives that 
crosscut NIH. OD is responsible for the development and 
management of intramural and extramural research and research 
training policy, the review of program quality and 
effectiveness, the coordination of selected NIH-wide program 
activities, and the administration of centralized support 
activities essential to the operations of NIH.
    Common Fund.--The Committee recommends $695,580,000 for the 
Commond Fund (CF), including $12,600,000 provided to support 
the Gabriella Miller Kids First Research Act for the fourth 
year of the ten-year Pediatric Research Initiative. NIH is 
expected to continue the longstanding CF policy for projects to 
be short-term, high-impact awards, with no projects receiving 
funding for more than 10 years.
    The Committee urges the Director to use a portion of the 
$10,000,000 made available to the Director's Discretionary Fund 
(DDF) to support additional pediatric research. The Committee 
requests a quarterly report on DDF obligations for each 
activity supported. The report should include a description of 
the program, which ICs are to provide continuation costs, and 
how this research serves a high priority for pediatric 
diseases. The quarterly reports shall be posted on the NIH 
website within 30 days after being released to the Committee on 
Appropriations of the House of Representatives and the Senate.
    Operating Plan.--The Committee continues the understanding 
that the IC mechanism tables serve as the NIH operating plans 
for available resources and requests NIH continue to provide 
quarterly updates of these mechanism operating plans to the 
Committee on Appropriations of the House of Representatives and 
the Senate.

Division of Program Coordination, Planning, and Strategic Initiatives 
        (DPCPSI)

    The mission of DPCPSI is to coordinate and facilitate 
trans-NIH research initiatives and emerging areas of scientific 
opportunities and public health challenges. The Division houses 
these NIH offices: the Office of Research on Women's Health; 
the Office of AIDS Research; the Office of Dietary Supplements; 
the Office of Behavioral and Social Sciences Research; the 
Office of Disease Prevention; and the Office Research 
Infrastructure Programs.
    The Committee directs the Director of DPCPSI to develop a 
trans-NIH strategic approach to improve coordination and 
facilitation of trans-NIH research with measurable objectives. 
The Director should also take specific steps with the ICs to 
strengthen to reduce duplication and increase effectiveness and 
efficiency of research.

Office of Research on Women's Health

    The Office of Research on Women's Health (ORWH) works in 
collaboration with the ICs to promote and foster efforts to 
address gaps in knowledge related to women's health through the 
enhancement and expansion of funded research and/or the 
initiation of new investigative studies. ORWH is responsible 
for supporting the inclusion of women in clinical research 
funded by NIH, including the development of a computerized 
tracking system and the implementation of guidelines on such 
inclusion. ORWH is also involved in promoting programs to 
increase the number of women in biomedical science careers, and 
in the development of women's health and gender factors as a 
focus in biology.

Office of AIDS Research

    The Office of AIDS Research (OAR) is authorized to manage 
trans-NIH AIDS research. The Director of OAR and the Director 
of NIH jointly determine the total for AIDS research within the 
NIH appropriation based on scientific need and meritorious 
scientific opportunity relative to NIH's overall plan. The 
Committee encourages the Office to use a strategic focus of 
resources allocated to AIDS towards the highest quality peer 
reviewed projected aimed at finding cures, creating a vaccine, 
and developing better treatments for the disease.

Office of Dietary Supplements

    The Office of Dietary Supplements (ODS) was established in 
recognition that dietary supplements can have an important 
impact on prevention and health maintenance. In collaboration 
with other NIH institutes and centers and other Federal 
agencies, ODS works to strengthen knowledge about dietary 
supplements by supporting and coordinating scientific research 
in the field.

Office of Behavioral and Social Sciences Research

    The Office of Behavioral and Social Sciences Research 
(OBSSR) provides leadership and direction for the development 
of a trans-NIH plan to increase the scope of and support for 
behavioral and social sciences research and in defining an 
overall strategy for the integration of these disciplines 
across NIH institutes and centers; develops initiatives to 
stimulate research in the behavioral and social sciences arena 
and to integrate a bio-behavioral perspective across the 
research areas of NIH; and promotes studies to evaluate the 
contributions of behavioral, social and lifestyle determinants 
in the development, course, treatment, and prevention of 
illness and related public health problems.

Office of Science Education

    The Office of Science Education (OSE) plans, develops, and 
coordinates a comprehensive science education program to 
strengthen and enhance efforts of the NIH to attract young 
people to biomedical and behavioral science careers and to 
improve science literacy in both adults and children. The 
Office develops curriculum supplements and other educational 
materials; maintains a website as a central source of 
information about NIH science education resources; establishes 
national model programs in public science education, and 
promotes science education reform as outlined in the National 
Science Education Standards and related guidelines.

Office of Disease Prevention

    The Office of Disease Prevention (ODP) assesses, 
facilitates, stimulates research into disease prevention and 
health promotion in collaboration with NIH and other public and 
private partners, and disseminates the results of this research 
to improve public health. ODP produces evidence-based consensus 
statements addressing controversial medical issues. The 
Committee expects ODP to disseminate consensus statements and 
disease prevention and health promotion information through 
appropriate HHS outreach programs.

Office of Research Infrastructure Programs

    The Office of Research Infrastructure Programs (ORIP) 
provides support for research and a variety of research 
infrastructure needs, including animal models and facilities; 
research models, biological materials, and human biospecimens; 
training and career development for veterinarians engaged in 
research; the acquisition of state-of-the-art instrumentation 
through the Shared and High-End Instrumentation Programs; 
research resources grants to expand, re-model, renovate, or 
alter existing research facilities or to construct new research 
facilities; and coordinates science education activities.

Multi-institute Research Issues

    Addressing Hispanic Research Issues.--The Committee is 
encouraged by NIH's efforts seeking to address health disparity 
research issues impacting the U.S. Hispanic population across 
various ICs. The Committee recognizes that the longitudinal 
Study of Latino Health research program being conducted by 
NHLBI, as well as the collaborative research efforts at NIMHD, 
are providing important progress in measuring more precisely 
the risk factors and outcomes and determining effective 
interventions among U.S. Hispanics. The Committee urges NIH to 
fill out key gaps in its translational research portfolio to 
include children and youth and reproductive-age young women, as 
well as older populations, in high-density areas to allow for 
broader research cohorts.
    Adolescents and Medication-Assisted Treatment.--The 
Committee applauds the ongoing coordinated efforts at NIH to 
understand and address substance use and substance use 
disorders among adolescents and young adults as a specific 
population. As part of those efforts, the Committee also 
encourages NIH to examine the effectiveness of medication 
assisted treatment in adolescents struggling with substance use 
disorder, and identify any barriers to treatment as well as 
potential unintended consequences.
    Adolescents and Young Adults.--The Committee encourages an 
NIH-wide emphasis on understanding and addressing substance use 
and substance use disorders among adolescents and young adults 
as a specific population. The Committee encourages NIH to 
identify and coordinate its efforts in this area and provide an 
update in the fiscal year 2019 Congressional Justification on 
these actions.
    Amyloidosis.--The Committee recommends that NIH continue to 
expand its research efforts into amyloidosis, a group of rare 
diseases characterized by abnormally folded protein deposits in 
tissues. Amyloidosis is often fatal and there is no known cure. 
Current methods of treatment are risky and unsuitable for many 
patients. The Committee directs 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.
    Angelman Syndrome.--The Committee recognizes the promising 
scientific gains made in the pursuit of treatments for Angelman 
Syndrome. The Committee applauds the significant contributions 
of the Angelman Syndrome Natural History Study, funded by NIH, 
and the private partners working diligently to advance the 
growing body of Angelman Syndrome research towards practical 
treatments. Because Angelman Syndrome is a single-gene 
disorder, specifically caused by a deleted UBE3A gene, the 
Committee believes that with recent advances in medical 
therapeutics and technology, the disorder is curable today. 
Further research in this area holds great promise for both 
Angelman Syndrome and forms of autism also linked to 
misexpression of the UBE3A gene. With two innovative new 
treatments poised for clinical trials, the Committee urges NIH 
to dedicate available resources to Angelman Syndrome research, 
and specifically to advance research in the roles of the UBE3A 
gene in brain functions. In this challenging budget 
environment, the Committee also believes public-private 
partnerships should be further encouraged as translational 
research progresses in the areas of Angelman Syndrome, autism, 
and UBE3A related disorders.
    Basic Biomedical Research.--The purpose of basic research 
is to discover the nature and mechanics of disease and identify 
potential therapeutic avenues likely to lead to the prevention 
and treatment of human disease. Without this early scientific 
investigation, future development of treatments and cures would 
be impossible. Basic biomedical research must remain a key 
component of both the intramural and extramural research 
portfolio at the NIH. The Committee encourages NIH to take 
actions to ensure the percentage of funding in the extramural 
research program on basic research does not fall below 55 
percent of NIH resources.
    Bilateral Renal Agenesis.--The Committee requests NIH 
conduct a state of the science report on bilateral renal 
agenesis research, possible treatments, and related dialysis 
for preemies and newborns, and provide an update in the fiscal 
year 2019 Congressional Justification.
    Cerebral Cavernous Angioma Research.--The Committee urges 
NIH to expand and strengthen NINDS programs regarding research 
and related activities for cavernous angioma by including 
basic, clinical, and translational research as well as 
promoting training programs for medical and allied health 
clinicians and scientists, increasing outreach and awareness, 
and sharing clinical and other surveillance information. The 
Committee also encourages NIH and FDA to work with patient 
advocacy organizations to research and promote effective 
treatments. The Committee is aware of patient advocacy groups 
asking NIH to conduct clinical trials. The Committee urges NIH 
to continue to work with these organizations on this request.
    Children in NIH Research.--The inclusion of children in 
clinical research is essential to ensure that children benefit 
from important scientific advances. The Committee appreciates 
provisions of the 21st Century Cures Act that will now require 
NIH to track systematically enrollment data to determine if 
children are actually being enrolled appropriately in clinical 
research. The Committee recognizes that without better data 
collection, the Committee is unable to fully exercise its 
oversight role and researchers are unable to determine whether 
children as a whole, or particular pediatric subpopulations, 
are underrepresented in Federally-funded biomedical research. 
The Committee directs NIH to implement these new requirements 
expeditiously.
    Chimpanzee Sanctuary Support.--The Committee commends NIH 
for their decision to relocate all Federally-owned chimpanzees 
to the federal sanctuary system. The Committee supports NIH's 
careful consideration for their welfare, including their health 
and social grouping. The Committee is pleased to see that NIH 
intends to continue transferring chimpanzees to the federal 
sanctuary system in fiscal year 2017 and strongly encourages 
further progress towards finding both cost-effective and humane 
care for all Federally-owned and -supported chimpanzees in 
their retirement. The Committee is aware of the suggestion that 
a change in transportation methods or a system expansion could 
facilitate earlier completion of the retirement effort. 
Therefore, the Committee directs NIH to develop a plan that 
addresses impediments in the rate of transportation of 
chimpanzees to the sanctuary system and explores the need for 
expansion, taking into account age and health of chimpanzees as 
well any expansion and facility costs. This plan should also 
include details on how NIH plans to meet the goal of retiring 
all the NIH-owned chimpanzees to the Federal sanctuary system 
as rapidly as possible, but no later than within five years. 
The NIH shall report back to the Committee with this plan 
within 120 days of enactment of this act.
    Chronic Fatigue Syndrome.--The Committee is pleased that 
NIH has begun to expedite research into Myalgic 
Encephalomyelitis/Chronic Fatigue Syndrome, including its 
intramural study and the request for applications (RFAs) for 
the collaborative research centers. However, the Committee is 
concerned that the level of funding is still very low 
considering the burden of disease and the current plan to 
expand research will take too long to produce Food and Drug 
Administration approved treatments and diagnostic tests. The 
Committee urges NIH to collaborate with disease experts and the 
patient community to identify additional opportunities to 
expedite progress on this understudied disease. Specifically, 
the Committee recommends that NIH significantly increase 
research funding to be commensurate with disease burden and use 
that funding to further accelerate the research field through a 
set of intramural and extramural investments such as (a) RFAs 
for biomarkers and treatment trials, (b) additional funding for 
investigator initiated studies and early stage investigator 
awards, (c) an initiative to reach consensus on the case 
definition, and (d) mechanisms to incentivize researchers to 
enter the field.
    Coordination with the Department of Energy (DOE) and 
National Laboratories to Implement 21st Century Cures Act.--NIH 
is encouraged enter into collaborative research programs, as 
appropriate, with DOE, the National Laboratories, and others 
determined to be appropriate, to utilize the broader scientific 
and technological capabilities of DOE and the National 
Laboratories relevant to the successful implementation of the 
21st Century Cures Act (P.L. 114-255).
    Dietary Reference Intake for Carbohydrates.--The Committee 
notes keen public interest in various dietary guidance 
proposals and food labeling initiatives regarding consumption 
of carbohydrates. Yet, the last Dietary Reference Intake (DRI) 
review conducted regarding carbohydrates was completed in 2002. 
The Committee encourages NIH to consider arranging for a DRI 
review for carbohydrates.
    Fragile X.--The Committee commends NIH for the NICHD-led 
effort that has resulted in significant progress in mapping the 
molecular, physiological, biological and genetic connections 
among Fragile X (FX), the FX protein, and autism. Increased 
focus on basic science is needed to identify additional 
targetable mechanisms of the disease. The Committee 
acknowledges that recently concluded drug trials were unable to 
demonstrate and measure positive clinical outcomes when 
compared to a placebo. The Committee urges the Director to 
support expanded natural history studies to supplement the 
CDC's efforts, and to focus on validating outcome measures and 
biomarkers that bridge the mouse model and humans with the 
disease across the full spectrum of CGG repeat expansion in 
males and females. The Committee endorses the creation of a 
Clinical Trial Network that builds upon the already established 
consortium of FX clinics to accelerate the development of 
specialized outcome measures. This will ensure that, as 
additional targetable mechanisms of the disease are identified, 
clinical trials can promptly follow. Given the inextricable 
connection between the FX protein and autism, the Committee 
urges the Director and his counterparts at each institute with 
Fragile X and autism portfolios to explore ways to create 
greater efficiency and synergy among these two research tracks 
to accelerate translational research toward a better 
understanding of both conditions and to shorten the time to 
bring effective treatments for both conditions to market. The 
Committee commends the NIH for its previous work to create and 
update the NIH Research Plan on Fragile X Syndrome and 
Associated Disorders.
    Gut Microbiome.--The Committee commends the Office of the 
Director's partnership with NIDDK on the Human Microbiome 
project and urges expanded investigation into the manipulation 
of the microbiome to improve scientific understanding of 
functional gastrointestinal disorders, including Irritable 
Bowel Syndrome.
    National Children's Study (NSC) Follow-On.--The Committee 
continues to recognize the importance of investigating the 
effects of environmental exposures on child health and 
development. The National Children's Study (NCS)/Environmental 
Influences on Child Health Outcomes (ECHO) Project has the 
potential to increase greatly understanding of this critical 
determinate of health across the lifespan. The Committee is 
pleased that NIH has established an External Scientific Board 
for NCS/ECHO that reports directly to the NIH Director, and 
encourages greater communication about to the program's 
progress toward goals, milestones, and projected funding 
estimates with both external stakeholders and Congress. The 
Committee directs NIH to provide an update in the fiscal year 
2019 Congressional Justification including a summary of 
progress made to date, an analysis of the composition of the 
funded cohort studies, and the short- and long-term goals of 
the study.
    Neurofibromatosis.--The Committee supports efforts to 
increase funding and resources for Neurofibromatosis (NF) 
research and treatment at multiple NIH Institutes, including 
NCI, NINDS, NIDCD, NHLBI, NICHD, NIMH, NCATS, and NEI. Children 
and adults with NF are at significant risk for the development 
of many forms of cancer; the Committee encourages NCI to 
increase its NF research portfolio in fundamental basic 
science, translational research and clinical trials focused on 
NF. The Committee also encourages the NCI to support NF 
centers, NF clinical trials consortia, NF preclinical mouse 
models consortia and NF-associated tumor sequencing efforts. 
Because NF causes brain and nerve tumors and is associated with 
cognitive and behavioral problems, the Committee urges NINDS to 
continue to aggressively fund fundamental basic science 
research on NF relevant to nerve damage and repair. Based on 
emerging findings from numerous researchers worldwide 
demonstrating that children with NF are at significant risk for 
autism, learning disabilities, motor delays, and attention 
deficits, the Committee encourages NINDS, NIMH and NICHD to 
expand their investments in laboratory-based and clinical 
investigations in these areas. Since NF2 accounts for 
approximately 5 percent of genetic forms of deafness, the 
Committee encourages NIDCD to expand its investment in NF2 
basic and clinical research. Since NF1 can cause vision loss 
due to optic gliomas, the Committee encourages NEI to expand 
its investment in NF1 basic and clinical research. The 
Committee requests an update on efforts to address these 
research efforts in the FY19 Congressional Justification.
    Neurogenic Bladder and Kidney Disease.--The Committee 
encourages NIA, NIDDK, NICHD, and NINDS to study the causes and 
care of the neurogenic bladder and kidney disease in order to 
improve the quality of life of children and adults with Spina 
Bifida; to support research to address issues related to the 
treatment and management of Spina Bifida and associated 
secondary conditions, such as hydrocephalus; and to invest in 
understanding the myriad co-morbid conditions experienced by 
individuals with Spina Bifida, including those associated with 
both paralysis and developmental delay.
    Pediatric Precision Medicine.--The Committee is encouraged 
by the enormous potential of precision medicine for all 
populations, including children, since much of adult health is 
rooted in the earliest years. The Committee is aware that, at 
an All of Us Research Program stakeholder briefing, NIH 
announced plans to develop a working group to address inclusion 
of the pediatric population and has also indicated plans to 
host a pediatric stakeholder convening. The Committee requests 
an update within 30 days of enactment of this Act on the status 
and timeline for the working group to release recommendations 
regarding pediatric enrollment in the All of Us Research 
Program and the expected timeline for beginning enrollment of 
children in the program. The Committee expects NIH to ensure 
that the research cohort includes a sufficient number of 
children to make meaningful studies possible.
    Pregnancy-Related Research.--Each year, approximately four 
million women give birth in the U.S. Pregnancy research is 
essential to learning more about the health and development of 
both mother and baby, yet this research lags behind disease or 
organ-specific research. The U.S. is ranked 47th globally for 
its maternal mortality rate, and unlike any other 
industrialized country, its rates are on the rise. As maternal 
mortality and maternal morbidity increases, health care costs 
rise, and pregnancy presents a greater need for improved 
research and clinical guidance, the need to understand how to 
manage pregnancy better to prevent poor outcomes and to have 
evidence-based guidelines for management of high-risk 
pregnancies is imperative. The Committee requests that NIH 
conduct a state of the science report on pregnancy research and 
provide an update in the fiscal year 2019 Congressional 
Justification. The Committee requests the following additional 
information from the NIH as it relates to research in 
pregnancy, for each of the last three years: the number of 
clinical research awards, including all Institutes and Centers, 
addressing questions related to pregnancy; within NICHD, what 
is the proportion of the total NICHD budget spent on clinical 
research involving pregnancy; and how might NIH better address 
questions related to pregnancy across the ICs.
    Teacher Stress.--The Committee is aware that high levels of 
stress are adversely affecting the health of teachers. 
Elementary school teachers who have greater stress and show 
more symptoms of depression create classroom environments that 
are less conducive to learning. Stress is contributing to the 
high turnover rate among teachers. The Committee encourages NIH 
to support research on reducing teacher stress and promoting 
wellbeing by implementing and analyzing evidence-based stress 
management programs that will help reduce the stress of 
teachers.
    Trisomy 21.--The Committee continues to recognize that the 
presence of a third copy of human chromosome 21, which causes 
Down syndrome, predisposes individuals to significant immune 
system dysregulation. This dysregulation is associated with the 
occurrence of Alzheimer's disease as individuals with Down 
syndrome age and the high incidence of autoimmune disease as 
well as protections against most solid tumor cancers and 
cardiovascular disease. These findings present a rich research 
opportunity and, based on the NIH's recently released report on 
the Feasibility of a Multi-Year Study on Trisomy 21 in Humans, 
the Committee encourages NIH to pursue a multi-year, trans-NIH 
research initiative examining immune system dysregulation and 
trisomy 21, with the aim of yielding scientific learnings that 
could significantly improve the health of individuals with Down 
syndrome as well as millions of typical individuals.
    Undiagnosed Illnesses.--The Committee urges the Undiagnosed 
Disease Network (UDN) to continue efforts to enhance access to 
patients, caregivers, and other stakeholders as well as make 
information obtained through the UDN available to Federal 
agencies and health-related agencies.
    Usher Syndrome.--The Committee continues to urge the NIH to 
prioritize Usher syndrome research at NEI and NIDCD. The 
Committee requests an update in the fiscal year 2019 
Congressional Justification. The update should include efforts 
to stimulate the field and to accelerate viable human treatment 
options for those with Usher syndrome.
    Valley Fever.--The Committee commends NIH and CDC on 
launching a Randomized Control Trial (RCT) to identify an 
effective treatment for Valley Fever. The Committee requests an 
update on the status of the RCT, and continues to support 
efforts to develop early diagnostic tests, increase awareness 
of this disease among medical professionals and the public, and 
develop a vaccine.
    Young Investigators.--The Committee expects NIH to report 
on actions it has taken to lower the median age at which 
investigators receive their first R01 awards annually in the 
fiscal year 2019 Congressional Justification. In addition, the 
NIH shall provide an update on the concrete steps it is taking 
to lower the median age at which individuals receive their 
first R01 award within 60 days of enactment of this Act.

                        BUILDINGS AND FACILITIES

    Mission.--The Buildings and Facilities appropriation 
provides for the design, construction, improvement, and major 
repair of clinical, laboratory, and office buildings and 
supporting facilities essential to the mission of the National 
Institutes of Health. The funds in this appropriation support 
the buildings on the main NIH campus in Bethesda, Maryland; the 
Animal Center in Poolesville, Maryland; the National Institute 
of Environmental Health Sciences facility in Research Triangle 
Park, North Carolina; and other smaller facilities throughout 
the U.S.
    The Committee notes NIH has a significant backlog of 
maintenance and repairs. The Committee requests NIH and HHS 
develop a coordinated plan to address the backlog with the 
Office of Management and Budget in the fiscal year 2019 
Congressional Justification.

       Substance Abuse and Mental Health Services Administration

    The Committee recommends $3,458,934,000 for the Substance 
Abuse and Mental Health Services Administration (SAMHSA), which 
is $306,086,000 below the fiscal year 2017 enacted program 
level and $68,101,000 above than the fiscal year 2018 budget 
request program level.
    The Committee includes bill language directing the 
Secretary to exempt the Mental Health Block Grant and the 
Substance Abuse Prevention and Treatment Block Grant as a 
source for the Public Health Service Act section 241 evaluation 
set-aside in fiscal year 2018.
    The Committee does not include the requested bill language 
allowing the Assistant Secretary for Mental Health and 
Substance Use to transfer three percent or less of funds 
between any of the SAMHSA accounts.
    American Indians and Alaska Natives continue to face 
significant behavioral health problems, and have significantly 
limited access to behavioral health services. The Committee is 
aware that State authorities must have meaningful and timely 
Tribal consultation as they undertake their block grant 
planning process. The Committee strongly encourages SAMHSA to 
ensure States engage meaningfully with their Tribal 
populations. The Committee would also support information from 
States on how block grant funds have been used to support 
Indian Tribes and/or Tribal organizations within their borders 
and to what extent States have consulted with Tribes on the 
disbursement of block grant funds.
    The Committee directs SAMHSA, where statute allows, when 
issuing new funding opportunity announcements, to include as 
eligible applicants, States, political subdivisions of States 
such as local government or communities, Indian Tribes or 
tribal organizations, health facilities, or programs operated 
by or in accordance with a contract or grant with the Indian 
Health Service, or other public or nonprofit private entities. 
It is important to the Committee that all of these entities 
have the opportunity to compete for funding. While States play 
a critical role, in many cases Tribal governments, nonprofit 
organizations, or local communities are better positioned to 
target resources to those most in need. The Committee 
encourages SAMHSA to provide outreach and technical assistance 
to these entities to ensure they are able to compete for new 
grant announcements.

                             MENTAL HEALTH

    The Committee provides $949,707,000 for Mental Health, 
which is $231,330,000 below the fiscal year 2017 enacted 
program level and $37,360,000 above the fiscal year 2018 budget 
request program level.
    The Committee requests an update in the fiscal year 2019 
Congressional Justification information on the costs to law 
enforcement, first responders, judicial systems, and health 
systems that accrue due to recidivist clients, including 
potential options for more cost-effective solutions to 
providing care for such clients.
    Within the total provided for Mental Health Programs of 
Regional and National Significance, the Committee provides the 
following amounts:

------------------------------------------------------------------------
                   Budget Activity                     FY 2018 Committee
------------------------------------------------------------------------
Capacity:
    Seclusion and Restraint..........................         $1,147,000
    Mental Health First Aid..........................         14,963,000
    National Child Traumatic Stress Network..........         48,887,000
    Children and Family Programs.....................          7,229,000
    Consumer and Family Network Grants...............          4,954,000
    Mental Health System Transformation and Health             3,779,000
     Reform..........................................
    Project LAUNCH...................................         23,605,000
    Primary and Behavioral Health Care Integration...         49,877,000
Suicide Prevention:
    National Strategy for Suicide Prevention.........         11,000,000
        Zero Suicide.................................          9,000,000
                American Indian and Alaska Native Set-         2,000,000
                 Aside...............................
    Suicide Lifeline.................................          7,198,000
Garrett Lee Smith-Youth Suicide Prevention:
    State Grants.....................................         35,427,000
    Campus Grants....................................          6,488,000
    American Indian and Alaska Native Suicide                  2,931,000
     Prevention......................................
    Tribal Behavioral Health Grants..................         15,000,000
    Homeless Prevention Programs.....................         30,696,000
    Minority AIDS....................................          4,206,000
    Criminal and Juvenile Justice Programs...........          4,269,000
    Assisted Outpatient Treatment....................         15,000,000
Science and Service:
    Garrett Lee Smith-Suicide Prevention Resource              5,988,000
     Center..........................................
    Consumer and Consumer Support Technical                    1,918,000
     Assistance Centers..............................
    Primary and Behavioral Health Care Integration             1,991,000
     Technical Assistance............................
    Minority Fellowship Program......................          8,059,000
    Disaster Response................................          1,953,000
    Homelessness.....................................          2,296,000
------------------------------------------------------------------------

    Mental Health First Aid.--The Committee is pleased with the 
progress of the Mental Health First Aid program including 
training more than 740,000 Americans to recognize the signs and 
symptoms of common mental disorders. In continuing competitive 
funding opportunities, SAMHSA is directed to include as 
eligible grantees local law enforcement agencies, fire 
departments, and emergency medical units with a special 
emphasis on training for crisis de-escalation techniques. 
SAMHSA is also encouraged to allow training for veterans, armed 
services personnel and their family members. Any qualified 
community mental health education program should be considered 
as eligible for funding under the Mental Health First Aid 
program.

Mental Health Block Grant

    The Committee recommends a total of $421,039,000 for the 
Mental Health Block Grant, which is $141,532,000 below the 
fiscal year 2017 enacted program level and $5,500,000 above the 
fiscal year 2018 budget request program level. The block grant 
provides funds to States to support mental illness prevention, 
treatment, and rehabilitation services. Funds are allocated 
according to a statutory formula among the States that have 
submitted approved annual plans.
    The Committee continues the ten percent set-aside within 
the Mental Health Block Grant for evidence-based programs that 
address the needs of individuals with early serious mental 
illness, including psychotic disorders. The Committee expects 
SAMHSA to continue its collaboration with the National 
Institute of Mental Health to encourage States to use this 
block grant funding to support programs that demonstrate strong 
evidence of effectiveness.

Children's Mental Health

    The Committee recommends $119,026,000 for the Children's 
Mental Health program, which is the same as the fiscal year 
2017 enacted level and $226,000 above the fiscal year 2018 
budget request. Funding for this program supports grants and 
technical assistance for community-based services for children 
and adolescents with serious emotional, behavioral, or mental 
disorders. The program assists States and local jurisdictions 
in developing integrated systems of community care.
    Pediatric Psychiatric Beds.--The Committee understands 
there is a shortage of psychiatric beds, particularly pediatric 
psychiatric beds, which help treat children with mental health 
and substance abuse issues. The Committee recommends SAMHSA 
review the best practices of pediatric psychiatric programs and 
provide an update in the fiscal year 2019 Congressional 
Justification on this topic.

Projects for Assistance in Transition from Homelessness

    The Committee recommends $64,635,000 for the Projects for 
Assistance in Transition from Homelessness (PATH) program, 
which is the same as the fiscal year 2017 enacted level and 
$123,000 above the fiscal year 2018 budget request. The PATH 
program supports grants to States and territories for 
assistance to individuals suffering from severe mental illness 
and/or substance abuse disorders and who are homeless or at 
imminent risk of becoming homeless. Grants may be used for 
outreach, screening and diagnostic treatment services, 
rehabilitation services, community mental health services, 
alcohol or drug treatment services, training, case management 
services, supportive and supervisory services in residential 
settings, and a limited set of housing services.

Protection and Advocacy for Individuals with Mental Illness

    The Committee recommends $36,146,000 for the Protection and 
Advocacy for Individuals with Mental Illness program, which is 
the same as the fiscal year 2017 enacted level and $69,000 
above the fiscal year 2018 budget request. This program serves 
to 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. Funds are 
allocated to States according to a formula based on population 
and relative per capita incomes.

                       SUBSTANCE ABUSE TREATMENT

    The Committee recommends $2,211,506,000 for Substance Abuse 
Treatment programs, which is $1,000,000 less than the fiscal 
year 2017 enacted program level and $15,071,000 more than the 
fiscal year 2018 budget request program level.
    State Targeted Response to the Opioid Crisis.--The 
Committee includes $500,000,000 for the second year of 
continuation funding as authorized under section 1003 of the 
21st Century Cures Act. Consistent with the authorization, the 
Committee recommends States be given flexibility within the 
existing grant to direct resources in accordance with local 
needs. SAMHSA should permit States to allocate funds for 
prevention, training, treatment, recovery, and other public 
health related activities at levels based on the conditions of 
each State.
    The Committee is aware of the significant challenge 
presented by opioid abuse, and believes that addressing the 
opioid crisis requires that states coordinate efforts among 
myriad agencies and organizations. Regional collaborations 
involving hospital systems, institutions of higher education, 
local government, and the judiciary can drive best practices 
and have shown success in identifying solutions for opioid 
abuse. Therefore, the Committee encourages SAMHSA to utilize 
such regional collaborative stakeholder teams.
    Within the total provided for Programs of Regional and 
National Significance, the Committee recommends the following 
amounts:

------------------------------------------------------------------------
                                                            FY 2018
                   Budget Activity                         Committee
------------------------------------------------------------------------
Capacity:
    Opioid Treatment Programs and Regulatory                  $8,724,000
     Activities......................................
    Screening, Brief Intervention and Referral to             30,000,000
     Treatment.......................................
        PHS Evaluation Funds.........................          2,000,000
    Targeted Capacity Expansion-General..............         67,192,000
        Medication-Assisted Treatment for                     56,000,000
         Prescription Drug and Opioid Addiction......
    Pregnant and Postpartum Women....................         19,931,000
    Recovery Community Services Program..............          2,434,000
    Children and Families............................         29,605,000
    Treatment Systems for Homeless...................         36,386,000
    Minority AIDS....................................         65,570,000
    Criminal Justice Activities......................         78,000,000
    Building Communities of Recovery.................          3,000,000
Science and Service:
    Addiction Technology Transfer Centers............          9,046,000
    Minority Fellowship Program......................          3,539,000
------------------------------------------------------------------------

Screening, Brief Intervention and Referral to Treatment

    The Committee provides $30,000,000 for Screening, Brief 
Intervention and Referral to Treatment, which is the same as 
the fiscal year 2017 enacted program level, and $16,804,000 
below the fiscal year 2018 budget request program level. Within 
this amount, the Committee provides $1,000,000 for grants to 
pediatric health care providers in accordance section 9016 of 
the 21st Century Cures Act (P.L. 114-255). Grants should focus 
on screening for underage drinking, opioid use, and other drug 
use. The Committee understands that substance use disorders, 
including opioid use, typically begin in adolescence, and that 
preventing underage drinking and other early substance use is a 
cost-effective strategy in preventing costly problems later in 
life.

Targeted Capacity Expansion

    The Committee recommends $67,192,000 for Targeted Capacity 
Expansion activities. Of this amount, $56,000,000 is for 
services that address prescription drug abuse and heroin use in 
high-risk communities. SAMHSA 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. The Center for Substance Abuse Treatment is directed 
to include as an allowable use medication-assisted treatment 
and other clinically appropriate services to achieve and 
maintain abstinence from all opioids and heroin and prioritize 
treatment regimens that are less susceptible to diversion for 
illicit purposes.

Pregnant and Postpartum Women

    The Committee provides $19,931,000 for Pregnant and 
Postpartum Women, which is the same as the fiscal year 2017 
enacted level and the same as the fiscal year 2018 budget 
request. Addiction to opioids has risen dramatically over the 
past few years. Especially important are pregnant women at risk 
for opioid dependence and opioid exposure during pregnancy, and 
infants born with neonatal abstinence syndrome. The Government 
Accountability Office conducted a review of programs and stated 
in a 2015 report ``the program gap most frequently cited was 
the lack of available treatment programs for pregnant women.'' 
Substance abuse treatment that supports the family as a unit 
has proven effective for maintaining maternal sobriety and 
child well-being. There is a need for increased availability of 
outpatient treatment options that are responsive to women's 
complex responsibilities, often as the primary or sole 
caregivers for their families. Reauthorized as part of the 
Comprehensive Addiction and Recovery Act (P.L. 114-198), the 
Pregnant and Postpartum Women program supports residential 
treatment programs for pregnant and postpartum women with 
substance use disorders, including opioids. These programs 
provide substance use disorder treatment to women in 
residential facilities, and allow women to bring their minor 
children. Congress authorized the program to use funds for 
pilot programs to address service delivery gaps for pregnant 
and postpartum women, including services in non-residential 
settings, and to encourage new approaches and models of service 
delivery across the continuum of care.

Criminal Justice Activities

    The Committee provides $78,000,000 for the Criminal Justice 
Activities program and expects that no less than $60,000,000 
will be used exclusively for Drug Court activities.
    Drug 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 directs 
SAMHSA to ensure that all drug treatment court grant recipients 
work directly with the corresponding State substance abuse 
agency in the planning, implementation, and evaluation of the 
grant. The Committee further directs SAMHSA to expand training 
and technical assistance to drug treatment court grant 
recipients to ensure evidence-based practices are fully 
implemented.

Minority AIDS

    Viral Hepatitis Screening.--The Committee commends SAMHSA 
for encouraging grantees to screen for viral hepatitis 
including the use of innovative strategies like rapid testing. 
The Committee notes the disproportionate impact of viral 
hepatitis among minority populations and the co-infection rate 
among individuals with HIV/AIDS. The Committee encourages 
SAMHSA to continue its work with grantees to incorporate 
hepatitis screening into programmatic activities and requests a 
report on the implementation of hepatitis screening activities 
in the fiscal year 2019 Congressional Justification.

Substance Abuse Prevention and Treatment Block Grant

    The Committee recommends a program level of $1,858,079,000 
for the Substance Abuse Prevention and Treatment Block Grant, 
which is the same as the fiscal year 2017 enacted program level 
and $3,382,000 above the fiscal year 2018 budget request 
program level. The Substance Abuse Prevention and Treatment 
Block Grant provides funds to States to support alcohol and 
drug abuse prevention, treatment, and rehabilitation services. 
The Committee recognizes the critical role the block grant 
plays in State systems across the country.
    Handheld Analyzers.--The Committee understands the role 
played by handheld drug analyzers, particularly for police 
officers and other first responders. These instruments can 
identify various drugs and assist first responders in treatment 
referral. They also keep officers safe by minimizing the 
exposure to toxic drugs, while reducing the overall cost and 
backlog of cases at crime labs. The Committee encourages SAMHSA 
to work with the relevant stakeholders to clarify the policy of 
block grant funds and handheld analyzers.
    Peer Recovery Support Services.--The Committee values the 
role of peer recovery support services to individuals and 
families impacted by substance use disorder treatment. The 
Committee requests information in the fiscal year 2019 
Congressional Justification on the amount of funds from the 
Substance Abuse Prevention and Treatment Block Grant used for 
peer recovery support services.
    Pregnant Women.--The Committee remains concerned about the 
lack of treatment options for pregnant women and women with 
dependent children. States are required to allocate a portion 
of their block grant funds to support treatment for this 
population. The Committee requests information in the fiscal 
year 2019 Congressional Justification on the amount of funds 
from the Substance Abuse Prevention and Treatment Block Grant 
used for pregnant women and women with dependent children, 
including information on how States are implementing these 
requirements, funding level by State, and information on 
availability of treatment, and barriers to treatment.

                       SUBSTANCE ABUSE PREVENTION

    The Committee recommends $165,373,000 for the Substance 
Abuse Prevention programs, which is $57,846,000 below the 
fiscal year 2017 enacted level and $15,670,000 above the fiscal 
year 2018 budget request.
    Within the total provided for Programs of Regional and 
National Significance, the Committee provides the following 
amounts:

------------------------------------------------------------------------
                                                            FY 2018
                   Budget Activity                         Committee
------------------------------------------------------------------------
Capacity:
Strategic Prevention Framework.......................        $74,000,000
    Strategic Prevention Framework Rx................         10,000,000
Grants to Prevent Prescription Drug and Opioid                12,000,000
 Overdose Related Deaths.............................
First Responder Training.............................         12,000,000
    Rural Focus......................................          6,000,000
Minority AIDS........................................         28,843,000
Federal Drug-Free Workplace..........................          4,894,000
Sober Truth on Preventing Underage Drinking
    National Adult-Oriented Media Public Service               1,000,000
     Campaign........................................
    Community Based Coalition Enhancement Grants.....          5,000,000
    Interagency Coordinating Committee to Prevent              1,000,000
     Underage Drinking...............................
Tribal Behavioral Health Grants......................         15,000,000
Science and Service:
    Center for the Application of Prevention                   7,493,000
     Technologies....................................
    Science and Service Program Coordination.........          4,072,000
    Minority Fellowship Program......................             71,000
------------------------------------------------------------------------

    Federal Drug Free Workplace.--The Committee is concerned 
that the Secretary of Health and Human Services has yet to 
release technical guidelines for the use of hair testing as a 
Federally accepted drug testing method, in accordance with 
section 5402 of the Fixing America's Surface Transportation Act 
(P.L.114-94). The Committee believes these guidelines pose 
tremendous safety implications due to hair testing's many 
advantages over currently recognized testing methods, including 
providing employers with a longer detection window than the 
standard urinalysis, as well as being easier to collect and 
harder to adulterate. Therefore, the Committee strongly 
encourages the Secretary to expeditiously produce the technical 
guidelines for the use of hair testing as a Federally accepted 
drug testing method. The Committee requests an update on this 
effort in the fiscal year 2019 Congressional Justification.
    Overdose Fatality Prevention.--The agreement reflects 
strong concerns about the increasing number of unintentional 
overdose deaths attributable to prescription and 
nonprescription opioids. SAMHSA is urged to take steps to 
encourage and support the use of Substance Abuse and Prevention 
Block Grant funds for opioid safety education and training, 
including initiatives that improve access for licensed 
healthcare professionals, including paramedics, to emergency 
devices used to rapidly reverse the effects of opioid 
overdoses. Such initiatives should incorporate robust evidence 
based intervention training, and must facilitate linkage to 
treatment and recovery services.
    Strategic Prevention Framework.--The Committee directs 
SAMHSA to provide continuation grants for Strategic Prevention 
Framework activities in fiscal year 2018.

                HEALTH SURVEILLANCE AND PROGRAM SUPPORT

    The Committee provides $132,348,000 for Health Surveillance 
and Program Support, which is $15,910,000 below the fiscal year 
2017 enacted program level and the same as the fiscal year 2018 
budget request program level.
    The Committee provides the following amounts for Health 
Surveillance and Program Support:

------------------------------------------------------------------------
                                                            FY 2018
                   Budget Activity                         Committee
------------------------------------------------------------------------
Health Surveillance..................................        $33,842,000
    PHS Evaluation Funds.............................         22,428,000
Program Support......................................         73,043,000
Public Awareness and Support.........................         11,572,000
Performance and Quality Information Systems..........         12,893,000
Agency-Wide Initiatives..............................
    PHS Evaluation Funds.............................            998,000
------------------------------------------------------------------------

    National Survey on Drug Use and Health.--The Committee 
provides level funding for the National Survey on Drug Use and 
Health.

               Agency for Healthcare Research and Quality


                    HEALTHCARE RESEARCH AND QUALITY

    The Committee recommends $300,000,000 in discretionary 
funds for the Agency for Healthcare Research and Quality 
(AHRQ), which is $24,000,000 below the fiscal year 2017 enacted 
level and $300,000,000 above the fiscal year 2018 budget 
request. Within the total for AHRQ, the agreement includes the 
following amounts:

------------------------------------------------------------------------
                                                            FY 2018
                   Budget Activity                         Committee
------------------------------------------------------------------------
Patient-Centered Health Research.....................                 $0
Prevention/Care Management...........................         11,649,000
    Health Information Technology (IT)...............         16,500,000
    Health IT to Improve Quality.....................         14,500,000
Patient Safety Research..............................         70,276,000
    Healthcare-Associated Infections (HAI) Prevention         36,000,000
    Combating Antibiotic-Resistant Bacteria (non-add          10,000,000
     within HAI).....................................
    Section 933 Grants...............................         10,000,000
    Patient Safety and Medical Errors................         19,000,000
    Patient Safety Organizations.....................          5,276,000
Crosscutting Activities Related to Quality,                   68,731,000
 Effectiveness and Efficiency Research...............
    Health Services Contract/IAA Research............         12,000,000
    Investigator-Initiated Research Grants...........         25,731,000
Medical Expenditure Panel Survey.....................         66,000,000
Program Management...................................         66,844,000
------------------------------------------------------------------------

    The Committee notes that the findings from research 
conducted and supported by AHRQ provide evidence to improve the 
quality, safety, accessibility, and affordability of health 
care. It is in the Nation's interest to ensure this work is 
being supported and managed effectively and efficiently, and in 
a way that avoids unnecessary duplication with other Federal 
agencies and/or the private sector. The Committee directs AHRQ 
to enter into an agreement with the National Academy of Public 
Administration to conduct a study and make recommendations for 
how the Federal government should best manage this important 
research, including the optimal organizational location and 
means of avoiding unnecessary overlap with other stakeholders.
    DRI for Sodium.--The Committee notes that the systematic 
review for updating the DRI for sodium for healthy populations 
is already underway. The Committee is concerned that the key 
questions being asked in the AHRQ systematic review ignore the 
impact of sodium intake on healthy populations within the 
normal (as defined by medical literature) versus low sodium 
ranges. This question must be answered in order for the DRI 
committee to be able to determine optimal sodium intakes for 
healthy populations, including whether the impact to health at 
normal vs. low intakes is linear or non-linear. The Committee 
requests that AHRQ answer this question and report back to the 
Committee before finalizing the systematic review and sending 
it to the DRI committee.
    Investigator-Initiated Research.--The Committee provides 
support for investigator-initiated research. Investigator-
initiated research should not be targeted to any specific area 
of health services research and should be merit based from the 
best unsolicited ideas from the research community within the 
AHRQ patient safety and medical error mission. The Committee is 
aware that enhanced utilization of independent academic medical 
centers (non-university-owned centers that retain significant 
graduate medical education positions) could lead to innovative 
and pragmatic solutions that improve clinical practices.
    Patient-Reported Outcomes in Children.--Patient-reported 
outcomes play a major role in assessing the type and quality of 
care being received by patients. While patient-reported outcome 
measures are being advanced as an important component of 
clinical decision-making, there is little evidence to guide 
pediatric providers with respect to implementation and 
application of these measures, particularly as children move 
from early childhood through adolescence and to adulthood. The 
Committee requests that AHRQ report back on the state of 
patient reported outcomes in children with kidney disease and 
how the agency intends to advance the scientific application of 
these measures toward improving health outcomes in kidney 
patients as they mature from newborns to young adults in the 
fiscal year 2019 Congressional Justification.
    Bibliography of Peer-Reviewed Tick-Borne Diseases 
Literature.--The Committee encourages AHRQ to assemble a 
bibliography of peer-reviewed tick-borne diseases literature, 
appropriately organized for use by the scientific community, 
treating physicians, and the public. The bibliography should 
include literature relating to possible mechanisms of 
persistent infection with Borrelia burgdorferi or other types 
of Borrelia.

               Centers for Medicare and Medicaid Services


                     GRANTS TO STATES FOR MEDICAID

    The Committee recommends $284,798,384,000 for the Federal 
share of Medicaid costs, which is $22,794,417,000 above the 
fiscal year 2017 enacted level and the same as the fiscal year 
2018 budget request. This amount does not include 
$125,219,452,000, which was provided as advance funding for the 
first quarter of fiscal year 2018. In addition, the Committee 
recommends an advance appropriation of $134,847,759,000 for 
program costs in the first quarter of fiscal year 2019.
    The Committee continues bill language providing indefinite 
budget authority for unanticipated costs in fiscal year 2018. 
Federal Medicaid grants reimburse States for a portion of their 
expenditures in providing health care for individuals whose 
income and resources fall below specified levels. Subject to 
certain minimum requirements, States are provided certain 
limited authority within the law to set eligibility, coverage, 
and payment levels.

                PAYMENTS TO THE HEALTH CARE TRUST FUNDS

    The Committee recommends $323,497,300,000 for the Payments 
to the Health Care Trust Funds account. This amount is 
$24,309,600,000 above the fiscal year 2017 enacted level and 
equal to the fiscal year 2018 budget request.
    This account includes the general fund subsidy to the 
Federal Supplementary Medical Insurance Trust Fund for Medicare 
Part B benefits, and Medicare drug benefits and administration, 
as well as other reimbursements to the Federal Hospital 
Insurance Trust Fund for benefits and related to administrative 
costs, which have not been financed by payroll taxes or premium 
contributions. The Committee continues bill language providing 
indefinite authority to pay the general revenue portion of the 
Medicare Part B premium match and providing resources for the 
Medicare Part D drug benefit program in the event that the 
annual appropriation is insufficient.

                           PROGRAM MANAGEMENT

    The Committee makes available $3,451,141,000 in trust funds 
for Federal administration of the Medicare and Medicaid 
programs, which is $218,603,000 below the fiscal year 2017 
enacted level and $136,855,000 below the fiscal year 2018 
budget request.

Program Operations

    The Committee recommends $2,341,274,000 for Program 
Operations to support activities used to administer the 
Medicare program, fund beneficiary outreach and education, 
maintain information technology (IT) infrastructure needed to 
support various claims processing systems, and continue 
programmatic improvements.
    Adult Immunization Quality Measures.--The Committee is 
aware that the Centers for Medicare & Medicaid Servies (CMS) is 
working to close gaps in quality measures to improve care 
delivery and patient outcomes, including reducing racial and 
ethnic health disparities. Adult immunization quality measures 
are one area where more work is needed, as noted in a 2014 
National Quality Forum (NQF) report entitled Priority Setting 
for Healthcare Performance Measurement: Addressing Performance 
Measure Gaps for Adult Immunization. The Committee recommends 
CMS work with relevant partners, such as NQF, to address the 
current gaps in adult immunization quality measures and ensure 
the quality measures reflect current immunization practice 
standards as well as the Advisory Committee on Immunization 
Practice recommendations for adult immunization. The Committee 
requests a report from CMS no later than 12 months following 
enactment of this Act on the steps the agency has taken to 
improve quality measures applicable to adult immunization under 
Medicare and Medicaid, including an action plan to enable 
widespread adoption across healthcare settings.
    Agents Used for Cosmetic Purposes or Hair Growth.--The 
Committee recognizes that recently passed legislation 
eliminated Federal Medicaid matching funds for prescription 
drugs used for cosmetic purposes or hair growth unless they are 
determined to be medically necessary. The Committee encourages 
CMS to include autoimmune conditions that cause hair loss, such 
as alopecia areata and thyroid disease, within these medically 
necessary coverage criteria.
    Ambulatory Surgical Centers.--CMS is directed to submit a 
report to the Committees on Appropriations of the House of 
Representatives and Senate, and the authorizing committees of 
jurisdiction, on any increased cost to the Medicare program and 
its beneficiaries due to the migration of procedures from 
ambulatory surgical centers (ASCs) to higher cost settings. The 
report will evaluate volume changes over the past ten years to 
identify procedures that are migrating from ASCs to higher cost 
settings and make specific recommendations that CMS can 
implement to reverse this trend.
    Chronic Obstructive Pulmonary Disease.--Chronic Obstructive 
Pulmonary Disease (COPD) is the third leading cause of death 
and fourth most costly condition with respect to hospital 
readmissions. Respiratory therapists are educated and trained 
in all aspects of pulmonary medicine and play a critical role 
in the treatment of COPD patients. The Committee encourages CMS 
to conduct an analysis of the most recent claims data of 
services provided to Medicare beneficiaries with COPD in the 
emergency department, inpatient and physician office settings, 
and long-term care facilities to determine the role of 
respiratory therapists in improved health outcomes, reduced 
readmissions, and potential cost savings. The Committee 
requests an update on this effort in the fiscal year 2019 
Congressional Justification.
    Colorectal Cancer Screening.--The Committee recognizes the 
inequity in beneficiary cost sharing for screening 
colonoscopies. The Committee urges CMS to align its 
interpretation of the colorectal cancer screening cost-sharing 
requirements for Medicare beneficiaries with the policy of 
colorectal cancer cost-sharing requirements for other Federally 
funded health programs. The Committee encourages CMS to conduct 
an analysis of recent scientific literature on the efficacy of 
colorectal cancer screening. The Committee requests an update 
on this topic in the fiscal year 2019 Congressional 
Justification.
    Critical Access Hospitals.--The Committee continues to note 
concerns about the proposal to eliminate Critical Access 
Hospitals (CAH) status from facilities located less than 10 
miles from another hospital and reducing the reimbursement rate 
from 101 to 100 percent. Changes to the reimbursement for CAH 
can affect their ability to provide proper care to local 
residents. The Committee supports efforts by CMS to address 
concerns from CAH.
    Diabetic Retinal Exams.--According to the CDC, diabetes-
related blindness costs the nation about $500 million annually. 
The Committee recognizes that as more Medicare beneficiaries 
are diagnosed with diabetes, diabetic retinopathy remains a 
concern. Experts recommend that all individuals diagnosed with 
diabetes should be examined for eye health yet failure to 
receive annual diabetic retinal exams (DREs) is prevalent due 
to a variety of reasons. The Committee urges CMS to update its 
policy to make DREs more accessible to diabetic patients in 
primary care settings.
    Electrodiagnostic (EDX) Patient Care.--The Committee thanks 
CMS for providing additional guidance on actions taken in 
response to the recommendations in the 2014 OIG Report: 
Questionable Billing for Medicare Electrodiagnostic Tests. The 
Committee notes that utilization of the codes for EDX testing 
continue to increase and that identified efforts to curb 
rampant fraud and abuse are exclusively focused on physicians 
with high utilization rates, and do not capture the full scope 
of the problem. The Committee remains interested in 
comprehensive solutions from CMS that advance quality care and 
cost savings by ensuring patients do not receive inadequate or 
unnecessary EDX tests.
    Evaluation and Management Codes.--Over 90 percent of the 
care provided by infectious disease (ID) physicians is 
considered evaluation and management (E&M;). These face-to-face 
encounters continue to be undervalued by current payment 
systems that much more generously reward procedures. This has 
created a significant compensation disparity between ID 
physicians and specialists who provide more procedure-based 
care, as well as primary care physicians who provide similar or 
identical E&M; services but who have received payment increases 
simply because their specialty enrollment designations as 
``primary care physicians.'' The Committee requests CMS, as 
part of its ongoing effort to improve valuation and payment 
accuracy, research the necessary documentation that would more 
precisely describe the cognitive work in the office visits of 
ID physicians. The Committee requests an update on this topic 
in the fiscal year 2019 Congressional Justification.
    Home Health Care.--The Committee is aware that the current 
requirement that home health plans be certified solely by a 
physician has resulted in problems with access to home health 
care. The Committee acknowledges CMS' efforts to limit the 
requirements placed on the certifying physician. The Committee 
requests an update in the fiscal year 2019 Congressional 
Justification on the face-to-face encounter performed by an 
allowed non-physician practitioner (working in collaboration 
with/under the supervision of the certifying physician or the 
acute/post-acute-care physician).
    Hospital Rating System.--The Committee is concerned with 
the implementation of CMS's Hospital Star Rating System. While 
the Committee supports the goals of transparency for patients, 
it is concerned with how CMS measures factors in determining 
these ratings. The Committee requests CMS provide details on 
the methodology used to determine the ratings in the fiscal 
year 2019 budget request. The Committee encourages CMS to 
solicit feedback from the stakeholder community regarding the 
methodology and factors used to determine ratings.
    Long Term Care Hospitals.--The Committee recognizes the 
challenges faced by Long Term Care Hospitals (LTCHs). The 
Committee encourages continued discussion and analysis on 
payment methodologies that permit flexibility for LTCHs to meet 
the needs of their patients and community.
    Medication Diversion.--The Committee understands the 
important role of medication-assisted treatment for 
beneficiaries with opioid use disorder. At the same time, there 
are reports from several authorities of rising rates of 
diversion of these Food and Drug Administration-approved 
medications. The Committee directs CMS to evaluate diversion 
data from the Drug Enforcement Administration and State sources 
to determine the scope of this problem and to include in the 
fiscal year 2019 Congressional Justification options to reduce 
diversion.
    National Health Expenditures.--The Committee requests CMS 
include information in its fiscal year 2019 Congressional 
Justification explaining the methodology for including data in 
the National Health Expenditure (NHE) database. In addition, 
the Committee requests an analysis of how CMS-published data 
compares to other comparable information on health 
expenditures, such as industry surveys.
    Out of Network Emergency Care.--The Committee is concerned 
the Center for Consumer Information and Insurance Oversight 
(CCIIO) has not provided sufficient clarity on how to determine 
the ``Usual, Customary & Reasonable'' (UCR) amount in its final 
rule for patient protections (80 Fed. Reg. 72191). Therefore, 
the Committee requests CCIIO publish guidance, which may come 
in the form of Frequently Asked Questions, clarifying what 
constitutes the UCR amount using a transparent and fair 
standard, such as an independent unbiased charge database.
    Patient Matching.--The Committee recognizes that a lack of 
a patient matching system for Medicare beneficiaries results in 
duplicate procedures and poses a significant patient safety 
risk. The Committee is aware that a number of patient matching 
systems are currently being used in the commercial sector, but 
one has yet to be adopted in Medicare. The Committee requests a 
report not less than 12 months after the date of enactment of 
this Act on the impact on care improvement, reduction in costs, 
estimated saved lives or reduction in errors, and improvements 
in patient safety if hospitals were required to use a patient 
matching system as a requirement for participation in the 
Medicare program.
    Readmission Rates.--The Committee continues to support CMS 
efforts to reduce readmission rates among high-risk seniors 
living in communities challenged by poverty, poor health 
literacy, health disparities or non-compliance with treatment 
regimens. In particular, flexible, community-based multi-payer 
arrangements have encouraged health and social service 
providers to combine efforts in tailoring services to these at-
risk populations. The Committee continues to encourage CMS to 
work with community-based organizations to help identify best 
practices and transition them to Medicare's value-based 
purchasing initiatives.
    Recovery Audit Contractors.--The Committee values the role 
played by Recovery Audit Contractors (RACs) in the 
identification and prevention of improper Medicare payments. 
However, some audit processes have resulted in prolonged delays 
in payment to providers. The Committee encourages efforts by 
CMS to provide oversight to ensure RACs are operating 
consistent with CMS issued guidance.
    Risk Corridors.--The Committee continues bill language 
prohibiting use of the Program Management appropriation from 
being available for risk corridor payments.
    Rural Health Clinics.--The Committee encourages CMS to 
engage States and other stakeholders on outstanding issues of 
payment recoupment, as it relates to CMS-designated Rural 
Health Clinics. The Committee also requests an update in the 
fiscal year 2019 Congressional Justification on the study 
requested in House Report 114-699 under this heading.
    Therapeutic Foster Care Services.--The Committee remains 
concerned about the lack of a uniform definition within the 
Medicaid program for therapeutic foster care (TFC) services. A 
uniform definition would improve the ability for more 
consistent care and treatment. The Committee requests an update 
in the fiscal year 2019 Congressional Justification on the 
study requested in House Report 114-699 under this heading.
    Transparency in Hospital Reimbursement.--The Committee 
requests CMS provide information in the fiscal year 2019 
Congressional Justification identifying all pass-through 
payments reimbursed from the Hospital Insurance Trust Fund. The 
Committee expects CMS to address pass-through payments for 
hospital-based nursing programs, as well as the oversight 
function CMS performs to ensure such programs are fully 
accredited.

Federal Administration

    The Committee recommends $712,533,000 for Federal 
Administration activities related to the Medicare and Medicaid 
programs, which is $20,000,000 below the fiscal year 2017 
enacted level and $10,000,000 below the fiscal year 2018 budget 
request. The Federal Administration funding supports CMS staff, 
along with operating and administrative expenses for planning, 
developing, managing, and evaluating healthcare financing 
programs and policies.
    Health Insurance Exchange Transparency.--The Committee 
continues to include bill language requiring 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 
Bid Review, Management and 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 and Employer Activities; and 
Other Marketplace 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 2019.

              HEALTH CARE FRAUD AND ABUSE CONTROL ACCOUNT

    The Committee provides $745,000,000 to the Health Care 
Fraud and Abuse Control Account (HCFAC). This includes a base 
amount of $311,000,000 and an additional $434,000,000 through a 
discretionary budget cap adjustment authorized under section 
251(b) of the Balanced Budget and Emergency Deficit Control Act 
of 1985. The HCFAC funds support activities conducted by CMS, 
the HHS Office of Inspector General, and the Department of 
Justice. This level is $20,000,000 above the fiscal year 2017 
enacted level and $6,000,000 below the fiscal year 2018 budget 
request.
    This funding is in addition to other mandatory funding 
provided through authorizing legislation. The funding will 
provide resources to continue efforts for Medicaid program 
integrity activities, for safeguarding the Medicare 
prescription drug benefit and the Medicare Advantage program, 
and for program integrity efforts carried out by the Department 
of Justice.
    The Committee continues to include bill language to ensure 
the Secretary funds the Senior Medicare Patrol Program 
administered by the Administration for Community Living from 
funds provided to this account.
    The Committee expects all recipients of funds from the 
Health Care Fraud and Abuse Control Account, the Centers for 
Medicare & Medicaid Services, the Department of Health and 
Human Services Office of Inspector General, and the Department 
of Justice, to use funds for efforts to address fraud and abuse 
as described in section 1128C of the Social Security Act.

                Administration for Children and Families


  PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY SUPPORT 
                                PROGRAMS

    The Committee recommends $2,995,400,000 for the Child 
Support Enforcement and Family Support programs, which is 
$15,231,000 below the fiscal year 2017 enacted level and the 
same as the fiscal year 2018 budget request. The Committee also 
recommends $1,400,000,000 in advance funding, as requested, for 
the first quarter of fiscal year 2019 to ensure timely payments 
for Child Support Enforcement programs. These programs support 
State-administered programs of financial assistance and 
services for low-income families to promote their economic 
security and self-sufficiency.

                   LOW INCOME HOME ENERGY ASSISTANCE

    The Committee recommends $3,390,304,000 for the Low Income 
Home Energy Assistance Program, which is the same as the fiscal 
year 2017 enacted level and $3,390,304,000 above the fiscal 
year 2018 budget request. Within the amount available for 
formula grants, the Committee recommends up to $2,988,000 for 
technical assistance, training, and monitoring of program 
activities.

                     REFUGEE AND ENTRANT ASSISTANCE

    The Committee recommends $1,022,811,000 for Refugee and 
Entrant Assistance programs, which is $651,880,000 below the 
fiscal year 2017 enacted level and $433,944,000 below the 
fiscal year 2018 budget request.
    The Office of Refugee Resettlement (ORR) programs are 
designed to help refugees, asylees, Cuban and Haitian entrants, 
and trafficking victims become employed and self-sufficient. 
These programs also provide for care of unaccompanied immigrant 
children in Federal custody and victims of torture.
    The Committee recognizes the responsibilities of the 
Federal government for the care of unaccompanied children while 
in Federal custody. The Committee supports policies that are in 
the best interest of the child while in the custody of the U.S. 
Department of Homeland Security and when subsequently 
transferred to the Department of Health and Human Service's 
Office of Refugee Resettlement (ORR). The Committee expects ORR 
to coordinate closely with U.S. Immigration and Customs 
Enforcement (ICE) on the transfer to ICE of unaccompanied 
children who turn 18 while in ORR custody.
    Within the total, the Committee recommends the following:

------------------------------------------------------------------------
                                                            FY 2018
                   Budget Activity                         Committee
------------------------------------------------------------------------
Transitional and Medical Services....................       $320,000,000
Victims of Trafficking...............................         18,755,000
Refugee Support Services.............................        175,321,000
Unaccompanied Children...............................        498,000,000
Victims of Torture...................................         10,735,000
------------------------------------------------------------------------

    Healthcare Costs Related to Illegal Immigration.--The 
Committee requests an update to the report submitted to 
Congress by the Department of Health and Human Services 
pursuant to this heading as it appeared in the explanatory 
statement accompanying division H of the Consolidated 
Appropriations Act, 2016 (P.L. 114-113).
    National Human Trafficking Training and Assistance 
Center.--The Committee directs the Administration for Children 
and Families to increase funding for the National Human 
Trafficking Hotline.

   PAYMENTS TO STATES FOR THE CHILD CARE AND DEVELOPMENT BLOCK GRANT

    The Committee recommends $2,860,000,000 for the 
discretionary portion of the Child Care and Development Fund, 
the Child Care and Development Block Grant, which is $4,000,000 
above the fiscal year 2017 enacted level and $99,000,000 above 
the fiscal year 2018 budget request. The Child Care and 
Development Block Grant provides funds according to a formula 
to States, territories, and Tribes to provide financial 
assistance to help low-income working families and families 
engaged in training or education activities access child care 
and to improve the quality of child care for all children.

                      SOCIAL SERVICES BLOCK GRANT

    The Committee recommends $1,700,000,000 for the Social 
Services Block Grant, which is the same as the fiscal year 2017 
enacted level and $1,700,000,000 above the fiscal year 2018 
budget request. States receive grants by formula. States have 
the flexibility to determine what services and activities are 
supported, provided they are targeted at a broad set of goals, 
including reducing or eliminating poverty, achieving or 
maintaining self-sufficiency, and preventing neglect, abuse, or 
exploitation of children and adults.

                CHILDREN AND FAMILIES SERVICES PROGRAMS

    The Committee recommends $11,181,500,000 for Children and 
Families Services programs, which is $112,868,000 below the 
fiscal year 2017 enacted level and $977,207,000 above the 
fiscal year 2018 budget request. The Children and Families 
Services programs fund activities serving children, youth, 
families, the developmentally disabled, Native Americans, 
victims of child abuse and neglect and domestic violence, and 
other vulnerable populations.
    The Committee recommends the following amounts:

------------------------------------------------------------------------
                                                            FY 2018
                   Budget Activity                         Committee
------------------------------------------------------------------------
Programs for Children, Youth, and Families:
Head Start...........................................     $9,275,000,000
Preschool Development Grants.........................        250,000,000
Runaway/Homeless Youth...............................        101,980,000
Abuse of Runaway Youth Prevention....................         17,141,000
State Child Abuse Prevention.........................         25,310,000
Discretionary Child Abuse Prevention.................         33,000,000
Community-based Child Abuse Prevention...............         39,764,000
Child Welfare Services...............................        268,735,000
Child Welfare Training...............................         17,984,000
Adoption Opportunities...............................         39,100,000
Adoption Incentives..................................         37,943,000
Social Services/Income Maintenance Research..........          6,512,000
Native American Programs.............................         52,050,000
Community Services:
    Community Services Block Grant...................        600,000,000
    Community Economic Development...................         10,000,000
    Rural Community Facilities.......................          7,500,000
Domestic Violence Hotline............................          8,750,000
Family Violence/Battered Women's Shelters............        151,000,000
Independent Living Training Vouchers.................         43,257,000
Disaster Human Services Case Management..............          1,864,000
Program Direction....................................        194,610,000
------------------------------------------------------------------------

Head Start

    The Committee recommends $9,275,000,000 for the Head Start 
program, which is $21,905,000 above the fiscal year 2017 
enacted level and $106,905,000 above the fiscal year 2018 
budget request. Within the total for Head Start, the Committee 
recommends a cost-of-living adjustment and includes $25,000,000 
for the Designation Renewal System. Within the total for Head 
Start, the Committee recommends $640,000,000 for Early Head 
Start-Child Care Partnership grants, which is the same as the 
fiscal year 2017 enacted level and $5,000,000 above the fiscal 
year 2018 budget request.
    The Committee is concerned about closures and 
consolidations of Head Start centers that have resulted from a 
number of re-competitions across the country in recent years. 
The Committee strongly encourages HHS to consider the 
consequences of Head Start program closures, reductions, and 
consolidations have on the ability of children and families to 
access Head Start services, particularly in rural areas. 
Transportation barriers can lead to increased absenteeism and 
missed work for families. In the event of a Head Start center 
closure, reduction, or consolidation, the Committee encourages 
the Office of Head Start to work with the local grantees to 
consider the impact on children, and encourage grantees to 
provide transportation for children who are displaced to a new 
Head Start center that is more than 15 miles from the center in 
which they were enrolled during the previous school year.

Preschool Development Grants

    The Committee recommends $250,000,000 for Preschool 
Development Grants, which is the same as the fiscal year 2017 
enacted level and $250,000,000 above the fiscal year 2018 
budget request. This program provides grants to States to build 
State and local capacity to provide preschool for 4-year-olds 
from low-and moderate-income families. Research confirms that 
high-quality preschool improves school readiness and long-term 
academic success of children by supporting their academic and 
social-emotional skills. Support for this grant is an important 
step to building a globally competitive 21st century workforce.

Child Abuse Discretionary Activities

    Infant-Toddler Court Teams.--The Committee continues 
funding to for a National resource center to preserve, 
disseminate, and amplify the work of the Quality Improvement 
Center (QIC) for Research-based Infant-Toddler Court Teams by 
providing training and technical assistance in support of such 
court teams' efforts across the country. This funding should 
help to build upon and continue the work of sites established 
through the QIC initiative, which have brought together the 
court system, child welfare agencies, health professionals, and 
community leaders to improve current practices in the child 
welfare system and make better-informed decisions on behalf of 
the child.

Native American Programs

    The Committee recommends $52,050,000 for Native American 
Programs, which is the same as the fiscal year 2017 enacted 
level and $2,145,000 above the fiscal year 2018 budget request.
    Within the total, the Committee recommendation includes 
$12,000,000 for Native American language preservation 
activities, including the requested $3,000,000 for Generation 
Indigenous, which focuses on improving Native American language 
instruction across the educational continuum. The Committee 
provides not less than $4,000,000 for language immersion 
programs as authorized by section 803C(b)(7)(A)-(C) of the 
Native American Programs Act, as amended by the Esther Martinez 
Native American Language Preservation Act of2006. The Committee 
strongly encourages the Administration for Children and 
Families (ACF) to give priority to grantees with rigorous 
immersion programs.

Community Services Programs

    Community Services Block Grant.--The Committee recommends 
$600,000,000 for the Community Services Block Grant, which is 
$115,000,000 below the fiscal year 2017 enacted level and 
$600,000,000 more than the fiscal year 2018 budget request.
    Community Economic Development.--The Committee provides 
$10,000,000 for Community Economic Development grants, which is 
$9,883,000 below the fiscal year 2017 enacted level and 
$10,000,000 above the fiscal year 2018 budget request. 
Community Economic Development is a Federal grant program 
funding Community Development Corporations that address the 
economic needs of individuals and families with low income 
through the creation of sustainable business development and 
employment opportunities. CED awards funds to private, non-
profit organizations that are community development 
corporations, including faith-based organizations, and Tribal 
and Alaskan Native organizations. The Committee directs the 
Administration for Children and Families to issue a funding 
opportunity announcement prioritizing applications from rural 
areas with high rates of poverty, unemployment, and substance 
abuse.
    Rural Community Facilities.--The Committee recommends 
$7,500,000 for the Rural Community Facilities program, which is 
the same as the fiscal year 2017 enacted level, and $7,500,000 
more than the fiscal year 2017 budget request. Grantees work 
with small communities on drinking water and wastewater issues.

Family Violence Prevention and Battered Women's Shelters

    The Committee recommends $151,000,000 for the Family 
Violence Prevention and Battered Women's Shelters programs, 
which is the same as the fiscal year 2017 enacted level and the 
fiscal year 2018 budget request. The Family Violence Prevention 
and Services Act programs provide funding to support the 
prevention of incidents of family violence, domestic violence, 
and dating violence, and provide the immediate shelter and 
supportive services for adult and youth victims (and their 
dependents).

                   PROMOTING SAFE AND STABLE FAMILIES

    The Committee recommends $325,000,000 in mandatory funds 
for the Promoting Safe and Stable Families program, which is 
the same as the fiscal year 2017 enacted level and $20,000,000 
below the fiscal year 2018 budget request. The Committee also 
recommends $59,765,000 in discretionary funds for this program, 
which is the same as the fiscal year 2017 enacted level and the 
fiscal year 2018 budget request. This program enables each 
State to operate a coordinated program of family preservation 
services, community-based family support services, time-limited 
reunification services, and adoption promotion and support 
services. States receive funds based on their share of children 
in all States receiving food stamp benefits.

                PAYMENTS FOR FOSTER CARE AND PERMANENCY

    The Committee recommends $6,225,000,000 for payments to 
States for foster care and adoption assistance, which is 
$461,000,000 more than the fiscal year 2017 enacted level and 
the same as the fiscal year 2018 budget request. The Committee 
also recommends an advance appropriation of $2,700,000,000 for 
the first quarter of fiscal year 2018 to ensure timely 
completion of first quarter grant awards.
    Within the total, the Committee recommends $5,537,000,000 
for the Foster Care program, which is $545,000,000 above the 
fiscal year 2017 enacted level and the same as the fiscal year 
2018 budget request. This program provides funds to States for 
foster care maintenance payments for children living in foster 
care. These funds also reimburse States for administrative 
costs to manage the program and training for staff and parents.
    Within the total, the Committee recommends $2,867,000,000 
for Adoption Assistance, which is $87,000,000 more than the 
fiscal year 2017 enacted level and the same as the fiscal year 
2018 budget request. This program provides funds to States to 
subsidize families who adopt children with special needs, such 
as older children, a member of a minority or sibling group, or 
children with physical, mental, and emotional disabilities. In 
addition, the program provides training for adoptive parents 
and State administrative staff. This annually appropriated 
entitlement provides alternatives to long, inappropriate stays 
in foster care by developing permanent placements with 
families.
    Within the total, the Committee recommends $181,000,000 for 
the Kinship Guardianship Assistance program, which is 
$29,000,000 more than the fiscal year 2017 enacted level and 
the same as the fiscal year 2018 budget request. This program 
provides subsidies to a relative taking legal guardianship of a 
child for whom being returned home or adoption are not 
appropriate permanency options.
    Finally, within the total, the Committee recommends 
$140,000,000 for the Independent Living program, which is the 
same as the fiscal year 2017 enacted level and the fiscal year 
2018 budget request. This program assists foster children age 
16 or older make successful transitions to independence. Funds 
support a variety of services, including educational 
assistance, career exploration, vocational training, job 
placement, life skills training, home management, health 
services, substance abuse prevention, preventive health 
activities, and room and board. Each State receives funds based 
on the number of children on whose behalf the State receives 
Federal Foster Care Payments.

                  Administration for Community Living


                 AGING AND DISABILITY SERVICES PROGRAMS

    The Committee recommends a total program level of 
$2,237,224,000 for the Administration for Community Living 
(ACL), which is $243,409,000 above the fiscal year 2017 enacted 
program level and $385,774,000 above the fiscal year 2018 
budget request. The Committee recommends funding for the Senior 
Medicare Patrol Program, and provides this funding under the 
Health Care Fraud and Control Abuse Account.

Home and Community-Based Supportive Services

    The Committee recommends $350,224,000 for Home and 
Community-Based Supportive Services, which is the same as the 
fiscal year 2017 enacted level and $3,161,000 above the fiscal 
year 2018 budget request. This program provides formula grants 
to States and territories to fund a wide range of social 
services that enable seniors to remain independent in their 
homes for as long as possible.

Preventive Health Services

    The Committee recommends $19,848,000 for Preventive Health 
Services, which is the same as the fiscal year 2017 enacted 
level and $38,000 above the fiscal year 2018 budget request. 
This program funds activities that help seniors remain healthy 
and avoid chronic diseases.

Protection of Vulnerable Older Americans

    The Committee recommends $20,658,000 for activities to 
protect vulnerable older Americans, which is the same as the 
fiscal year 2017 enacted level and $39,000 above the fiscal 
year 2018 budget request. These programs provide grants to 
States for protection of vulnerable older Americans through the 
Long-Term Care Ombudsman and Prevention of Elder Abuse and 
Neglect programs.

Family Caregiver Support Services

    The Committee recommends $150,586,000 for the National 
Caregiver Support program, which is the same as the fiscal year 
2017 enacted level and $286,000 above the fiscal year 2018 
budget request. This program supports a multifaceted support 
system in each State for family caregivers.

Native American Caregiver Support Services

    The Committee recommends $7,556,000 for the Native American 
Caregiver Support program, which is the same as the fiscal year 
2017 enacted level and $39,000 above the fiscal year 2018 
budget request. 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 
disabilities.

Congregate and Home-Delivered Nutrition Services

    The Committee recommends a total of $837,753,000 for senior 
nutrition. The Committee recommends $450,342,000 for Congregate 
Nutrition Services, which is the same as the fiscal year 2017 
enacted level and $2,852,000 above the fiscal year 2018 budget 
request. The Committee recommends $227,342,000 for Home-
Delivered Meal Services, which is the same as the fiscal year 
2017 enacted level and $1,430,000 above the fiscal year 2018 
budget request. The Committee recommends $160,069,000 for the 
Nutrition Services Incentives program, which is the same as the 
fiscal year 2017 enacted level and $304,000 above the fiscal 
year 2018 budget request. These programs help older Americans 
remain healthy and independent in their communities by 
providing meals and related services in a variety of settings 
(including congregate facilities such as senior centers) and 
via home-delivery to older adults who are homebound due to 
illness, disability, or geographic isolation.

Native American Nutrition and Supportive Services

    The Committee recommends $31,208,000 for Native American 
Nutrition and Supportive Services, which is the same as the 
fiscal year 2017 enacted level and $109,000 above the fiscal 
year 2018 budget request. This program provides grants to 
Tribes to promote the delivery of nutrition and home and 
community-based supportive services to Native American, Alaskan 
Native, and Native Hawaiian elders.

Aging Network Support Activities

    The Committee recommends $9,961,000 for the Aging Network 
Support Activities, which is the same as the fiscal year 2017 
enacted level and $19,000 above the fiscal year 2018 budget 
request. This program supports activities that expand public 
understanding of aging and the aging process.
    Holocaust Survivor's Assistance.--Within funding for the 
Aging Network Support Activities, the Committee provides not 
less than $3,000,000 for Holocaust Survivor's Assistance. This 
program provides supportive services for aging Holocaust 
survivors living in the United States.

Alzheimer's Disease Services

    The Committee recommends $19,500,000 for the Alzheimer's 
Disease Services programs, which is the same as the 2016 
enacted program level and $10,000 above the fiscal year 2018 
budget request. These programs provide competitive matching 
grants to a limited number of States to encourage program 
innovation and coordination of public and private services for 
people with Alzheimer's disease and their families.
    The Committee accepts the Administration's proposal to 
consolidate funding for Alzheimer's disease programs into one 
more flexible program authorized under Title IV of the Older 
Americans Act.

Lifespan Respite Care

    The Committee recommends $3,360,000 for Lifespan Respite 
Care, which is the same as the fiscal year 2017 enacted level 
and $6,000 above the fiscal year 2018 budget request. The 
program focuses on easing the burdens of caregiving by 
providing grants to eligible State organizations to improve the 
quality of, and access to, respite care for family caregivers.

Elder Falls

    The Committee recommends $5,000,000 for the Elder Falls 
program, which is the same as the fiscal year 2017 enacted 
level and the fiscal year 2018 budget request. Fall prevention 
grants support the promotion and dissemination of prevention 
tools delivered in community settings.

Chronic Disease Self-Management Program

    The Committee recommends $5,000,000 for Chronic Disease 
Self-Management program, which is $3,000 below the fiscal year 
2017 enacted level and the same as the fiscal year 2018 budget 
request. This program supports grants to States for low-cost, 
evidence-based prevention models that use state-of-the-art 
techniques to help those with chronic conditions address issues 
related to the management of their disease.

Elder Rights Support Activities

    The Committee recommends $11,874,000 for Elder Rights 
Support Activities, which is $2,000,000 below the fiscal year 
2017 enacted level and $23,000 above the fiscal year 2018 
budget request. This program supports efforts that provide 
information, training, and technical assistance to legal and 
aging services organizations towards the end of preventing and 
detecting elder abuse and neglect.

Aging and Disability Resource Centers

    The Committee recommends $6,119,000 for Aging and 
Disability Resource Centers, which is the same as the fiscal 
year 2017 enacted level and $12,000 above the fiscal year 2018 
budget request. These centers provide information, counseling 
and access for individuals to learn about the services and 
support options available to seniors and the disabled so they 
may retain their independence.

Senior Community Service Employment Program

    The Committee transfers the Senior Community Service 
Employment Program (SCSEP) from the Department of Labor to the 
Administration for Community Living. The Committee recommends 
$300,000,000 for the administrative and operational costs of 
SCSEP, which is $100,000,000 below the fiscal year 2017 enacted 
level and $300,000,000 above the fiscal year 2018 budget 
request. This program supports low-income seniors in community 
service positions.

State Health Insurance Program

    Due to funding constraints, the Committee recommends no 
funding for the State Health Insurance program, which is 
$47,115,000 below the fiscal year 2017 enacted level and the 
same as the fiscal year 2018 budget request. Other Federal 
programs provide similar services.

Paralysis Resource Center

    The Committee recommends $6,700,000 for the Paralysis 
Resource Center, which is the same as the fiscal year 2017 
enacted level and $6,700,000 above the fiscal year 2018 budget 
request. The Paralysis Resource Center offers activities and 
services aimed at increasing independent living for people with 
paralysis and related mobility impairments, and supporting 
integration into the physical and cultural communities in which 
they live.

Limb Loss Resource Center

    The Committee recommends $2,500,000 for the Limb Loss 
Resource Center, which is the same as the fiscal year 2017 
enacted level and $2,500,000 above the fiscal year 2018 budget 
request. The Limb Loss Resource Center supports a variety of 
programs and services for those living with limb loss, 
including a national peer support program, educational events, 
training for consumers and healthcare professionals, and 
information and referral services.

Traumatic Brain Injury

    The Committee recommends $9,321,000 for the Traumatic Brain 
Injury program, which is the same as the fiscal year 2017 
enacted level and $6,159,000 above the fiscal year 2017 budget 
request. The program provides grants to States for the 
development of a comprehensive, coordinated family and person-
centered service system at the state and community level for 
individuals who sustain a traumatic brain injury.

Developmental Disabilities State Councils

    The Committee recommends $73,000,000 for State Councils on 
Developmental Disabilities, which is the same as the fiscal 
year 2017 enacted level and $73,000,000 above the fiscal year 
2018 budget request. The State Councils work to develop, 
improve and expand the system of services and supports for 
people with developmental disabilities.

Partnerships for Innovation, Inclusion, and Independence

    The Committee does not consolidate the State Councils on 
Developmental Disabilities, State Independent Living Councils, 
and State Advisory Boards on Traumatic Brain Injury. The 
Committee recognizes the unique role played by each program and 
believes consolidation into one program will not serve the 
needs of people living with a disability.

Developmental Disabilities Protection and Advocacy

    The Committee recommends $38,734,000 for Developmental 
Disabilities Protection and Advocacy, which is the same as the 
2017 enacted level and $74,000 above the fiscal year 2018 
budget request. This formula grant program provides funding to 
States to establish and maintain protection and advocacy 
systems to protect the legal rights of persons with 
developmental disabilities.
    The Committee recognizes that the Americans with 
Disabilities Act (ADA) encourages states to administer services 
for people with intellectual/developmental disabilities (I/DD) 
``in the most integrated setting appropriate to the needs of 
qualified individuals with disabilities.'' As a result of 
enactment of the ADA and the Supreme Court decision in Olmstead 
v. L.C. (1999), there has been a National trend towards 
deinstitutionalization, whereby individuals have been 
encouraged to move out of State-run and other Federally-funded, 
certified facilities and into residential settings in their 
respective communities. However, the Committee is aware that 
many family members and legal guardians of individuals residing 
in these facilities have been pressured to move their loved 
ones into the community against their wishes. The Committee is 
concerned about the adequacy of community-based housing and the 
lack of specialized care and support services available in 
them, the pace of transfer, higher rates of abuse and mortality 
in community settings, and the adequacy of opportunities for 
residents to express views and preferences throughout the 
process.
    The Committee fully supports the ADA's goal of enabling 
people with I/DD to receive services ``in the most integrated 
setting appropriate to the[ir] needs.'' However, the Committee 
also notes that Olmstead held that the ADA does not condone or 
require removing individuals from institutional settings when 
they are unable to handle or benefit from a community-based 
setting and that the ADA does not require the imposition of 
community-based treatment on patients who do not desire it. 
Congress endorsed the same principle in the Developmental 
Disabilities (DD) Act of 2000. The Committee strongly urges the 
DD Act programs (state developmental disabilities councils, 
protection and advocacy systems and university centers for 
excellence in developmental disabilities) to continually 
consult with parents and guardians of those individuals within 
these facilities. The Committee urges the Administration on 
Community Living to monitor this matter and to include an 
update on the efforts to ensure compliance with bill language 
requiring notification in the fiscal year 2019 Congressional 
Justification.
    The Committee strongly urges the Department to ensure that 
DD Act programs properly account for the needs and desires of 
patients, their families, and caregivers, and the importance of 
affording patients the proper setting for their care, into 
their enforcement of the ADA.

Voting Access for Individuals with Disabilities

    The Committee recommends $4,963,000 for Voting Access for 
Individuals with Disabilities program, which is the same as the 
fiscal year 2017 enacted level and $9,000 above the fiscal year 
2018 budget request.
    The Voting Access for Individuals with Disabilities program 
authorized by the Help America Vote Act provides formula grants 
to ensure full participation in the electoral process for 
individuals with disabilities, including registering to vote, 
casting a vote, and accessing polling places.

Developmental Disabilities Projects of National Significance

    The Committee recommends $7,600,000 for Developmental 
Disabilities Projects of National Significance, which is 
$2,400,000 below the fiscal year 2017 enacted level and the 
same as the fiscal year 2018 budget request. This program funds 
grants and contracts that develop new technologies and 
demonstrate innovative methods to support the independence, 
productivity, and integration of the disabled into the 
community.

University Centers for Excellence in Developmental Disabilities

    The Committee recommends $38,619,000 for University Centers 
for Excellence in Developmental Disabilities, which is the same 
as the fiscal year 2017 enacted level and $73,000 above the 
fiscal year 2018 budget request.

Independent Living

    The Committee recommends $101,183,000 for the Independent 
Living program, of which $22,878,000 is for the Independent 
Living State Grants program and $78,305,000 is for the Centers 
for Independent Living program. This funding level is the same 
as the fiscal year 2017 enacted level and $23,027,000 above the 
fiscal year 2018 budget request. Independent Living programs 
maximize the leadership, empowerment, independence and 
productivity of individuals with disabilities.

National Institute on Disability, Independent Living, and 
        Rehabilitation Research

    The Committee recommends $103,970,000 for the National 
Institute on Disability, Independent Living, and Rehabilitation 
Research, which is the same as the fiscal year 2017 enacted 
level and $8,843,000 above the fiscal year 2018 budget request. 
The National Institute on Disability, Independent Living, and 
Rehabilitation Research serves to generate knowledge and 
promote its effective use to enhance the abilities of people 
with disabilities to perform activities of their choice in the 
community and to expand society's capacity to provide full 
opportunities for its citizens with disabilities.

Assistive Technology

    The Committee recommends $34,000,000 for Assistive 
Technology, which is the same as the fiscal year 2017 enacted 
level and $2,061,000 above the fiscal year 2018 budget request. 
Of this amount, the Committee provides $2,000,000 for 
competitive grants to support existing and new alternative 
financing programs that provide for the purchase of assistive 
technology (AT) devices. The Committee intends for this funding 
to support the expansion of existing programs and the creation 
of new programs that allow greater access to affordable 
financing to help people with disabilities purchase the 
specialized technologies required to live independently, to 
succeed at school and work and to live active and productive 
lives. Programs that have previously received funding are 
eligible to compete but must report on how the prior funding 
has been used, including the number of loans extended and 
individuals served, funding leveraged, and asset development 
programs created. The Committee intends for applicants to 
incorporate credit-building activities into their programs, 
including financial education and information about other 
possible funding sources. Successful applicants must emphasize 
consumer choice and control and build programs that will 
provide financing for the full array of AT devices and services 
and ensure that all people, regardless of type of disability or 
health condition, age, level of income, and residence have 
access to the program. Assistive Technology programs maximize 
the ability of individuals with disabilities of all ages and 
their family members, guardians, advocates, and authorized 
representatives to obtain AT devices and AT services.

Program Administration

    The Committee recommends $37,987,000 for Program 
Administration, which is $2,076,000 below the fiscal year 2017 
enacted level and the same as the fiscal year 2018 budget 
request. This funding supports Federal administrative costs 
associated with administering ACL programs.

                        Office of the Secretary


                    GENERAL DEPARTMENTAL MANAGEMENT

    The Committee recommends a program level total of 
$350,346,000 for General Departmental Management, which is 
$175,111,000 below the fiscal year 2017 enacted level and 
$11,620,000 below the fiscal year 2018 budget request. Of the 
funds provided, $57,465,000 shall be derived from evaluation 
set-aside funds available under section 241 of the Public 
Health Service Act, which is $7,363,000 below the fiscal year 
2017 enacted level and the same as the fiscal year 2018 budget 
request.
    This appropriation supports activities that are associated 
with the Secretary's roles as policy officer and general 
manager of the Department of Health and Human Services. The 
Office of the Secretary also implements administration and 
Congressional directives, and provides assistance, direction 
and coordination to the headquarters, regions, and field 
organizations of the department. In addition, this funding 
supports the Office of the Surgeon General and several other 
health promotion and disease prevention activities that are 
centrally administered.

Office of the Assistant Secretary for Health

    Breastfeeding.--The Committee recognizes the importance of 
breast milk in improving health outcomes for babies and mothers 
and requests HHS to report to the Committee on the impact of 
recommended breastfeeding rates on health outcomes and 
healthcare costs. The report should examine the impact of 
clinically recommended breastfeeding rates on associated 
Medicaid expenditures, urgent care costs, and direct and 
indirect medical costs, including workplace productivity and 
employee retention. The Committee also directs the Secretary to 
ensure that pregnant women have access to guidance on 
nutritional advice based on the latest scientific research on 
the health and cost benefits of human milk.
    Chronic Fatigue Syndrome (CFS).--The Committee supports the 
CFS Advisory Committee and encourages HHS agencies to partner 
with the medical community and other stakeholders to ensure 
access to clinical care and expert medical providers and Food 
and Drug Administration approved treatments to better address 
the needs of over one million Americans suffering from CFS.
    Embryo Adoption Awareness Campaign.--The Committee 
recommends $1,000,000 for the Embryo Adoption Awareness 
Campaign, the same as the fiscal year 2017 enacted level and 
the budget request. These funds will be used to educate 
Americans about the existence of frozen human embryos 
(resulting from in-vitro fertilization), which may be available 
for donation/adoption to help other couples build their 
families. The Committee includes bill language permitting these 
funds also to be used to provide medical and administrative 
services to individuals adopting embryos, deemed necessary for 
such adoptions, consistent with the Code of Federal 
Regulations.
    Evidence-Based Programming.--The Committee is concerned 
about the uneven capacity of HHS operating divisions to apply 
and to build evidence that will improve program effectiveness. 
The Committee believes that ASPE can play a central role in 
improving evaluation and evidence-based policymaking across the 
Department by helping all HHS components develop capacity to 
meet the standards set forth in the Administration on Children 
and Families' Evaluation Policy. The Committee encourages ASPE 
to help operating divisions adopt cost-effective approaches to 
building evidence through use of innovative grant designs that 
support partnerships between service delivery projects and 
researchers; by leveraging emerging opportunities to use linked 
data to measure performance and conduct comprehensive, rigorous 
evaluations at a reasonable cost; and by partnering with 
philanthropic organizations that focus on improving the use of 
rigorous research to inform policy.
    Global Health.--The Committee requests an update on how the 
CDC, Food and Drug Administration (FDA), Biomedical Advanced 
Research and Development Authority (BARDA), and NIH--including 
the National Center for Advancing Translational Science--
jointly coordinate global health research activities with 
specific measurable metrics used to track progress and 
collaboration toward shared health goals.
    Indian Hospital Facilities.--The Committee continues to be 
concerned by the poor quality of facilities operated by HHS in 
Indian country. The Committee is aware that funding from the 
Nonrecurring Expenses Fund has been planned for facility 
upgrades in these hospitals, and strongly supports this effort. 
The Committee directs the Secretary to prioritize obligations 
for these facilities and expects obligation of such funds as 
quickly as possible in order to continue progress on improving 
these structures. The Committee requests an update within 45 
days of enactment of this Act on all obligations from the 
Nonrecurring Expenses Fund.
    Opioid Response.--The Committee believes that the Federal 
response to the opioid epidemic will be most effective if 
resources made available through the Comprehensive Addiction 
and Recovery Act and related programs are directed to 
strategies that are backed by strong evidence or to innovative 
and promising approaches that will be rigorously evaluated to 
learn their impact. In implementing new and existing programs 
that address the opioid epidemic, HHS is urged to utilize 
evidence-based policymaking principles, tools, and program 
designs such as those disseminated by the Evidence-Based 
Policymaking Collaborative. The Committee encourages HHS to 
collaborate with outside researchers and philanthropic 
organizations that focus on improving the use of rigorous 
research to inform policy.
    Pulmonary Hypertension (PH).--The Committee remains 
concerned that most PH patients are not diagnosed for many 
years until the condition has reached a catastrophic stage, 
which leads to greatly increased mortality and the need for 
costly and dramatic medical interventions. There are many 
effective therapies for early-stage PH and HHS is encouraged to 
work collaboratively with the patient and professional 
community to prepare recommendations to improve early diagnosis 
and treatment of PH.
    Sexual Risk Avoidance.--The Committee provides $20,000,000 
in budget authority for sexual risk avoidance programs, which 
is $5,000,00 above the fiscal year 2017 level and the fiscal 
year 2018 budget request.
    In implementing these funds, it is the intent of the 
Committee that HHS provide substantive and practical technical 
assistance to grantees so they place meaningful emphasis on 
Sexual Risk Avoidance (SRA) in all educational messaging to 
teens. The Committee notes that such technical assistance 
should be provided in the following venues: during National and 
regional conferences, webinars and one-on-one conversations 
with funded projects. The Committee further intends that SRA-
credentialed experts consult with grantees and HHS staff with 
oversight of these programs on methodologies and best practices 
in SRA for teens. The Committee also encourages all operating 
divisions at HHS that implement or inform youth programs to 
implement consistently a public health model that stresses risk 
avoidance or works to return individuals to a lifestyle without 
risk, particularly as it relates to sexual risk.
    Vector-Borne Disease Research.--A number of agencies across 
the Federal government are engaged in various facets of vector-
borne disease research and control. In an effort to foster 
greater coordination, collaboration and transparency across 
agency lines, the Committee encourages the Secretary to 
establish a coordinating office to facilitate and expedite the 
government's response to vector-borne disease threats, 
including combating the spread of disease through innovative 
vector control technologies.

Office of Minority Health

    The Committee provides $45,250,000 for the Office of 
Minority Health (OMH), which is $11,420,000 below the fiscal 
year 2017 enacted level and $11,312,000 below the budget 
request. The OMH works with U.S. Public Health Service agencies 
and other agencies of the Department to address the health 
status and quality of life for racial and ethnic minority 
populations in the United States. OMH develops and implements 
new policies; partners with States, Tribes, and communities 
through cooperative agreements; supports research, 
demonstration, and evaluation projects; and disseminates 
information.
    Hepatitis.--The Committee continues to be concerned about 
the HIV/AIDS epidemic in the African American and Hispanic 
communities, and is aware of the concurrent high co-infection 
rate for hepatitis C. The Committee commends OMH for their 
advancements in the treatment and management of hepatitis. The 
Committee asks that the agency provide the Committee with a 
report that outlines the progress in continuing encouragement 
of community partnerships that promote awareness and outreach 
to improve testing, diagnosis, and treatment no later than 60 
days after enactment of this Act.
    Lupus.--The agreement continues to provide $2,000,000 for 
Lupus activities at OMH. The Committee continues to support the 
OMH National Health Education Lupus Program. The action plan 
will focus on fostering public-private and community 
partnerships, evaluating current minority clinical trial 
education and participation programs, and creating a research 
plan for new clinical trial education models in lupus. The 
Committee is encouraged by the research conducted by the OMH 
National Health Education Lupus Program and encourages OMH to 
optimize that research and utilize other resources in 
development to further support populations at highest risk; 
more specifically Hispanics, Native Americans, Asians and 
African Americans. The Committee recommends collaborating with 
the lupus community to expand the development of linguistically 
and culturally appropriate tools, resources and materials for 
these adults and children with lupus, their caregivers and 
health care providers.

Office of Women's Health

    The Committee includes $25,712,000 for the Office of 
Women's Health, which is $6,428,000 below the fiscal year 2017 
enacted level and the 2018 budget request.

Faith Based Center

    The Committee includes $1,299,000 for the Faith Based 
Center, the same as fiscal year 2017 enacted level and the 
fiscal year 2018 budget request.

                OFFICE OF MEDICARE HEARINGS AND APPEALS

    The Committee provides $112,381,000 for the Office of 
Medicare Hearings and Appeals, which is $5,000,000 above the 
fiscal year 2017 enacted level and $4,796,000 below the fiscal 
year 2018 budget request. This Office supports hearings at the 
administrative law judge level, the third level of Medicare 
claims appeals.
    Medicare Appeals Backlog.--The Committee is concerned with 
the size of the Medicare Appeals Backlog. The Committee 
supports the Office of Medicare Hearings and Appeals to take 
administrative actions that will reduce the number of cases 
awaiting a hearing with an Administrative Law Judge.

  OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION TECHNOLOGY

    The Committee provides $38,381,000 for the Office of the 
National Coordinator for Health Information Technology (ONC), 
which is $21,986,000 below the fiscal year 2017 enacted level 
and the same as the fiscal year 2018 budget request. ONC is the 
principal Federal entity charged with coordination of 
Nationwide efforts to implement and use the most advanced 
health information technology and the electronic exchange of 
health information.
    Patient Data Matching.--The Committee is aware that a 
challenge inhibiting the safe and secure electronic exchange of 
health information is the lack of a consistent approach to 
matching patient data. The Committee encourages ONC to engage 
with stakeholders on private-sector led initiatives to develop 
a coordinated strategy that will promote patient safety by 
accurately identifying patients to their health information.
    Prescription Drug Monitoring.--The Committee understands 
that the spread of the prescription drug epidemic throughout 
the Nation has made the creation, implementation, and use of 
State prescription drug monitoring programs (PDMPs) and their 
ability to operate in concert with electronic health record 
(EHR) and electronic prescribing (e-prescribing) systems more 
important than ever. The Committee encourages ONC to continue 
its support for pilot programs to find usability challenges 
among PDMP, EHR, and e-prescribing systems; develop and award 
challenge awards to private entities for health information 
technology innovation; and offer targeted technical assistance 
to help medical professionals use PDMP, EHR, and e-prescribing 
systems. The Committee further encourages ONC to collaborate 
and coordinate its efforts with partner agencies such as the 
Centers for Disease Control and Prevention and the Bureau of 
Justice Assistance in the Department of Justice.

                      OFFICE OF INSPECTOR GENERAL

    The Committee recommends $80,000,000 for the Office of 
Inspector General (OIG), which is the same as the fiscal year 
2017 enacted level and $11,915,000 above the fiscal year 2018 
budget request. In addition, within the Health Care Fraud and 
Abuse Control (HCFAC) program discretionary appropriations for 
fiscal year 2018, the Committee provides the OIG with 
$82,132,000. Mandatory appropriations for this office also are 
contained in the HCFAC program and the Health Insurance 
Portability and Accountability Act of 1996.
    Within the total provided, the Committee provides 
sufficient funding for the OIG to monitor HHS compliance with 
the provision that prohibits the use of Federal funding for 
lobbying campaigns. The Committee remains concerned that 
certain HHS operating divisions have skirted the prohibition on 
using taxpayer funding to lobby State and or local governments. 
As such, the Committee requests that the OIG monitor grantee 
activities to ensure that no taxpayer resources are used for 
lobbying.

                        OFFICE FOR CIVIL RIGHTS

    The Committee provides $38,798,000 for the Office for Civil 
Rights (OCR), which is the same as the fiscal year 2017 enacted 
level and $6,268,000 above the 2018 budget request. The OCR is 
responsible for enforcing civil rights statutes that prohibit 
discrimination in health and human services programs. OCR 
implements the civil rights laws through a compliance program 
designed to generate voluntary compliance among all HHS 
recipients.
    The Committee is concerned about reports of continued 
discrimination against persons with disabilities in organ 
transplant programs. Despite the Americans with Disabilities 
Act (ADA) and Section 504 of the Rehabilitation Act prohibiting 
discrimination on the basis of disability in organ 
transplantation, a number of States have found it necessary to 
enact laws to address continued barriers to receiving this 
lifesaving care. These barriers are reported to include medical 
professionals and transplant centers refusing to approve organ 
transplants for people with disabilities who may need help in 
order to follow complicated post-transplant treatment plans, or 
deciding that people with disabilities should be given a lower 
priority on waiting lists to receive an organ transplant. In 
coordination with HRSA, the Committee urges the Office for 
Civil Rights (OCR) to develop and issue guidance that clarifies 
the obligations of ADA- and Section 504-covered entities 
participating in the transplant process to provide equal access 
to their programs to individuals with disabilities. In 
developing such guidance, the Committee encourages OCR to 
consider prohibiting such covered entities from, among other 
things, denying medical services related to organ 
transplantation, refusing to refer an individual to a 
transplant center or other related specialist for the purpose 
of evaluation or receipt of an organ transplant, and refusing 
to place an individual on an organ transplant waiting list, or 
placement of the individual at a lower-priority position on the 
list than the position at which he or she would have been 
placed if not for his or her disability.

     RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS

    The Committee provides for retirement pay and medical 
benefits of Public Health Service Commissioned Officers, for 
payments under the Retired Serviceman's Family Protection Plan, 
and for medical care of dependents and retired personnel. Total 
costs are estimated to be $618,689,000 for fiscal year 2018, 
which is $11,719,000 below the fiscal year 2017 enacted level 
and the same as the fiscal year 2018 budget request.

            PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND

    The Committee provides $1,739,258,000 for the Public Health 
and Social Services Emergency Fund to support a comprehensive 
program to prepare for and respond to the health and medical 
consequences of all public health emergencies, including 
bioterrorism, and support the cybersecurity efforts of the 
Department of Health and Human Services. This amount is 
$221,300,000 above the fiscal year 2017 enacted level and 
$76,642,000 above the 2018 budget request.
    The Committee does not include the authority requested in 
the budget to create a Federal Emergency Response Fund. 
However, the Committee recognizes the benefit of allowing some 
flexibility to allow HHS to move more quickly in the event of a 
public health emergency. To address this issue, the Committee 
provides enhanced transfer authority to make it easier for HHS 
to direct resources where they are needed in the case of a 
public health emergency, such as an influenza pandemic.
    National Ebola Training and Education Center.--The 
Committee supports the continued efforts of the National Ebola 
Training and Education Center (NETEC). Supplemental funds to 
support NETEC were provided in P.L. 113-235.

Office of the Assistant Secretary for Preparedness and Response

    The Committee provides $1,424,928,000 for activities 
administered by the Office of the Assistant Secretary for 
Preparedness and Response (ASPR). This amount is $28,300,000 
above the fiscal year 2017 enacted level and $55,883,000 above 
the fiscal year 2018 budget request. ASPR is responsible for 
coordinating national policies and plans for medical and public 
health preparedness and for administering a variety of public 
health preparedness programs, including the National Disaster 
Medical System, the Hospital Preparedness Cooperative Agreement 
Grants Program, Project BioShield, and the Office of Biomedical 
Advanced Research and Development Authority.

Biomedical Advanced Research and Development Authority (BARDA)

    The Committee provides $520,000,000 for BARDA, which is 
$8,300,000 above fiscal year 2017 enacted level and the fiscal 
year 2018 budget request. In addition, the Committee provides 
$530,000,000 for Project BioShield, which is $20,000,000 above 
the fiscal year 2017 enacted level and the fiscal year 2018 
budget request. The funds support acquisitions of medical 
countermeasures (MCMs) to address Chemical, Biological, 
Radiological, and Nuclear (CBRN) threats.
    The Committee remains committed to ensuring the nation is 
adequately prepared against CBRN attacks. Public-private 
partnerships to develop MCMs are required to successfully 
prepare and defend the nation against these threats. The 
Committee supports the goal of market development where there 
is little or no commercial market. The funds allow for 
sustained management and funding of critical priorities, 
facilitate flexible and rapid response to emerging threats, and 
prevent the loss of resources from year to year, especially 
when the country is facing such tight budget constraints while 
threats persist.
    Pathogen Reduction Technology.--The Committee commends 
BARDA for taking the critical steps of supporting FDA-approved 
pathogen reduction technology in U.S. blood centers to ensure 
the safety of blood products being provided to patients and 
specifically for patients at risk for exposure to emerging 
pathogens. The Committee urges BARDA to continue funding the 
development of pathogen reduction technology.
    The Committee recommends $250,000,000 for the ASPR's 
pandemic influenza program, which is $178,000,000 above the 
fiscal year 2017 enacted level and $43,137,000 above the fiscal 
year 2018 budget request. This funding supports research and 
development of next-generation influenza MCMs, preparedness 
testing and evaluation, and stockpiling.

                           General Provisions


                   PREVENTION AND PUBLIC HEALTH FUND

    The Committee continues a provision that directs the 
transfer of the Prevention and Public Health (PPH) Fund. In 
fiscal year 2018, the level appropriated for the fund is 
$840,600,000 after accounting for sequestration. The agreement 
includes bill language in section 225 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:

------------------------------------------------------------------------
                                                            FY 2018
             Agency                 Budget Activity        Agreement
------------------------------------------------------------------------
CDC.............................  Breast Feeding              $8,000,000
                                   Grants (Hospitals
                                   Promoting
                                   Breastfeeding).
CDC.............................  Diabetes...........         72,000,000
CDC.............................  Epidemiology and            40,000,000
                                   Laboratory
                                   Capacity Grants.
CDC.............................  Healthcare                  12,000,000
                                   Associated
                                   Infections.
CDC.............................  Heart Disease and          107,950,000
                                   Stroke Prevention
                                   Program.
CDC.............................  Good Health and             16,000,000
                                   Wellness in Indian
                                   Country.
CDC.............................  Million Hearts               4,000,000
                                   Program.
CDC.............................  Preventive Health          160,000,000
                                   and Health
                                   Services Block
                                   Grant.
CDC.............................  Tobacco............        126,000,000
CDC.............................  Section 317                273,650,000
                                   Immunization
                                   Grants.
CDC.............................  Lead Poisoning              17,000,000
                                   Prevention.
CDC.............................  Early Care                   4,000,000
                                   Collaboratives.
------------------------------------------------------------------------

    Sec. 201. The Committee continues a provision to limit the 
amount available for official reception and representation 
expenses.
    Sec. 202. The Committee continues a provision to limit the 
salary of an individual through an HHS grant or other 
extramural mechanism to not more than the rate of Executive 
Level II.
    Sec. 203. The Committee continues a provision to prohibit 
the Secretary from using evaluation set-aside funds until the 
Committees on Appropriations of the House of Representatives 
and the Senate receive a report detailing the planned use of 
such funds.
    Sec. 204. The Committee modifies a provision regarding the 
enacted level for the PHS evaluation set-aside, reducing it to 
2.4 percent.

                          (TRANSFER OF FUNDS)

    Sec. 205. The Committee continues a provision permitting 
the Secretary of HHS to transfer up to one percent of any 
discretionary funds between appropriations, provided that no 
appropriation is increased by more than three percent by any 
such transfer to meet emergency needs. Notification must be 
provided to the Committees on Appropriations at the program, 
project, and activity level in advance of any such transfer.
    Sec. 206. The Committee continues the 60 day flexibility 
for National Health Service Corps contract terminations.
    Sec. 207. The Committee continues a provision to prohibit 
the use of Title X funds unless the applicant for the award 
certifies to the Secretary that it encourages family 
participation in the decision of minors to seek family planning 
services and that it provides counseling to minors on how to 
resist attempts to coerce minors into engaging in sexual 
activities.
    Sec. 208. The Committee continues a provision stating that 
no provider of services under Title X shall be exempt from any 
state law requiring notification or the reporting of child 
abuse, child molestation, sexual abuse, rape, or incest.
    Sec. 209. The Committee continues a provision related to 
the Medicare Advantage program.
    Sec. 210. The Committee continues a provision prohibiting 
funds from being used to advocate or promote gun control.
    Sec. 211. The Committee continues a provision to allow 
funding for HHS international HIV/AIDS and other infectious 
disease, chronic and environmental disease, and other health 
activities abroad to be spent under the State Department Basic 
Authorities Act of 1956.
    Sec. 212. The Committee continues a provision authorizing 
certain international health activities.

                          (TRANSFER OF FUNDS)

    Sec. 213. The Committee continues a provision to provide 
the Director of NIH, jointly with the Director of the Office of 
AIDS Research, the authority to transfer up to three percent of 
human immunodeficiency virus funds.

                          (TRANSFER OF FUNDS)

    Sec. 214. The Committee continues a provision that makes 
NIH funds for human immunodeficiency virus research available 
to the Office of AIDS Research.
    Sec. 215. The Committee continues a provision granting 
authority to the Office of the Director of the NIH to enter 
directly into transactions in order to implement the NIH Common 
Fund for medical research and permitting the Director to 
utilize peer review procedures, as appropriate, to obtain 
assessments of scientific and technical merit.
    Sec. 216. The Committee continues a provision clarifying 
that funds appropriated to NIH institutes and centers may be 
used for minor repairs or improvements to their buildings, up 
to $3,500,000 per project with a total limit for NIH of 
$45,000,000.

                          (TRANSFER OF FUNDS)

    Sec. 217. The Committee continues a provision transferring 
one percent of the funding made available for National 
Institutes of Health National Research Service Awards to the 
Health Resources and Services Administration.
    Sec. 218. The Committee continues the Biomedical Advanced 
Research and Development Authority ten year contract authority.
    Sec. 219. The Committee continues a provision relating to 
publicly accessible information regarding uses of funds under 
section 4002 of Public Law 111-148.
    Sec. 220. The Committee continues language requiring HHS to 
include certain information concerning the number of full-time 
Federal employees and contractors working on the Affordable 
Care Act in the fiscal year 2018 budget request.
    Sec. 221. The Committee continues specific report 
requirements for CMS's marketplaces activities in the fiscal 
year 2018 budget request.
    Sec. 222. The Committee continues certain Congressional 
notification requirements.
    Sec. 223. The Committee continues a provision prohibiting 
CMS Program Management account from being used to support risk 
corridor payments.
    Sec. 224. The Committee continues a provision requiring HHS 
to submit an analysis of the impact of section 2713 of the PHS 
Act on discretionary programs.
    Sec. 225. The Committee continues language directing the 
spending of the Prevention and Public Health fund.
    Sec. 226. The Committee includes a new provision 
prohibiting funds from being used for Title X family planning 
activities.
    Sec. 227. The Committee continues a provision relating to 
breast cancer screening.
    Sec. 228. The Committee includes a new provision relating 
to indirect cost negotiated rates.
    Sec. 229. The Committee includes a new provision 
prohibiting funds from being used for the Navigators program.

                   TITLE III--DEPARTMENT OF EDUCATION


                    EDUCATION FOR THE DISADVANTAGED

    The Committee recommends $15,953,790,000 for the Education 
for the Disadvantaged programs, which is $190,000,000 below the 
fiscal year 2017 enacted level and $393,768,000 below the 
fiscal year 2018 budget request. Of the total amount available, 
$5,035,990,000 is appropriated for fiscal year 2018 for 
obligation on or after July 1, 2018 and $10,841,177,000 is 
appropriated for fiscal year 2018 for obligation on or after 
October 1, 2018. This appropriation account includes 
compensatory education programs authorized under title I and 
subpart 2 of part B of title II of the Elementary and Secondary 
Education Act of 1965 (ESEA) and section 418A of the Higher 
Education Act.

Grants to Local Educational Agencies

    For fiscal year 2018, the Committee recommends 
$15,459,802,000 for Title I grants to Local Educational 
Agencies (LEAs, or school districts), which is the same as the 
fiscal year 2017 enacted level and $421,656,000 below the 
fiscal year 2018 budget request. Title I grants provide 
supplemental education funding for activities that offer extra 
academic support to help students from low-income families and 
in high-poverty schools to meet State academic standards.
    Of the amounts provided for Title I programs, 
$6,459,401,000 is available for Basic Grants to LEAs, which is 
the same as the fiscal year 2017 enacted level and $28,344,000 
above the fiscal year 2018 budget request. Basic grants are 
awarded to school districts with at least 10 low-income 
children who make up more than two percent of the school-age 
population.
    Within the amount for Title I Basic Grants, up to 
$5,000,000 is made available to the Secretary of Education on 
October 1, 2017, to obtain annually-updated LEA-level poverty 
data from the Bureau of the Census.
    The Committee recommends $1,362,301,000 for Title I 
Concentration Grants, which is the same as the fiscal year 2017 
enacted level and the fiscal year 2018 budget request. 
Concentration Grants target funds to school districts in which 
the number of low-income children exceeds 6,500 or 15 percent 
of the total school-age population.
    The Committee recommends $3,819,050,000 for Title I 
Targeted Grants, which is the same as the fiscal year 2017 
enacted level and $275,000,000 above the fiscal year 2018 
budget request. Targeted Grants provide higher payments to 
school districts with high numbers or percentages of low-income 
students.
    The Committee recommends $3,819,050,000 for Title I 
Education Finance Incentive Grants (EFIGs), which is the same 
as the fiscal year 2017 enacted level and $275,000,000 above 
the fiscal year 2018 budget request. EFIGs provide payments to 
States and school districts that incorporate ``equity'' and 
``effort'' factors to improve the equity of State funding 
systems.
    The Committee is aware of the budget request proposal to 
include up to $1,000,000,000 for grants to local educational 
agencies to implement weighted per-pupil funding systems, 
including open enrollment systems that allow students to enroll 
in a public school selected by their parents. However, the 
Committee notes that such a program has not been authorized. 
Accordingly, the Committee has not provided funding for such a 
program within this bill. Funding for this approach will be 
considered should it be authorized in law.

Comprehensive Literacy Development Grants

    The Committee recommends no funding for Comprehensive 
Literacy Development Grants, which is $190,000,000 below the 
fiscal year 2017 enacted level and the same as the fiscal year 
2018 budget request. The Committee notes that the current 
cohort of grantees will complete projects in fiscal year 2017, 
so program termination will not impact funding for any existing 
grantees.

Innovative Approaches to Literacy

    The Committee recommends $27,000,000 for Innovative 
Approaches to Literacy, the same as the 2017 enacted level and 
$27,000,000 above the fiscal year 2018 budget request. This 
program provides competitive grants to support school 
libraries.

State Agency Programs: Migrant

    The Committee recommends $374,751,000 for the State Agency 
Program for Migrant Education, which is the same as the fiscal 
year 2017 enacted level and $712,000 above the fiscal year 2018 
budget request. This program supports special educational and 
related services for children of migrant agricultural workers 
and fishermen, including: (1) supplementary academic education; 
(2) remedial or compensatory instruction; (3) English for 
limited English proficient students; (4) testing; (5) guidance 
counseling; and (6) other activities to promote coordination of 
services across States for migrant children whose education is 
interrupted by frequent moves.

State Agency Programs: Neglected and Delinquent

    For the State Agency Program for Neglected and Delinquent 
Children, the Committee recommends $47,614,000, which is the 
same as the fiscal year 2017 enacted level and $91,000 above 
the fiscal year 2018 budget request. This formula grant program 
supports educational services for children and youth under age 
21 in State-run institutions, attending community day programs, 
and in correctional facilities. A portion of these funds is 
provided for projects that support the successful re-entry of 
youth offenders into postsecondary and vocational programs.

Special Programs for Migrant Students

    The Committee recommends $44,623,000 for the Special 
Programs for Migrant Students, which is the same as the fiscal 
year 2017 enacted level and $85,000 above the fiscal year 2018 
budget request. These programs make grants to colleges, 
universities, and nonprofit organizations to support 
educational programs designed for students who are engaged in 
migrant and other seasonal farm work. The High School 
Equivalency Program (HEP) recruits migrant students age 16 and 
over and provides academic and support services to help those 
students obtain a high school equivalency certificate and 
subsequently to gain employment or admission to a postsecondary 
institution or training program. The College Assistance Migrant 
Program (CAMP) provides tutoring and counseling services to 
first-year, undergraduate migrant students and assists those 
students in obtaining student financial aid for their remaining 
undergraduate years. The Committee recommendation assumes the 
allocation of funds between HEP and CAMP as proposed by the 
Administration.

                               IMPACT AID

    The Committee recommends $1,333,603,000 for Federal Impact 
Aid programs, which is $5,000,000 above the fiscal year 2017 
enacted level and $97,168,000 above the fiscal year 2018 budget 
request. This account supports payments to school districts 
affected by Federal activities, such as those that educate 
children whose families are connected with the military or who 
live on Indian land.

Basic Support Payments

    The Committee recommends $1,194,233,000 for Basic Support 
Payments to LEAs, which is $5,000,000 above the fiscal year 
2017 enacted level and $28,221,000 above the fiscal year 2018 
budget request. Basic Support Payments compensate school 
districts for lost tax revenue and are made on behalf of 
Federally-connected children, such as children of members of 
the uniformed services who live on Federal property.

Payments for Children with Disabilities

    The Committee recommends $48,316,000 for Payments for 
Children with Disabilities, which is the same as the fiscal 
year 2017 enacted level and $92,000 above the fiscal year 2018 
budget request. These payments compensate school districts for 
the increased costs of serving Federally-connected children 
with disabilities.

Facilities Maintenance

    The Committee recommends $4,835,000 for Facilities 
Maintenance, which is the same as the fiscal year 2017 enacted 
level and $9,000 above the fiscal year 2018 budget request. 
These capital payments are authorized for maintenance of 
certain facilities owned by the Department.

Construction

    The Committee recommends $17,406,000 for the Construction 
program, which is the same as the fiscal year 2017 enacted 
level and $33,000 above the fiscal year 2018 budget request. 
This program provides competitive grants for building and 
renovating school facilities to school districts that educate 
Federally-connected students or have Federally-owned land.

Payments for Federal Property

    The Committee recommends $66,813,000 for Payments for 
Federal Property, which is the same as the fiscal year 2017 
enacted level and $66,813,000 above the fiscal year 2018 budget 
request. Funds are awarded to school districts to compensate 
for lost tax revenue as the result of Federal acquisition of 
real property since 1938.

                      SCHOOL IMPROVEMENT PROGRAMS

    The Committee recommends $2,261,064,000 for School 
Improvement Programs, which is $2,147,503,000 below the fiscal 
year 2017 enacted level and $1,563,833,000 above the fiscal 
year 2018 budget request. The School Improvement account 
includes programs authorized under Titles I, II, IV, VI, and 
VII of the ESEA; the McKinney-Vento Homeless Assistance Act; 
Title IV-A of the Civil Rights Act; section 203 of the 
Educational Technical Assistance Act of 2002; and section 105 
of the Compact of Free Association Amendments Act of 2003.

Supporting Effective Instruction State Grants

    The Committee recommends no funding for Supporting 
Effective Instruction State Grants, which is $2,055,830,000 
below the fiscal year 2017 enacted level and the same as the 
fiscal year 2018 budget request. This program duplicates 
activities that may be supported with other funds, has not 
demonstrated success in contributing to improved teacher 
quality and makes formula-based allocations to school districts 
that often are too small to have a meaningful impact on student 
outcomes.

Supplemental Education Grants

    The Committee recommends $16,699,000 for Supplemental 
Education Grants to the Federated States of Micronesia and the 
Republic of the Marshall Islands, which is the same as the 
fiscal year 2017 enacted level and $32,000 above the fiscal 
year 2018 budget request. The Compact of Free Association 
Amendments Act of 2003 (P.L. 108-188) authorizes these entities 
to receive funding for general education assistance. The 
Committee recommendation includes a consolidated amount for 
Supplemental Education Grants because the underlying statute 
determines the allocation between Micronesia and the Marshall 
Islands.

21st Century Community Learning Centers

    The Committee recommends $1,000,000,000 for 21st Century 
Community Learning Centers, which is $191,673,000 below the 
fiscal year 2017 enacted level and $1,000,000,000 above the 
fiscal year 2018 budget request. This program awards formula 
grants to States, which in turn distribute funds on a 
competitive basis to local school districts, nonprofit 
organizations, and other public entities. Funds may be used to 
provide activities that complement and reinforce the regular 
school-day program for participating students and may also fund 
local activities that are included as part of an expanded 
learning time program. The Committee notes that $1,000,000,000 
is the level authorized for this program by the ESSA.

State Assessments

    The Committee recommends $369,100,000 for State 
Assessments, which is the same as the fiscal year 2017 enacted 
level and $8,181,000 below the fiscal year 2018 budget request. 
Funds are available to develop and implement academic standards 
and assessments. The program includes a set-aside for audits to 
identify and eliminate low-quality or duplicative assessments.

Education for Homeless Children and Youth

    The Committee recommends $77,000,000 for the Education for 
Homeless Children and Youth program, which is the same as the 
fiscal year 2017 enacted level and $7,133,000 above the fiscal 
year 2018 budget request. The Committee recognizes that without 
an education, these at-risk children and youth are unlikely to 
obtain the skills they need to become productive adults 
contributing to the economy and their communities. Grants are 
allocated to States in proportion to the total each State 
receives under the Title I program.

Training and Advisory Services

    The Committee recommends $6,575,000 for Training and 
Advisory Services authorized by Title IV-A of the Civil Rights 
Act, which is the same as the fiscal year 2017 enacted level 
and $12,000 above the fiscal year 2018 budget request. Title 
IV-A authorizes technical assistance and training services for 
school districts to address problems associated with 
desegregation on the basis of race, sex, or national origin. 
The Department awards three-year grants to regional Equity 
Assistance Centers (EACs) located in each of the 10 Department 
of Education regions. The EACs provide services to school 
districts upon request. Typical activities include 
disseminating information on successful education practices and 
legal requirements related to nondiscrimination on the basis of 
race, sex, and national origin in educational programs.

Education for Native Hawaiians

    The Committee recommends $33,397,000 for the Education for 
Native Hawaiian program, which is the same as the fiscal year 
2017 level and $33,397,000 above the fiscal year 2018 budget 
request. Funds are used to provide competitive awards for 
supplemental education services to the Native Hawaiian 
population. The Committee does not include bill language 
allowing these funds to be used for construction.

Alaska Native Education Equity

    The Committee recommends $32,453,000 for the Alaska Native 
Education Equity program, which is the same as the fiscal year 
2017 level and $32,453,000 above the fiscal year 2018 budget 
request. Funds are used to provide competitive awards for 
supplemental education services to the Alaska Native 
population. The Committee does not include bill language 
allowing these funds to be used for construction.

Rural Education

    The Committee recommends $175,840,000 for Rural Education 
programs, which is the same as the fiscal year 2017 enacted 
level and $334,000 above the fiscal year 2018 budget request. 
There are two programs to assist rural school districts with 
improving teaching and learning in their schools: the Small, 
Rural Schools Achievement program, which provides funds to 
rural districts that serve a small number of students; and the 
Rural and Low-Income Schools program that provides funds to 
rural districts that serve concentrations of poor students, 
regardless of the number of students served by the district. 
Funds appropriated for Rural Education shall be divided equally 
between these two programs.

Comprehensive Centers

    The Committee recommends $50,000,000 for Comprehensive 
Centers, which is the same as the fiscal year 2017 enacted 
level and $1,347,000 above the fiscal year 2018 budget request. 
This grant program currently supports 22 comprehensive centers, 
including 15 regional centers that provide training, technical 
assistance, and professional development to build State 
capacity to provide high-quality education to all students. The 
remaining seven centers specialize in particular content areas. 
The Committee includes bill language directing the Secretary to 
ensure that the Bureau of Indian Education (BIE) has access to 
services provided under this section.

Student Support and Academic Enrichment State Grants

    The Committee recommends $500,000,000 for Student Support 
and Academic Enrichment (SSAE) State Grants, which is 
$100,000,000 above the fiscal year 2017 enacted level and 
$500,000,000 above the fiscal year 2018 budget request. The 
ESSA eliminated several narrowly-focused competitive grant 
programs and replaced them with this new formula grant program. 
States and school districts have flexibility to focus these 
resources on locally-determined priorities to provide students 
with access to a well-rounded education, including rigorous 
coursework, and to improve school conditions and the use of 
technology.
    STEM and Computer Science Education.--The Committee notes 
that funds available under this program may be used by States 
and school districts to provide or strengthen instruction in 
STEM fields, including computer science. The Committee 
recognizes the importance of funding Pre K-12 computer science 
education to address national security, and ensure American 
competitiveness. Supporting education in the science, 
technology, engineering, arts, and mathematics fields, 
particularly computer science, is critical to ensure that our 
nation continues to lead in innovation. As computer science is 
a basic skill in the 21st century global economy, the Committee 
encourages the Department to support Pre K-12 computer science 
education to schools across the country.
    Non-Cognitive Factors.--The Committee notes that programs 
designed to support non-cognitive factors such as critical 
thinking skills, social skills, work ethic, problem solving, 
and community responsibility are an eligible use of funds under 
SSAE grants supporting a well-rounded education.

                            INDIAN EDUCATION

    The Committee recommends $164,939,000 for Indian Education, 
which is the same as the fiscal year 2017 enacted level and 
$21,274,000 above the fiscal year 2018 budget request. This 
account supports programs authorized by part A of title VI of 
the ESEA.

Grants to Local Educational Agencies

    The Committee recommends $100,381,000 for Grants to Local 
Educational Agencies, which is the same as the fiscal year 2017 
enacted level and $191,000 above the fiscal year 2018 budget 
request. This program provides assistance through formula 
grants to school districts and schools supported or operated by 
the Bureau of Indian Education. The purpose of this program is 
to improve elementary and secondary school programs that serve 
Indian students, including preschool children. Grantees must 
develop a comprehensive plan and ensure that the programs they 
carry out will help Indian students reach the same challenging 
standards that apply to all students. This program supplements 
the regular school program to help Indian children sharpen 
their academic skills, bolster their self-confidence, and 
participate in enrichment activities that would otherwise be 
unavailable.

Special Programs for Indian Children

    The Committee recommends $57,993,000 for Special Programs 
for Indian Children, which the same as the fiscal year 2017 
enacted level and $20,072,000 above the fiscal year 2018 budget 
request. These programs make competitive awards to improve the 
quality of education for American Indian students. The program 
also funds the American Indian Teacher Corps and the American 
Indian Administrator Corps to recruit and support American 
Indians as teachers and school administrators.

National Activities

    The Committee recommends $6,565,000 for National 
Activities, which is the same as the fiscal year 2017 enacted 
level and $1,011,000 above the fiscal year 2018 budget request. 
Funds under this authority support (1) research, evaluation and 
data collection to provide information about the educational 
status of Indian students and the effectiveness of Indian 
education programs; (2) grants to support Native language 
immersion schools and programs; and (3) grants to tribes for 
education administrative planning, development, and 
coordination.
    State-Tribal Education Partnership.--The Committee 
recommends continued funding for the State-Tribal Education 
Partnership (STEP) program. This program makes grants to tribes 
to build capacity to assume certain State responsibilities for 
the administration of ESEA programs. Indian educators have long 
called for Tribal-State-Federal partnerships to involve Indian 
Tribes in educating their students and to improve American 
Indian education outcomes. STEP programs have, and will 
continue to, assist State and Tribal governments to continue 
delivering the highest quality education for Indian students.
    Language Immersion Program.--Within the total for National 
Activities, the Committee continues funding for a Native 
American and Alaska Native Language Immersion Program, the same 
as the fiscal year 2018 budget request. This program, which was 
authorized in ESSA, will make grants to maintain and promote 
the use of Native languages, support Native language education 
and development, and provide professional development to 
teachers.

                       INNOVATION AND IMPROVEMENT

    The Committee recommends $747,904,000 for Innovation and 
Improvement programs, which is $139,671,000 below the fiscal 
year 2017 enacted level and $460,122,000 below the fiscal year 
2018 budget request. This appropriation account includes 
programs authorized under portions of Titles II and IV of the 
ESEA.

Education Innovation and Research

    The Committee recommends no funding for the Education 
Innovation and Research program. This amount is $100,000,000 
below the fiscal year 2017 enacted level and $370,000,000 below 
the fiscal year 2018 budget request. This program makes 
competitive grants to support the replication and scaling-up of 
evidence-based education innovations. Given budget constraints, 
the Committee has chosen instead to focus resources on core 
formula grant programs.
    The Committee is aware of the budget request proposal to 
include up to $250,000,000 for grants to local educational 
agencies to implement a program of awarding scholarships to 
students from low-income families to attend a private school 
selected by their parents. However, the Committee notes that 
such a program has not been authorized. Accordingly, the 
Committee has not provided funding for such a program within 
this bill. Funding for this approach will be considered should 
a program be authorized.

Teacher and School Leader Incentive Grants

    The Committee recommends $200,000,000 for the Teacher and 
School Leader Incentive Grants program, which is the same as 
the fiscal year 2017 enacted level and $437,000 above the 
fiscal year 2018 budget request. This program provides grants 
to States, school districts, and partnerships to develop, 
implement, improve, or expand human capital management systems 
or performance-based compensation systems in schools.

American History and Civics Academies

    The Committee recommends no funding for American History 
and Civics Academies, $1,815,000 below the fiscal year 2017 
enacted level and the same as the fiscal year 2018 budget 
request. This program reaches only a very limited number of 
teachers and students since an academy may select no more than 
300 teachers or students for participation.

American History and Civics National Activities

    The Committee recommends $1,700,000 for American History 
and Civics National Activities, the same as the fiscal year 
2017 enacted level and $1,700,000 above the fiscal year 2018 
budget request. The Committee recognizes the importance of 
improving the quality of instruction in American history, 
civics, and geography, particularly for schools in underserved 
rural and urban communities. In recognition of the fact that no 
one size fits all in effective education, and that a variety of 
approaches are required to meet the range of student and 
community needs, these competitive grants will support multiple 
grantees in making available a menu of innovative, effective 
approaches to teaching American history, civics and government, 
and geography. These validated approaches will be available to 
schools and school districts for their consideration and 
voluntary use, based on the approach that best meets the needs 
of the students and community.

Supporting Effective Educator Development

    The Committee recommends $42,000,000 for the Supporting 
Effective Educator Development (SEED) grant program, 
$23,000,000 below the fiscal year 2017 level and the same as 
the fiscal year 2018 budget request. SEED provides competitive 
grants to Institutions of Higher Education (IHEs), national 
nonprofit organizations, BIE, and partnerships to support 
alternative certification and other professional development 
and enrichment activities for teachers, principals, and other 
school leaders. Funds are included to support fully 
continuation costs for grants made in prior years.

School Leader Recruitment and Support

    The Committee recommends no funding for School Leader 
Recruitment and Support, which is $14,500,000 below the fiscal 
year 2017 level and the same as the budget request. This 
program supports a small number of grantees and has minimal 
national impact. While school leadership is important, other 
Federal funds are available to support improved leadership in 
high-need schools.

Charter Schools Grants

    The Committee recommends $370,000,000 for Charter Schools 
Grants, which is $27,828,000 above the fiscal year 2017 enacted 
level and $130,000,000 below the fiscal year 2018 budget 
request.
    In exchange for a commitment to increase student 
achievement, charter schools are exempt from many statutory and 
regulatory requirements. The Charter Schools Grants program 
awards grants to State Educational Agencies (SEAs) or, if a 
State's SEA chooses not to participate, to charter school 
developers to support the development and initial 
implementation of public charter schools. State Facilities 
Incentive Grants and Credit Enhancement for Charter School 
Facilities awards help charter schools obtain adequate school 
facilities. These programs work in tandem to support the 
development and operation of charter schools.
    The Committee recommends an allocation of funds within this 
program that aligns with ESSA.

Magnet Schools Assistance

    The Committee recommends $96,463,000 for the Magnet Schools 
Assistance program, which is $1,184,000 below the fiscal year 
2017 enacted level and the same as the fiscal year 2018 budget 
request. This program makes competitive grants to support the 
establishment and operation of magnet schools that are a part 
of a court-ordered or Federally-approved voluntary 
desegregation plan.

Ready to Learn Programming

    The Committee recommends $25,741,000 for Ready to Learn 
Programming, which is the same as the fiscal year 2017 enacted 
level and $25,741,000 above the fiscal year 2018 budget 
request. This program supports the development and distribution 
of educational video programming for preschool and elementary 
school children and their parents, caregivers, and teachers.

Arts in Education

    The Committee recommends no funding for Arts in Education, 
$27,000,000 below the fiscal year 2017 level and the same as 
the fiscal year 2018 budget request. This program provides 
competitive grants to support professional development and the 
development of instructional materials and programming that 
integrate the arts into the curricula. States and school 
districts may use funds from the SSAE grants to support arts 
education.

Javits Gifted and Talented Education

    The Committee recommends $12,000,000 for the Javits Gifted 
and Talented Education Program, which is the same as the fiscal 
year 2017 enacted level and $12,000,000 above the fiscal year 
2018 budget request. This program has limited impact, and the 
Department can support research on gifted and talented 
education through other Institute of Education Science 
programs.

                 SAFE SCHOOLS AND CITIZENSHIP EDUCATION

    The Committee recommends $138,000,000 for Safe Schools and 
Citizenship Education programs, which is $13,254,000 below the 
fiscal year 2017 enacted level and $3,143,000 above the fiscal 
year 2018 budget request. This appropriation account includes 
programs authorized under parts of Title IV of the ESEA.

Promise Neighborhoods

    The Committee recommends $60,000,000 for Promise 
Neighborhoods, which is $13,254,000 below the fiscal year 2017 
enacted level and the same as the fiscal year 2018 budget 
request. Promise Neighborhoods supports grants to nonprofit, 
community-based organizations for the development of 
comprehensive neighborhood programs designed to combat the 
effects of poverty and improve educational outcomes for 
children and youth, from birth through college.

School Safety National Activities

    The Committee recommends $68,000,000 for School Safety 
National Activities, which is the same as the fiscal year 2017 
enacted level and $6,857,000 below the fiscal year 2018 budget 
request. This program includes a variety of competitive grants 
that aim to increase students' safety and well-being.

Full-Service Community Schools

    The Committee recommends $10,000,000 for Full-Service 
Community Schools, which is the same as the fiscal year 2017 
level and $10,000,000 above the fiscal year 2018 budget 
request. This program makes competitive grants to support 
school-based comprehensive services for students, families, and 
communities.

                      ENGLISH LANGUAGE ACQUISITION

    The Committee recommends $737,400,000 for the English 
Language Acquisition program, which is the same as the fiscal 
year 2017 enacted level and $1,402,000 above the fiscal year 
2018 budget request. Of this amount provided for the 2018-2019 
academic year, funds are appropriated for obligation on or 
after July 1, 2018 and available through September 30, 2018.
    This program provides formula grants to States to serve 
Limited English Proficient (LEP) students. Grants are based on 
each State's share of the National LEP and recent immigrant 
student population. Funds under this account also support 
professional development to increase the pool of teachers 
prepared to serve LEP students as well as evaluation 
activities. The bill continues language to calculate all State 
awards based on a three-year average of data from the American 
Community Survey.
    The Committee is interested in information on the 
effectiveness of English Learner (EL) programs in delivering 
adequate services and accommodations to qualified students and 
requests the Department to include information on outcomes in 
English language acquisition and proficiency levels in math and 
reading nationwide, disaggregated, to the extent possible, by 
the major race and ethnicity categories in the Decennial 
Census, in the fiscal year 2019 Congressional Justification.

                           SPECIAL EDUCATION

    The Committee recommends $13,251,691,000 for programs 
authorized under the Individuals with Disabilities Education 
Act (IDEA) for children with disabilities. This is $187,333,000 
above the fiscal year 2017 enacted level and $309,565,000 above 
the fiscal year 2018 budget request. Of the total amount 
available, $1,864,818,000 is available for obligation on July 
1, 2018, and $11,164,824,000 is available for obligation on 
October 1, 2018. These grants help States and localities pay 
for a free appropriate education for 6.7 million students with 
disabilities aged 3 through 21 years.

Grants to States

    The Committee recommends $12,202,848,000 for Part B Grants 
to States, which is $200,000,000 above the fiscal year 2017 
enacted level and $312,646,000 above the fiscal year 2018 
budget request. This program provides formula grants to assist 
States in meeting the costs of providing special education and 
related services to children with disabilities. States 
generally transfer most of the funds to LEAs; however, they can 
reserve some funds for program monitoring, technical 
assistance, and other related activities. In order to be 
eligible for funds, States must make free appropriate public 
education available to all children with disabilities.
    The Committee continues to include bill language excluding 
any amount by which a State's allocation is reduced for failure 
to meet the maintenance of effort threshold from being used to 
calculate the State's allocation under section 611(d) of the 
IDEA in subsequent years. The Committee also continues to 
include bill language directing the Secretary to distribute any 
reduction in a State's allocation under said section to all 
other States based on the formula established under section 
611(d), excluding those States that are penalized.

Preschool Grants

    The Committee recommends $368,238,000 for Preschool Grants, 
which is the same as the fiscal year 2017 enacted level and 
$700,000 above the fiscal year 2018 budget request. These funds 
provide additional assistance to States to help them make free, 
appropriate public education available to children with 
disabilities ages three through five.

Grants for Infants and Families

    The Committee recommends $458,556,000 for Grants for 
Infants and Families, which is the same as the fiscal year 2017 
enacted level and $872,000 above the fiscal year 2018 budget 
request. These funds provide additional assistance to States to 
help them make free, appropriate public education available to 
children with disabilities from birth through age two.

IDEA National Activities

    The Committee recommends $222,049,000 for the IDEA National 
Activities program, which is $12,667,000 below the fiscal year 
2017 enacted level and $4,653,000 below the fiscal year 2018 
budget request. The IDEA National Activities programs support 
State efforts to improve early intervention and education 
results for children with disabilities.
    State Personnel Development.--The Committee recommends 
$38,630,000 for State Personnel Development, which is the same 
as the fiscal year 2017 enacted level and $2,921,000 below the 
fiscal year 2018 budget request. This program supports grants 
to States to assist with improving personnel preparation and 
professional development related to early intervention and 
educational and transition services that improve outcomes for 
students with disabilities. Funds are included to fully support 
continuation costs for grants made in prior years.
    Technical Assistance and Dissemination.--The Committee 
recommends $44,261,000 for Technical Assistance and 
Dissemination, which is $12,667,000 below the fiscal year 2017 
enacted level and the same as the fiscal year 2018 budget 
request. This program provides funding for technical 
assistance, demonstration projects, and information 
dissemination. These funds support efforts by State and local 
educational agencies, IHEs, and other entities to build State 
and local capacity to make systemic changes and improve results 
for children with disabilities. Funds are included to fully 
support continuation costs for grants made in prior years.
    Personnel Preparation.--The Committee recommends 
$83,700,000 for Personnel Preparation, which is the same as the 
fiscal year 2017 enacted level and $159,000 above the fiscal 
year 2018 budget request. This program supports competitive 
awards to help address State-identified needs for qualified 
personnel to work with children with disabilities, and to 
ensure that those personnel have the necessary skills and 
knowledge to serve children with special needs. Awards focus on 
addressing the need for leadership and personnel to serve low-
incidence populations. Funds are included to fully support 
continuation costs for grants made in prior years.
    Parent Information Centers.--The Committee recommends 
$27,411,000 for Parent Information Centers, which is the same 
as the fiscal year 2017 enacted level and $52,000 above the 
fiscal year 2018 budget request. 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. 
Technical assistance is also provided under this program for 
developing, assisting, and coordinating centers receiving 
assistance under this program.
    Educational Technology, Media, and Materials.--The 
Committee recommends $28,047,000 for Educational Technology, 
Media, and Materials, which is the same as the fiscal year 2017 
enacted level and $1,943,000 below the fiscal year 2018 budget 
request. This program makes competitive awards to support the 
development, demonstration, and use of technology and 
educational media activities of educational value to children 
with disabilities. The Committee recognizes the ongoing 
progress made with the tools and services provided under this 
program that have allowed more than 440,000 students with 
disabilities free access to more than 515,000 books in 
digitally accessible formats. The Committee strongly encourages 
continued effort to expand this program's reach to K-12 
students in underserved areas.

                        REHABILITATION SERVICES

    The Committee recommends $3,562,582,000 for Rehabilitation 
Services, which is $26,993,000 above the fiscal year 2017 
enacted level and $426,000 below the fiscal year 2018 budget 
request. The programs in this account are authorized by the 
Rehabilitation Act of 1973 and the Helen Keller National Center 
Act.

Vocational Rehabilitation State Grants

    The Committee recommends $3,452,931,000 for Vocational 
Rehabilitation (VR) State Grants, which is $54,377,000 above 
the fiscal year 2017 enacted level and the same as the fiscal 
year 2018 budget request.
    This program supports basic vocational rehabilitation 
services through formula grants to the States. These grants 
support a wide range of services designed to help persons with 
physical and mental disabilities prepare for and engage in 
gainful employment to the extent of their capabilities. 
Emphasis is placed on providing vocational rehabilitation 
services to persons with the most significant disabilities. The 
Committee's recommendation provides the cost-of-living 
adjustment for Vocational Rehabilitation Grants to States, as 
authorized.

Client Assistance State Grants

    The Committee recommends $13,000,000 for Client Assistance 
State Grants, which is the same as the fiscal year 2017 enacted 
level and $25,000 above the fiscal year 2018 budget request. 
Client Assistance State Grants support services for eligible 
individuals and applicants of the VR State Grants program, and 
other programs, projects, and services funded under the 
Rehabilitation Act. These formula grants are used to help 
persons with disabilities overcome problems with the service 
delivery system and improve their understanding of services 
available to them under the Rehabilitation Act.

Training

    The Committee recommends $29,388,000 for the Training 
program, which is the same as the fiscal year 2017 enacted 
level and $743,000 below the fiscal year 2018 budget request. 
The program supports long-term and short-term training, in-
service personnel training, and training of interpreters for 
deaf persons. Projects in a broad array of disciplines are 
funded to ensure that skilled personnel are available to serve 
the vocational needs of persons with disabilities. Funds are 
included to fully support continuation costs for grants made in 
prior years.

Demonstration and Training Programs

    The Committee recommends $5,796,000 for Demonstration and 
Training Programs, which is the same as the fiscal year 2017 
enacted level and $11,000 above the fiscal year 2018 budget 
request. These programs authorize competitive grants to public 
and private organizations to support demonstrations, direct 
services, and related activities for persons with disabilities.

Protection and Advocacy of Individual Rights

    The Committee recommends $17,650,000 for Protection and 
Advocacy of Individual Rights, which is the same as the fiscal 
year 2017 enacted level and $34,000 above the fiscal year 2018 
budget request. Grants are awarded to entities that have the 
authority to pursue legal, administrative, and other 
appropriate remedies to protect and advocate for the rights of 
persons with disabilities.

Supported Employment State Grants

    The Committee recommends no funding for Supported 
Employment State Grants, which is $27,548,000 below the fiscal 
year 2017 enacted level and the same as the fiscal year 2018 
budget request. These formula grants assist States in 
developing collaborative programs with public agencies and 
nonprofit agencies for training and post-employment services 
leading to supported employment. Because supported employment 
is now an integral part of the vocational rehabilitation State 
grants program, there is no longer a need for a separate 
funding stream to ensure the provision of these services. This 
elimination will therefore reduce unnecessary administrative 
burden. The Committee expects State vocational rehabilitation 
agencies to continue to provide supported employment services 
in fiscal year 2018 to approximately the same number of 
individuals as they did previously.

Independent Living Services for Older Individuals Who Are Blind

    The Committee recommends $33,317,000 for Independent Living 
Services for Older Individuals Who Are Blind, which is the same 
as the fiscal year 2017 enacted level and $63,000 above the 
fiscal year 2018 budget request. Funds are distributed to 
States according to a formula based on the population of 
individuals who are 55 or older, and provide support for 
services to persons 55 years old or over whose severe visual 
impairment makes gainful employment extremely difficult to 
obtain, but for whom independent living goals are feasible.

Helen Keller National Center

    The Committee recommends $10,500,000 for the Helen Keller 
National Center for Deaf-Blind Youth and Adults, which is 
$164,000 above the fiscal year 2017 enacted level and $184,000 
above the fiscal year 2018 budget request. These funds are used 
for the operation of a National center that provides intensive 
services for deaf-blind individuals and their families at Sands 
Point, New York, and a network of ten regional offices that 
provide referral, counseling, transition services, and 
technical assistance to service providers.

           SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES

    The Committee recommends $224,447,000 for Special 
Institutions for Persons with Disabilities, which is $7,725,000 
above as the fiscal year 2017 enacted level and $8,137,000 
above the fiscal year 2018 budget request.

                 AMERICAN PRINTING HOUSE FOR THE BLIND

    The Committee recommends $26,431,000 for the American 
Printing House for the Blind, which is $1,000,000 above the 
fiscal year 2017 enacted level and $1,048,000 above the fiscal 
year 2018 budget request. This funding subsidizes the 
production of educational materials for legally blind persons 
enrolled in pre-college programs. The Printing House, which is 
chartered by the Commonwealth of Kentucky, manufactures and 
maintains an inventory of educational materials in accessible 
formats that are distributed free of charge to schools and 
States based on the number of blind students in each State. The 
Printing House also conducts research and field activities to 
inform educators about the availability of materials and how to 
use them.

               NATIONAL TECHNICAL INSTITUTE FOR THE DEAF

    The Committee recommends $70,016,000 for the National 
Technical Institute for the Deaf, which is the same as the 
fiscal year 2017 enacted level and $133,000 above the fiscal 
year 2018 budget request. Congress established the National 
Technical Institute for the Deaf in 1965 to provide a 
residential facility for postsecondary technical training and 
education for deaf persons with the purpose of promoting the 
employment of these individuals. The Institute also conducts 
applied research and provides training in various aspects of 
deafness. The Secretary of Education administers these 
activities through a contract with the Rochester Institute of 
Technology in Rochester, New York.

                          GALLAUDET UNIVERSITY

    The Committee recommends $128,000,000 for Gallaudet 
University, which is $6,725,000 above the fiscal year 2017 
enacted level and $6,956,000 above the fiscal year 2018 budget 
request.
    Gallaudet is a private, non-profit educational institution 
Federally chartered in 1864 providing elementary, secondary, 
undergraduate, and continuing education for deaf persons. In 
addition, the University offers graduate programs in fields 
related to deafness for deaf and hearing students, conducts 
research on deafness, and provides public service programs for 
deaf persons.

                 CAREER, TECHNICAL, AND ADULT EDUCATION

    The Committee recommends $1,720,686,000 for Career, 
Technical, and Adult Education programs, which is the same as 
the fiscal year 2017 enacted level and $244,245,000 above the 
fiscal year 2018 budget request. This account includes 
vocational education programs authorized by the Carl D. Perkins 
Career and Technical Education Act of 2006 and the Adult 
Education and Family Literacy Act (AEFLA).

Career and Technical Education: State Grants

    The Committee recommends $1,117,598,000 for Career and 
Technical Education: State Grants, which is the same as the 
fiscal year 2017 enacted level and $168,099,000 above the 
fiscal year 2018 budget request. Funds are made available for 
obligation on October 1, 2018.
    State Grants support a variety of career and technical 
education programs developed in accordance with the State plan. 
The Act focuses Federal resources on institutions with high 
concentrations of low-income students. The populations assisted 
by State Grants range from secondary students in pre-vocational 
courses to adults who need retraining to adapt to changing 
technological and labor markets. Funding for State Grants will 
continue support for state-of-the art career and technical 
training to approximately 6 million students in secondary 
schools and more than 4 million students in community and 
technical colleges.
    Maker Education.--The Committee recogmzes the need for 
increased maker education in career and technical education in 
addition to K-12 curriculum in response to the increasing 
reliance on tools such as 3D printers, laser cutters, desktop 
machines, and programs for digital design becoming more 
affordable. Maker education exposes students to hands on 
project based learning approaches that build critical skills 
needed to increase economic growth and encourages students to 
imagine, create, innovate, and collaborate through the process 
of manufacturing, testing and demonstrating their ideas. The 
Committee encourages the expansion of maker-spaces in schools, 
which are community spaces that provide access to tools, 
technology and knowledge for learners and entrepreneurs and 
result in the prototyping or creation of physical goods, and 
support the development of educational opportunities for 
personal growth, workforce training, and early stage business 
ventures.

National Programs

    The Committee recommends $7,421,000 for National Programs, 
which is the same as the fiscal year 2017 enacted level and 
$19,986,000 below the fiscal year 2018 budget request. This 
authority supports the conduct and dissemination of research in 
career and technical education. It also includes support for 
the National Centers for Research and Dissemination in Career 
and Technical Education and other discretionary research.

Adult Basic and Literacy Education State Grants

    The Committee recommends $581,955,000 for Adult Basic and 
Literacy Education State Grants, which is the same as the 
fiscal year 2017 enacted level and $96,106,000 above the fiscal 
year 2018 budget request. State formula grants, authorized 
under the AEFLA, support programs to enable all adults to 
acquire basic literacy skills, to enable those who so desire to 
complete secondary education, and to make available to adults 
the means to become more employable, productive, and 
responsible citizens.

Adult Education National Leadership Activities

    The Committee recommends $13,712,000 for National 
Leadership Activities, which is the same as the fiscal year 
2017 enacted level and $26,000 above the fiscal year 2018 
budget request. This program supports applied research, 
development, dissemination, evaluation, and program improvement 
efforts to strengthen the quality of adult education services.

                      STUDENT FINANCIAL ASSISTANCE

    The Committee recommends $24,198,210,000 for Student 
Financial Assistance programs, which is the same as the fiscal 
year 2017 enacted level and $1,265,584,000 above the fiscal 
year 2018 budget request.

Pell Grants

    The Committee recommends $22,475,352,000 for the Pell Grant 
program, which is the same as the fiscal year 2017 enacted 
level and $42,726,000 above the fiscal year 2018 budget 
request. These funds will support Pell grants to students for 
the 2018-2019 academic year.
    The Pell Grant program costs have come in below estimates 
for the past few years, resulting in a surplus of funding for 
the program. Because of this surplus, the Congressional Budget 
Office estimates that the budget authority provided in this 
bill is sufficient to maintain the discretionary portion of the 
maximum Pell Grant award at $4,860. Combined with mandatory 
funding streams, the maximum Pell Grant in 2018-2019 will be 
maintained at $5,920.
    Pell Grants help to ensure access to higher educational 
opportunities for low-and middle-income students by providing 
need-based financial assistance. Grants are determined 
according to a statutory formula, which considers income, 
assets, household size, and the number of family members in 
college, among other factors. Pell Grants are the foundation of 
Federal postsecondary student aid programs.

Federal Supplemental Educational Opportunity Grants

    The Committee recommends $733,130,000 for this program, 
which is the same as the fiscal year 2017 enacted level and 
$733,130,000 above the fiscal year 2018 budget request. 
Supplemental Educational Opportunity Grants (SEOG) provide 
funds to postsecondary institutions for need-based grants of up 
to $4,000 to undergraduate students, with priority given to 
students who are Pell-eligible. Approximately 71 percent of 
dependent recipients have annual family incomes under $30,000 
and nearly 76 percent of independent SEOG recipients have 
annual family incomes under $20,000. Institutions must 
contribute a 25 percent match toward their SEOG allocation.

Federal Work-Study

    The Committee recommends $989,728,000 for the Federal Work-
Study program, which is the same as the fiscal year 2017 
enacted level and $489,728,000 above the fiscal year 2018 
budget request. Federal Work-Study funds are provided through 
institutions to students who work part-time. The funds assist 
with paying for the cost of education. Approximately 3,300 
colleges and universities receive funding, according to a 
statutory formula, and may allocate it for job location and job 
development centers. Work-study jobs must pay at least the 
Federal minimum wage and institutions must provide 25 percent 
of student earnings.
    Within the total funding level for the Federal Work-Study 
program, the Committee recommends $8,390,000 for the Work 
Colleges program, which is the same as the fiscal year 2017 
enacted level. The Work Colleges program is authorized under 
section 448 of the HEA and supports institutions that require 
all resident students to participate in a work-learning 
program.

                       Student Aid Administration

    The Committee recommends $1,697,711,000 for the Student Aid 
Administration (SAA), which is $120,857,000 above the fiscal 
year 2017 enacted level and the same as the fiscal year 2018 
budget request. Programs administered under this account 
include Pell Grants, campus-based programs, Teacher Education 
Assistance for College and Higher Education grants, and Federal 
student loan programs.
    Salaries and Expenses.--Within the total provided for 
Student Aid Administration, the Committee recommends 
$680,711,000 for salaries and expenses, which $15,932,000 below 
the fiscal year 2017 enacted level and the same as the fiscal 
year 2018 budget request.
    Loan Servicing Activities.--Within the total provided for 
SAA, the Committee recommends $1,017,000,000 for Loan Servicing 
Activities, which is $136,789,000 above the fiscal year 2017 
enacted level and the same as the fiscal year 2018 budget 
request.

                            HIGHER EDUCATION

    The Committee recommends $2,038,126,000 for Higher 
Education programs, which is $17,313,000 below the fiscal year 
2017 enacted level and $492,821,000 above the fiscal year 2018 
budget request.

Strengthening Institutions

    The Committee recommends $86,534,000 for the Part A, 
Strengthening Institutions program, which is the same as the 
fiscal year 2017 enacted level and 86,534,000 above the fiscal 
year 2018 budget request. This program provides competitive 
grants for general operating subsidies to institutions with low 
average educational and general expenditures per student and 
significant percentages of low-income students. Funds may be 
used for faculty and academic program development, management, 
joint use of libraries and laboratories, acquisition of 
equipment, and student services.

Strengthening Hispanic-Serving Institutions

    The Committee recommends $107,795,000 for the Hispanic-
Serving Institutions program, which is the same as the fiscal 
year 2017 enacted level and $205,000 above the fiscal year 2018 
budget request. The Hispanic-Serving Institutions program 
provides operating subsidies to schools that serve at least 25 
percent Hispanic students. Funds may be used for faculty and 
academic program development, management, joint use of 
libraries and laboratories, acquisition of equipment, and 
student services.

Promoting Postbaccalaureate Opportunities for Hispanic Americans

    The Committee recommends $9,671,000 for the Promoting 
Postbaccalaureate Opportunities for Hispanic Americans program, 
which is the same as the fiscal year 2017 enacted level and 
$18,000 above the fiscal year 2018 budget request. This program 
provides expanded post baccalaureate educational opportunities 
for the academic attainment of Hispanic and low-income 
students. In addition, it expands academic offerings and 
enhances program quality at IHEs educating the majority of 
Hispanic college students.

Strengthening Historically Black Colleges and Universities

    The Committee recommends $244,694,000 for Strengthening 
Historically Black Colleges and Universities (HBCUs), which is 
the same as the fiscal year 2017 enacted level and $465,000 
above the fiscal year 2018 budget request. This program 
provides operating subsidies to accredited, historically black 
colleges and universities that were established prior to 1964, 
with the principal mission of educating black Americans. Funds 
are distributed through a formula grant based on the enrollment 
of Pell Grant recipients, number of graduates, and the number 
of graduates entering graduate or professional schools in which 
blacks are underrepresented.

Strengthening Historically Black Graduate Institutions

    The Committee recommends $63,281,000 for the Strengthening 
Historically Black Graduate Institutions program, which is the 
same as the fiscal year 2017 enacted level and $120,000 above 
the fiscal year 2018 budget request. The program provides five-
year grants to 18 postsecondary institutions that are specified 
in section 326(e)(1) of the Higher Education Act. Institutions 
may use funds to build endowments, provide scholarships and 
fellowships, and to assist students with the enrollment and 
completion of post baccalaureate and professional degrees.

Strengthening Predominantly Black Institutions

    The Committee recommends $9,942,000 for the Strengthening 
Predominantly Black Institutions (PBIs) program, which is the 
same as the fiscal year 2017 enacted level and $19,000 above 
the fiscal year 2018 budget request. This program provides 
grants to PBIs to increase their capacity to serve the academic 
needs of students.

Strengthening Asian American and Native American Pacific-Islander-
        Serving Institutions

    The Committee recommends $3,348,000 for the Asian American 
Pacific Islander program, which is the same as the fiscal year 
2017 enacted level and $6,000 above the fiscal year 2018 budget 
request. This program provides grants to undergraduate 
institutions that have an undergraduate student enrollment of 
at least 10 percent Asian American or Native American Pacific 
Islander.

Strengthening Alaska Native and Native Hawaiian-Serving Institutions

    The Committee recommends $13,802,000 for the Strengthening 
Alaska Native and Native Hawaiian-Serving Institutions program, 
which is the same as the fiscal year 2017 enacted level and 
$26,000 above the fiscal year 2018 budget request, to provide 
competitive grants to improve capacity to serve Alaska Native 
and Native Hawaiian students.

Native American Serving Non-Tribal Institutions

    The Committee recommends $3,348,000 for the Native American 
Serving Non-Tribal Institutions program, which is the same as 
the fiscal year 2017 enacted level and $6,000 above the fiscal 
year 2018 budget request. This program makes grants to IHEs at 
which enrollment is at least 10 percent Native American 
students and that are not Tribally-Controlled Colleges or 
Universities.

Strengthening Tribally Controlled Colleges and Universities

    The Committee recommends $27,599,000 for the Strengthening 
Tribally Controlled Colleges and Universities (TCCUs) program, 
which is the same as the fiscal year 2017 enacted level and 
$52,000 above the fiscal year 2018 budget request. This program 
makes grants to TCCUs to increase their capacity to serve the 
academic needs of students.

International Education and Foreign Language Studies

    Domestic Programs.--The Committee recommends $65,103,000 
for the Domestic Programs of the International Education and 
Foreign Languages Studies program, which is the same as the 
fiscal year 2017 enacted level and $65,103,000 above the fiscal 
year 2018 budget request. Authorized by title VI of the Higher 
Education Act, these programs include National resource 
centers, foreign language and area studies fellowships, 
undergraduate international studies and foreign language 
programs, international research and studies projects, business 
and international education projects, international business 
education centers, language resource centers, American overseas 
research centers, and technological innovation and cooperation 
for foreign information access.
    Overseas Programs.--The Committee recommends no funding for 
the Overseas Programs, which is $7,061,000 below the fiscal 
year 2017 enacted level and the same as the fiscal year 2018 
budget request. Funding for these programs support group 
projects, faculty research, special bilateral research, and 
doctoral dissertation research conducted abroad. The U.S. 
Department of State funds similar programs that can continue to 
support these activities.

Postsecondary Programs for Students with Intellectual Disabilities

    The Committee recommends $11,800,000 for Postsecondary 
Programs for Students with Intellectual Disabilities, which is 
the same as the fiscal year 2017 level and $22,000 above the 
fiscal year 2018 budget request. This program supports grants 
to create model transition programs into higher education for 
students with intellectual disabilities.

Minority Science and Engineering Improvement

    The Committee recommends $9,648,000 for the Minority 
Science and Engineering Improvement Program, which is the same 
as the fiscal year 2017 enacted level and $18,000 above the 
fiscal year 2018 budget request. This program awards grants to 
improve mathematics, science, and engineering programs at 
institutions serving primarily minority students and to 
increase the number of minority students who pursue advanced 
degrees and careers in those fields.

Tribally Controlled Postsecondary Career and Technical Institutions

    The Committee recommends $8,286,000 for this program, which 
is the same as the fiscal year 2017 enacted level and $16,000 
above the fiscal year 2018 budget request. This program 
provides competitive grants to Tribally controlled 
postsecondary career and technical institutions to provide 
career and technical education to Native American students.

Federal TRIO Programs

    The Committee recommends $1,010,000,000 for TRIO programs, 
which is $60,000,000 above the fiscal year 2017 enacted level 
and $201,711,000 above the fiscal year 2018 budget request. The 
TRIO programs provide a variety of outreach and support 
services to encourage low-income, often first-generation 
college students to enter and complete college. Discretionary 
grants of up to four or five years are awarded competitively to 
IHEs and other nonprofit organizations. At least two thirds of 
the eligible participants in TRIO must be low-income, first-
generation college students.
    The Committee intends that funds be allocated in the same 
ratio as they were allocated during fiscal year 2017.

Gaining Early Awareness and Readiness for Undergraduate Programs

    The Committee recommends $350,000,000 for Gaining Early 
Awareness and Readiness for Undergraduate Programs (GEAR UP), 
which is $10,246,000 above the fiscal year 2017 enacted level 
and $131,000,000 above the fiscal year 2018 budget request. 
GEAR UP provides grants to States and partnerships of low-
income middle and high schools, IHEs, and community 
organizations to target entire grades of students and give them 
the skills, encouragement, and scholarships to pursue 
successfully postsecondary education.
    In addition to making continuation awards to existing 
grantees, the Committee directs the Department to conduct a new 
grant competition for this program in fiscal year 2018. The 
Department is strongly encouraged to publish the notice 
inviting applications as soon as possible.
    The Committee continues bill language allowing the 
Department to maintain the GEAR UP evaluation set-aside at 1.5 
percent to work with the GEAR UP community and grantees to 
standardize data collection, including through the use of 
third-party data systems.

Graduate Assistance in Areas of National Need

    The Committee recommends $5,775,000 for the Graduate 
Assistance in Areas of National Need program, which is 
$22,272,000 below the fiscal year 2017 enacted level and the 
same as the fiscal year 2018 budget request. This program 
duplicates the efforts of other Federally-funded programs that 
support fellowships in these disciplines within the Department 
and other agencies. The Committee recommendation will enable 
the Department to fund fully the continuation costs of current 
awards. This program operates at a high per student cost, 
$50,000 per student, and as a result, the program supports only 
a limited number of graduate students.

Teacher Quality Partnership Grants

    The Committee recommends no funding for Teacher Quality 
Partnerships, which is $43,092,000 below the fiscal year 2017 
enacted level and the same as the fiscal year 2018 budget 
request. The Department has determined that the authority for 
this program is overly restrictive and does not provide States, 
school districts and institutions of higher education the 
flexibilities needed to make meaningful design changes to 
teacher preparation, recruitment and induction to meet their 
needs. Other Federal and State programs may provide funding for 
these activities. Existing authority will enable grantees to 
close out existing projects and draw down grant funds already 
awarded in prior years.

Child Care Access Means Parents in School

    The Committee recommends no funding for the Child Care 
Access Means Parents in School program, which is $15,134,000 
below the fiscal year 2017 enacted level and the same as the 
fiscal year 2018 budget request. This program makes competitive 
grants to colleges and universities to support or establish a 
campus-based childcare program primarily serving the needs of 
low-income students enrolled at the institution. Given budget 
constraints, the Committee chose to reduce investment in 
narrowly focused grant programs such as this one.

                           HOWARD UNIVERSITY

    The Committee recommends $221,821,000 for Howard 
University, which is the same as the fiscal year 2017 enacted 
level and $422,000 above the fiscal year 2018 budget request. 
Howard University is a ``Research I'' university located in the 
District of Columbia. Howard University provides undergraduate 
liberal arts, graduate and professional instruction to over 
10,000 students from all 50 States.
    Within the amount provided, the Committee recommends 
$27,325,000 for the Howard University Hospital, which is the 
same as the fiscal year 2017 enacted level and $52,000 above 
the fiscal year 2018 budget request. The hospital serves as a 
major acute and ambulatory care center for the District of 
Columbia, and functions as a major teaching facility.

         COLLEGE HOUSING AND ACADEMIC FACILITIES LOANS PROGRAM

    The Committee recommends $434,000 for the Federal 
administration of the College Housing and Academic Facilities 
Loan program, the Higher Educational Facilities Loans program, 
and the College Housing Loans program, which is the $1,000 
below the fiscal year 2017 enacted level and the same as the 
fiscal year 2018 budget request. Previously, these programs 
helped to ensure that postsecondary institutions were able to 
make necessary capital improvements to maintain and increase 
their ability to provide a high-quality education. Since 1994, 
no new loans have been made, and the Department's role has been 
to manage the outstanding loans.

  HISTORICALLY BLACK COLLEGE AND UNIVERSITY CAPITAL FINANCING PROGRAM 
                                ACCOUNT

    The Committee recommends $20,445,000 for the HBCU Capital 
Financing program, which $39,000 below the fiscal year 2017 
enacted level and the same as the fiscal year 2018 budget 
request. Funds are available through September 30, 2018. This 
program is authorized under part D of Title III of the HEA and 
makes capital available for repair and renovation of facilities 
at historically black colleges and universities. In exceptional 
circumstances, capital provided under the program can be used 
for construction or acquisition of facilities.
    Within the total provided for this program, the Committee 
recommendation includes $333,000 for the administrative 
expenses to carry out the program and $20,112,000 for loan 
subsidy costs that will be sufficient to guarantee up to 
$313,513,000 in new loans in fiscal year 2018. Funds will also 
be used to continue technical assistance services to help HBCUs 
improve their financial stability and access to capital 
markets.

                    INSTITUTE OF EDUCATION SCIENCES

    The Committee recommends $605,267,000 for the Institute of 
Education Sciences, which is the same as the fiscal year 2017 
enacted level and $11,572,000 below the fiscal year 2018 budget 
request. This account supports education research, statistics, 
dissemination, evaluation, and assessment activities.
    The Committee recognizes the lack of publicly available 
research indicating the specific educational needs of students 
with elevated blood lead levels. The Committee encourages the 
Department to collaborate with the CDC to improve awareness of 
educational intervention strategies for children with elevated 
blood lead levels. The Department and the CDC are expected to 
implement prioritization initiatives and provide technical 
assistance that informs educators, parents, and State and local 
education agencies about the severity and symptoms of lead 
poisoning and intervention strategies for children with 
elevated blood lead levels. The Committee requests an update on 
the Department's strategy and its outcomes on this topic.

Research, Development, and Dissemination

    The Committee recommends $187,500,000 for Research, 
Development, and Dissemination, which is the same as the fiscal 
year 2017 enacted level and $7,129,000 below the fiscal year 
2018 budget request. This budget account supports research, 
development, and National dissemination activities that are 
aimed at expanding fundamental knowledge of education and 
promoting the use of research and development findings in the 
design of efforts to improve education.

Statistics

    The Committee recommends $109,500,000 for the activities of 
the National Center for Education Statistics (NCES), which is 
the same as fiscal year 2017 enacted level and $2,287,000 below 
the fiscal year 2018 budget request. Statistics activities are 
authorized under title I of the Education Sciences Reform Act 
of 2002. The Center collects, analyzes, and reports statistics 
on all levels of education in the United States. Activities are 
carried out directly and through grants and contracts and 
include projections of enrollments, teacher supply and demand, 
and educational expenditures. NCES also provides technical 
assistance to State and local educational agencies and 
postsecondary institutions.

Regional Educational Laboratories

    The Committee recommends $54,423,000 for Regional 
Educational Laboratories, which is the same as the fiscal year 
2017 enacted level and $103,000 above the fiscal year 2018 
budget request. This program support a network of ten 
laboratories that promote the use and development of knowledge 
and evidence to increase student learning and further school 
improvement efforts. Funds are included to support fully 
continuation costs for grants made in prior years.

Research in Special Education

    The Committee recommends $54,000,000 for Research in 
Special Education, which is the same as the fiscal year 2017 
enacted level and $103,000 above the fiscal year 2018 budget 
request. This program supports competitive awards to produce 
and advance the use of knowledge to improve services and 
results for children with disabilities. The program focuses on 
producing new knowledge, integrating research and practice, and 
improving the use of knowledge.

Special Education Studies and Evaluations

    The Committee recommends $10,818,000 for Special Education 
Studies and Evaluations, which is the same as the fiscal year 
2017 enacted level and $21,000 above the fiscal year 2018 
budget request. This program awards competitive grants, 
contracts and cooperative agreements to assess the 
implementation of the IDEA and the effectiveness of State and 
local efforts to provide special education and early 
intervention programs and services to infants, toddlers, and 
children with disabilities.

Statewide Data Systems

    The Committee recommends $32,281,000 for Statewide Data 
Systems, which is the same as the fiscal year 2017 enacted 
level and $2,192,000 below the fiscal year 2018 budget request. 
Competitive grants under this authority are made to SEAs to 
help them manage, analyze, disaggregate and use student data 
consistent with the ESEA.

Assessment

    The Committee recommends $156,745,000 for Assessment, which 
is the same as the fiscal year 2017 enacted level and $191,000 
below the fiscal year 2018 budget request. This amount includes 
$7,745,000 for the National Assessment Governing Board (NAGB), 
which is the same as the fiscal year 2017 enacted level and 
$474,000 below the fiscal year 2018 budget request.
    The National Assessment of Educational Progress (NAEP) is 
the only nationally representative and continuing survey of 
educational ability and achievement of American students. The 
primary goal of the Assessment is to determine and report the 
status and trends of the knowledge and skills of students, 
subject by subject. Subject areas assessed in the past have 
included reading, writing, mathematics, science, and history, 
as well as citizenship, literature, art, and music. The NAEP is 
operated by contractors through competitive awards made by the 
NCES. The NAGB formulates the policy guidelines for the 
program.

                        DEPARTMENTAL MANAGEMENT

    The Committee recommends $598,756,000 for Departmental 
Management, which is $1,000,000 below the fiscal year 2017 
enacted level and $7,184,000 below the fiscal year 2018 budget 
request. These activities are authorized by the Department of 
Education Organization Act (P.L. 96-88) and include costs 
associated with the management and operation of the Department 
as well as separate costs associated with the Office for Civil 
Rights and the Office of Inspector General.

Program Administration

    The Committee recommends $431,000,000 for Program 
Administration, which is $1,000,000 below the fiscal year 2017 
enacted level and $7,000,000 below the fiscal year 2018 budget 
request. These funds support the staff and other costs of 
administering programs and activities at the Department. Items 
include personnel compensation, health, retirement, and other 
benefits as well as travel, rent, telephones, utilities, 
postage fees, data processing, printing, equipment, supplies, 
technology training, consultants, and other contractual 
services.
    Absenteeism.--The Committee notes the need to support 
evidence-based strategies to address chronic absenteeism, and 
the need to expand the reach of attendance-focused activities 
that have been found to be more likely to decrease the 
percentage of students who miss twenty or more days of school 
each year. Students who are chronically absent, on average, 
score lower than students with better attendance on the 
National Assessment for Educational Progress, regardless of 
race or socioeconomic status. Students who are chronically 
absent in preschool, kindergarten, and 1st grade are much less 
likely to read at grade level by the 3rd grade. Additional 
studies demonstrate the connection between chronic absenteeism, 
low academic achievement and high dropout rates and suggest 
that attendance may predict a student's academic progress as 
effectively as test scores. The Committee notes that chronic 
absenteeism programs that use school, family, and community 
partnership practices can significantly decrease chronic 
absenteeism.
    Education Costs Related to Illegal Immigration.--The 
Committee requests an update to the report submitted to 
Congress by the Department of Education on this topic as it 
appeared in the explanatory statement accompanying division H 
of the Consolidated Appropriations Act, 2016 (P.L. 114-113).
    Physical Education.--The Committee believes that physical 
education is a foundation for healthy, active lifestyles and an 
important part of a well-rounded public education. The 
Department is encouraged to provide guidance to States and 
school districts on all available funding for physical 
education under ESSA.
    Physician Assistant (PA) Education Access.--The Committee 
encourages the Secretary of Education to investigate the impact 
that lower Federal Direct Unsubsidized Stafford Loan borrowing 
limits for PA students has on access to physician assistant 
education, overall student loan debt upon graduation, and 
impact on PA graduate employment in underserved and rural 
communities.
    Puerto Rico.--The Committee understands that Puerto Rico is 
facing additional technical assistance needs as it works to 
restructure its education system, and encourages the Department 
to work closely with Puerto Rico to identify and address those 
needs.
    Science, Technology, Engineering, and Math (STEM).--The 
Committee recognizes the benefits and advantages of a diverse 
workforce and encourages the Department of Education to 
increase diversity in the STEM workforce and pipeline by 
working to assist small and disadvantaged businesses, minority 
serving institutions, and underserved communities in developing 
greater diversity. The Committee supports robust investments in 
STEM training for teachers, internship opportunities in STEM 
industries such as biotechnology, and creating clear education 
pathways in STEM between K-12, community colleges, and four-
year institutions.
    The Committee encourages the Secretary of Education to 
study the feasibility of creating a database for schools, which 
would document employees of educational institutions who have 
been convicted of sexual assault and make such information 
available to the public.
    Youth Deradicalization.--As defense, security, law 
enforcement and diplomatic efforts work together to combat 
extremism and terror at home and abroad, the effectiveness of 
our counter-terrorism policy and prevention efforts also need 
to continuously evolve. Domestically, the public education 
system may be a key point for intervention within the United 
States, but there is a gap in research or guidance from Federal 
agencies on the most effective methods, practices, programs, 
curriculum, modules, methodologies and holistic approaches to 
combating radicalization and extremist ideology influence on 
youth and students. In order to inform instruction, teachers, 
administrators and communities, such research could help assess 
and implement preventative measures to combat the growing 
impact of extremist and radical organizations on youth, school 
climate, safety and quality. The Committee believes the 
National Academy of Education may be well suited to conduct 
exploratory research to identify the best practices and most 
effective intervention models to combat the influence of 
extremist organizations and radicalization of youth in schools.

                        OFFICE FOR CIVIL RIGHTS

    The Committee recommends $108,500,000 for the Office for 
Civil Rights, which is the same as the fiscal year 2017 enacted 
level and $1,703,000 below the fiscal year 2018 budget request. 
The Office for Civil Rights is responsible for enforcing laws 
that prohibit discrimination on the basis of race, color, 
national origin, sex, disability, and age in all programs and 
institutions that receive funds from the Department. These laws 
extend to 50 State educational agencies, 18,200 LEAs, and 
nearly 7,200 IHEs, including proprietary schools. They also 
extend to 80 State rehabilitation agencies, libraries, museums, 
and other institutions receiving Federal funds.

                      OFFICE OF INSPECTOR GENERAL

    The Committee recommends $59,256,000 for the Office of 
Inspector General, which is the same as the fiscal year 2017 
enacted level and $1,887,000 below the fiscal year 2018 budget 
request. This Office has authority to inquire into all program 
and administrative activities of the Department as well as into 
related activities of grant and contract recipients. It 
conducts audits and investigations to determine compliance with 
applicable laws and regulations, to check alleged fraud and 
abuse, efficiency of operations, and effectiveness of results.

                           General Provisions

    Sec. 301. The Committee continues a provision that 
prohibits funds in this Act from being used for the 
transportation of students or teachers in order to overcome 
racial imbalances or to carry out a plan of racial 
desegregation.
    Sec. 302. The Committee continues a provision that 
prohibits funds in this Act from being used to require the 
transportation of any student to a school other than the 
school, which is nearest the student's home in order to comply 
with Title VI of the Civil Rights Act of 1964.
    Sec. 303. The Committee continues a provision that 
prohibits funds in this Act from being used to prevent the 
implementation of programs of voluntary prayer and meditation 
in public schools.

                          (TRANSFER OF FUNDS)

    Sec. 304. The Committee continues a provision providing the 
Secretary of Education with the authority to transfer up to one 
percent of discretionary funds between appropriations, provided 
that no appropriation is increased by more than three percent 
by any such transfer. This transfer authority is available only 
to meet emergency needs, and may not be used to create any new 
program or fund a project or activity that is not otherwise 
funded in this Act. All transfers are subject to notification 
to the Committees on Appropriations of the House of 
Representatives and the Senate.
    Sec. 305. The Committee continues to include a provision 
that permits Palau to continue participating in Department of 
Education and other programs pending formal ratification of a 
new compact agreement.
    Sec. 306. The Committee amends a provision allowing ESEA 
funds consolidated for evaluation purposes to be available from 
July 1, 2018 through September 30, 2018.
    Sec. 307. The Committee includes a provision allowing 
certain institutions to continue to use endowment income for 
student scholarships.
    Sec. 308. The Committee continues to include a provision 
extending the authorization of the National Advisory Committee 
on Institutional Quality and Integrity.
    Sec. 309. The Committee continues to include a provision 
extending the authority to provide account maintenance fees to 
guaranty agencies for Federal student loans.
    Sec. 310. The Committee modifies a provision to rescind 
$3,270,844,000 from the Pell Grant program surplus.

                       TITLE IV--RELATED AGENCIES


 Committee for Purchase From People Who Are Blind or Severely Disabled


                         SALARIES AND EXPENSES

    The Committee recommends $8,000,000 for the Committee for 
Purchase From People Who Are Blind or Severely Disabled 
(referred to as the AbilityOne Commission), which is the same 
as the fiscal year 2017 enacted level and $1,883,000 above the 
fiscal year 2018 budget request. The Committee believes 
oversight is necessary to ensure the program is operating in 
accordance with statutory requirements that blind or other 
severely disabled individuals provide at least 75 percent of 
hours or direct labor required for the production or provision 
of the products or services to Federal government agencies. To 
ensure the AbilityOne Commission maintains its oversight 
capacity, the Committee continues bill language requiring the 
AbilityOne Commission to establish written agreements with any 
central nonprofit agencies (CNA). The written agreements ensure 
the AbilityOne Commission can conduct appropriate audit, 
oversight, and reporting functions in accordance with standard 
Federal procurement policies.
    Committee For Purchase From People Who Are Blind or 
Severely Disabled--Requested Reports.--The Committee for 
Purchase From People Who Are Blind or Severely Disabled shall 
submit in an electronic format quarterly reports, due at the 
end of each calendar month after the end of the fiscal year 
quarter, to the Committees on Oversight and Government Reform 
and Education and the Workforce of the House of 
Representatives, Committees on Homeland Security and 
Governmental Affairs and Health, Education, Labor, and Pensions 
of the Senate, and Committees on Appropriations of the House of 
Representatives and the Senate. The first report (Report 1) 
will include information on fees charged by a CNA. The report 
shall include the following:
          1. Each fee charged pursuant to section 51-3.5 of 
        title 41, Code of Federal Regulations
          2. Each organization charged a fee pursuant to 
        section 51-3.5 of title 41, Code of Federal Regulations
          3. For each fee charged, for each Government order, 
        please include the following information:
                  a. name of the nonprofit agency,
                  b. description of product or service ordered,
                  c. ordering government agency,
                  d. order price (total), and
                  e. contract award ID associated with any 
                order, where applicable.
    The second report (Report 2) will include information on 
CNA Expenditures. Each CNA designated pursuant to section 
8503(c) of title 41, United States Code shall submit, in an 
electronic format, a report on expenditures, due at the end of 
each calendar month after the end of the fiscal year quarter, 
to the Committees on Oversight and Government Reform and 
Education and the Workforce of the House of Representatives, 
Committees on Homeland Security and Governmental Affairs and 
Health, Education, Labor, and Pensions of the Senate, and 
Committees on Appropriations of the House of Representatives 
and the Senate. The report shall include the total amount 
obligated by the CNA in the previous quarter for each of the 
following:
          1. Employee salaries (total), including executive 
        salaries,
          2. Employee benefits, including executive benefits,
          3. Executive salaries,
          4. Executive benefits,
          5. Total travel expenses,
          6. Executive travel,
          7. Lobbying,
          8. Advertising and promotion,
          9. CNA reserve level, and
          10. Funds spent to support the efforts of the 
        Committee For Purchase From People Who Are Blind or 
        Severely Disabled, including a description of the 
        activities, services, and products supplied to the 
        Committee For Purchase From People Who Are Blind or 
        Severely Disabled.
    Office of Inspector General.--The Committee recommends not 
less than $1,250,000 for the Office of Inspector General.

             Corporation for National and Community Service


                           OPERATING EXPENSES

    The Committee recommends $1,030,358,000 to the Corporation 
for National and Community Service (Corporation) to carry out 
activities authorized under the Domestic Volunteer Service Act 
of 1973 and the National and Community Service Act of 1990. 
This funding level is the same as the fiscal year 2017 enacted 
level and $895,366,000 above the fiscal year 2018 budget 
request.

Volunteers in Service to America (VISTA)

    The Committee recommends $92,364,000 for VISTA, which is 
the same as the fiscal year 2017 enacted level and $87,454,000 
above the fiscal year 2018 budget request. This program 
provides capacity building for small, community-based 
organizations with a mission of combating poverty. VISTA 
members raise resources, recruit and organize volunteers, and 
establish and expand programs in housing, employment, health, 
and economic development activities.

National Senior Volunteer Corps

    The Committee recommends $202,117,000 for the National 
Senior Volunteer Corps programs, which is the same as the 
fiscal year 2017 enacted level and $201,766,000 above the 
fiscal year 2018 budget request. Senior Corps is 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. The breakout of 
funding by program is as follows:

------------------------------------------------------------------------
           National Senior Volunteer Corps             FY 2018 Committee
------------------------------------------------------------------------
Foster Grandparents Program..........................       $107,702,000
Senior Companion Program.............................         45,512,000
Retired Senior Volunteer Program.....................         48,903,000
------------------------------------------------------------------------

AmeriCorps State and National Grants

    The Committee recommends $386,010,000 for AmeriCorps State 
and National Grants, which is the same as the fiscal year 2017 
enacted level and $383,669,000 above the fiscal year 2018 
budget request. This program provides funds to local and 
national organizations and agencies to address community needs 
in education, public safety, health, and the environment.

Innovation, Assistance, and Other Activities

    The Committee recommends $5,000,000 for this program, which 
is the same as the fiscal year 2017 enacted level and 
$5,000,000 above the fiscal year 2018 budget request.

Evaluation

    The Committee recommends $4,000,000 for this program, which 
is the same as the fiscal year 2017 enacted level and 
$4,000,000 above the fiscal year 2018 budget request. These 
funds support research on program effectiveness.

National Civilian Community Corps

    The Committee recommends $30,000,000 for this program, 
which is the same as the fiscal year 2017 enacted level and 
$5,913,000 above the fiscal year 2018 budget request. This 
program supports residential, team-based service opportunities 
for individuals aged 18-24.

State Commission Administrative Grants

    The Committee recommends $16,538,000 for this program, 
which is the same as the fiscal year 2017 enacted level and 
$16,538,000 above the fiscal year 2018 budget request. Funds 
are used for formula grants to support State oversight of 
service programs.

                 Payment to the National Service Trust

    The Committee recommends $206,842,000 for payments to the 
National Service Trust, which is the same as the fiscal year 
2017 enacted level and $206,842,000 above the fiscal year 2018 
budget request. The National Service Trust makes payments for 
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 the 
Corporation.

                         SALARIES AND EXPENSES

    The Committee recommends $81,737,000 for Salaries and 
Expenses, which is the same as the fiscal year 2017 enacted 
level and $17,998,000 below the fiscal year 2018 budget 
request.

                      OFFICE OF INSPECTOR GENERAL

    The Committee recommends $5,750,000 for the Office of 
Inspector General, which is the same as the fiscal year 2017 
enacted level and $2,182,000 above the fiscal year 2018 budget 
request.

                       ADMINISTRATIVE PROVISIONS

    Sec. 401. The Committee continues bill language that 
combines separate matching requirements for AmeriCorps grants.
    Sec. 402. The Committee continues bill language related to 
National Service Trust minimum share requirements.
    Sec. 403. The Committee continues bill language related to 
donations.
    Sec. 404. The Committee continues bill language related to 
veterans.
    Sec. 405. The Committee continues bill language related to 
criminal history background checks.

                  Corporation for Public Broadcasting

    The Committee recommends $445,000,000 for the Corporation 
for Public Broadcasting for fiscal year 2020. This 
appropriation will fund content development, community 
services, and other local station and system needs for the 
Corporation for Public Broadcasting (CPB). The Committee does 
not provide funding for the public broadcasting interconnection 
system. The Committee recommendation is $50,000,000 below the 
fiscal year 2017 enacted level and $445,000,000 more than the 
fiscal year 2018 budget request.
    The Committee values the contributions of public television 
and radio stations in serving the needs of their local 
communities. National organizations should continue to invest 
in high quality, national, diverse programming to be made 
available to locally-owned and operated stations. In fulfilling 
the mission of the Public Broadcasting Act, CPB should 
encourage Federally funded content distributed through National 
organizations to focus on rural America, civic discourse and 
engagement, and life-long learning. This content should reflect 
America's increasing diversity, including age, ethnicity, race, 
gender, socio-economic background, geography, and points of 
view. Local television and radio stations, in the interest of 
best serving their communities, should continue to have 
discretion on what content to broadcast from the National 
organizations.
    National Minority Consortia.--According to the Public 
Broadcasting Act, one of the greatest priorities of public 
broadcasting is to address the needs of unserved and 
underserved audiences, particularly children and minorities. 
Programming that reflects the histories and perspectives of 
diverse racial and ethnic communities is a core value and 
responsibility of public broadcasting, therefore the Committee 
supports continued investment in the National Minority 
Consortia to help accomplish this goal.

               Federal Mediation and Conciliation Service


                         SALARIES AND EXPENSES

    The Committee recommends $46,650,000 for the Federal 
Mediation and Conciliation Service, which is the same as the 
fiscal year 2017 enacted level and $2,005,000 less than the 
fiscal year 2018 budget request.

            Federal Mine Safety and Health Review Commission


                         SALARIES AND EXPENSES

    The Committee recommends $17,134,000 for the Federal Mine 
Safety and Health Review Commission, which is $50,000 less than 
the fiscal year 2017 enacted level and $81,000 more than the 
fiscal year 2018 budget request.

                Institute of Museum and Library Services


    OFFICE OF MUSEUM AND LIBRARY SERVICES: GRANTS AND ADMINISTRATION

    The Committee recommends $231,000,000 for the Institute of 
Museum and Library Services (IMLS), which is the same as the 
fiscal year 2017 enacted level and $208,000,000 above the 
fiscal year 2018 budget request. Within the total for IMLS, the 
Committee recommends the following amounts:

------------------------------------------------------------------------
                   Budget Activity                         This Bill
------------------------------------------------------------------------
Library Services Technology Act:
    Grants to States.................................       $156,103,000
    Native American Library Services.................          4,063,000
    National Leadership: Libraries...................         13,406,000
    Laura Bush 21st Century Librarian................         10,000,000
Museum Services Act:
    Museums for America..............................         21,149,000
    21st Century Museum Professionals................                  0
    Conservation Project Support.....................                  0
    Native American/Hawaiian Museum Services.........            972,000
    National Leadership: Museums.....................          8,113,000
African American History and Culture Act:
    Museum Grants for African American History and             1,481,000
     Culture.........................................
Museum and Library Services Act General Provisions:
    Research, Analysis and Data Collection...........          1,713,000
Program Administration...............................         14,000,000
------------------------------------------------------------------------

Library Services and Technology

    The Grants to State Library Agencies program provides funds 
to State Library Administrative Agencies using a population-
based formula.

Program Administration

    The Committee recommends $14,000,000 for Program 
Administration, which is the same as the fiscal year 2017 
enacted level. These funds provide administrative and 
management support for all programs administered by IMLS. The 
Committee also includes $1,713,000 for IMLS' activities in 
policy, research, and data collection, including functions 
formerly conducted by the National Commission on Libraries and 
Information Science.

                  Medicare Payment Advisory Commission


                         SALARIES AND EXPENSES

    The Committee recommends $12,175,000 for the Medicare 
Payment Advisory Commission, which is $250,000 more than the 
fiscal year 2017 enacted level and $120,000 less than the 
fiscal year 2018 budget request.
    The Medicare Payment Advisory Commission (MedPAC) is an 
independent agency tasked with advising the U.S. Congress on 
issues affecting the Medicare program. In addition to advising 
the Congress on payments to private health plans participating 
in Medicare and providers in Medicare's traditional fee-for-
service program, MedPAC is also responsible for providing 
analysis on access to care, quality of care, and other issues 
affecting Medicare.

            Medicaid and CHIP Payment and Access Commission


                         SALARIES AND EXPENSES

    The Committee provides $7,500,000 for the Medicaid & CHIP 
Payment and Access Commission, which is $265,000 less than the 
fiscal year 2017 enacted level and $1,200,000 below the fiscal 
year 2018 budget request.
    The Committee supports the unique role played by the 
Medicaid and CHIP Payment and Access Commission (MACPAC) in 
providing nonpartisan policy and data analysis on a wide array 
of issues affecting Medicaid and the State Children's Health 
Insurance Program. In addition to the analysis, MACPAC is also 
responsible for making recommendations to ensure the programs 
continue to serve low-income and other vulnerable populations, 
including an examination of the budget consequences. The 
Committee encourages MACPAC to include in their policy 
recommendations additional specific recommended policy changes 
to the program that can results in savings to accompany any 
policy changes that may entail additional costs. Recognizing 
the wide array of State practices and States' unique 
partnership role in running the Medicaid program, the Committee 
also encourages MACAPAC to consider how it may serve as a 
resource in highlighting State innovations in delivery system 
reforms, cost-containment strategies, care coordination best 
practices, and other efforts to run an efficient and effective 
State Medicaid program.

                     National Council on Disability


                         SALARIES AND EXPENSES

    The Committee recommends $3,200,000 for the National 
Council on Disability, which is $50,000 below the fiscal year 
2017 enacted level and $11,000 below the fiscal year 2018 
budget request.

                     National Labor Relations Board


                         SALARIES AND EXPENSES

    The Committee recommends $249,000,000 for the National 
Labor Relations Board, which is $25,224,000 less than the 
fiscal year 2017 enacted level and $9,000,000 less than the 
fiscal year 2018 budget request.

                       ADMINISTRATIVE PROVISIONS

    Sec. 406. The Committee continues a provision relating to 
electronic voting for purposes of collective bargaining.
    Sec. 407. The Committee includes a new provision relating 
to jurisdiction over Indian tribes.
    Sec. 408. The Committee includes a new provision relating 
to joint-employer standards.
    Sec. 409. The Committee includes a new provision relating 
to collective bargaining units.

                        National Mediation Board


                         SALARIES AND EXPENSES

    The Committee recommends $13,500,000 for the National 
Mediation Board, which is $300,000 above the fiscal year 2017 
enacted level and $295,000 below the fiscal year 2018 budget 
request.

            Occupational Safety and Health Review Commission


                         SALARIES AND EXPENSES

    The Committee recommends $12,875,000 for the Occupational 
Safety and Health Review Commission, which is $350,000 below 
the fiscal year 2017 enacted level and $260,000 above the 
fiscal year 2018 budget request.

                       Railroad Retirement Board


                     DUAL BENEFITS PAYMENTS ACCOUNT

    The Committee recommends $22,000,000 for dual benefits, 
which is $3,000,000 below the fiscal year 2017 enacted level 
and the same as the fiscal year 2018 budget request. This 
appropriation is authorized by the Railroad Retirement Act of 
1974 to fund vested dual benefits received by railroad retirees 
who, under prior law, would have become covered by both the 
railroad retirement system and the Social Security system 
because railroad retirement was not fully coordinated with 
social security from 1937 to 1974. The Committee includes a 
provision permitting a portion of these funds to be derived 
from income tax receipts on dual benefits as authorized by law. 
The Railroad Retirement Board estimates that approximately 
$1,000,000 may be derived in this manner.

          FEDERAL PAYMENT TO THE RAILROAD RETIREMENT ACCOUNTS

    The Committee recommends $150,000 for the interest earned 
on unnegotiated checks, which is the same as the fiscal year 
2017 enacted level and the fiscal year 2018 budget request.

                      LIMITATION ON ADMINISTRATION

    The Committee recommends a consolidated limitation of 
$113,500,000 on the expenditure of Railroad Retirement and 
Railroad Unemployment Trust Funds for administrative expenses 
of the Railroad Retirement Board (RRB), which is the same as 
the fiscal year 2017 enacted level and $2,275,000 above the 
fiscal year 2018 budget request.
    The Committee maintains its position that the financial 
statements and audit of the National Railroad Retirement 
Investment Trust should remain separate from the financial 
statements and audit of the RRB. The Committee notes that the 
Railroad Retirement and Survivors' Improvement Act of 2001 
mandates that the Trust function independently from the RRB. 
Further, the Act specifically requires a separate audit of the 
Trust by a nongovernmental auditor and requires that the 
results of this audit be included in the Trust's Annual 
Management Report to Congress. The Committee expects that the 
Trust shall be administered and audited solely in conformance 
with the Railroad Retirement and Survivors' Improvement Act of 
2001.

             LIMITATION ON THE OFFICE OF INSPECTOR GENERAL

    The Committee recommends authority to expend $10,000,000 
from the Railroad Retirement and Railroad Unemployment 
Insurance Trust Funds for the Office of Inspector General, 
which is equal to the fiscal year 2017 enacted level and 
$1,563,000 above the fiscal year 2018 budget request.

                     Social Security Administration


                PAYMENTS TO SOCIAL SECURITY TRUST FUNDS

    The Committee recommends $11,400,000 for mandatory payments 
necessary to compensate the Old Age and Survivors Insurance 
(OASI) Trust Fund and the Disability Insurance (DI) Trust Fund, 
which is the same as the fiscal year 2017 enacted level and the 
fiscal year 2018 budget request. This appropriation provides 
reimbursement to the Social Security trust funds for non-trust 
fund activities.

                  SUPPLEMENTAL SECURITY INCOME PROGRAM

    The Committee recommends $38,591,635,000 for the 
Supplemental Security Income (SSI) program, which is 
$5,026,528,000 below the fiscal year 2017 enacted level and 
$35,109,000 above the fiscal year 2018 budget request. The 
Committee recommends $19,500,000,000 in advance funding for the 
first quarter of fiscal year 2019, as requested.

Research and Demonstration

    Within the appropriation for SSI, the Committee recommends 
$101,000,000 for research and demonstration activities, which 
is $43,000,000 more than the fiscal year 2017 enacted level and 
the same as the fiscal year 2018 budget request.
    The Committee does not include bill language extending the 
period of availability for research and demonstrations. The 
Committee requests, as part of the fiscal year 2019 
Congressional Justification, for each research or demonstration 
project the total cost obligated to date.

Administration

    Within the appropriation for SSI, the Committee recommends 
$5,095,635,000, which is $66,208,000 above the fiscal year 2017 
enacted level and $35,109,000 above the fiscal year 2018 budget 
request level for payment to the Social Security trust funds 
for SSI's share of the base administrative expenses of the 
Social Security Administration (SSA).

                 LIMITATION ON ADMINISTRATIVE EXPENSES

    The Committee recommends $10,538,945,000 for the Limitation 
on Administrative Expenses (LAE) account to be funded from the 
Social Security and Medicare trust funds, which is the same as 
the fiscal year 2017 enacted level and $64,055,000 below the 
fiscal year 2018 budget request. The LAE funds support SSA 
operational costs to administer the Old Age and Survivors 
Insurance (OASI), Disability Insurance (DI), and Supplemental 
Security Income programs, and to support the Centers for 
Medicare and Medicaid Services in administering their programs.
    Pilot Program Metrics.--Pilot programs are valuable 
opportunities to evaluate the effects of programmatic changes, 
but require a well thought out design that includes appropriate 
measures to evaluate the pilot's effectiveness. For instance, 
the Social Security Advisory Board found, despite beginning the 
Single Decision Maker pilot in 1999, the Social Security 
Administration (SSA) is unable to determine if it was effective 
due to a lack of quality data. The Committee is concerned with 
the SSA's consistent struggle to capture useful metrics to 
evaluate the performance of its pilot programs and expects 
that, prior to undertaking any new pilots, the SSA will ensure 
that it has developed a research design that includes adequate 
metrics to determine the pilot's effectiveness. For any new 
pilot launched in the prior fiscal year, or proposed in the 
current or budget year, the Committee directs the SSA to 
include in the fiscal year 2019 Congressional Justification a 
description of the pilot and what measures SSA will use to 
determine its effectiveness.
    Information Technology.--The Committee continues to request 
the plan referenced under this heading in House Report 114-699.
    Reducing Social Security Number Use.--Social Security 
numbers (SSNs) are valuable targets for identity theft because 
of their regular use by both the Federal government and the 
private sector as a unique identifier. Despite this, the Social 
Security Administration (SSA) still mails full SSNs on 
approximately 233 million notices or forms of correspondence 
each year. While the SSA has committed to removing SSNs from 
its mailings whenever possible, it has not provided a timeframe 
to do so. The Committee appreciates the SSA's stated commitment 
to reducing the use of SSNs on mailed documents and requires 
additional information to monitor progress. The Committee 
directs the SSA to provide a report within 60 days of enactment 
of this Act to the House of Representatives Committee on 
Appropriations Subcommittee on Labor, Health and Human 
Services, and Education, and Related Agencies and to the 
Committee on Ways and Means Subcommittee on Social Security, 
that includes the title and identification number of each 
document used by the SSA containing a full SSN, the most recent 
date this document was updated, and either a justification for 
why the use of a full SSN is necessary for inclusion on that 
document or the projected date on which the full SSN will be 
removed from the document.
    Report on Medical Listings.--SSA employs medical listings 
to make disability determinations, many of which have not been 
updated. The Committee continues direction for SSA to provide a 
report within 60 days of enactment to the House of 
Representatives Committee on Appropriations Subcommittee on 
Labor, Health and Human Services, and Education, and Related 
Agencies and the Committee on Ways and Means Subcommittee on 
Social Security regarding the number of years since the last 
update and when the agency expects to conduct all of the 
updates for all medical listings.
    Report on LAE Expenditures.--The Committee continues to 
request the report referenced under this heading in House 
Report 114-699 as part of the fiscal year 2019 Congressional 
Justification.

Social Security Advisory Board

    The Committee recommends that not less than $2,300,000 of 
the LAE funding be available for the Social Security Advisory 
Board, which is the same as the fiscal year 2017 enacted level 
and the fiscal year 2018 budget request.
    The Committee requests the Social Security Advisory Board 
include additional information regarding the work of the Social 
Security Advisory Board in developing recommendations to 
improve SSA's quality of service to the public in the fiscal 
year 2019 Congressional Justification. The Committee does not 
include bill language providing the Social Security Advisory 
Board reception and representation authority.

User Fees

    In addition to the other amounts provided, the Committee 
recommends $119,000,000 for administrative activities funded 
from user fees. Of this amount, $118,000,000 is derived from 
fees collected from States that request SSA to administer State 
SSI supplementary payments.

Continuing Disability Reviews and Redeterminations

    The Committee recommends $1,735,000,000 for program 
integrity activities. In the wake of multiple large-scale 
disability fraud cases, the Committee believes that successful 
program integrity activities are vital to maintaining the 
public's support for benefit payments to recipients deserving 
of assistance.

                    OFFICE OF THE INSPECTOR GENERAL

                     (INCLUDING TRANSFER OF FUNDS)

    The Committee recommends $105,500,000 for the Office of 
Inspector General, of which the bill provides authority to 
expend $75,500,000 from the OASI and DI trust funds. This 
funding level is the same as the fiscal year 2017 enacted level 
and the fiscal year 2018 budget request.

                      TITLE V--GENERAL PROVISIONS


                          (TRANSFER OF FUNDS)

    Sec. 501. The Committee continues a provision allowing the 
Secretaries of Labor, Health and Human Services, and Education 
to transfer unexpended balances of prior appropriations to 
accounts corresponding to current appropriations to be used for 
the same purposes and for the same periods of time for which 
they were originally appropriated.
    Sec. 502. The Committee continues a provision prohibiting 
the obligation of funds beyond the current fiscal year unless 
expressly so provided.
    Sec. 503. The Committee continues a provision prohibiting 
funds from being used to support or defeat legislation.
    Sec. 504. The Committee continues a provision limiting the 
amount available for official reception and representation 
expenses for the Secretaries of Labor and Education, the 
Director of the Federal Mediation and Conciliation Service, and 
the Chairman of the National Mediation Board.
    Sec. 505. The Committee continues a provision requiring 
grantees receiving Federal funds to clearly state the 
percentage of the total cost of the program or project that 
will be financed with Federal money.
    Sec. 506. The Committee continues a provision prohibiting 
the use of funds for any abortion.
    Sec. 507. The Committee continues a provision providing 
exceptions to section 506 and a provision prohibiting funds 
from being made available to a Federal agency or program, or to 
a State or local government, if such agency, program or 
government discriminates against institutional or individual 
health care entities because they do not provide, pay for, 
provide coverage of, or refer for abortions.
    Sec. 508. The Committee continues a provision prohibiting 
use of funds for certain research involving human embryos.
    Sec. 509. The Committee continues a provision prohibiting 
use of funds for any activity that promotes the legalization of 
any drug or substance included in schedule I of the schedules 
of controlled substances.
    Sec. 510. The Committee continues a provision prohibiting 
use of funds to promulgate or adopt any final standard 
providing for a unique health identifier until legislation is 
enacted specifically approving the standard.
    Sec. 511. The Committee continues a provision related to 
annual reports to the Secretary of Labor.
    Sec. 512. The Committee continues a provision prohibiting 
transfer of funds made available in this Act except by 
authority provided in this Act or another appropriations Act.
    Sec. 513. The Committee continues a provision to limit 
funds in the bill for public libraries to those that comply 
with the requirements of the Children's Internet Protection 
Act.
    Sec. 514. The Committee continues a provision regarding 
procedures for reprogramming of funds.
    Sec. 515. The Committee continues a provision pertaining to 
appointments to scientific advisory committees.
    Sec. 516. The Committee continues a provision requiring 
each department and related agency funded through this Act to 
submit an operating plan within 45 days of enactment, detailing 
any funding allocations that are different than those specified 
in this Act, the accompanying detailed table, or budget 
request.
    Sec. 517. The Committee continues a provision requiring the 
Secretaries of Labor, Health and Human Services, and Education 
to submit a quarterly report to the Committees on 
Appropriations of the House of Representatives and the Senate 
containing certain information on noncompetitive contracts, 
grants, and cooperative agreements exceeding $500,000 in value.
    Sec. 518. The Committee continues a provision prohibiting 
the use of funds to process claims for credit for quarters of 
coverage based on work performed under a Social Security number 
that was not the claimant's number, where the performance of 
such work under such number has formed the basis for a 
conviction of the claimant of a violation of section 208(a)(6) 
or (7) of the Social Security Act.
    Sec. 519. The Committee continues a provision prohibiting 
the use of funds to implement a Social Security totalization 
agreement with Mexico.
    Sec. 520. The Committee continues a provision related to 
needle exchange.
    Sec. 521. The Committee continues a provision prohibiting 
the use of funds for the downloading or exchanging of 
pornography.
    Sec. 522. The Committee continues a provision that 
prohibits funding from going to the Association of Community 
Organizations for Reform Now (ACORN), or any of its affiliates, 
subsidiaries, allied organizations, or successors.
    Sec. 523. The Committee continues a provision relating to 
reporting requirements for conference expenditures.
    Sec. 524. The Committee continues a provision relating to 
disclosure of U.S. taxpayer funding for programs used in 
advertising.
    Sec. 525. The Committee continues a provision relating to 
performance partnership pilots.
    Sec. 526. The Committee continues provision requesting 
quarterly reports on the status of balances of appropriations 
from the Departments of Labor, Health and Human Services and 
Education and the Social Security Administration.
    Sec. 527. The Committee includes a new provision 
prohibiting use of funds to implement, administer, enforce or 
further the provisions of Public Law 111-148 and portions of 
public Law 111-152 with certain exceptions.
    Sec. 528. The Committee includes a new provision 
prohibiting use of funds for research on fetal tissue obtained 
from an induced abortion.
    Sec. 529. The Committee includes a new provision 
restricting funding to certain health care entities.

                              (RESCISSION)

    Sec. 530. The Committee rescinds $560,000,000 from the 
nonrecurring expenses fund.

                              (RESCISSION)

    Sec. 531. The Committee rescinds $15,000,000 provided under 
section 3403 [Independent Payment Advisory Board] of Public Law 
111-148.
    Sec. 532. The Committee modifies a provision relating to 
the Child Enrollment Contingency Fund.

                              (RESCISSION)

    Sec. 533. The Committee rescinds $323,000,000 in unused 
funds provided under section 1101(g) [Pre-Existing Condition 
Insurance Program] of Public Law 111-148.

                              (RESCISSION)

    Sec. 534. The Committee rescinds $88,613,000 in unused 
funds provided under section 2105(a)(3) [Children's Health 
Insurance Program Performance Bonus Payment] of the Social 
Security Act.

                              (RESCISSION)

    Sec. 535. The Committee rescinds $3,945,905,000 in unused 
funds provided under section 301(b)(3) [Children's Health 
Insurance Program allotments] of Public Law 114-10.
    Sec. 536. The Committee includes a new provision relating 
to conscience protection with respect to health care entities 
that refuse to participate in abortions.
    Sec. 537. The Committee includes a new provision relating 
to minimum wage on Federal lands.

                       SPENDING REDUCTION ACCOUNT

    Sec. 538. The Committee includes a Spending Reduction 
Account.

            House of Representatives Reporting Requirements

    The following materials are submitted in accordance with 
various requirements of the Rules of the House of 
Representatives:

         STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES

    Pursuant to clause 3(c)(4) of rule XIII of the Rules of the 
House of Representatives, the following is a statement of 
general performance goals and objectives for which this measure 
authorizes funding: The Committee on Appropriations considers 
program performance, including a program's success in 
developing and attaining outcome-related goals and objectives, 
in developing funding recommendations.

                          RESCISSION OF FUNDS

    Pursuant to clause 3(f)(2) of rule XIII of the Rules of the 
House of Representatives, the following lists the rescissions 
of unexpended balances included in the accompanying bill:

                  RESCISSIONS RECOMMENDED IN THE BILL

------------------------------------------------------------------------
                       Account                               Amount
------------------------------------------------------------------------
Department of Labor
    Dislocated Workers National Reserve..............       $200,000,000
Department of Health and Human Services
    Nonrecurring Expenses Fund.......................        560,000,000
    Independent Payment Advisory Board...............         15,000,000
    Preexisting Condition Insurance Program..........        323,000,000
    Children's Health Insurance Program..............      3,945,905,000
    Performance Bonus Payments.......................         88,046,000
Department of Education
    Pell Grants......................................      3,270,844,000
------------------------------------------------------------------------

                           TRANSFER OF FUNDS

    Pursuant to clause 3(f)(2) of rule XIII of the Rules of the 
House of Representatives, the following lists the transfers of 
unexpended balances included in the accompanying bill:

                                TITLE I

    Language is included under ``Job Corps'' permitting the 
transfer of funds for Job Corps Center construction, 
rehabilitation and acquisition to meet the operational needs of 
Job Corps Centers or to achieve administrative efficiencies.
    Language is included under ``Special Benefits''' which 
provides for the transfer of such sums as necessary from the 
``Postal Service'' account.
    Language is included under ``Black Lung Disability Trust 
Fund'' which provides for the transfer of funds to the 
``Department of Labor, Office of Workers' Compensation Program, 
Salaries and Expenses.''
    Language is included under ``Black Lung Disability Trust 
Fund'' which provides for the transfer of funds to the 
``Department of Labor, Departmental Management, Salaries and 
Expenses.''
    Language is included under ``Black Lung Disability Trust 
Fund'' which provides for the transfer of funds to the 
``Department of Labor, Departmental Management, Office of 
Inspector General.''
    Language is included under ``Black Lung Disability Trust 
Fund'' which provides for the transfer of funds to the 
``Department of the Treasury.''
    Language is included under ``Departmental Management, 
Salaries and Expenses''' authorizing the transfer of funds 
available for program evaluation to any other account within 
the Department to carry out evaluation activities.
    A general provision is included that allows not to exceed 
one percent of any discretionary appropriations to be 
transferred between an appropriation of the Department of 
Labor, provided that no such appropriation is increased by more 
than three percent by such transfer.
    A general provision is included that authorizes the 
transfer of funds from the ``Employment and Training 
Administration'' for technical assistance services to grantees 
to ``Program Administration.''
    A general provision is included that provides for the 
transfer of up to 0.75 percent of funds from each appropriation 
to carry out evaluations of any of the programs or activities 
from ``Training and Employment Services'', `` Job Corps'', 
``Community Service Employment for Older Americans,'' ``State 
Unemployment Insurance and Employment Service Operations'', 
``Employee Benefits Security Administration'', ``Office of 
Workers' Compensation Programs'', ``Wage and Hour Division'', 
``Office of Federal Contract Compliance Programs'', ``Office of 
Labor-Management Standards'', ``Occupational Safety and Health 
Administration'', ``Mine Safety and Health Administration'', 
Office of Disability Employment Policy, ``Bureau of 
International Affairs'' and Women's Bureau'' within the 
Departmental Management, Salaries and Expenses'' account, and 
``Veterans Employment and Training'' for use by the Office of 
the Chief Evaluation Officer.

                                TITLE II

    Language is included under ``Centers for Disease Control 
and Prevention, Buildings and Facilities'' to allow the 
transfer of prior year unobligated Individual Learning Account 
funds to be transferred to this account to carry out the 
purpose of this account.
    Language is included under ``Administration for Children 
and Families--Refugee and Entrant Assistance'' permitting 
transfers pursuant to a general provision to increase an 
appropriation under this heading by ten percent.
    Language is included under ``Administration for Community 
Living, Aging and Disability Services Programs'' for transfer 
to the Secretary of Agriculture to carryout section 311 of the 
Older Americans Act of 1965.
    Language is included under ``Public Health and Social 
Services Emergency Fund'' to provide enhanced transfer 
authority to this account to address public health emergencies.
    A general provision is included that allows not to exceed 
one percent of any discretionary funds to be transferred 
between appropriation accounts of the ``Department of Health 
and Human Services'', provided that no appropriation account is 
increased by more than three percent by such transfer.
    A general provision is included that allows the transfer of 
up to three percent among the institutes and centers of the 
``National Institutes of Health'' from amounts identified as 
pertaining to the human immunodeficiency virus.
    A general provision is included that allows the transfer of 
funding determined to be related to the human immunodeficiency 
virus to the ``Office of AIDS Research''.
    A general provision is included that transfers one percent 
of the amount made available for ``National Research Service 
Awards'' at the ``National Institutes of Health'' to the 
``Health Resources and Services Administration''.
    A general provision is included to direct the transfer of 
the ``Prevention and Public Health Fund'' as specified in the 
committee report accompanying this Act.

                               TITLE III

    A general provision is included that allows not to exceed 
one percent of any discretionary funds to be transferred 
between appropriation accounts of the Department of Education, 
provided that no appropriation account is increased by more 
than three percent by such transfer.

                                TITLE IV

    Language is included under Payment to the National Service 
Trust authorizing the transfer of funds from the ``Corporation 
for National and Community Service, Operating Expenses'' to 
support the activities of national service participants.
    Language is included under ``Social Security 
Administration'' authorizing the transfer of up to three 
percent of the Social Security Administration's ``Limitation on 
Administration Expenses''' account to be available for purposes 
of the Office of Inspector General.

                                TITLE V

    A general provision is included that allows the Secretaries 
of Labor, Health and Human Services, and Education to transfer 
balances of prior appropriation to accounts corresponding to 
current appropriations.

   DISCLOSURE OF EARMARKS AND CONGRESSIONALLY DIRECTED SPENDING ITEMS

    Neither the bill nor the report contains any Congressional 
earmarks, limited tax benefits, or limited tariff benefits as 
defined in clause 9 of rule XXI.

          Compliance With Rule XIII, CL. 3(E) (Ramseyer Rule)

    In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italic, existing law in which no change is 
proposed is shown in roman):

HIGHER EDUCATION ACT OF 1965

           *       *       *       *       *       *       *



TITLE I--GENERAL PROVISIONS

           *       *       *       *       *       *       *


PART B--ADDITIONAL GENERAL PROVISIONS

           *       *       *       *       *       *       *


SEC. 114. NATIONAL ADVISORY COMMITTEE ON INSTITUTIONAL QUALITY AND 
                    INTEGRITY.

  (a) Establishment.--There is established in the Department a 
National Advisory Committee on Institutional Quality and 
Integrity (in this section referred to as the ``Committee'') to 
assess the process of accreditation and the institutional 
eligibility and certification of institutions of higher 
education (as defined in section 102) under title IV.
  (b) Membership.--
          (1) In general.--The Committee shall have 18 members, 
        of which--
                  (A) six members shall be appointed by the 
                Secretary;
                  (B) six members shall be appointed by the 
                Speaker of the House of Representatives, three 
                of whom shall be appointed on the 
                recommendation of the majority leader of the 
                House of Representatives, and three of whom 
                shall be appointed on the recommendation of the 
                minority leader of the House of 
                Representatives; and
                  (C) six members shall be appointed by the 
                President pro tempore of the Senate, three of 
                whom shall be appointed on the recommendation 
                of the majority leader of the Senate, and three 
                of whom shall be appointed on the 
                recommendation of the minority leader of the 
                Senate.
          (2) Qualifications.--Individuals shall be appointed 
        as members of the Committee--
                  (A) on the basis of the individuals' 
                experience, integrity, impartiality, and good 
                judgment;
                  (B) from among individuals who are 
                representatives of, or knowledgeable 
                concerning, education and training beyond 
                secondary education, representing all sectors 
                and types of institutions of higher education 
                (as defined in section 102); and
                  (C) on the basis of the individuals' 
                technical qualifications, professional 
                standing, and demonstrated knowledge in the 
                fields of accreditation and administration in 
                higher education.
          (3) Terms of members.--Except as provided in 
        paragraph (5), the term of office of each member of the 
        Committee shall be for six years, except that any 
        member appointed to fill a vacancy occurring prior to 
        the expiration of the term for which the member's 
        predecessor was appointed shall be appointed for the 
        remainder of such term.
          (4) Vacancy.--A vacancy on the Committee shall be 
        filled in the same manner as the original appointment 
        was made not later than 90 days after the vacancy 
        occurs. If a vacancy occurs in a position to be filled 
        by the Secretary, the Secretary shall publish a Federal 
        Register notice soliciting nominations for the position 
        not later than 30 days after being notified of the 
        vacancy.
          (5) Initial terms.--The terms of office for the 
        initial members of the Committee shall be--
                  (A) three years for members appointed under 
                paragraph (1)(A);
                  (B) four years for members appointed under 
                paragraph (1)(B); and
                  (C) six years for members appointed under 
                paragraph (1)(C).
          (6) Chairperson.--The members of the Committee shall 
        select a chairperson from among the members.
  (c) Functions.--The Committee shall--
          (1) advise the Secretary with respect to 
        establishment and enforcement of the standards of 
        accrediting agencies or associations under subpart 2 of 
        part H of title IV;
          (2) advise the Secretary with respect to the 
        recognition of a specific accrediting agency or 
        association;
          (3) advise the Secretary with respect to the 
        preparation and publication of the list of nationally 
        recognized accrediting agencies and associations;
          (4) advise the Secretary with respect to the 
        eligibility and certification process for institutions 
        of higher education under title IV, together with 
        recommendations for improvements in such process;
          (5) advise the Secretary with respect to the 
        relationship between--
                  (A) accreditation of institutions of higher 
                education and the certification and eligibility 
                of such institutions; and
                  (B) State licensing responsibilities with 
                respect to such institutions; and
          (6) carry out such other advisory functions relating 
        to accreditation and institutional eligibility as the 
        Secretary may prescribe by regulation.
  (d) Meeting Procedures.--
          (1) Schedule.--
                  (A) Biannual meetings.--The Committee shall 
                meet not less often than twice each year, at 
                the call of the Chairperson.
                  (B) Publication of date.--The Committee shall 
                submit the date and location of each meeting in 
                advance to the Secretary, and the Secretary 
                shall publish such information in the Federal 
                Register not later than 30 days before the 
                meeting.
          (2) Agenda.--
                  (A) Establishment.--The agenda for a meeting 
                of the Committee shall be established by the 
                Chairperson and shall be submitted to the 
                members of the Committee upon notification of 
                the meeting.
                  (B) Opportunity for public comment.--The 
                agenda shall include, at a minimum, opportunity 
                for public comment during the Committee's 
                deliberations.
          (3) Secretary's designee.--The Secretary shall 
        designate an employee of the Department to serve as the 
        Secretary's designee to the Committee, and the 
        Chairperson shall invite the Secretary's designee to 
        attend all meetings of the Committee.
          (4) Federal advisory committee act.--The Federal 
        Advisory Committee Act (5 U.S.C. App.) shall apply to 
        the Committee, except that section 14 of such Act shall 
        not apply.
  (e) Report and Notice.--
          (1) Notice.--The Secretary shall annually publish in 
        the Federal Register--
                  (A) a list containing, for each member of the 
                Committee--
                          (i) the member's name;
                          (ii) the date of the expiration of 
                        the member's term of office; and
                          (iii) the name of the individual 
                        described in subsection (b)(1) who 
                        appointed the member; and
                  (B) a solicitation of nominations for each 
                expiring term of office on the Committee of a 
                member appointed by the Secretary.
          (2) Report.--Not later than the last day of each 
        fiscal year, the Committee shall make available an 
        annual report to the Secretary, the authorizing 
        committees, and the public. The annual report shall 
        contain--
                  (A) a detailed summary of the agenda and 
                activities of, and the findings and 
                recommendations made by, the Committee during 
                the fiscal year preceding the fiscal year in 
                which the report is made;
                  (B) a list of the date and location of each 
                meeting during the fiscal year preceding the 
                fiscal year in which the report is made;
                  (C) a list of the members of the Committee; 
                and
                  (D) a list of the functions of the Committee, 
                including any additional functions established 
                by the Secretary through regulation.
  (f) Termination.--The Committee shall terminate on September 
30, [2017] 2018.

           *       *       *       *       *       *       *


TITLE IV--STUDENT ASSISTANCE

           *       *       *       *       *       *       *



PART D--WILLIAM D. FORD FEDERAL DIRECT LOAN PROGRAM

           *       *       *       *       *       *       *


SEC. 458. FUNDS FOR ADMINISTRATIVE EXPENSES.

  (a) Administrative Expenses.--
          (1) Mandatory funds for fiscal year 2006.--For fiscal 
        year 2006, there shall be available to the Secretary, 
        from funds not otherwise appropriated, funds to be 
        obligated for--
                  (A) administrative costs under this part and 
                part B, including the costs of the direct 
                student loan programs under this part; and
                  (B) account maintenance fees payable to 
                guaranty agencies under part B and calculated 
                in accordance with subsections (b) and (c),
        not to exceed (from such funds not otherwise 
        appropriated) $820,000,000 in fiscal year 2006.
          (2)
          (3) Authorization for administrative costs beginning 
        in fiscal years 2007 through 2014.--For each of the 
        fiscal years 2007 through 2014, there are authorized to 
        be appropriated such sums as may be necessary for 
        administrative costs under this part and part B, 
        including the costs of the direct student loan programs 
        under this part.
          (4) Continuing mandatory funds for account 
        maintenance fees.--For each of the fiscal years 2007 
        through [2017] 2018, there shall be available to the 
        Secretary, from funds not otherwise appropriated, funds 
        to be obligated for account maintenance fees payable to 
        guaranty agencies under part B and calculated in 
        accordance with subsection (b).
          (5) Account maintenance fees.--Account maintenance 
        fees under paragraph (3) shall be paid quarterly and 
        deposited in the Agency Operating Fund established 
        under section 422B.
          (6) Technical assistance to institutions of higher 
        education.--
                  (A) Provision of assistance.--The Secretary 
                shall provide institutions of higher education 
                participating, or seeking to participate, in 
                the loan programs under this part with 
                technical assistance in establishing and 
                administering such programs.
                  (B) Funds.--There are authorized to be 
                appropriated, and there are appropriated, to 
                carry out this paragraph (in addition to any 
                other amounts appropriated to carry out this 
                paragraph and out of any money in the Treasury 
                not otherwise appropriated), $50,000,000 for 
                fiscal year 2010.
                  (C) Definition.--In this paragraph, the term 
                ``assistance'' means the provision of technical 
                support, training, materials, technical 
                assistance, and financial assistance.
          (7) Additional payments.--
                  (A) Provision of assistance.--The Secretary 
                shall provide payments to loan servicers for 
                retaining jobs at locations in the United 
                States where such servicers were operating 
                under part B on January 1, 2010.
                  (B) Funds.--There are authorized to be 
                appropriated, and there are appropriated, to 
                carry out this paragraph (in addition to any 
                other amounts appropriated to carry out this 
                paragraph and out of any money in the Treasury 
                not otherwise appropriated), $25,000,000 for 
                each of the fiscal years 2010 and 2011.
          (8) Carryover.--The Secretary may carry over funds 
        made available under this section to a subsequent 
        fiscal year.
  (b) Calculation Basis.--Account maintenance fees payable to 
guaranty agencies under subsection (a)(4) shall be calculated 
on the basis of 0.06 percent of the original principal amount 
of outstanding loans on which insurance was issued under part 
B.
  (c) Budget Justification.--No funds may be expended under 
this section unless the Secretary includes in the Department of 
Education's annual budget justification to Congress a detailed 
description of the specific activities for which the funds made 
available by this section have been used in the prior and 
current years (if applicable), the activities and costs planned 
for the budget year, and the projection of activities and costs 
for each remaining year for which administrative expenses under 
this section are made available.

           *       *       *       *       *       *       *

                              ----------                              


PUBLIC HEALTH SERVICE ACT

           *       *       *       *       *       *       *



TITLE II--ADMINISTRATION AND MISCELLANEOUS PROVISIONS

           *       *       *       *       *       *       *



Part B--Miscellaneous Provisions

           *       *       *       *       *       *       *



SEC. 245A. PROHIBITING GOVERNMENTAL DISCRIMINATION AGAINST PROVIDERS OF 
                    HEALTH SERVICES THAT ARE NOT INVOLVED IN ABORTION.

  (a) In General.--Notwithstanding any other law, the Federal 
Government, and any State or local government that receives 
Federal financial assistance, may not penalize, retaliate 
against, or otherwise discriminate against a health care 
provider on the basis that the provider does not--
          (1) perform, refer for, pay for, or otherwise 
        participate in abortion;
          (2) provide or sponsor abortion coverage; or
          (3) facilitate or make arrangements for any of the 
        activities specified in this subsection.
  (b) Rule of Construction.--Nothing in this section shall be 
construed--
          (1) to prevent any health care provider from 
        voluntarily electing to participate in abortions or 
        abortion referrals;
          (2) to prevent any health care provider from 
        voluntarily electing to provide or sponsor abortion 
        coverage or health benefits coverage that includes 
        abortion;
          (3) to prevent an accrediting agency, the Federal 
        Government, or a State or local government from 
        establishing standards of medical competency applicable 
        only to those who have knowingly, voluntarily, and 
        specifically elected to perform abortions, or from 
        enforcing contractual obligations applicable only to 
        those who, as part of such contract, knowingly, 
        voluntarily, and specifically elect to provide 
        abortions;
          (4) to affect, or be affected by, section 1867 of the 
        Social Security Act (42 U.S.C. 1395dd, commonly 
        referred to as the ``Emergency Medical Treatment and 
        Active Labor Act''); or
          (5) to supersede any law enacted by any State for the 
        purpose of regulating insurance, except as specified in 
        subsection (a).
  (c) Administration.--The Secretary shall designate the 
Director of the Office for Civil Rights of the Department of 
Health and Human Services--
          (1) to receive complaints alleging a violation of 
        this section, section 245 of this Act, or any of 
        subsections (b) through (e) of section 401 of the 
        Health Programs Extension Act of 1973; and
          (2) to pursue the investigation of such complaints in 
        coordination with the Attorney General.
  (d) Definitions.--For purposes of this section:
          (1) Federal financial assistance.--The term ``Federal 
        financial assistance'' means Federal payments to cover 
        the cost of health care services or benefits, or other 
        Federal payments, grants, or loans to promote or 
        otherwise facilitate health-related activities.
          (2) Health care provider.--The term ``health care 
        provider'' means--
                  (A) an individual physician, nurse, or other 
                health care professional;
                  (B) a hospital, health system, or other 
                health care facility or organization (including 
                a party to a proposed merger or other 
                collaborative arrangement relating to health 
                services, and an entity resulting therefrom);
                  (C) a provider-sponsored organization, an 
                accountable care organization, or a health 
                maintenance organization;
                  (D) a social services provider that provides 
                or authorizes referrals for health care 
                services;
                  (E) a program of training in the health 
                professions or an applicant to or participant 
                in such a program;
                  (F) an issuer of health insurance coverage; 
                or
                  (G) a group health plan or student health 
                plan, or a sponsor or administrator thereof.
          (3) State or local government that receives federal 
        financial assistance.--The term ``State or local 
        government that receives Federal financial assistance'' 
        includes every agency and other governmental unit and 
        subdivision of a State or local government, if such 
        State or local government, or any agency or 
        governmental unit or subdivision thereof, receives 
        Federal financial assistance.

SEC. 245B. CIVIL ACTION FOR CERTAIN VIOLATIONS.

  (a) In General.--A qualified party may, in a civil action, 
obtain appropriate relief with regard to a designated 
violation.
  (b) Definitions.--For purposes of this section:
          (1) Qualified party.--The term ``qualified party'' 
        means--
                  (A) the Attorney General of the United 
                States; or
                  (B) any person or entity adversely affected 
                by the designated violation.
          (2) Designated violation.--The term ``designated 
        violation'' means an actual or threatened violation 
        of--
                  (A) section 245 or 245A of this Act; or
                  (B) any of subsections (b) through (e) of 
                section 401 of the Health Programs Extension 
                Act of 1973 regarding an objection to abortion.
  (c) Administrative Remedies Not Required.--An action under 
this section may be commenced, and relief may be granted, 
without regard to whether the party commencing the action has 
sought or exhausted available administrative remedies.
  (d) Defendants in Actions Under This Section May Include 
Governmental Entities as Well as Others.--
          (1) In general.--An action under this section may be 
        maintained against, among others, a party that is a 
        Federal or State governmental entity. Relief in an 
        action under this section may include money damages 
        even if the defendant is such a governmental entity.
          (2) Definition.--For the purposes of this subsection, 
        the term ``State governmental entity'' means a State, a 
        local government within a State, and any agency or 
        other governmental unit or subdivision of a State or of 
        such a local government.
  (e) Nature of Relief.--In an action under this section, the 
court shall grant--
          (1) all necessary equitable and legal relief, 
        including, where appropriate, declaratory relief and 
        compensatory damages, to prevent the occurrence, 
        continuance, or repetition of the designated violation 
        and to compensate for losses resulting from the 
        designated violation; and
          (2) to a prevailing plaintiff, reasonable attorneys' 
        fees and litigation expenses as part of the costs.

           *       *       *       *       *       *       *


               CHANGES IN THE APPLICATION OF EXISTING LAW

    Pursuant to clause 3(f)(1)(A) of rule XIII of the Rules of 
the House of Representatives, the following statements are 
submitted describing the effect of provisions in the 
accompanying bill that directly or indirectly change the 
application of existing law.

                      TITLE I--DEPARTMENT OF LABOR

    Language is included under ``Employment and Training 
Administration'' providing that allotments to outlying areas 
are not required to be made through the Pacific Region 
Educational Laboratory as provided by section 127 of the 
Workforce Innovation and Opportunity Act (WIOA).
    Language is included under ``Employment and Training 
Administration'' providing amounts made available for 
dislocated workers may be used for State activities or across 
multiple local areas where workers remain dislocated.
    Language is included under ``Employment and Training 
Administration'' providing that technical assistance projects 
may provide assistance to new entrants in the workforce and 
incumbent workers.
    Language is included under ``Employment and Training 
Administration'' providing that the Secretary of Labor may 
reserve not more than 10 of funds to provide technical 
assistance activities related to the transition to WIOA.
    Language is included under ``Employment and Training 
Administration'' providing that the Department of Labor may 
take no action to limit the number or proportion of eligible 
applicants receiving related assistance services in the migrant 
and seasonal farmworkers programs.
    Language is included under ``Job Corps'' providing that 
amounts made available for construction and rehabilitation may 
include acquisition and maintenance of major items of 
equipment.
    Language is included under ``Job Corps'' providing 
authority to transfer up to 15 percent of construction and 
rehabilitation funds for operational needs with prior written 
notice to the Committee and that any such transfers are 
available for obligation through June 30, 2019.
    Language is included under ``Job Corps'' providing that no 
funds from any other appropriation may be used for meal 
services at Job Corps.
    Language in included under ``Federal Unemployment Benefits 
and Allowances'' providing that funding may be available beyond 
the current year in accordance with section 245(c) of the Trade 
Act of 1974.
    Language is included under ``State Unemployment Insurance 
and Employment Service Operations'' providing for reemployment 
services and referrals to training for all claimants of 
unemployment insurance for ex-service members, for improper 
payment reviews, and for unemployment claimants most likely to 
exhaust their benefits.
    Language is included under ``State Unemployment Insurance 
and Employment Service Operations'' providing for additional 
administrative funds from the Unemployment Trust Fund if 
unemployment claims exceed certain levels.
    Language is included under ``State Unemployment Insurance 
and Employment Service Operations'' providing authority for 
States to use funds to assist other States to carry out 
authorized activities in cases of a major disaster declared by 
the President under the Robert T. Stafford Disaster Relief and 
Emergency Assistance Act.
    Language is included under ``State Unemployment Insurance 
and Employment Service Operations'' providing that the 
Department of Labor may make payments on behalf of States for 
the use of the National Directory of New Hires.
    Language is included under ``State Unemployment Insurance 
and Employment Service Operations'' providing that the 
Department of Labor may make payments from funds appropriated 
for States' grants on behalf of States to the entity operating 
the State Information Data Exchange System.
    Language is included under ``State Unemployment Insurance 
and Employment Service Operations'' providing that the 
Department of Labor may make payments from funds appropriated 
for States' grants on behalf of States to the entity operating 
the Unemployment Insurance Integrity Center of Excellence.
    Language is included under ``State Unemployment Insurance 
and Employment Service Operations'' providing that 
appropriations for establishing a national one-stop career 
system may be obligated in contracts, grants or agreements with 
States or non-State entities.
    Language is included under ``State Unemployment Insurance 
and Employment Service Operations'' providing that States 
awarded grants to support national activities of the Federal-
State unemployment insurance system may award subgrants to 
other States.
    Language is included under ``State Unemployment Insurance 
and Employment Service Operations'' providing that funds 
available for integrated Unemployment Insurance and Employment 
Service automation may be used by States notwithstanding cost 
allocation principles prescribed under the Office of Management 
and Budget ``Uniform Administrative Requirements, Cost 
Principles, and Audit Requirements for Federal Awards.''
    Language is included under ``State Unemployment Insurance 
and Employment Service Operations'' providing that the 
Department of Labor may reallot funds among States 
participating in a consortium.
    Language is included under ``State Unemployment Insurance 
and Employment Service Operations'' allowing the Secretary to 
collect fees, to remain available until September 30, 2019, for 
the costs associated with additional data collection, analyses, 
and reporting services related to the National Agricultural 
Workers Survey.
    Language is included under ``Pension Benefit Guarantee 
Corporation'' providing for additional administrative funds if 
participants with plans terminated during the period exceed a 
certain level.
    Language is included under ``Pension Benefit Guarantee 
Corporation'' providing that obligations may exceed amounts 
provided for unforeseen and extraordinary pretermination 
expenses or unforeseen and extraordinary multiemployer program 
expenses if approved by the Office of Management and Budget.
    Language is included under ``Special Benefits'' providing 
that the Department of Labor may use authority to reimburse an 
employer who is not the employer at the time of injury for 
portions of the salary of a re-employed, disabled beneficiary.
    Language is included under ``Special Benefits'' providing 
that balances of reimbursements unobligated on September 30, 
2017 shall remain available until expended.
    Language is included under ``Special Benefits'' providing 
that funds shall be transferred to the appropriation from 
entities required under 5 U.S.C. 8147(c) as determined by the 
Department of Labor.
    Language is included under ``Special Benefits'' providing 
that funds transferred from entities under 5 U.S.C 8147(c), 
specified amounts may be used by the Department of Labor for 
maintenance and data and communications systems, workload 
processing, roll disability management and medical review, and 
program integrity with remaining amounts paid into the 
Treasury.
    Language is included under ``Special Benefits'' providing 
that the Secretary may prescribe regulations requiring 
identification for the filing benefit claims.
    Language is included under ``Administrative Expenses, 
Energy Employees Occupational Illness Compensation Fund'' 
providing that the Secretary may prescribe regulations for 
requiring identification for the filing benefit claims.
    Language is included under ``Occupational Safety and Health 
Administration'' providing that up to a certain amount of fees 
collected from the training institute may be retained and used 
for related training and education.
    Language is included under ``Occupational Safety and Health 
Administration'' providing that fees collected from Nationally 
Recognized Testing Laboratories may be used to administer 
laboratory recognition programs that insure safety of equipment 
used in the workplace.
    Language is included under ``Occupational Safety and Health 
Administration'' that prohibits enforcement on farming 
operations of 10 or fewer employees or of an employer with 10 
or fewer employees that is below the national average in 
specific injury categories except under specific exclusions.
    Language is included under ``Mine Safety and Health 
Administration'' providing that funds made available for State 
assistance grants may be used for the purchase and maintenance 
of equipment required by the Coal Mine Dust rule.
    Language is included under ``Mine Safety and Health 
Administration'' providing that a specific amount may be 
collected by the National Mine Health and Safety Academy and 
made available for mine safety and health education and 
training.
    Language is included under ``Mine Safety and Health 
Administration'' providing that a specific amount may be 
collected from the approval and certification of equipment and 
materials and made available for other such activities.
    Language is included under ``Mine Safety and Health 
Administration'' providing that the Department of Labor may 
accept lands, buildings, equipment, and other contributions 
from public and private sources for cooperative projects.
    Language is included under ``Mine Safety and Health 
Administration'' providing that the Department of Labor may 
promote health and safety education and training through 
cooperative agreements with States, industry and safety 
associations.
    Language is included under ``Mine Safety and Health 
Administration'' providing that the Department of Labor may 
recognize the Joseph A. Holmes Safety Association as the 
principal safety association and may provide funds or personnel 
as officers in local chapters or the national organization.
    Language is included under ``Mine Safety and Health 
Administration'' providing that the Department of Labor may use 
appropriated funds to provide for costs associated with mine 
rescue and survival operations in the event of a major 
disaster.
    Language is included under ``Departmental Management--
Salaries and Expenses'' providing that the Bureau of 
International Labor Affairs may operating international labor 
activities through grants, subgrants or other arrangements.
    Language is included under ``Departmental Management--
Salaries and Expenses'' providing that funds available for 
program evaluation may be used to administer grants for 
evaluation purposes under certain conditions.
    Language is included under ``Departmental Management--
Salaries and Expenses'' providing that funds available to the 
Women's Bureau may be used for grants to service and promote 
the interests of women in the workplace.
    Language is included under ``Departmental Management--
Salaries and Expenses'' providing that certain amounts made 
available to the Women's Bureau shall be used for grants 
authorized by the Women in Apprenticeship and Nontraditional 
Occupations Act.
    Language is included under ``Veterans Employment and 
Training'' providing that up to three percent of States' grants 
may be used for federal expenditures for data systems and 
contract support.
    Language is included under ``Veterans Employment and 
Training'' providing that funds may be used for support 
specialists providing intensive services to wounded 
servicemembers.
    Language is included under ``Veterans Employment and 
Training'' providing that Department of Labor may reallocate up 
to three percent of funds provided among appropriated accounts.
    Language is included under ``Veterans Employment and 
Training'' providing that the HIRE Vets Medallion Award Fund 
shall be available to the Secretary for expenses of the HIRE 
Vets Medallion Award Program.
    Language is included under ``Veterans Employment and 
Training'' providing that funds made available to assist 
homeless veterans may be awarded through September 30, 2018.
    Language is included under ``Veterans Employment and 
Training'' providing that authorized services to veterans may 
also be provided to veterans recently released from 
incarceration.
    Language is included under ``General Provisions'' 
prohibiting the use of Job Corps funds to pay the salaries and 
bonuses at a rate in excess of Executive Level II.
    Language is included under ``General Provisions'' 
authorizing the transfer of up to one percent of discretionary 
funds between programs, projects, or activities as long as the 
transfer does not increase any program, project, or activity by 
more than three percent and no new program, project, or 
activity is created by such transfer.
    Language is included under ``General Provisions'' 
prohibiting the use funds for procurement of goods or services 
rendered by forced or indentured child labor.
    Language is included under ``General Provisions'' 
prohibiting the use of any funds appropriated for grants 
solicited after January 15, 2014, under section 414(c) of the 
American Competitiveness and Workforce Improvement Act of 1998, 
for purposes other than competitive grants for training 
individuals over the age of 16 who are not currently enrolled 
in school in the occupations and industries for which employers 
are using H-1B visa to hire foreign workers.
    Language is included under ``General Provisions'' 
prohibiting the use of any funds appropriated for Employment 
and Training Administration programs to be used to pay the 
salaries and bonuses at a rate in excess of Executive Level II 
except under specific exclusions.
    Language is included under ``General Provisions'' providing 
that the Department of Labor may transfer funds from the 
Employment and Training Administration to Program 
Administration when it is determined that services will be more 
efficiently performed and that the Department may transfer 
certain amounts to Program Administration to conduct program 
integrity activities.
    Language is included under ``General Provisions'' providing 
that the Department of Labor may transfer funds from specified 
accounts to the ``Office of the Chief Evaluation Officer'' for 
program evaluations.
    Language is included under ``General Provisions'' providing 
that the Department of Labor may use the performance 
accountability system in effect prior to July 1, 2016 for 
purposes of implementing section 147 of the WIOA.
    Language is included under ``General Provisions'' regarding 
the application of certain Fair Labor Standards Act 
requirements pertaining to the evaluation of claims following a 
major disaster.
    Language is included under ``General Provisions'' 
rescinding advance appropriations for the Dislocated Workers 
National Reserve.
    Language is included under ``General Provisions'' providing 
flexibility of crossing for H-2B nonimmigrant workers in the 
seafood industry.
    Language is included under ``General Provisions'' providing 
requirements for the determination of prevailing wages in the 
H-2B nonimmigrant workers program.
    Language is included under ``General Provisions'' 
prohibiting the use of any funds to enforce certain 
administrative requirements under the H-2B nonimmigrant workers 
program.
    Language is included under ``General Provisions'' providing 
that the regulation regarding the definition of the term 
fiduciary has no effect.

           TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES

    Language is included under ``Health Resources and Services 
Administration--Health Workforce'' overriding the proportional 
funding requirements in the Public Health Service Act for 
sections 736, 747, 751, and 762.
    Language is included under ``Health Resources and Services 
Administration--Health Workforce'' providing that fees 
collected for the disclosure of information under the 
information reporting requirement program authorized by section 
1921 of the Social Security Act shall be sufficient to recover 
the full costs of the operation program and shall remain 
available until expended to carry out that Act.
    Language is included under ``Center for Disease Control and 
Prevention--Public Health Preparedness and Response'' 
permitting CDC to operate and maintain an aircraft.
    Language is included under ``Center for Disease Control and 
Prevention--Buildings and Facilities'' providing the use of 
funds to support acquisition, renovation, or replacement, of 
the National Institute Occupational Safety and Health's 
underground and surface coal mining research capacity.
    Language is included under ``Center for Disease Control and 
Prevention--Buildings and Facilities'' providing funds from 
former employees with existing Individual Learning Accounts 
unobligated to be available to support acquisition, renovation, 
or replacement, of the National Institute for Occupational 
Safety and Health's underground and surface coal mining 
research capacity.
    Language is included under ``Substance Abuse and Mental 
Health Services Administration--Mental Health'' that allows 
SAMHSA to provide technical assistance to communities that do 
not receive grants but want to implement systems of care model 
programs.
    Language is included under ``Substance Abuse and Mental 
Health Services Administration--Mental Health'' requiring 
states to spend 10 percent of the Mental Health Block Grant for 
programs for individuals with early serious mental illness.
    Language is included under ``Substance Abuse and Mental 
Health Services Administration--Mental Health'' exempting the 
Mental Health Block Grant from the evaluation set-aside in 
section 241 of the Public Health Service Act.
    Language is included under ``Substance Abuse and Mental 
Health Services Administration Substance Abuse Treatment'' 
exempting the Substance Abuse Prevention and Treatment Block 
Grant from the evaluation set-aside in section 241 of the 
Public Health Service Act.
    Language is included under ``Centers for Medicare and 
Medicaid Services--Program Management'' prohibiting the 
collection of fees from qualified health plans offered through 
an Exchange established under Public Law 111-148.
    Language is included under ``Centers for Medicare and 
Medicaid Services--Health Care Fraud and Abuse Control 
Account'' providing funds to support the cost of the Senior 
Medicare Patrol program.
    Language is included under ``Administration for Children 
and Families Refugee and Entrant Assistance'' permitting a 10 
percent transfer.
    Language is included under Administration for Community 
Living establishing an assistive technology alternative 
financing program.
    Language is included under Administration for Community 
Living prohibiting the use of the funds provided in the bill to 
pursue legal action on behalf of a protection and advocacy 
system described in section 103 of the Protection and Advocacy 
for Individuals with Mental Illness Act unless public notice 
has been provided within 90 of instituting action to the named 
person or their legal guardian.
    Language is included under Administration for Community 
Living waiving the public notice requirement for individuals 
without a guardian, who are not competent to consent, who are 
wards of the State or subject to public guardianship.
    Language is included under ``General Departmental 
Management'' for competitive grants that implement education in 
sexual risk avoidance using medically accurate information, 
evidence-based approaches and teach benefits of healthy 
relationships, goal setting and resisting sexual coercion and 
other youth risk behaviors.
    Language is included under ``Public Health and Social 
Services Emergency Fund'' to provide enhanced transfer 
authority to this account to address public health emergencies.
    Section 201 limits the amount available for official 
reception and representation expenses.
    Section 202 limits the salary of an individual through an 
HHS grant or other extramural mechanism to not more than the 
rate of Executive Level II.
    Section 203 prohibits the Secretary from using evaluation 
set-aside funds until the Committees on Appropriations of the 
House of Representatives and the Senate receive a report 
detailing the planned use of such funds.
    Section 204 reduces the PHS evaluation set-aside to 2.4 
percent.
    Section 205 permits the Secretary of HHS to transfer up to 
one percent of any discretionary funds between appropriations, 
provided that no appropriation is increased by more than three 
percent by any such transfer to meet emergency needs. 
Notification must be provided to the Committees on 
Appropriations at the program, project, and activity level in 
advance of any transfer.
    Section 206 continues the 60 day flexibility for National 
Health Service Corps contract terminations.
    Section 207 prohibits the use of Title X funds unless the 
applicant for the award certifies to the Secretary that it 
encourages family participation in the decision of minors to 
seek family planning services and that it provides counseling 
to minors on how to resist attempts to coerce minors into 
engaging in sexual activities.
    Section 208 states that no provider of services under Title 
X shall be exempt from any state law requiring notification or 
the reporting of child abuse, child molestation, sexual abuse, 
rape, or incest.
    Section 209 provides conscience protections to participants 
in the Medicare Advantage program who chose not to provide, pay 
for, provide coverage of, or provide referrals for abortions.
    Section 210 prohibits funds from being used to advocate or 
promote gun control.
    Section 211 permits funding for HHS international HIV/AIDS 
and other infectious disease, chronic and environmental 
disease, and other health activities abroad to be spent under 
the State Department Basic Authorities Act of 1956.
    Section 212 relates to certain international health 
activities.
    Section 213 provides the Director of NIH, jointly with the 
Director of the Office of AIDS Research, the authority to 
transfer up to three percent of human immunodeficiency virus 
funds.
    Section 214 makes NIH funds available for human 
immunodeficiency virus research available to the Office of AIDS 
Research.
    Section 215 grants authority to the Office of the Director 
of the NIH to enter directly into transactions in order to 
implement the NIH Common Fund for medical research and 
permitting the Director to utilize peer review procedures, as 
appropriate, to obtain assessments of scientific and technical 
merit.
    Section 216 clarifies that funds appropriated to NIH 
institutes and centers may be used for minor repairs or 
improvements to their buildings, up to $3,500,000 per project 
with a total limit for NIH of $45,000,000.
    Section 217 transfers one percent of the funding made 
available for National Institutes of Health National Research 
Service Awards to the Health Resources and Services 
Administration and Agency for Healthcare Research and Quality.
    Section 218 continues the Biomedical Advanced Research and 
Development Authority ten year contract authority.
    Section 219 requires HHS to provide details on its public 
website related to how the Prevention and Public Health Funds 
are used.
    Section 220 requires HHS to include certain information 
concerning the number of full-time federal employees and 
contractors working on the ACA in the fiscal year 2019 budget 
request.
    Section 221 includes specific report requirements for CMS's 
marketplaces activities in the fiscal year 2019 budget request.
    Section 222 continues certain Congressional notification 
requirements.
    Section 223 prohibits CMS Program Account from being used 
to support risk corridor payments.
    Section 224 requires HHS to submit an analysis of the 
impact of section 2713 of the PHS Act on discretionary 
programs.
    Section 225 directs the spending of the Prevention and 
Public Health fund.
    Section 226 prohibits funds from being used for Title X 
family planning activities.
    Section 227 continues a provision relating to breast cancer 
screening.
    Section 228 requires the NIH to continue to use existing 
indirect cost negotiated rates.
    Section 229 prevents funding of the Navigator program.

                   TITLE III--DEPARTMENT OF EDUCATION

    Language is included under ``General Provisions'' allowing 
ESEA funds consolidated for evaluation purposes to be available 
from July 1, 2018 through September 30, 2019.
    Language is included under ``General Provisions'' allowing 
certain institutions to continue to use endowment income for 
student scholarships.
    Language is included under ``General Provisions'' extending 
the authorization of the National Advisory Committee on 
Institutional Quality and Integrity.
    Language is included under ``General Provisions'' extending 
the authority to provide account maintenance fees to guaranty 
agencies for Federal student loans.

                       TITLE IV--RELATED AGENCIES

    Language is included under ``Federal Mediation and 
Conciliation Service--Salaries and Expenses'' providing that 
fees charged for special training and other services and be 
retained and used for authorized purposes, that fees for 
arbitration services may only be used for training agency 
personnel, and that the Director may accept gifts and services 
in aid of any projects under the Director's jurisdiction.
    Language is included under ``National Labor Relations 
Board--Salaries and Expenses'' prohibiting the use of funds for 
organizing or assisting in the organization of agricultural 
workers or for investigations, hearings, directives, or orders 
related to bargaining units of agricultural workers including 
employees involved in the maintenance and operations of 
ditches, canals, reservoirs and waterways for agricultural 
purposes.
    Language is included under ``National Labor Relations 
Board--Administrative Provisions'' prohibiting the use of 
electronic voting in representation elections.
    Language is included under ``National Labor Relations 
Board--Administrative Provisions'' prohibiting the exertion of 
jurisdiction related to Indian Tribes.
    Language is included under ``National Labor Relations 
Board--Administrative Provisions'' prohibiting the application 
of a new ``joint-employer'' standard.
    Language is included under ``National Labor Relations 
Board--Administrative Provisions'' prohibiting the application 
of a certain bargaining unit standard.
    Language is included under ``The Committee for Purchase 
from People Who are Blind or Severely Disabled'' requiring that 
written agreements, with certain oversight provisions, be in 
place in order for authorized fees to be charged by certified 
nonprofit agencies.

                      TITLE V--GENERAL PROVISIONS

    Section 501 permits the Secretaries of Labor, Health and 
Human Services, and Education to transfer unexpended balances 
of prior appropriations to accounts corresponding to current 
appropriations to be used for the same purpose and for the same 
periods of time for which they were originally appropriated.
    Section 502 prohibits the obligation of funds beyond the 
current fiscal year unless expressly so provided.
    Section 503 prohibits funds from being used to support or 
defeat legislation.
    Section 504 limits the amount available for official 
reception and representation expenses for the Secretaries of 
Labor and Education, the Director of the Federal Mediation and 
Conciliation Service, and the Chairman of the National 
Mediation Board.
    Section 505 requires grantees receiving Federal funds to 
clearly state the percentage of the total cost of the program 
or project that will be financed with Federal money.
    Section 506 prohibits the use of funds for any abortion.
    Section 507 provides exceptions to section 506 and a 
provision prohibiting funds from being made available to a 
Federal agency or program, or to a State or local government, 
if such agency, program or government discriminates against 
institutional or individual health care entities because they 
do not provide, pay for, provide coverage of, or refer for 
abortions.
    Section 508 prohibits use of funds for certain research 
involving human embryos.
    Section 509 prohibits use of funds for any activity that 
promotes the legalization of any drug or substance included in 
schedule I of the schedules of controlled substances.
    Section 510 prohibits use of funds to promulgate or adopt 
any final standard providing for a unique health identifier 
until legislation is enacted specifically approving the 
standard.
    Section 511 prohibits funds to be obligated or expended on 
a contract with an entity that has not submitted a report on 
qualified veteran employees as required under 38 U.S.C. 
4212(d).
    Section 512 prohibits any transfer of funds made available 
in this Act except by the authority provided in this Act or 
another appropriations Act.
    Section 513 limits funds in the bill for public libraries 
to those that comply with the requirements of the Children's 
Internet Protection Act.
    Section 514 dictates the procedures for the reprogramming 
of any funds provided in the bill.
    Section 515 continues a provision pertaining to 
appointments to federal scientific advisory committees to 
prevent the disclosure of information like political 
affiliation of candidates for appointment.
    Section 516 requires each department and related agency 
funded through this Act to submit an operating plan within 45 
days of enactment, detailing any funding allocations that are 
different than those specified in this Act, the accompanying 
detailed table, or budget request.
    Section 517 requires the Secretaries of Labor, Health and 
Human Services, and Education to submit a quarterly report to 
the Committees on Appropriations of the House of 
Representatives and the Senate containing certain information 
on noncompetitive contracts, grants, and cooperative agreements 
exceeding $500,000 in value.
    Section 518 prohibits use of funds to process claims for 
credit for quarters of coverage based on work performed under a 
Social Security number that was not the claimant's number, 
where the performance of such work under such number has formed 
the basis for a conviction of the claimant of a violation of 
section 208(a)(6) or (7) of the Social Security Act.
    Section 519 prohibits use of funds to implement a Social 
Security totalization agreement with Mexico.
    Section 520 prohibits federal funds for the purchase of 
syringes or sterile needles, but allows communities with rapid 
increases in cases of HIV and Hepatitis to access federal funds 
for other activities, including substance use counseling and 
treatment referrals.
    Section 521 prohibits the use of funds for the downloading 
or exchanging of pornography.
    Section 522 prohibits 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 directs certain reporting requirements for 
conference expenditures.
    Section 524 requires disclosure of U.S. taxpayer funding 
for programs used in advertising.
    Section 525 authorizes performance partnership pilots.
    Section 526 requires quarterly reports on the status of 
balances of appropriations from the Departments of Labor, 
Health and Human Services and Education and the Social Security 
Administration.
    Section 527 prohibits the use of funds to implement, 
administer, enforce or further the provisions of Public Law 
111-148 and portions of Public Law 111-152 with certain 
exceptions.
    Section 528 prohibits funds for research on fetal tissue 
obtained from an induced abortion.
    Section 529 restricts funding to certain health care 
entities.
    Section 532 delays obligations in the Child Enrollment 
Contingency Fund.
    Section 537 prohibits application of certain minimum wage 
requirements on Federal lands.

                  APPROPRIATIONS NOT AUTHORIZED BY LAW

    Pursuant to clause 3(f)(1)(B) of rule XIII of the Rules of 
the House of Representatives, the following table lists the 
appropriations in the accompanying bill which are not 
authorized by law for the period concerned:

----------------------------------------------------------------------------------------------------------------
                                                                                  Appropriations
                                         Last Year of                              in Last Year   Appropriations
          Agency Program                Authorization       Authorization Level         of         in this Bill
                                                                                   Authorization
----------------------------------------------------------------------------------------------------------------
DEPARTMENT OF LABOR ETA:
    Reintegration of Ex-Offenders   FY 2010..............  $20,000,000..........     $15,000,000     $82,078,000
     (transition activities
     authorized by Second Chance
     Act, 2007).
VETERANS' EMPLOYMENT AND TRAINING
 SERVICE:
    Homeless Veterans Program.....  FY 2015..............  50,000,000...........      38,109,000      47,537,000
DEPARTMENT OF HEALTH AND HUMAN
 SERVICES:
    HRSA:
        Nursing Education Loan      FY 2007..............  Such Sums............      31,055,000      83,135,000
         Repayment.
        Faculty Loan Repayment....  FY 2014..............  5,000,000............       1,187,000       1,190,000
        Scholarships for            FY 2014..............  Such Sums............      44,857,000      45,970,000
         Disadvantaged Students.
        National Center for         FY 2014..............  7,500,000............       4,651,000       4,663,000
         Workforce Analysis.
        Primary Care Training and   FY 2014..............  Such Sums............      36,831,000      38,924,000
         Enhancement.
        Oral Health Training        FY 2012..............  25,000,000...........      31,928,000      36,673,000
         Programs.
        Area Health Education       FY 2014..............  125,000,000..........      30,250,000      30,250,000
         Centers.
        Education & Training--
         Geriatrics.
            (Workforce              FY 2014..............  10,800,000...........      33,237,000      34,737,000
             Development).
            (Career Incentive       FY 2013..............  10,000,000...........  ..............  ..............
             Awards).
        Mental & Behavioral Health  FY 2013..............  35,000,000...........       7,896,000       9,916,000
         Education.
        Nursing Workforce
         Development.
            (Nurse Education,       FY 2014..............  Such Sums............      37,913,000     128,067,000
             Practice, Retention,
             and Quality Grants).
        (Nurse Faculty Loan         FY 2014..............  Such Sums............      24,500,000  ..............
         Program).
        Sickle Cell...............  FY 2009..............  10,000,000...........       4,455,000       4,455,000
        Healthy Start.............  FY 2013..............  Formula..............     100,746,000     103,500,000
        Emergency Relief--Part A..  FY 2013..............  789,471,000..........     649,373,000     655,876,000
        Comprehensive Care--Part B  FY 2013..............  1,562,169,000........   1,314,446,000   1,315,005,000
        Early Intervention--Part C  FY 2013..............  285,766,000..........     205,544,000     201,079,000
        Coordinated Services and    FY 2013..............  87,273,000...........      75,088,000      75,088,000
         Access to Research for
         Women, Infants, Children
         and Youth--Part D.
        Special Projects of         FY 2013..............  25,000,000...........      25,000,000      25,000,000
         National Significance--
         Part F.
        Education and Training      FY 2013..............  42,178,000...........      33,275,000      33,611,000
         Centers--Part F.
        Dental Reimbursement--Part  FY 2013..............  15,802,000...........      12,991,000      13,122,000
         F.
        Organ Transplantation.....  FY 1993..............  Such Sums............       2,767,000      23,549,000
        Rural Health Outreach       FY 2012..............  45,000,000...........      55,553,000      65,500,000
         Grants.
        Rural Hospital Flexibility  FY 2012..............  Such Sums............      41,040,000      43,609,000
         Grants.
        State Offices of Rural      FY 2002..............  Such Sums............       4,000,000      10,000,000
         Health.
        Telehealth................  FY 2006..............  Such Sums............       6,814,000      18,500,000
    CDC:
        Sexually Transmitted        FY 1998..............  Such Sums............     113,671,000     152,310,000
         Diseases Grants.
        National Cancer Registries  FY 2003..............  Such Sums............             N/A      49,440,000
        National Center for Health  FY 2003..............  Such Sums............     125,899,000     155,397,000
         Statistics.
        WISEWOMEN.................  FY 2003..............  Such Sums............      12,419,000      21,120,000
        Asthma (Environmental)....  FY 2005..............  Such Sums............      32,422,000      29,000,000
        Folic Acid................  FY 2005..............  Such Sums............       2,188,000       3,150,000
        Injury Prevention and       FY 2005..............  Such Sums............     138,237,000     286,059,000
         Control.
        Oral Health Promotion.....  FY 2005..............  Such Sums............      11,204,000      18,500,000
        Safe Motherhood/Infant      FY 2005..............  Such Sums............      44,738,000      44,000,000
         Health Promotion.
        Birth Defects,              FY 2007..............  Such Sums............     122,242,000     137,560,000
         Developmental Disability,
         Disability and Health.
        Developmental Disabilities  FY 2011..............  21,000,000...........      21,380,000      23,100,000
         Surveillance and Research
         Program (Autism).
        Breast and Cervical Cancer  FY 2012..............  275,000,000..........     204,779,000     210,000,000
        Johanna's Law.............  FY 2012..............  18,000,000...........       4,972,000       5,500,000
        Epidemiology Laboratory     FY 2013..............  190,000,000..........      32,424,000      40,000,000
         Capacity Grants.
        National TB Strategy/       FY 2013..............  243,101,000..........     132,997,000     142,256,000
         Grants.
        Public Health Workforce     FY 2013..............  39,500,000...........      64,000,000      45,000,000
         and Career Development.
        National Diabetes           FY 2014..............  Such Sums............      10,000,000      25,000,000
         Prevention Program.
        Section 317 Immunization..  FY 2014..............  Such Sums............     610,847,000     556,792,000
        Young Women's Breast        FY 2014..............  9,000,000............       4,951,000       4,960,000
         Health Awareness.
        Congenital Heart Disease    FY 2015..............  Such Sums............       4,000,000       4,000,000
         Programs.
    SAMHSA:
        Treatment Systems for       FY 2003..............  50,000,000...........      16,700,000      36,386,000
         Homeless Individuals.
    AHRQ:
        Research on Health Costs,   FY 2005..............  Such Sums............     324,000,000     300,000,000
         Quality, and Outcomes.
    ACF:
        Low Income Home Energy      FY 2007..............  5,100,000,000........   2,161,170,000   3,390,304,000
         Assistance Program.
        Children and Families
         Services Programs
            Adoption Awareness      FY 2005..............  Such Sums............      12,453,000      39,100,000
             Programs.
            Adoption and Legal      FY 2016..............  Such Sums............      37,943,000      37,943,000
             Guardianship
             Incentive Payments.
            Native American         FY 2002..............  Such Sums............      45,826,000      52,050,000
             Programs.
            Community Services      FY 2003..............  Such Sums............     645,762,000     600,000,000
             Block Grant.
            Head Start............  FY 2012..............  Such Sums............   7,968,544,000   9,275,000,000
            Runaway and Homeless    FY 2013..............  Such Sums............     107,852,000     119,121,000
             Youth Programs.
            CAPTA programs........  FY 2015..............  Such Sums............     143,981,000     137,174,000
            Family Violence         FY 2015..............  178,500,000..........     139,500,000     159,750,000
             Programs.
            Disaster Human          N/A..................  N/A..................             N/A       1,864,000
             Services Case
             Management.
    Refugee and Entrant Assistance
        Transitional and Medical    FY 2002..............  Such Sums............     227,243,000     320,000,000
         Services.
            Victims of Torture....  FY 2007..............  25,000,000...........       9,817,000      10,735,000
    ACL:
        Alzheimer's Diseases        FY 2002..............  Such Sums............      11,483,000      19,500,000
         Demonstration.
        Lifespan Respite Care.....  FY 2011..............  94,810,000...........       2,495,000       3,360,000
        Developmental Disabilities  FY 2007..............  Such Sums............     155,115,000     162,916,000
        Voting Access for People    FY 2005..............  17,410,000...........      13,879,000       4,963,000
         with Disabilities.
        Elder Justice/Adult         FY 2014..............  129,000,000..........               0      11,874,000
         Protective Services.
        Assistive Technology......  FY 2010..............  Such Sums............      25,000,000      34,000,000
DEPARTMENT OF EDUCATION:
    Adult Education...............  FY 2004..............  Such Sums............     590,233,000     579,195,000
    Howard University--Endowment    FY 1985..............  Such Sums............       2,000,000       3,405,000
     Program.
    Institute of Education          FY 2009..............  Such Sums............     617,175,000     459,903,000
     Sciences.
RELATED AGENCIES:
    Corporation for Public          FY 1996..............  425,000,000..........     275,000,000     445,000,000
     Broadcasting.
    Institute of Museum and         FY 2009..............  Such Sums............     274,840,000     231,000,000
     Library Services.
    National Council on Disability  FY 2003..............  Such Sums............       3,144,000       3,200,000
----------------------------------------------------------------------------------------------------------------

                          PROGRAM DUPLICATION

    Pursuant to section 3(j)(2) of H. Res. 5 (115th Congress), 
no provision of this bill establishes or reauthorizes a program 
of the Federal Government known to be duplicative of another 
Federal program, a program that was included in any report from 
the Government Accountability Office to Congress pursuant to 
section 21 of Public Law 111-139, or a program related to a 
program identified in the most recent Catalog of Federal 
Domestic Assistance.

                          DIRECTED RULE MAKING

    The bill does not direct any rule making.

                 COMPARISON WITH THE BUDGET RESOLUTION

    Pursuant to clause 3(c)(2) of rule XIII of the Rules of the 
House of Representatives and Section 308(a)(1)(A) of the 
Congressional Budget Act of 1974, the following table compares 
the levels of new budget authority provided in the bill with 
the appropriate allocations under section 302(b) of the Budget 
Act:

                                            [In millions of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                  302(b) Allocation             This Bill
                                                             ---------------------------------------------------
                                                                 Budget                    Budget
                                                               Authority     Outlays     Authority     Outlays
----------------------------------------------------------------------------------------------------------------
Discretionary...............................................     $157,938     $170,231     $157,938  \1\$168,476
Mandatory...................................................      778,472      778,222      778,472   \1\778,222
----------------------------------------------------------------------------------------------------------------
\1\Includes outlays from prior-year budget authority.

                      FIVE-YEAR OUTLAY PROJECTIONS

    Pursuant to section 308(a)(1)(B) of the Congressional 
Budget Act of 1974, the following table contains five-year 
projections prepared by the Congressional Budget Office of 
outlays associated with the budget authority provided in the 
accompanying bill:

                        [In millions of dollars]
------------------------------------------------------------------------
 
------------------------------------------------------------------------
Projection of outlays associated with the
 recommendation:
    2018.......................................              \1\$847,411
    2019.......................................                   71,432
    2020.......................................                   18,776
    2021.......................................                    2,909
    2022 and future years......................                      628
------------------------------------------------------------------------
\1\Excludes outlays from prior-year budget authority.

               ASSISTANCE TO STATE AND LOCAL GOVERNMENTS

    Pursuant to section 308(a)(1)(C) of the Congressional 
Budget Act of 1974, the amounts of financial assistance to 
State and local governments is as follows:

                        [In millions of dollars]
------------------------------------------------------------------------
 
------------------------------------------------------------------------
New Budget Authority...........................                 $428,675
Fiscal year 2018 outlays resulting therefrom...               \1\425,239
------------------------------------------------------------------------
\1\Excludes outlays from prior-year budget authority.




        MINORITY VIEWS OF REP. NITA LOWEY AND REP. ROSA DeLAURO

    We would like to acknowledge the efforts of Chairman 
Frelinghuysen and Chairman Cole to hold a full committee markup 
of the Labor-HHS-Education bill for the third consecutive year. 
This bill, which includes some of the nation's most important 
domestic programs, needs to be debated by the committee in 
public every year.
    We are disappointed, however, that Republicans introduced 
and approved a bill that would cut labor, health, and education 
programs by $5 billion compared to the fiscal year 2017 enacted 
level. We are concerned that such a severe cut would harm 
students, seniors, women, families, and workers. To make 
matters worse, the Labor-HHS-Education bill's allocation is 
already $30 billion below the fiscal year 2010 level, after 
adjusting for inflation.
    The biggest economic challenge of our time is that too many 
people are in jobs that do not pay them a living wage. Too 
often, workers lack the skills and experience to access better 
jobs and earn family-sustaining wages.
    It used to be that workers with high school degrees were 
able to secure good paying jobs, in manufacturing and 
elsewhere, that allowed them and their families to prosper. But 
those jobs, and the high wages that used to go with them, have 
been in decline over the past 40years.
    We need to enact policies that ensure everyone can benefit 
from a growing economy, and that everyone has the skills and 
training to get a good job with high wages. We need a country 
that works for the middle class and the vulnerable, not just 
the wealthy and those with the most lobbyists.
    That's why the Labor-HHS-Education bill is so important. 
The programs in this bill provide opportunities for hardworking 
Americans to improve their economic security and for our 
economy to grow. This committee must commit to investing in 
education and job training to fulfill this country's potential.
    We must put at the center of our effort the 70 percent of 
Americans for whom a four-year college degree is not their 
preferred pathway. We must recognize and support their 
aspirations for their families and communities.
    If people are to achieve better lives for their families, 
we must build a pipeline of skilled workers. That means we need 
to have a public workforce development system that adapts to 
businesses' changing needs. In many cases, work-based learning 
and apprenticeship programs are the best options to equip 
workers with the skills to get a good job with high wages.
    The federal government has a rich history of helping 
Americans learn and grow through workforce development and 
connecting businesses with a skilled workforce, and we need to 
reinvest in that system. We will describe below how this 
Republican Labor-HHS-Education bill is a repudiation of the 
American tradition of the federal government improving schools, 
making college more affordable, training workers for better 
paying jobs, and providing health services for women.
    Of course, there are a few bright spots in this bill. We 
strongly support increases for NIH research, emergency 
preparedness, Special Education, and TRIO and GEAR UP. But even 
those increases show the fundamental insufficiency of the 
subcommittee's allocation: the NIH increase is about half the 
size of the increase for each of the past two years, and 
Special Education funding continues to fall short. When 
adjusting for inflation, the increase for Special Education 
State Grants is an effective cut, taking us further away from 
living up to our commitment to fully fund IDEA.
    Overall, the modest increases in this bill are far 
outweighed by harmful cuts to programs that ought to be 
increased.

                        LABOR-HHS-EDUCATION CUTS
                          [Dollars in millions]
------------------------------------------------------------------------
                                                     FY 2018 House comp
                               FY 2017    FY 2018    to FY 2017 Enacted
                               Enacted     House   ---------------------
                                                      dollar    percent
------------------------------------------------------------------------
Elementary & Secondary           23,822     21,337     -2,485       -10%
 Education..................
Pell Grants (discretionary).     22,475     22,475          0         0%
    Pell Grant Rescission        -1,310     -3,271     -1,961       150%
     (non-add)..............
Health Service and Resources      6,206      5,824       -382        -6%
 Admin......................
Centers for Disease Control/      7,165      7,001       -163        -2%
 Prevention.................
Substance Abuse and Mental        3,765      3,459       -306        -8%
 Health.....................
Agency for Healthcare               324        300        -24        -7%
 Research/Quality...........
CMS Program Management......      3,975      3,451       -524       -13%
Administration for Children      19,275     18,514       -761        -4%
 and Families...............
Administration for Community      1,994      1,937        -57        -3%
 Living.....................
HHS GDM and other HHS               812        620       -192       -24%
 agencies...................
Job Training (including Job       5,202      4,887       -314        -6%
 Corps).....................
Senior Community Service            400        300       -100       -25%
 Employment.................
UI & Employment Service           3,524      2,831       -693       -20%
 Operations.................
Worker Protection Agencies..      1,595      1,537        -59        -4%
International Labor Affairs.         86         27        -60       -69%
------------------------------------------------------------------------

                  EDUCATION--A KEY TO THE MIDDLE CLASS

    The Department of Education is cut by $2.2 billion below 
the fiscal year 2017 enacted level, before accounting for the 
rescission of $3.3 billion from the Pell Grant program.
    We are deeply disappointed that the bill fails to make 
additional investments in Title I, which reaches 25 million 
students in more than 80 percent of our school districts, and 
imposes harmful cuts to the 21st Century Community Learning 
Centers program, which would deny 192,000 kids enrichment 
opportunities in before- and after-school and summer school 
programs. To restore these harmful cuts, we offered an 
amendment to return the program's funding to the fiscal year 
2017 level. Unfortunately, it was defeated.
    Despite the mountain of evidence that early childhood 
interventions work to reduce inequality and narrow achievement 
gaps, the bill provides level funding for Preschool Development 
Grants and nominal increases for Head Start and Child Care, 
meaning we will continue to fall behind in providing children 
and families with high-quality early education opportunities 
and care.
    We proposed amendments to boost funding for these programs 
as well as the Child Care Access Means Parents in School 
program to help meet the needs of students with kids. 
Unfortunately, the amendments were defeated.
    This bill is fundamentally anti-teacher. It eliminates the 
Supporting Effective Instruction grants, which reduce class 
sizes and give teachers evidence-based professional 
development. Approximately 8,000 teachers across the country 
would lose their jobs. States represented by Members of this 
committee would lose a total of $1.7 billion if the majority's 
proposal was enacted.
    We proposed an amendment to restore funding for this 
program and a number of other teacher programs proposed to be 
cut or eliminated in the bill because we know that strong 
leaders are the most important school-based factor in our kids' 
academic success. While we attracted one member from across the 
aisle to join us, the amendment was ultimately defeated.
    The bill eliminates nearly a dozen education programs, 
including the largest reading program for low-income children 
and youth, Special Olympics, and funding to expand access to 
the arts in our most under-resourced communities.It imposes 
harmful cuts to proven education programs like Promise 
Neighborhoods. Cutting funding for the Special Olympics will 
not make a difference in reducing the Federal debt, but it will 
rob a segment of our population a chance at an enriching 
experience.
    We proposed amendments to reverse damaging cuts to these 
and other programs, in order to provide our children with tools 
for success. Unfortunately, while we had one member of the 
majority join us, all other Republicans opposed this amendment 
to restore funds.
    The bill threatens the very future of the Pell Grant 
program by slashing $3.3 billion and doing nothing to make 
college more affordable. It sets Pell on a dangerous path at a 
time when 44 million student borrowers have more than $1.3 
trillion in student debt.
    We tried to improve the bill by offering an amendment to 
increase the maximum Pell Grant award by $135 to keep up with 
inflation. Our Republican colleagues rejected our effort to 
help make college more affordable by voting against the 
amendment.
    In addition, we offered an amendment to require the 
Secretary of Education to implement the Borrower Defense to 
Repayment regulation to safeguard students and taxpayer dollars 
from unscrupulous institutions that commit fraud and mislead 
students. The majority opposed, and the amendment failed. We 
also offered an amendment affirming that all students deserve 
to learn in an environment free from sexual violence. With the 
support of only one member from across the aisle, the amendment 
was defeated.

                            HEALTH SERVICES

    Setting aside the much-needed increase for research at the 
National Institutes of Health, the rest of the Department of 
Health and Human Services would be cut by more than $2 billion 
under this bill.
    The bill cuts access to Mental Health and Substance Abuse 
Prevention services by more than $300 million below the fiscal 
year 2017 level, which is particularly distressing due to the 
ongoing opioid crisis. We speak often about the opioid crisis, 
but when the opportunity arises to take strong action, we fail 
to fund these priorities in a meaningful way.
    Democrats proposed amendments to restore funding for mental 
health and substance abuse prevention, in addition to nurse 
training, tobacco prevention, immunizations, research in health 
care settings, and a slate of programs that disproportionately 
serve minority communities. We also proposed an amendment to 
provide $5 billion in emergency funding to the Public Health 
Emergency Fund.
    Unfortunately, all of our efforts to improve health care 
services, train a health workforce, and fund a rapid emergency 
response were rejected.

                                SENIORS

    The bill cuts and eliminates programs designed to protect 
one of our most vulnerable populations: seniors. The State 
Health Insurance Assistance Program provides seniors with help 
in navigating the complex Medicare program; the Senior 
Community Service Employment Program provides unemployed low-
income older adults with paid work experiences; and Elder 
Rights Support Activities helps protect our elderly through the 
prevention and detection of abuse.
    We proposed an amendment to restore the harmful cuts 
proposed to these critical programs, but it was rejected.

                        WOMEN'S HEALTH SERVICES

    This bill's approach to women's health pushes a dangerous 
and harmful ideological agenda. It eliminates funding for Title 
X Family Planning and the Teen Pregnancy Prevention program--a 
combined cut of about $400 million to reproductive health 
services for women--and includes new ideological riders that 
would block funding for Planned Parenthood and effectively 
block life-saving research using cells from fetal tissue.
    We proposed amendments to restore funding for Title X 
Family Planning and the Teen Pregnancy Prevention program. In 
addition, we offered amendments to strike several ideological 
riders that would be harmful to women's health, including the 
riders that would block funding for Planned Parenthood and 
fetal tissue research. To our disappointment, the majority 
rejected restoring funds for reproductive health and retained 
each of the ideological riders that do not belong in this bill.

                             THE UNEMPLOYED

    The largest proportional department-level cut in the bill 
is the Department of Labor by $1.2 billion, or 10.1 percent, 
below the fiscal year 2017 level, before accounting for the 
rescission of $200 million from the Dislocated Worker National 
Reserve. That is baffling given the President's campaign 
promises to American workers.
    This bill hurts workers by eliminating the Employment 
Service, which helped nearly six million unemployed workers, 
including veterans, find jobs in 2015. This funding goes to our 
One-Stops to help people looking for jobs get relevant skills. 
Cutting this funding is a betrayal of job seekers in our 
economy.
    The bill also eliminates grants expanding the highly-
effective Registered Apprenticeship model that connects job 
seekers with good paying jobs employers are desperate to fill. 
The bill includes cuts to programs that make our country more 
competitive, like Job Corps, slashes job training for 
dislocated workers, and eliminates a tool that helps us 
evaluate if workforce and education programs are effective. Why 
would we eliminate programs that have for so long been about 
economic opportunity and a ladder to the middle class?
    We proposed amendments to restore funding for job training 
programs and apprenticeships, as well as Job Corps and the 
Employment Service. We also fought to restore funding to 
crucial enforcement agencies and the Bureau of International 
Labor Affairs. Once again, the majority opposed our efforts and 
the amendments failed.

                         PARTISAN POLICY RIDERS

    In addition to riders that would limit a woman's access to 
health care, this bill also attempts to block all funding for 
the Affordable Care Act. It continues to prohibit funding for 
gun violence prevention, which has had a chilling effect on gun 
violence research. And it prohibits the Department of Labor 
from ensuring that financial advisers act in the best interests 
of their clients.
    We proposed amendments to eliminate each of these 
ideological riders; unfortunately, the majority rejected each 
amendment.

                               CONCLUSION

    This bill stands in stark contrast to the bipartisan Labor-
HHS-Education bill included in the fiscal year 2017 Omnibus. 
The funding in this bill fails to meet our country's needs and 
breaks our promises to students, seniors, women, families and 
our workforce. It does not reflect our values of putting the 
middle class and the vulnerable first; instead, it benefits 
those with the most money and the most lobbyists.
    We hope our colleagues on the other side of the aisle will 
work with Democrats during the conference process to fix the 
many inadequacies in this bill. At that point, we look forward 
to working with Chairman Frelinghuysen and Chairman Cole to 
move forward on a bill we can all support.
                                   Nita M. Lowey.
                                   Rosa DeLauro.