95–187 PDF 

Calendar No. 137 

114TH CONGRESS REPORT " ! SENATE 1st Session 114–74 

DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATION BILL, 2016 

JUNE 25, 2015.—Ordered to be printed 

Mr. BLUNT, from the Committee on Appropriations, 

submitted the following 

R E P O R T 

[To accompany S. 1695] 

The Committee on Appropriations reports the bill (S. 1695) making appropriations for Departments of Labor, Health and Human 

Services, and Education, and related agencies for the fiscal year 

ending September 30, 2016, and for other purposes, reports favorably thereon without amendment and recommends that the bill do 

pass. 

Amounts to new budget authority 

Total of bill as reported to the Senate ....................$879,922,043,000 

Amount of 2015 appropriations ............................... 848,302,078,000 

Amount of 2016 budget estimate ............................ 892,775,228,000 

Bill as recommended to Senate compared to: 

2015 appropriations .......................................... ∂31,619,965,000 

2016 budget estimate ........................................ ¥12,853,185,000 
(2) 

C O N T E N T S 

Page 

List of Abbreviations ............................................................................................... 4 

Summary of Budget Estimates and Committee Recommendations .................... 8 

Overview ............................................................................................................ 8 

National Institutes of Health .......................................................................... 8 

Preventing Bureaucratic Overreach ................................................................ 10 

Improving Fiscal Accountability ...................................................................... 12 

Fighting Opioid Abuse ..................................................................................... 13 

Combating Antibiotic Resistant Bacteria ....................................................... 13 

Rural Health Care ............................................................................................ 14 

Increasing the Efficiency and Cost Effectiveness of Government ................ 14 

Other Highlights of the Bill ............................................................................. 16 

Title I: Department of Labor: 

Employment and Training Administration .................................................... 19 

Employee Benefits Security Administration .................................................. 27 

Pension Benefit Guaranty Corporation .......................................................... 27 

Wage and Hour Division .................................................................................. 28 

Office of Labor-Management Standards ......................................................... 28 

Office of Federal Contract Compliance Programs .......................................... 29 

Office of Workers’ Compensation Programs ................................................... 29 

Occupational Safety and Health Administration ........................................... 32 

Mine Safety and Health Administration ........................................................ 33 

Bureau of Labor Statistics ............................................................................... 34 

Office of Disability Employment Policy .......................................................... 34 

Departmental Management ............................................................................. 35 

General Provisions ........................................................................................... 37 

Title II: Department of Health and Human Services: 

Health Resources and Services Administration ............................................. 39 

Centers for Disease Control and Prevention .................................................. 56 

National Institutes of Health .......................................................................... 78 

Substance Abuse and Mental Health Services Administration .................... 108 

Agency for Healthcare Research and Quality ................................................ 116 

Centers for Medicare and Medicaid Services ................................................. 119 

Administration for Children and Families ..................................................... 128 

Administration for Community Living ........................................................... 138 

Office of the Secretary ...................................................................................... 144 

General Provisions ........................................................................................... 157 

Title III: Department of Education: 

Education for the Disadvantaged .................................................................... 159 

Impact Aid ......................................................................................................... 161 

School Improvement Programs ........................................................................ 162 

Indian Education .............................................................................................. 166 

Innovation and Improvement .......................................................................... 167 

Safe Schools and Citizenship Education ......................................................... 171 

English Language Acquisition ......................................................................... 172 

Special Education ............................................................................................. 173 

Rehabilitation Services and Disability Research ........................................... 175 

Special Institutions for Persons With Disabilities: 

American Printing House for the Blind ................................................... 177 

National Technical Institute for the Deaf ............................................... 177 

Gallaudet University ................................................................................. 178 

Career, Technical, and Adult Education ........................................................ 178 

Student Financial Assistance .......................................................................... 179 

Student Aid Administration ............................................................................ 181 

Higher Education ............................................................................................. 183 
Page

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Title III—Continued 

Howard University ........................................................................................... 187 

College Housing and Academic Facilities Loans Program ............................ 188 

Historically Black College and University Capital Financing Program 

Account .......................................................................................................... 188 

Institute of Education Sciences ....................................................................... 188 

Departmental Management: 

Program Administration ........................................................................... 191 

Office for Civil Rights ............................................................................... 192 

Office of the Inspector General ................................................................ 192 

General Provisions ........................................................................................... 192 

Title IV: Related Agencies: 

Committee for Purchase From People Who Are Blind or Severely Disabled ............................................................................................................... 194 

Corporation for National and Community Service ........................................ 194 

Corporation for Public Broadcasting ............................................................... 197 

Federal Mediation and Conciliation Service .................................................. 197 

Federal Mine Safety and Health Review Commission .................................. 198 

Institute of Museum and Library Services ..................................................... 198 

Medicaid and CHIP Payment and Access Commission ................................. 199 

Medicare Payment Advisory Commission ...................................................... 199 

National Council on Disability ........................................................................ 199 

National Labor Relations Board ...................................................................... 200 

National Mediation Board ............................................................................... 200 

Occupational Safety and Health Review Commission ................................... 201 

Railroad Retirement Board .............................................................................. 201 

Social Security Administration ........................................................................ 202 

Title V: General Provisions ..................................................................................... 206 

Compliance With Paragraph 7, Rule XVI of the Standing Rules of the Senate .......................................................................................................................... 208 

Compliance With Paragraph 7(c), Rule XXVI of the Standing Rules of the 

Senate ................................................................................................................... 208 

Compliance With Paragraph 12, Rule XXVI of the Standing Rules of the 

Senate ................................................................................................................... 209 

Budgetary Impact of Bill ......................................................................................... 217 

Comparative Statement of New Budget Authority ............................................... 218 
(4) 

LIST OF ABBREVIATIONS 

ACA—Patient Protection and Affordable Care Act 

ACL—Administration for Community Living 

ADAP—AIDS Drug Assistance Program 

AHEC—area health education center 

AHRQ—Agency for Healthcare Research and Quality 

AP—Advanced Placement 

APH—American Printing House for the Blind 

ARRA—American Recovery and Reinvestment Act of 2009 

ASH—Assistant Secretary for Health 

ASPR—Assistant Secretary for Preparedness and Response 

BARDA—Biomedical Advanced Research and Development Authority 

BCA—Budget Control Act of 2011 

BLS—Bureau of Labor Statistics 

CAN—Cures Acceleration Network 

CCAMPIS—Child Care Access Means Parents in School 

CCDBG—Child Care and Development Block Grant 

CDC—Centers for Disease Control and Prevention 

CHAFL—College Housing and Academic Facilities Loans 

CHC—Community health center 

CHGME—Children’s Hospitals Graduate Medical Education 

CJ—Justification of Estimates for Appropriations Committees 

CMHS—Center for Mental Health Services 

CMS—Centers for Medicare and Medicaid Services 

CNCS—Corporation for National and Community Service 

CPB—Corporation for Public Broadcasting 

CSAP—Center for Substance Abuse Prevention 

CSAT—Center for Substance Abuse Treatment 

CSBG—Community Services Block Grant 

CSEOA—Community Service Employment for Older Americans 

DOD—Department of Defense 

DOE—Department of Energy 

DOL—Department of Labor 

EBSA—Employee Benefits Security Administration 

EEOICPA—Energy Employees Occupational Illness Compensation Program Act 

ERISA—Employee Retirement Income Security Act of 1974 

ESEA—Elementary and Secondary Education Act 

ETA—Employment and Training Administration 

FDA—Food and Drug Administration 

FEMA—Federal Emergency Management Agency 

FIC—Fogarty International Center 

FIE—Fund for the Improvement of Education 

FIPSE—Fund for the Improvement of Postsecondary Education 

FMCS—Federal Mediation and Coalition Service 

FMSHRC—Federal Mine Safety and Health Review Commission 
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FTE—full-time equivalent 

FWS—Federal Work Study 

GAANN—Graduate Assistance in Areas of National Need 

GAO—Government Accountability Office 

GEAR UP—Gaining Early Awareness and Readiness for Undergraduate Programs 

HBCUs—Historically Black Colleges and Universities 

HCERA—Health Care and Education Reconciliation Act of 2010 

HCFAC—Health Care Fraud and Abuse Control 

HEA—Higher Education Act 

HELP—Health, Education, Labor, and Pensions 

HFFI—Healthy Foods Financing Initiative 

HHS—Health and Human Services 

HRSA—Health Resources and Services Administration 

IC—Institute and Center 

IDeA—Institutional Development Award 

IDEA—Individuals with Disabilities Education Act 

IES—Institute of Education Sciences 

IMLS—Institute of Museum and Library Services 

IOM—Institute of Medicine 

LEA—local educational agency 

LIHEAP—Low Income Home Energy Assistance Program 

MACPAC—Medicaid and CHIP Payment and Access Commission 

MCH—maternal and child health 

MedPAC—Medicare Payment Advisory Commission 

MSHA—Mine Safety and Health Administration 

NAEP—National Assessment of Educational Progress 

NAGB—National Assessment Governing Board 

NCATS—National Center for Advancing Transitional Sciences 

NCBDDD—National Center on Birth Defects and Developmental 

Disabilities 

NCES—National Center for Education Statistics 

NCHS—National Center for Health Statistics 

NCI—National Cancer Institute 

NEI—National Eye Institute 

NHGRI—National Human Genome Research Institute 

NHLBI—National Heart, Lung, and Blood Institute 

NIA—National Institute on Aging 

NIAAA—National Institute on Alcohol Abuse and Alcoholism 

NIAID—National Institute of Allergy and Infectious Disease 

NIAMS—National Institute of Arthritis and Musculoskeletal and 

Skin Diseases 

NIBIB—National Institute of Biomedical Imaging and Bioengineering 

NICHD—Eunice Kennedy Shriver National Institute of Child 

Health and Human Development 

NIDA—National Institute on Drug Abuse 

NIDCD—National Institute on Deafness and Other Communication Disorders 

NIDCR—National Institute of Dental and Craniofacial Research 

NIDDK—National Institute of Diabetes and Digestive and Kidney Disease 

NIDRR—National Institute on Disability and Rehabilitation Research 
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NIEHS—National Institute of Environmental Health Sciences 

NIGMS—National Institute of General Medical Sciences 

NIH—National Institutes of Health 

NIMH—National Institute on Mental Health 

NIMHD—National Institute on Minority Health and Health Disparities 

NINDS—National Institute of Neurological Disorders and Stroke 

NINR—National Institute of Nursing Research 

NLM—National Library of Medicine 

NLRB—National Labor Relations Board 

NSF—National Science Foundation 

NSIP—Nutrition Services Incentives Program 

NTID—National Technical Institute for the Deaf 

NFP—Not-for-Profit 

OAR—Office of AIDS Research 

OCR—Office for Civil Rights 

ODEP—Office of Disability Employment Policy 

OFCCP—Office of Federal Contract Compliance Programs 

OIG—Office of the Inspector General 

OLMS—Office of Labor-Management Standards 

OMB—Office of Management and Budget 

OMH—Office of Minority Health 

OMHA—Office of Medicare Hearings and Appeals 

ONC—Office of the National Coordinator for Health Information 

Technology 

ORR—Office of Refugee Resettlement 

ORWH—Office of Research on Women’s Health 

OSEP—Office of Special Education Programs 

OSHA—Occupational Safety and Health Administration 

OWCP—Office of Workers’ Compensation Programs 

OWH—Office of Women’s Health 

PAIMI—protection and advocacy for individuals with mental illness 

PATH—Projects for Assistance in Transition From Homelessness 

PBGC—Pension Benefit Guaranty Corporation 

PHS—Public Health Service 

PPH Fund—Prevention and Public Health Fund 

PRNS—Programs of Regional and National Significance 

PROMISE—Promoting School Readiness of Minors in SSI 

RSA—Rehabilitation Services Administration 

SAMHSA—Substance Abuse and Mental Health Services Administration 

SAPT—substance abuse prevention and treatment 

SEA—State educational agency 

SEOG—Supplemental Educational Opportunity Grant 

SIG—School Improvement Grants 

SPRANS—Special Projects of Regional and National Significance 

SSA—Social Security Administration 

SSBG—Social Services Block Grant 

SSI—Supplemental Security Income 

STEM—science, technology, engineering, and mathematics 

TB—tuberculosis 

TBI—traumatic brain injury 

TIF—Teacher Incentive Fund 
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TIVAS—Title IV Additional Servicers 

UAC—unaccompanied alien children 

UCEDD—University Center for Excellence in Developmental 

Disabilities 

UI—unemployment insurance 

USAID—U.S. Agency for International Development 

VETS—Veterans’ Employment and Training Services 

VISTA—Volunteers in Service to America 

VR—Vocational Rehabilitation 

WANTO—Women in Apprenticeship and Non-Traditional Occupations 

WHD—Wage and Hour Division 

WIA—Workforce Investment Act 

WIF—Workforce Innovation Fund 

WISEWOMAN—Well-Integrated Screening and Evaluation for 

Women Across the Nation 
(8) 

SUMMARY OF BUDGET ESTIMATES AND COMMITTEE 

RECOMMENDATIONS 

For fiscal year 2016, the Committee recommends total budget authority of $879,922,043,000 for the Departments of Labor, Health 

and Human Services, and Education, and Related Agencies. This 

amount includes $153,188,000,000 in current year discretionary 

funding subject to discretionary spending caps and $1,561,000,000 

in cap adjustments for healthcare fraud and abuse control and for 

program integrity at the Social Security Administration, in accordance with the allocation for this bill. 

Fiscal year 2015 levels cited in this report reflect the enacted 

amounts in Public Law 113–235, the Consolidated and Further 

Continuing Appropriations Act, 2015 and exclude funds designated 

as emergency requirements for Ebola response and preparedness. 

OVERVIEW

The Labor, Health and Human Services, and Education, and Related Agencies [Labor-HHS-Education] appropriations bill constitutes the largest share of non-defense discretionary spending, 31 

percent of the total in fiscal year 2016. Total spending in this bill 

subject to discretionary spending caps is $3,575,000,000 or 2.3 percent, below the comparable fiscal year 2015 level. This significant 

funding reduction has required the Committee to make difficult decisions regarding funding reductions and consider the appropriate 

role and jurisdiction of Federal programs. 

The priorities and considerations of the Committee in developing 

this bill are summarized in the section below: 

NATIONAL INSTITUTES OF HEALTH

The Committee recommendation includes $32,084,000,000 for the 

National Institutes of Health [NIH], an increase of $2,000,000,000. 

This is the largest increase the NIH has received since Congress 

doubled the agency’s funding in 2003. The Committee strongly believes that in this difficult budget environment that the LaborHHS-Education appropriations bill must reprioritize how funding 

is allocated and must clearly recognize the essential role biomedical 

research plays in every American’s life. 

NIH-funded research has raised life expectancy, improved quality 

of life, and is an economic engine helping to sustain American competitiveness. NIH-funded biomedical research is the catalyst behind 

many of the advances that are now helping Americans live longer 

and healthier lives. Because of the Federal investment in biomedical research, U.S. cancer death rates are falling 1 percent each 

year, with each 1 percent decline saving our Nation about 

$500,000,000,000. U.S. death rates from heart disease and stroke 

have declined more than 60 percent in the last half-century. Be-
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tween 1997 and 2006, the death rate among adults with diabetes 

declined by 23 percent. 

The Committee recommendation places a high priority on funding for the NIH and believes this funding is necessary to address 

our Nation’s growing health concerns, spur medical innovation, 

sustain America’s competitiveness, and reduce healthcare costs. 

Over the past decade, the NIH has lost approximately 22 percent 

of its purchasing power for research. The likelihood that a grant 

application will receive funding has fallen to the lowest percentage 

in decades, now less than 20 percent. However, under the Committee recommendation, these trends will begin to reverse. Within 

this bill, Research Project Grants, NIH’s funding mechanism for investigator-initiated research, will increase over 7 percent. The 

Committee recommendation is estimated to support over 11,500 

new and competing grants in fiscal year 2016, an increase of nearly 

2,500 grants or more than 26 percent above the fiscal year 2015 estimate. 

The Committee recommendation allocates funding to areas holding the most extraordinary promise of scientific advancement, 

while allowing NIH to maintain flexibility to pursue unplanned scientific opportunities and address unforeseen public health needs. 

Alzheimer’s Disease.—Estimates indicate that more than 5 million people age 65 and older suffer from Alzheimer’s disease in the 

United States. This disease is not just a burden on our health; it 

is also a burden on our economy. The total payments for 

healthcare, long-term care, and hospice for people with Alzheimer’s 

and other dementias are projected to increase from 

$226,000,000,000 in 2015 to $1,100,000,000,000 in 2050. Without a 

medical breakthrough to prevent, slow, or stop the disease, 

Medicare- and Medicaid-related costs could rise nearly five-fold. 

Yet, for every $260 Medicare and Medicaid spends on caring for individuals with Alzheimer’s disease, the Federal Government spends 

only $1 on Alzheimer’s research. 

NIH-funded research is the only way to manage this disease in 

the future. Therefore, the Committee recommendation includes an 

increase of approximately $350,000,000 for the National Institute 

on Aging, the NIH Institute with the primary responsibility for 

preventing, treating, and curing Alzheimer’s disease. 

Antimicrobial Resistance.—Antibiotics have been used to successfully treat patients for more than 70 years, but over time the drugs 

have become less effective as organisms adapt to the drugs designed to kill them. Recognizing the growing public health threat 

of antimicrobial resistance, the Committee recommendation includes an increase of $100,000,000 for the National Institute of Allergy and Infectious Diseases to help expand efforts to develop new 

antibiotics and rapid diagnostic tests, and build a national genome 

sequence database on all reported resistant human infections. 

Funding is provided as part of the Combating Antibiotic Resistant 

Bacteria [CARB] initiative requested by the administration. 

BRAIN.—The Committee continues to support the Brain Research through Advancing Innovative Neurotechnologies [BRAIN] 

Initiative and fully funds the administration’s request for the program in fiscal year 2016, an increase of $70,000,000 above fiscal 

year 2015. The BRAIN Initiative will help develop a deeper under-
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standing of brain function and has the possibility of helping millions of people who suffer from a wide variety of neurological and 

psychiatric disorders such as Parkinson’s disease, schizophrenia, 

Alzheimer’s disease, and traumatic brain injury. 

Precision Medicine.—$200,000,000 is provided in the Committee’s 

recommendation for the new Precision Medicine Initiative. Instead 

of a one-size-fits-all approach, the Precision Medicine Initiative will 

allow physicians to individualize treatment to patients and allow 

treatments to be as individualized as the disease. 

Research Facilities.—Much of the Nation’s biomedical research 

infrastructure, including laboratories and research facilities at academic institutions and nonprofit research organizations, is outdated or insufficient. For taxpayers to receive full value from their 

considerable investments in biomedical research, researchers must 

have access to appropriate research facilities. $50,000,000 is provided for grants or contracts to research entities to expand, remodel, renovate, or alter existing research facilities or construct 

new research facilities as authorized under 42 U.S.C. 283k. 

PREVENTING BUREAUCRATIC OVERREACH

The growth in bureaucracy under the current administration has 

brought with it numerous rules and regulations that push the administration’s statutory authority as well as overburden job creators, educators, and healthcare providers. Such overreach threatens to undermine entire sectors of the economy, and in some cases, 

is clearly intended to achieve no other end than to upset the balance between employers and employees. The Committee has included several provisions to limit the onerous rules and regulations 

released by the administration over the past several years. 

Independent Payment Advisory Board [IPAB].—The Committee 

recommendation eliminates funding for the IPAB, an unaccountable panel tasked with rationing Medicare spending. 

Labor Regulations.—The Federal Government can play an important role in supporting economic growth through the establishment 

of a measured regulatory environment that protects both the employee and the employer and does not unduly hinder job creation. 

However, issuing excessive or burdensome regulations that stifle 

growth or slow or reverse job creation can result in the opposite— 

greater cost than benefit and a weaker economy. 

The Committee recommendation includes several provisions to 

restrain regulatory overreach by the administration. For example, 

the bill prohibits the National Labor Relations Board [NLRB] from 

allowing small groups of employees to create a ‘‘micro-union’’ in 

spite of opposition to the creation of a union by the majority of 

workers, and blocks a potential revision of the joint employer 

standard that could undermine the foundation of how franchise 

businesses operate. The bill also curbs new regulations from the 

Department of Labor regarding temporary, seasonal workers. The 

Committee believes it is critical to ensure that the Federal Government creates economic conditions that support job creators, and 

these provisions restore a reasonable balance to make certain that 

regulations serve both the workforce and employers fairly. 

Higher Education Regulations.—The Committee recommendation 

prohibits the Department of Education from unilaterally moving 
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forward with several recent and significant policy changes impacting higher education programs until Congress is able to weigh in 

through the authorization process. Specifically, the bill prohibits 

the Department from developing a post-secondary institution rating 

system, administratively defining the phrase ‘‘gainful employment’’, 

establishing requirements governing the State authorization process for higher education programs, establishing a Federal definition 

of the term ‘‘credit hour’’, and establishing a Federal framework for 

evaluating teacher preparation programs, at least until Congress 

reauthorizes the Higher Education Act. The Committee supports 

many of the goals of these regulations, but each represents a significant expansion of administrative authority. The Committee 

strongly believes these issues should be addressed as part of the 

normal legislative process. Regarding the post-secondary institution 

ratings system in particular, the Committee strongly believes this 

represents a misguided use of limited resources and the lack of 

specificity in the draft framework is an indication of the inherent 

flaw in the proposal. 

The Committee recommendation also includes language directing 

the Department of Education to evaluate all higher education regulations to eliminate unnecessary or duplicative requirements, as 

part of an overall effort to improve affordability of and access to 

post-secondary education. 

Dietary Guidelines.—Significant concerns have been raised about 

the 2015 Dietary Guidelines for Americans, including basing some 

recommendations on environmental sustainability. Making a recommendation based on anything but a preponderance of sound 

science is outside the scope of the Advisory Committee and contrary to the statute creating the Advisory Committee itself. The 

Committee recommendation includes a provision to prohibit the 

Secretary of the Department of Health and Human Services, who 

has the administrative leadership for the 2015 Dietary Guidelines 

edition, from moving forward with the Guidelines unless the guidelines are solely nutritional and dietary in nature and based on a 

preponderance of scientific evidence. 

Recovery Audit Contractors [RAC] Audits.—To decrease the number of Medicare improper payments, CMS utilizes RACs to provide 

post payment reviews of Medicare payments. However, because 

RACs are paid on a contingency fee basis, they have a strong incentive to focus on the quantity of reviews versus the quality of the 

audit. As a result, healthcare providers are using precious resources and staff time to fight erroneous audit findings instead of 

providing care to patients. The Committee includes language directing CMS to expeditiously resolve any pending issues with the 

new RAC contracts so that the new, more tailored RAC requirements can be implemented to require RACs to focus on the quality 

of their reviews. This will also help providers resolve their audit 

appeals faster by reducing the number of claims appealed at the 

Office of Medicare and Medicaid Appeals [OMHA]. In addition, language is included directing the Department of Health and Human 

Services to continue to evaluate the process until this issue is resolved. 
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IMPROVING FISCAL ACCOUNTABILITY

The Committee has an obligation to promote fiscal accountability 

and the effective use of U.S. taxpayer funds. The annual appropriation process affords Congress the opportunity to continuously improve and refine how government works. Appropriations bills provide oversight of every discretionary program, every year, which 

gives these bills the unique ability to react to changing needs and 

unintended consequences in the intervening years of an authorization bill. 

Affordable Care Act [ACA] Oversight.—The Committee includes 

several provisions to increase transparency and oversight of the billions of dollars spent on the ACA. The Committee is proactively 

protecting discretionary funds in the bill by preventing the administration from transferring these funds to bail out ACA activities 

that were never intended to be funded through the discretionary 

appropriations process. The Committee includes the following: 

—Risk Corridor.—The Committee continues bill language requiring the administration to operate the Risk Corridor program in 

a budget neutral manner by prohibiting any funds from the 

Labor-HHS-Education appropriations bill to be used as payments for the Risk Corridor program. 

—State-Based Exchanges.—With the increasing number of StateBased Exchanges failing due to lack of revenue, the Committee 

includes new bill language preventing the administration from 

using discretionary funds to pay for operational costs for these 

Exchanges. 

—Health Exchange Transparency.—The Committee continues bill 

language requiring the administration to publish ACA-related 

spending by category since its inception. 

—ACA Personnel.—The Committee continues bill language requiring the administration to publish information on the number of employees, contractors, and activities involved in implementing, administering, or enforcing provisions of the ACA. 

—Notification.—The Committee recommendation requires the administration to provide prior notification to the Appropriations 

Committees of the House of Representatives and the Senate 

before releasing information to the press. 

NLRB Right-Sizing.—Since 2008, the NLRB’s budget has increased 8.9 percent while its workload has remained relatively flat. 

The administration has requested an additional 30 full-time employees in fiscal year 2016 even though a recent reorganization was 

intended to yield further efficiencies and eliminate unneeded infrastructure. To put NLRB’s budget increases in perspective, NIH research funding increased only 1.5 percent during the same timeframe. Further, the Committee remains concerned about recent action the agency has taken to reverse long-standing policies and 

other regulatory initiatives. Most recently, both the Senate and 

House of Representatives voted to reject the NLRB’s new regulation on ‘‘ambush’’ elections which will aggressively reduce the time 

for union elections. Yet, the agency is moving forward to implement 

the rule anyway. In an effort to right-size and reprioritize funding 

within this bill, the Committee recommendation reduces funding 

for the NLRB to $246,802,000. 
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Taxpayer Transparency.—The U.S. taxpayer has a right to know 

how the Federal Government is spending their hard-earned taxpayer dollars—especially when that money is being spent on advertising Federal programs. The Committee recommendation includes 

a new provision to promote Government transparency and accountability by requiring Federal agencies funded in this act to include 

disclaimers when advertising materials are paid for with Federal 

funds. 

Program Eliminations.—Lean economic times require tough 

choices and a critical review of all programs in the bill, even those 

that have been funded for decades. The Committee recommendation includes 44 program eliminations, equating to $1,256,180,000 

in spending reductions. 

FIGHTING OPIOID ABUSE

According to the Centers for Disease Control and Prevention 

[CDC], deaths from prescription opioids quadrupled between 1999 

and 2013 claiming more than 145,000 lives over the past decade. 

These overdoses cost the economy an estimated $20,000,000,000 in 

medical costs and work loss productivity each year. Even more dangerous, prescription opioids can act as a gateway drug to heroin 

use, another form of opioids. Approximately three out of four new 

heroin users abused prescription opioids before switching to heroin. 

To stop the spread of further opioid abuse, the bill provides 

$67,000,000, an increase of $35,000,000 above fiscal year 2015, in 

funding to fight both prescription opioid and heroin abuse: 

Abuse Prevention.—$37,500,000 to CDC for expanding State-level 

prevention efforts such as increasing adoption of safe opioid prescribing guidelines and improving data collection and collaboration 

among States. 

Drug Treatment, Prevention, and Awareness.—$29,500,000 to 

Substance Abuse and Mental Health Services Administration 

[SAMHSA] for State grants to expand access to drug treatment 

services for those with a dependence on prescription opioids or heroin. Funds will be targeted to States that have experienced the 

greatest increase in treatment admissions for these drugs. Funds 

will also be used to help States purchase and train first responders 

on emergency devices that rapidly reverse the adverse effects of 

opioid overdoses and to increase awareness of the dangers of opioid 

use to the public. 

COMBATING ANTIBIOTIC RESISTANT BACTERIA

Antibiotic resistance is an increasingly serious public health 

threat: Each year in the United States over 2 million people become infected with bacteria that are resistant to antibiotics, and at 

least 23,000 people die as a direct result of these infections. According to the latest available data, antibiotic resistance in the United 

States costs an estimated $20,000,000,000 a year in healthcare 

costs. Without immediate action, routine infections as well as common surgical procedures are likely to become life-threatening 

events. The Committee recommendation includes $664,000,000, an 

increase of $193,000,000 above fiscal year 2015, to combat antibiotic resistant bacteria using a multi-pronged strategy: 
14 

Detect and Protect.—The Committee includes an increase of 

$30,000,000 to CDC for faster identification and characterization of 

emerging resistance patterns as well as collaborations with 

healthcare facilities to implement best practices for antibiotic prescribing and infection prevention. 

Antibiotic Discovery.—With the health system rapidly running 

short of ammunition in the battle against resistant infections, the 

development of new drugs is of prime importance. The Committee 

includes $461,000,000, a $100,000,000 increase over fiscal year 

2015 to NIH and $143,000,000, a $59,000,000 increase over fiscal 

year 2015 to BARDA to spur the development of novel antibiotics 

and help revitalize the drug development pipeline. 

Antibiotic Stewardship.—The Committee includes $10,000,000, a 

$4,000,000 increase over fiscal year 2015, for AHRQ to support activities developing new antibiotic stewardship programs specifically 

focused on ambulatory and long-term care facilities. 

RURAL HEALTH CARE

The obstacles faced by patients and providers in rural communities are unique and often significantly different than those in 

urban areas. These issues can range from a lack of access to primary care physicians to difficulty finding specialists. As a result, 

many patients have to drive long distances to receive care or may 

not seek care until it is too late. This creates unnecessary disparities in healthcare not found in other parts of the country and which 

will ultimately cost taxpayers more in Medicare and Medicaid expenditures. The Committee recommendation addresses the unique 

challenges faced by rural patients and providers in several ways: 

First, the Committee rejects the administration’s request to 

eliminate the Small Hospital Improvement Program [SHIP]. Instead, the Committee recommendation provides $14,942,000 for 

SHIP to support quality improvement and meaningful use of health 

information technology for small hospitals with under 49 beds. Second, the Committee includes $18,000,000, an increase of 

$3,100,000, for Telehealth programs. The Committee believes it is 

important for telehealth capabilities to be expanded and improved 

in rural and remote healthcare settings. Finally, the Committee 

recommendation provides $63,500,000, an increase of $4,500,000, 

for Rural Health Outreach Grants. These grants are critical to improving access to care, coordination of care, and integration of services in rural health settings. 

INCREASING THE EFFICIENCY AND COST EFFECTIVENESS OF

GOVERNMENT

The Committee provides funding for a variety of activities aimed 

at reducing fraud, waste, and abuse of taxpayer dollars. These program integrity initiatives have proven to be a wise Federal investment, resulting in billions of dollars of savings each year. In addition, the Committee recommendation provides direction to the Departments on opportunities to take action where Federal programs 

are fragmented or duplicative. The bill advances several initiatives 

to increase the efficiency and cost effectiveness of Government, including: 
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Fighting Healthcare Fraud and Abuse.—The Committee includes 

$706,000,000 for the Health Care Fraud and Abuse Control 

[HCFAC] program at CMS. The Committee notes that the latest 

data demonstrates for every $1 spent on fraud and abuse, $8.10 is 

recovered by the Treasury. By utilizing the cap adjustment provided in the Budget Control Act, the Committee recommendation 

will create over $5,718,000,000 in savings to the U.S. Treasury. 

Preventing Improper Social Security Payments.—The Committee 

recommendation includes $1,439,000,000, a $43,000,000 increase 

for the Social Security Administration to conduct continuing disability reviews and SSI program redeterminations of non-medical 

eligibility. Combined these activities are estimated to save approximately $10,000,000,000 in taxpayer dollars by reducing waste, 

fraud, abuse, and improper payments in the Social Security, Medicare, and Medicaid programs. 

Strengthening Oversight of Social Security Disability Benefits.— 

The Committee recommendation includes new language strengthening oversight of Social Security disability programs. Specifically, 

the Committee will work with SSA to expedite efforts to update 

medical vocational guidelines used as part of the initial disability 

determination process and to clarify how the medical improvement 

standard, and exceptions from it, should be applied during continuing disability reviews. 

Taxpayer Accountability.—In recent reports, the Government Accountability Office [GAO] identified several areas, in particular, in 

the healthcare sector where the Federal Government had opportunities to improve overall performance. Given the current fiscal environment, it is imperative for Government agencies to increase efficiencies to maximize the effectiveness of agency programs. 

—Recovery Audit Data Warehouse.—The Committee was disappointed to learn that CMS was not effectively utilizing the 

Recovery Audit Data Warehouse which was designed to prevent contractors from conducting duplicative audits on the 

same claim. The Committee recommendation directs CMS to 

implement GAO’s recommendations to prevent further waste of 

resources or additional burdens on healthcare providers. 

—Mental Health.—The Committee is concerned that SAMHSA, 

the Federal Government’s lead agency for addressing mental 

health issues, failed to provide high level coordination within 

the Department of Health and Human Services on serious 

mental health issues, and did not properly evaluate some of its 

own programs. GAO also highlighted SAMHSA’s failure to document how it applied its own grant criteria before making 

awards for mental health grants, and their lack of documentation used to oversee these programs. Without such coordination 

and oversight, scarce Federal funds are being wasted on duplicative and ineffective mental health programs run by several 

different agencies without any clear, overarching objective or 

accountability. As a result, the Committee recommendation directs SAMHSA to implement the GAO recommendations in fiscal year 2016. In addition, SAMHSA shall provide any additional training to its grants staff and develop an internal 

grants compliance plan. 
16 

Empowering States With Flexibility To Meet Their Own Unique 

Needs.—The Committee recommendation restores the Governors’ 

State Workforce Innovation and Opportunity Act [WIOA] training 

set-aside to the full 15 percent level authorized by law. The Governors’ set-aside is a powerful tool for States to meet their own 

unique workforce and employment needs on a State-wide or regional basis. With additional funding, States will be able to enhance services at their discretion on a State-wide basis. Many 

States want to offer additional job training for regionally-demanded 

occupations aligned with business needs, to enhance the coordination of workforce development services throughout the State, to develop new online resources for job seekers and employers, and to 

provide additional services to at-risk populations such as the longterm unemployed, disconnected youth, and veterans. 

Public Health Services Act [PHS] Evaluation Transfer.—The 

Committee recommendation continues to ensure that in fiscal year 

2016, no funds will leave NIH via the transfer required by section 

241 of the PHS Act. 

Inspectors General.—The Committee recommendation provides $213,352,000 for the inspectors general at the three Departments 

and the Corporation for National and Community Service to conduct additional audits and investigations of possible waste and 

fraud in Government programs. 

Printing Costs.—The Committee is concerned about the millions 

of taxpayer dollars spent on wasteful printing practices each year 

and the lack of clear printing policies within each of the agencies. 

While progress has been made to better utilize the cloud and digitalize records, little progress has been made to reform in-house 

printing practices. The Committee directs each agency to work with 

Office of Management and Budget to reduce printing and reproduction by 34 percent and report to the Committee within 60 days 

after enactment of this act on what steps have been taken to reduce printing volume and costs. The report should specifically identify how much money each agency will be saving. 

OTHER HIGHLIGHTS OF THE BILL

Community Health Centers [CHC].—The Committee recommendation includes $1,491,522,000 for CHCs. Combined with 

the $3,600,000,000 in mandatory funding appropriated for fiscal 

year 2016, and $138,478,000 in unobligated balances from prior 

years, the Committee’s recommended program level totals 

$5,200,000,000, an increase of $830,478,000 above the President’s 

budget request. In addition, the Committee took into account in the 

program level the possibility that $30,000,000 may be transferred 

from the Community Health Centers mandatory funds by Public 

Law 114–22. This funding is projected to support at least 75 new 

access points and continue quality improvement activities for more 

than 1,300 health centers operating over 9,000 primary sites. 

Child Care.—The Committee recommendation includes 

$2,585,000,000 for the Child Care and Development Block Grant 

[CCDBG], a $150,000,000 increase. In November 2014, Congress 

overwhelmingly passed a reauthorization of the CCDBG Act. This 

bill included important reforms to strengthen child care health and 

safety standards, and improve the overall quality of child care pro-
17 

grams. The Committee recommendation will help States implement 

these and other key changes. 

Early Head Start.—The Committee recommendation includes a 

$100,000,000 increase to expand Early Head Start, including 

through Early Head Start-Child Care Partnerships. Research increasingly points towards the importance of high-quality early 

childhood care and education beginning at birth, and for families 

starting before birth. Early Head Start provides high-quality early 

childhood services for children and families from before birth to age 

3. Early Head Start-Child Care Partnerships in particular leverage 

resources within the Child Care and Development Fund to help 

further improve the availability of high-quality child care programs. 

Children’s Hospitals Graduate Medical Education [CHGME].— The Committee recommendation includes $270,000,000 for 

CHGME, an increase of $5,000,000 above fiscal year 2015. This 

funding supports freestanding children’s teaching hospitals to provide Graduate Medical Education for physicians. The Committee 

rejects the administration’s proposal to pay only for direct costs of 

the program. 

Cancer Screenings.—The Committee rejects the administration’s 

proposed cuts to CDC’s breast, cervical, and colorectal cancer 

screening programs. These programs specifically serve low-income, 

uninsured, and underinsured adults. The administration made a 

political choice to cut the cancer screening programs because the 

ACA is supposed to cover these individuals. However, the ACA has 

fallen short of insuring every individual. Recent data show that up 

to 4.5 million women may remain eligible for CDC’s National 

Breast and Cervical Cancer Early Detection Program. Therefore, 

the Committee recommendation provides $250,287,000 for these 

cancer screenings. 

Immunization Program.—The Committee rejects the administration’s proposed funding reduction for the 317 Immunization program and restores full funding for this program. Similar to CDC’s 

cancer screening programs, the administration made a choice to cut 

funding because of the promises of the ACA. Yet, as we have seen 

with the recent measles outbreak, vaccine programs should not be 

taken for granted. The 317 Immunization program serves as a safety-net for the uninsured and underinsured populations that remain 

even with the implementation of the ACA. Vaccines remain one of 

the most important and successful public health breakthroughs to 

prevent death and disability. The Committee recommendation includes $610,847,000 for the 317 Immunization program. 

Increase in Maximum Pell Grant.—The Committee recommendation provides funding to maintain the discretionary portion of the 

maximum Pell grant, which triggers an automatic increase in the 

overall maximum Pell grant, from $5,775 in the 2015–2016 schoolyear, to an estimated $5,915 for the 2016–2017 school-year. This 

builds on increases in the maximum award over the last several 

years, which by the 2016–17 school year will have increased by 

over $1,800 over the last decade. 

Supports State and Local Flexibility in Elementary and Secondary Education.—The Committee recommendation includes 

$14,559,802,000 for title I grants to LEAs, a $150 million increase; 
18 

$12,414,642,000 for IDEA parts B and C, a $125,000,000 increase; 

and $273,172,000 for charter school grants, a $20,000,000 increase. 

In addition, the Committee includes language affirming that the 

Federal Government cannot mandate or incentivize in any way the 

adoption of any specific standards or assessments. Combined, this 

helps provide flexible resources that States, LEAs, and schools can 

decide how to use best to improve student outcomes, including students with disabilities. 

Training Assistance to Coal Workers.—The bill dedicates 

$19,000,000 of the Dislocated Worker National Reserve to ensure 

reemployment and training assistance are provided to workers dislocated from coal mines and coal-fired power plants as requested by 

the administration. 

License Portability.—The Committee funds a new proposal by the 

administration to reduce barriers created by unnecessary occupational licensing requirements. Funding is provided for States to 

evaluate and pursue cooperative approaches to enhance reciprocity 

or portability of occupational licenses across State lines. Such 

agreements would significantly ease barriers to opportunity and reemployment for thousands of Americans, especially for military 

spouses, dislocated workers, and transitioning servicemembers. 

Medicare Appeals Process.—The number of cases appealed to 

OMHA has increased 545 percent in 3 years. OMHA currently receives over a year’s worth of work every 8 weeks, and at the start 

of fiscal year 2015, OMHA already had 10 years’ worth of work 

with the existing staff. The Committee recommendation includes a 

$10,000,000 increase to help OMHA expand capacity to address the 

significant backlog of appeals. 

Unemployment Insurance Trust Fund Integrity.—The Committee 

provides an increase to enhance Reemployment Services and Eligibility Assessments for fiscal year 2016. Recent research cited by 

the administration has shown that this program significantly reduces the time participating individuals receive unemployment 

compensation payments and reduces the total amount of benefits 

paid. Claimants are more successful in returning to work sooner in 

jobs with higher wages. The study estimated that $2.60 in savings 

are produced for every $1 in cost. Enhanced, in-person assessments 

also play an impactful role in protecting the integrity of the Unemployment Insurance Trust Fund by reducing improper payments 

made to ineligible claimants. 

Reducing the Backlog of Foreign Labor Certifications.—The Department of Labor plays a role in supporting economic growth by 

certifying, on a case-by-case basis, that the admission of foreign 

workers into the United States will not adversely affect the job opportunities, wages, and working conditions of American workers. 

Employers who are unable to find qualified American workers to 

fill positions rely on prompt and fair review of their petitions. The 

Committee recommendation makes funds available for 1 year to 

hire temporary employees to address a growing backlog of Permanent Labor Certification cases. The additional funds will provide 

for the processing of about 96,450 cases, reducing the backlog by 

approximately 16,000 cases. 
19 

TITLE I 

DEPARTMENT OF LABOR 

EMPLOYMENT AND TRAINING ADMINISTRATION

TRAINING AND EMPLOYMENT SERVICES

Appropriations, 2015 ............................................................................. $3,139,706,000 

Budget estimate, 2016 ........................................................................... 3,402,431,000 

Committee recommendation ................................................................. 2,936,244,000 

The Training and Employment Services account provides funding 

primarily for activities under the Workforce Innovation and Opportunity Act [WIOA], and is comprised of programs designed to enhance the employment and earnings of economically disadvantaged 

and dislocated workers, operated through a decentralized integrated system of skill training and related services. Funds provided 

for fiscal year 2016 will support the program from July 1, 2016, 

through June 30, 2017. A portion of this account’s funding, 

$1,772,000,000, is available on October 1, 2016, for the 2016 program year. 

Any references in this title of the report to the ‘‘Secretary’’ or the 

‘‘Department’’ shall be interpreted to mean the Secretary of Labor 

or the Department of Labor, respectively, unless otherwise noted. 

The Committee strongly encourages the Department to continue 

to work with other Federal agencies to align and streamline employment and training services. In cases where legislation would be 

required, the President’s budget request should include recommendations and specific proposals for consolidation of programs. 

The Committee notes that the disparity between the skills job 

seekers have and the skills employers need to fill available positions, also known as the ‘‘skills gap,’’ can hinder employers from expanding, innovating, and improving productivity and limit workers’ 

ability to obtain well-paying jobs in in-demand industries. The 

Committee encourages the Department to continue and expand its 

efforts in preparing workers for in-demand occupations through a 

coordinated strategy. This strategy should include close engagement with employers by all levels of the workforce development 

system to ensure that provided training services align with the demands of those who would hire program participants. 

The Committee commends the Employment and Training Administration [ETA] for its collaborative work with the Institute for Museum and Library Services to integrate the education, employment, 

and training services provided by public libraries into the workforce development system. The Committee encourages ETA to continue to strengthen partnerships between the one-stop system and 

public libraries. 

Grants to States 

The Committee recommends $2,492,000,000 for Training and 

Employment Services Grants to States. 

Under WIOA, a local board is given significant transfer authority 

between Adult and Dislocated Worker activities upon approval of 

the Governor. 
20 

The Committee recommendation is consistent with the WIOA authorization regarding the amount of WIOA State grant funding 

that may be set aside by Governors. Therefore, the Governor of a 

State shall reserve not more than 15 percent of the funds allotted 

to a State through the WIOA State grant programs for State-wide 

workforce investment activities. This increased flexibility will assist Governors in meeting unexpected needs, effectively targeting 

pockets of unemployment in their States, and fulfilling their oversight and technical assistance responsibilities. 

Adult Employment and Training.—For adult employment and 

training activities, the Committee recommends $737,000,000. 

Formula funding is provided to States and further distributed to 

local workforce investment areas through one-stop centers. The 

program provides employment and training services to disadvantaged, low-skilled, unemployed, and underemployed adults, including veterans. 

Funds are made available in this bill for adult employment and 

training activities in program year 2016, which occurs from July 1, 

2016, through June 30, 2017. The bill provides that $25,000,000 is 

available for obligation on July 1, 2016, and that $712,000,000 is 

available on October 1, 2016. Both categories of funding are available for obligation through June 30, 2017. 

Youth Training.—For youth training activities, the Committee 

recommends $790,000,000. 

The purpose of this program is to provide low-income youth facing barriers to employment with services that prepare them to succeed in the knowledge-based economy. The program provides assistance to youth in achieving academic and employment success 

through improved education and skill competencies, connections to 

employers, mentoring, training, and supportive services. The program also supports summer employment directly linked to academic and occupational learning, incentives for recognition and 

achievement, and activities related to leadership development, citizenship, and community service. Funds are made available for 

youth training activities in program year 2016, which occurs from 

April 1, 2016, through June 30, 2017. 

Dislocated Worker Assistance.—For dislocated worker assistance, 

the Committee recommends $965,000,000. 

This program is a State-operated effort that provides training 

services and support to help permanently separated workers return 

to productive unsubsidized employment. In addition, States must 

use State-wide reserve funds for rapid response assistance to help 

workers affected by mass layoffs and plant closures. States must 

also use these funds to carry out additional State-wide employment 

and training activities such as providing technical assistance to 

certain low-performing local areas, evaluating State programs, and 

assisting with the operation of one-stop delivery systems. States 

may also use funds for implementing innovative incumbent and 

dislocated worker training programs. 

Funds made available in this bill support activities in program 

year 2016, which occurs from July 1, 2016, through June 30, 2017. 

The bill provides that $105,000,000 is available for obligation on 

July 1, 2016, and that $860,000,000 is available on October 1, 
21 

2016. Both categories of funding are available for obligation 

through June 30, 2017. 

Federally Administered Programs 

Dislocated Worker Assistance National Reserve.—The Committee 

recommends $200,000,000 for the Dislocated Worker Assistance 

National Reserve, which is available to the Secretary for activities 

such as responding to mass layoffs, plant and/or military base closings, and natural disasters that cannot be otherwise anticipated, as 

well as for technical assistance, training, and demonstration 

projects. The bill provides that the full $200,000,000 is available on October 1, 2016. 

The Committee bill includes new language setting aside $19,000,000 to ensure assistance is provided to workers dislocated 

from coal mines and coal-fired power plants as requested by the administration. 

Indian and Native American Programs.—The Committee recommends $40,500,000 for Indian and Native American Programs. 

These programs are designed to improve the academic, occupational, and literacy skills of Native Americans, Alaskan Natives, 

and Native Hawaiians to aid the participants in securing permanent, unsubsidized employment. Allowable training services include 

adult basic education, GED attainment, literacy training, English 

language training, as well as the establishment of linkages with remedial education. 

The Committee directs the Department to obligate funding at the 

authorized levels for activities pursuant to section 166(k) of subtitle 

D of title I of the WIOA (Public Law 113–128). 

Office of Disability Employment Policy [ODEP].—The Committee 

recommendation transfers ODEP to ETA. ETA is the premier 

grant-making and employment policy entity within the Department 

of Labor and has always coordinated closely with ODEP. By co-locating ODEP with ETA, ETA will be able to coordinate and integrate the effort to assist Americans with disabilities more fully into 

the workforce development system consistent with the consolidated 

approach of WIOA. 

The Committee recommendation includes $23,750,000 for ODEP, 

of which $15,000,000 shall be for grants, and $8,750,000 shall be 

for salaries and expenses. The recommended funding level allows 

ETA to retain ODEP’s subject matter expertise as well as provides 

funding consistent with the range of total grant awards approximated by the Department for Disability Employment Initiative 

grants for fiscal year 2015 to continue the dedicated grant program. The Committee expects ODEP and ETA to continue to develop not only appropriate focus areas for future grant rounds, but 

also innovative approaches through the comprehensive WIOA system to help individuals with disabilities enhance their job skills 

and overcome barriers to employment. 

Migrant and Seasonal Farmworker Programs.—The Committee 

recommends $73,000,000 for migrant and seasonal farmworkers 

programs, which serve members of economically disadvantaged 

families whose principal livelihood is derived from migratory and 

other forms of seasonal farm work, fishing, or logging activities. 
22 

Enrollees and their families are provided with employment, training, and related services intended to prepare them for stable, yearround employment within and outside of the agriculture industry. 

The Committee recommendation provides that $67,306,000 be 

used for State service area grants. The Committee recommendation 

also includes bill language directing that $5,200,000 be used for migrant and seasonal farmworker housing grants, of which not less 

than 70 percent shall be for permanent housing. The principal purpose of these funds is to continue the network of local farmworker 

housing organizations working on permanent housing solutions for 

migrant and seasonal farmworkers. 

Women in Apprenticeship.—The Committee accepts the administration’s request to eliminate the Women in Apprenticeship program. 

YouthBuild.—The Committee strongly supports the YouthBuild 

program and recommends $79,689,000 to support its work to target 

at-risk high school dropouts and prepare them with the skills and 

knowledge they need to succeed in a knowledge-based economy. 

National Activities 

Reintegration of Ex-Offenders.—The Committee recommends 

$22,305,000 for the Reintegration of Ex-Offenders program. The 

Reintegration of Ex-Offenders program helps prepare and assist 

adult ex-offenders return to their communities through pre-release 

services, mentoring, and case management. The program also provides support, opportunities, education, and training to youth who 

are involved in court and on probation, in aftercare, or on parole, 

or who would benefit from alternatives to incarceration or diversion 

from formal judicial proceedings. Programs are carried out directly 

through State and local governmental entities and community 

based organizations, as well as indirectly through intermediary organizations. Given Federal budget constraints, States are encouraged to continue to support reintegration efforts for ex-offenders 

with resources available through the comprehensive workforce development investment system. The funds appropriated for fiscal 

year 2016 shall be for competitive grants for activities that prepare 

young ex-offenders and school dropouts for employment. The Committee directs the Department to use funding to support efforts in 

high-crime, high-poverty areas and, in particular, communities that 

have recently experienced significant civil unrest. 

Evaluation.—The bill continues to use a set-aside funding mechanism to support the evaluation of employment and training programs. Instead of directly providing funds for evaluation, the Committee recommendation supports evaluation activities through a 0.5 

percent set-aside on all training and employment programs, including the WIOA formula programs, Job Corps, Community Service 

Employment for Older Americans, the Employment Service, and 

others. The set-aside approach ensures that sufficient funding is 

available to carry out comprehensive evaluation and applied research activities. 

The ETA will continue to conduct evaluation and applied research activities in consultation with the Department’s chief evaluation officer, who oversees the evaluation program. Results will 
23 

inform policy, advance the Department’s mission, and improve its 

performance-based management initiatives. 

Workforce Data Quality Initiative.—The Committee recommends 

$4,000,000 for the Workforce Data Quality Initiative, the same as 

last year. Funds are used to assist States with incorporating comprehensive workforce information into longitudinal data systems 

being developed in part with the support of funding provided by the 

Department of Education. The initiative is also intended to help 

improve the quality and accessibility of performance data being 

produced by training providers. 

JOB CORPS

Appropriations, 2015 ............................................................................. $1,688,155,000 

Budget estimate, 2016 ........................................................................... 1,715,944,000 

Committee recommendation ................................................................. 1,683,155,000 

The recommendation for operations of Job Corps centers is $1,578,008,000. The Committee recommendation for administrative 

costs is $31,147,000. 

The Committee also recommends a total of $74,000,000 in construction, renovation, and acquisition [CRA] funds. This amount is 

available from July 1, 2016, to June 30, 2019. The Committee continues bill language allowing the Secretary to transfer up to 15 percent of CRA funds, if necessary, to meet the operational needs of 

Job Corps centers or to achieve administrative efficiencies. The bill 

continues to require the Secretary to notify the House and Senate 

Committees on Appropriations at least 15 days in advance of any 

transfer. The Committee expects any notification to include a justification. 

The Committee accepts the Department’s proposed bill provision 

clarifying that the Secretary, in consultation with the Secretary of 

Agriculture, may use a competitive process to select an entity to operate a Civilian Conservation Center [CCC] in accordance with section 147 of WIOA if the Center has had consistently low performance. CCCs are operated by the Department of Agriculture under 

an agreement with the Secretary of Labor. The competitive process 

provided for under this provision would be the same process used 

to select operators of other Job Corps Centers and consistent with 

WIOA. This process would provide an important opportunity to improve the performance of such Centers with respect to the outcomes achieved by program participants, including their placement 

in unsubsidized employment or further education and training 

after they exit the program, their median earnings, and their attainment of recognized credentials. 

Gulfport Job Corps Center.—The Committee remains deeply concerned with the emergency reconstruction of the Gulfport Job 

Corps Center in Gulfport, MS, after it was badly damaged during 

Hurricane Katrina in 2005. A decade has now passed, and the 

damaged structures are not restored and serviceable in spite of 

funds appropriated for this purpose. The Department should remain committed to ensuring that the Center is rebuilt and able to 

return to serving the number of young people that it once served, 

while reserving the funds set aside for the project until the facility 

can be fully restored. Therefore, the Committee directs the Department to provide a report, not later than 90 days after the enact-
24 

ment of this act to the Committees on Appropriations of the House 

of Representatives and the Senate, that outlines a plan for successful completion of the Gulfport Job Corps Center. 

The WIOA included reforms to the Job Corps procurement process, including changes to ensure that high performing Job Corps 

operators would be able to compete for contracts. The Committee 

urges the Department to implement these provisions immediately. 

The Committee directs the Department to report on its progress in 

implementing these provisions within 30 days of enactment of this 

act to the Committees on Appropriations of the House of Representatives and the Senate. 

COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS

Appropriations, 2015 ............................................................................. $434,371,000 

Budget estimate, 2016 ........................................................................... 434,371,000 

Committee recommendation ................................................................. 400,000,000 

Community Service Employment for Older Americans [CSEOA] 

provides part-time employment in community service activities for 

unemployed, low-income persons aged 55 and older. The Committee 

recommendation includes $400,000,000 for CSEOA. 

FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES

Appropriations, 2015 ............................................................................. $710,600,000 

Budget estimate, 2016 ........................................................................... 664,200,000 

Committee recommendation ................................................................. 664,200,000 

The Committee recommendation includes mandatory funds for 

the Federal unemployment benefits and allowances program that 

assists trade-impacted workers with benefits and services to upgrade skills and retrain in new careers. These benefits and services 

are designed to help participants find a path back into middle-class 

jobs, improve earnings, and increase credential and education 

rates. The Committee recommendation provides for the full operation of the Trade Adjustment Act program in fiscal year 2016 consistent with the continuation provided in fiscal year 2015. 

STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE

OPERATIONS

Appropriations, 2015 ............................................................................. $3,597,150,000 

Budget estimate, 2016 ........................................................................... 4,138,023,000 

Committee recommendation ................................................................. 3,519,561,000 

The Committee recommendation includes $3,433,133,000 authorized to be drawn from the Employment Security Administration account of the Unemployment Trust Fund and $86,428,000 to be provided from the general fund of the Treasury. 

The funds in this account are used to provide administrative 

grants and assistance to State agencies that administer Federal 

and State unemployment compensation laws and operate the public 

employment service. The Committee recommends a total of $2,738,442,000 for UI activities. For UI State operations, the Committee recommends 

$2,725,550,000. Of these funds, the Committee includes 

$100,000,000, an increase of $20,000,000, to help address and prevent long-term unemployment through a Reemployment and Eligi-
25 

bility Assessments and Reemployment Services [REA/RES] initiative. Of the funding included in the budget request, $30,000,000 

was proposed to be provided through a discretionary cap adjustment amendment to the Balanced Budget and Emergency Deficit 

Control Act of 1985. The Committee recommendation does not include funding through the cap adjustment. 

The Committee recommendation continues to support investments in UI program integrity activities, including technologybased programs that identify and reclaim overpayments. The Committee continues bill language allowing funding to pay for the administration of trade adjustment allowances for individuals certified for the Trade Adjustment Assistance program under petitions 

filed prior to January 1, 2016. 

The Committee recommendation does not provide funding for an 

additional round of incentive grants related to worker 

misclassification. The Committee notes that the first round of funding from fiscal year 2014 is newly awarded and proposals for fiscal 

year 2015 have not yet been solicited. Therefore, no performance 

results are yet available to assess its efficacy. 

The Committee recommendation maintains bill language, as re- quested by the administration, providing $3,000,000 for continued 

support of the UI Integrity Center of Excellence. The Center’s mission is to develop, implement, and promote innovative integrity 

strategies in the UI program, focusing on the prevention and detection of fraud. 

The Committee recommendation provides for a contingency reserve amount should the unemployment workload exceed an average weekly insured claims volume of 2,957,000. 

The Committee maintains bill language to improve efficiencies by 

allowing the Department to consolidate and make payments on behalf of States from administration grants to the entity operating 

the State Information Data Exchange System. 

The Committee recommendation maintains bill language allowing funds used to carry out national activities of the employment 

service to be obligated in contracts, grants, or agreements with 

States as well as non-State entities. 

The Committee recommends $12,892,000 for UI national activities, which will support activities that benefit the Federal-State UI 

system, including helping States adopt common technology-based 

solutions to improve efficiency and performance, including the replacement of the aging UI Reporting System hardware infrastructure and software applications installed in the State workforce 

agencies and to support the Interstate Connection Network, which 

enables the timely and accurate payment of UI benefits. 

For the Employment Service allotments to States, the Committee 

recommends $634,775,000. This amount includes $20,775,000 in 

general funds together with an authorization to spend 

$614,000,000 from the Employment Security Administration account of the Unemployment Trust Fund. 

The Committee also recommends $19,000,000 for Employment 

Service national activities. The administration of the work opportunity tax credit program accounts for $18,200,000 of the recommended amount; the balance is for technical assistance and 

training to States. 
26 

For carrying out the Department’s responsibilities related to foreign labor certification activities, the Committee recommends 

$61,691,000. In addition, 5 percent of the revenue from H–1B fees 

is available to the Department for costs associated with processing 

H–1B alien labor certification applications. Further, the Committee 

has included a new general provision to allow the use of H–1B fees 

to address the backlog of certifications in the PERM program. The 

Department is authorized to use $13,000,000 for that purpose, the 

same amount requested by the administration. 

In the determination of prevailing wage for the purposes of the 

H-2B program, the Secretary shall accept private wage surveys 

even in instances where Occupational Employment Survey data are 

available unless the Secretary determines that the methodology 

and data in the provided survey are not statistically supported. The 

bill also contains new general provisions related to enforcement of 

new H-2B rules. 

For one-stop career centers and labor market information, the 

Committee recommends $65,653,000. The Committee supports the 

new proposal to establish occupational licensing grants for State 

consortia to identify, explore, and address areas where licensing requirements create an unnecessary barrier to labor market entry or 

labor mobility where interstate portability of licenses could improve 

economic opportunity, particularly for dislocated workers, 

transitioning servicemembers, veterans, and military spouses. The 

Committee also encourages the Department to urge participating 

States to consider ways to increase their recognition of military certifications for equivalent private sector skills and occupations to 

further ease the transition of former servicemembers to comparable 

civilian jobs. ETA is directed to use $7,500,000 of the funds provided in this budget activity to initiate this effort. 

The request for $5,000,000 to conduct a study and pilot approaches to modernize the O*NET is not funded. 

ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS

The Committee bill continues language providing such sums as 

are necessary in mandatory funds for this account. The appropriation is available to provide advances to several accounts for purposes authorized under various Federal and State unemployment 

compensation laws and the Black Lung Disability Trust Fund, 

whenever balances in such accounts prove insufficient. 

PROGRAM ADMINISTRATION

Appropriations, 2015 ............................................................................. $154,559,000 

Budget estimate, 2016 ........................................................................... 176,564,000 

Committee recommendation ................................................................. 144,017,000 

The Committee recommendation of $144,017,000 for program administration includes $97,733,000 in general funds and $46,284,000 

from the Employment Security Administration account of the Unemployment Trust Fund. 

General funds in this account pay for the Federal staff needed 

to administer employment and training programs under WIOA, 

OAA, the Trade Act of 1974, and the National Apprenticeship Act. 

Trust funds provide for the Federal administration of employment 
27 

security, training and employment, and executive direction functions. 

Of the funding provided for Program Administration, the Committee recommendation includes $31,450,000 for the Office of Apprenticeship, a decrease of $2,550,000 below the fiscal year 2015 

level. 

EMPLOYEE BENEFITS SECURITY ADMINISTRATION

SALARIES AND EXPENSES

Appropriations, 2015 ............................................................................. $181,000,000 

Budget estimate, 2016 ........................................................................... 207,455,000 

Committee recommendation ................................................................. 168,930,000 

The Committee recommends $168,930,000 for the Employee Benefits Security Administration [EBSA]. 

EBSA plays a critical role in protecting health benefits and retirement security for American workers and their families. EBSA 

is responsible for the enforcement of title I of ERISA in both civil 

and criminal areas and for enforcement of sections 8477 and 8478 

of the Federal Employees’ Retirement Security Act of 1986. EBSA 

administers an integrated program of regulation, compliance assistance and education, civil and criminal enforcement, and research 

and analysis. 

Benefits under EBSA’s jurisdiction consist of approximately $8.5 

trillion in assets covering approximately 142 million workers, retirees, and their families. EBSA oversees benefit security for an estimated 677,000 private retirement plans, 2.4 million health plans, 

and similar numbers of other welfare benefit plans, such as those 

providing life or disability insurance. 

Mental health disorders affected an estimated 43.8 million adults 

in the United States in 2013. The Committee believes that progress 

has been made in this country in recognizing the significance of 

mental healthcare and treating it equitably with physical health. 

Nonetheless, there is little information available assessing activities of the States toward this end. The Committee requests the Secretary to coordinate with the Secretary of Health and Human Services to prepare a report within 180 days of enactment of this act 

to the Committees on Appropriation of the Senate and House of 

Representatives assessing activities of the States on this issue. 

PENSION BENEFIT GUARANTY CORPORATION

PBGC’s estimated obligations for fiscal year 2016 include singleemployer benefit payments of $6,386,000,000, multi-employer financial assistance of $269,000,000, and administrative expenses of 

$431,799,000. Administrative expenses are comprised of three activities: pension insurance activities, pension plan termination expenses, and operational support. These expenditures are financed 

by permanent authority. The Committee has accepted the PBGC’s 

proposal to reform the previous administrative apportionment classifications from three budget activities to one budget activity to 

make operations more efficient and improve stewardship of resources. However, PBGC is directed to continue providing detail on 

the three activities in its annual congressional budget justification. 
28 

The PBGC is a wholly owned Government corporation established by ERISA. The law places it within DOL and makes the Secretary the chair of its board of directors. The Corporation receives 

its income primarily from insurance premiums collected from covered pension plans, assets of terminated pension plans, collection 

of employer liabilities imposed by the act, and investment earnings. 

The primary purpose of the Corporation is to guarantee the payment of pension plan benefits to participants if covered defined 

benefit plans fail or go out of existence. 

PBGC’s single-employer program protects about 31 million workers and retirees in approximately 22,000 pension plans. The multiemployer insurance program protects about 10 million participants 

in roughly 1,400 plans. 

The President’s budget proposes and the bill continues authority 

for a contingency fund for the PBGC that provides additional administrative resources when the number of participants in terminated plans exceeds 100,000. When the trigger is reached, an additional $9,200,000 becomes available through September 30, 2017, 

for every 20,000 additional participants in terminated plans. The 

Committee bill also continues authority allowing the PBGC additional obligation authority for unforeseen and extraordinary pretermination expenses, after approval by OMB and notification of 

the Committees on Appropriations of the House of Representatives 

and the Senate. 

WAGE AND HOUR DIVISION

SALARIES AND EXPENSES

Appropriations, 2015 ............................................................................. $227,500,000 

Budget estimate, 2016 ........................................................................... 277,100,000 

Committee recommendation ................................................................. 210,000,000 

The Committee recommends $210,000,000 for the Wage and 

Hour Division [WHD]. 

WHD is responsible for administering and enforcing laws that 

provide minimum standards for wages and working conditions in 

the United States. The Fair Labor Standards Act [FLSA], employment rights under the Family and Medical Leave Act [FMLA], and 

the Migrant and Seasonal Agricultural Worker Protection Act are 

several of the important laws that WHD is charged with administering and/or enforcing. 

OFFICE OF LABOR-MANAGEMENT STANDARDS

SALARIES AND EXPENSES

Appropriations, 2015 ............................................................................. $39,129,000 

Budget estimate, 2016 ........................................................................... 46,981,000 

Committee recommendation ................................................................. 36,000,000 

The Committee recommends $36,000,000 for the Office of LaborManagement Standards [OLMS]. 

OLMS administers the Labor-Management Reporting and Disclosure Act of 1959 and related laws. These laws establish safeguards 

for union democracy and financial integrity. They also require public disclosure by unions, union officers, employers, and others. In 
29 

addition, the Office administers employee protections under federally sponsored transportation programs. 

OFFICE OF FEDERAL CONTRACT COMPLIANCE PROGRAMS

SALARIES AND EXPENSES

Appropriations, 2015 ............................................................................. $106,476,000 

Budget estimate, 2016 ........................................................................... 113,687,000 

Committee recommendation ................................................................. 96,000,000 

The Committee recommends $96,000,000 for the Office of Federal 

Contract Compliance Programs [OFCCP]. 

This Office protects workers and potential employees of Federal 

contractors from employment discrimination prohibited under Executive Order 11246, section 503 of the Rehabilitation Act of 1973, 

and the Vietnam Era Veterans’ Readjustment Assistance Act of 

1974. 

The Committee is concerned that OFCCP has lost its focus on 

identifying and addressing real employment discrimination and is 

imposing excessive compliance burdens on contractors. More specifically, OFCCP appears to prioritize specific quota results rather 

than equal consideration and opportunity because of its reliance on 

statistical analysis in evaluating contractor hiring practices. 

OFCCP should focus on actual discriminatory treatment instead of 

presumed discrimination based solely on benchmarks that may not 

be uniformly applicable. Strict and exclusive use of statistical significance tests effectively requires contractors to use a quota hiring 

system in violation of the Civil Rights Act to avoid adverse impact 

claims by OFCCP. The Committee is also concerned about reports 

that OFCCP is increasingly subjecting contractors to overly broad 

and unnecessary document and data requests as well as unreasonably numerous and lengthy compliance reviews. The OFCCP is directed to cease utilization of this de facto quota system for evaluating hiring practices and to report within 120 days of enactment 

to the Committees on Appropriations of the House of Representatives and Senate on steps it is taking to enforce non-discrimination 

standards on a more fair, case-by-case basis focused on evidence of 

actual discrimination rather than on statistical generalizations and 

quota benchmarks. 

OFFICE OF WORKERS’ COMPENSATION PROGRAMS

SALARIES AND EXPENSES

Appropriations, 2015 ............................................................................. $113,000,000 

Budget estimate, 2016 ........................................................................... 119,574,000 

Committee recommendation ................................................................. 109,677,000 

The Committee recommends $109,677,000 for the Office of Workers’ Compensation [OWCP]. The bill provides authority to expend 

$2,177,000 from the special fund established by the Longshore and 

Harbor Workers’ Compensation Act. 

OWCP administers four distinct compensation programs: the 

Federal Employees’ Compensation Act [FECA], the Longshore and 

Harbor Workers’ Compensation Act, the Black Lung Benefits programs, and the Energy Employees Occupational Illness Compensa-
30 

tion Program. In addition, OWCP houses the Division of Information Technology Management and Services. 

SPECIAL BENEFITS

Appropriations, 2015 ............................................................................. $210,000,000 

Budget estimate, 2016 ........................................................................... 210,000,000 

Committee recommendation ................................................................. 210,000,000 

The Committee recommends $210,000,000 for this account. This 

mandatory appropriation, which is administered by OWCP, primarily provides benefits under FECA. 

The Committee recommends continuation of appropriations language to provide authority to require disclosure of Social Security 

account numbers by individuals filing claims under FECA or the 

Longshore and Harbor Workers’ Compensation Act and its extensions. 

The Committee recommends continuation of appropriations language that provides authority to use FECA funds to reimburse a 

new employer for a portion of the salary of a newly reemployed injured Federal worker. FECA funds will be used to reimburse new 

employers during the first 3 years of employment, not to exceed 75 

percent of salary in the worker’s first year, and declining thereafter. 

The Committee recommendation continues language that allows 

carryover of unobligated balances to be used in the following year 

and that provides authority to draw such sums as are needed after 

August 15 to pay current beneficiaries. Such funds are charged to 

the subsequent year appropriation. 

The Committee recommends continuation of appropriations language to provide authority to deposit into the special benefits account of the employees’ compensation fund those funds that the 

Postal Service, the Tennessee Valley Authority, and other entities 

are required to pay to cover their fair share of the costs of administering the claims filed by their employees under FECA. 

The Committee bill includes language that allows fair share collections to be used to pay for capital investment projects and specific initiatives to strengthen compensation fund control and oversight. 

Finally, the Committee recommends language consistent with 

long-standing interpretations and implementation of this appropriation stating that, along with the other compensation statutes 

already specifically enumerated, the appropriation is used to pay 

obligations that arise under the War Hazards Compensation Act, 

and the appropriation is deposited in the Employees’ Compensation 

Fund and assumes its attributes, namely availability without time 

limit as provided by 5 U.S.C. section 8147. 

SPECIAL BENEFITS FOR DISABLED COAL MINERS

Appropriations, 2015 ............................................................................. $77,262,000 

Budget estimate, 2016 ........................................................................... 69,302,000 

Committee recommendation ................................................................. 69,302,000 

The Committee recommends a mandatory appropriation of 

$69,302,000 in fiscal year 2016 for special benefits for disabled coal 

miners. This is in addition to the $21,000,000 appropriated last 

year as an advance for the first quarter of fiscal year 2016, for a 
31 

total program level of $90,302,000 in fiscal year 2016. The decrease 

in this account below the fiscal year 2015 level reflects a declining 

beneficiary population. 

These mandatory funds are used to provide monthly benefits to 

coal miners disabled by black lung disease and their widows and 

certain other dependents, as well as to pay related administrative 

costs. 

The Committee also recommends an advance appropriation of $19,000,000 for the first quarter of fiscal year 2017. These funds 

will ensure uninterrupted benefit payments to coal miners, their 

widows, and dependents. 

DIVISION OF ENERGY EMPLOYEES OCCUPATIONAL ILLNESS

COMPENSATION

SALARIES AND EXPENSES

Appropriations, 2015 ............................................................................. $56,406,000 

Budget estimate, 2016 ........................................................................... 58,552,000 

Committee recommendation ................................................................. 58,552,000 

The Committee recommends $58,552,000 for the Division of Energy Employees Occupational Illness Compensation. This is a mandatory appropriation. 

The Division administers EEIOCPA, which provides benefits to 

eligible employees and former employees of the Department of Energy [DOE], its contractors and subcontractors, or to certain survivors of such individuals. The mission also includes delivering 

benefits to certain beneficiaries of the Radiation Exposure Compensation Act. The Division is part of OWCP. 

In fiscal year 2016, the volume of incoming claims under part B 

of EEOICPA is estimated at about 5,400 from DOE employees or 

survivors, and private companies under contract with DOE, who 

suffer from a radiation-related cancer, beryllium-related disease, or 

chronic silicosis as a result of their work in producing or testing 

nuclear weapons. 

Under part E, approximately 4,440 new claims will be received 

during fiscal year 2016. Under this authority, the Department provides benefits to eligible DOE contractor employees who were found 

to have work-related occupational illnesses due to exposure to a 

toxic substance at a DOE facility, or to the employees’ survivors. 

BLACK LUNG DISABILITY TRUST FUND

Appropriations, 2015 ............................................................................. $325,955,000 

Budget estimate, 2016 ........................................................................... 341,467,000 

Committee recommendation ................................................................. 341,467,000 

The Committee bill provides an estimated $341,467,000 as requested for this mandatory appropriations account. This estimate 

is comprised of $66,206,000 for administrative expenses and an estimated $275,261,000 for benefit payment and interest costs. 

The Committee bill continues to provide indefinite authority for 

the Black Lung Disability Trust Fund to provide for benefit payments. In addition, the bill provides for transfers from the trust 

fund for administrative expenses for the following Department 

agencies as requested: up to $35,244,000 for the part C costs of the 

Division of Coal Mine Workers’ Compensation Programs; up to 
32 

$30,279,000 for Departmental Management, Salaries and Expenses; and up to $327,000 for Departmental Management, Inspector General. The bill also allows a transfer of up to $356,000 for 

the Department of the Treasury. 

The Trust Fund pays all black lung compensation/medical and 

survivor benefit expenses when no responsible mine operation can 

be assigned liability for such benefits or when coal mine employment ceased prior to 1970, as well as all administrative costs that 

are incurred in administering the benefits program and operating 

the trust fund. 

OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION

SALARIES AND EXPENSES

Appropriations, 2015 ............................................................................. $552,787,000 

Budget estimate, 2016 ........................................................................... 592,071,000 

Committee recommendation ................................................................. 524,476,000 

The Committee recommends $524,476,000 for the Occupational 

Safety and Health Administration [OSHA], which is responsible for 

enforcing the Occupational Safety and Health Act of 1970 in the 

Nation’s workplaces. 

The Committee continues bill language to allow OSHA to retain 

course tuition and fees for training institute courses used for occupational safety and health training and education activities in the 

private sector. The cap established by the bill is $499,000, the same 

as current law. 

The bill retains language that continues to effectively exempt 

farms employing 10 or fewer people from the provisions of the act 

with the exception of those farms having a temporary labor camp. 

The bill also retains language exempting small firms in industry 

classifications having a lost workday injury rate less than the national average from general schedule safety inspections. 

The exemption of small farming operations from OSHA regulation has been in place since 1976. OSHA clarified the limits of its 

authority to conduct enforcement on small farms in July 2014, particularly regarding post-harvest activities of a farming operation. 

The continued exemption for small farms and recognition of limits 

of the OSHA regulatory authority are critical for family farms. It 

is also important the Department of Agriculture be consulted in 

any future attempts by OSHA to redefine or modify any aspect of 

the small farm exemption. 

The Committee recommends $98,746,000 for grants to States 

under section 203(g) of the Occupational Safety and Health Act. 

These funds primarily are provided to States that have taken responsibility for administering their own occupational safety and 

health programs for the private sector and/or the public sector. 

State plans must be at least as effective as the Federal program 

and are monitored by OSHA. The Committee bill continues language that allows OSHA to provide grants of up to 50 percent for 

the costs of State plans approved by the agency. 

The Committee believes that OSHA’s worker safety and health 

training and education programs, including the grant program that 

supports such training, are a critical part of a comprehensive approach to worker protection. Under the program, grants are made 
33 

to various types of organizations representing employers and labor 

organizations for direct training of workers on occupational safety 

and health. The Committee recommendation includes $10,149,000 

for the OSHA Susan Harwood Training Grant Program. 

The Committee is aware of recent reports of unhealthy and dangerous working conditions in some nail salons. While OSHA has 

previously awarded several grants that support training and compliance assistance in this area, the Committee notes that employment for nail salon workers is projected to grow by 16 percent from 

2012 to 2020—faster than the average for all occupations. Therefore, the Committee directs the agency to allocate funds within the 

Susan Harwood grants program to strengthen safety and health 

competencies in the nail salon industry, as well as to train workers 

to understand the requirements of OSHA regulations and standards and how to assert their rights. 

The Committee recognizes that fewer injuries mean lower worker’s compensation and healthcare costs, and safer, more productive 

workers. Statistical evidence for the Voluntary Protection Program’s [VPP] success is impressive. The average VPP worksite has 

a Days Away Restricted or Transferred [DART] case rate of 52 percent below the average for its industry. These sites typically do not 

start out with such low rates. Reductions in injuries and illnesses 

begin when the site commits to the VPP approach to safety and 

health management and the challenging VPP application process. 

OSHA shall dedicate not less than $3,500,000 per year for the 

purpose of administering the VPP in its Federal Compliance Assistance budget. OSHA shall not reduce funding levels or the number 

of full time employees administering the VPP, the Safety and 

Health Achievement Recognition Program [SHARP], or Federal 

Compliance Assistance, and shall not collect any monies from participants for the purpose of administering these programs. 

The Committee understands that, as a result of Executive Order 

13650, Improving Chemical Safety and Security, OSHA is considering options to ensure the safety of ammonium nitrate handling 

and storage. The Committee also understands that there is no 

record thus far of an accidental detonation of ammonium nitrate in 

a situation where a storage facility has been compliant with 

OSHA’s existing regulations at 29 CFR 1910.109(i). The existing 

regulations are based on standards of the National Fire Protection 

Association. Before any new regulations are proposed for the storage of solid ammonium nitrate, the Secretary shall submit a report 

to the Committees on Appropriations of the House Representatives 

and the Senate; the Senate Health, Education, Labor and Pensions 

Committee; and the House Committee on Education and the Workforce that identifies any provisions of OSHA’s current 29 CFR 

1910.109(i) regulations under consideration for update and that 

evaluates the costs and benefits of such changes. 

MINE SAFETY AND HEALTH ADMINISTRATION

SALARIES AND EXPENSES

Appropriations, 2015 ............................................................................. $375,887,000 

Budget estimate, 2016 ........................................................................... 394,932,000 

Committee recommendation ................................................................. 356,878,000 
34 

The Committee recommendation includes $356,878,000 for the 

Mine Safety and Health Administration [MSHA]. 

MSHA enforces the Federal Mine Safety and Health Act by conducting inspections and special investigations of mine operations, 

promulgating mandatory safety and health standards, cooperating 

with the States in developing effective State programs, and improving training in conjunction with States and the mining industry. 

The bill continues language authorizing MSHA to use up to $2,000,000 for mine rescue and recovery activities. It also retains 

the provision allowing the Secretary to use any funds available to 

the Department to provide for the costs of mine rescue and survival 

operations in the event of a major disaster. To prepare properly for 

an actual emergency, the Committee also directs MSHA to continue 

to devote sufficient resources toward a competitive grant activity 

for effective emergency response and recovery training in various 

types of mine conditions. The Committee supports MSHA’s ongoing 

work to improve mine rescue communications capabilities. 

In addition, bill language is included to allow the National Mine Health and Safety Academy to collect not more than $750,000 for 

room, board, tuition, and the sale of training materials to be available for mine safety and health education and training activities. 

Bill language also allows MSHA to retain up to $2,499,000 from 

fees collected for the approval and certification of equipment, materials, and explosives for use in mines, and to utilize such sums for 

these activities. 

BUREAU OF LABOR STATISTICS

SALARIES AND EXPENSES

Appropriations, 2015 ............................................................................. $592,212,000 

Budget estimate, 2016 ........................................................................... 632,737,000 

Committee recommendation ................................................................. 579,194,000 

The Committee recommends $579,194,000 for the Bureau of 

Labor Statistics [BLS]. This amount includes $63,700,000 from the 

Employment Security Administration account of the Unemployment Trust Fund and $515,494,000 in Federal funds. 

BLS is the principal fact finding agency in the Federal Government in the broad field of labor economics. 

The Committee recognizes that the Nation requires current, accurate, detailed workforce statistics for Federal and non-Federal 

data users as provided by BLS. 

OFFICE OF DISABILITY EMPLOYMENT POLICY

Appropriations, 2015 ............................................................................. $38,500,000 

Budget estimate, 2016 ........................................................................... 38,203,000 

Committee recommendation ................................................................. ........................... 

The Committee recommendation transfers the Office of Disability 

Employment Policy [ODEP] into the Employment and Training Administration [ETA]. The Committee expects ODEP and ETA to continue to provide technical assistance to the workforce system in 

support of effective disability employment policies, to manage the 

Disability Employment Initiative [DEI] grant program with resources provided, and to manage the Advisory Committee on Increasing Competitive Integrated Employment for Individuals with 
35 

Disabilities through the completion of a final report in fiscal year 

2016, and to further integrate services for adults and youth with 

disabilities into the WIOA system. The recommended funding level 

allows ETA to maintain the DEI grant program and to retain the 

core of ODEP’s subject matter expertise to pair with ETA’s grant 

management and policy support. 

DEPARTMENTAL MANAGEMENT

SALARIES AND EXPENSES

Appropriations, 2015 ............................................................................. $337,929,000 

Budget estimate, 2016 ........................................................................... 375,985,000 

Committee recommendation ................................................................. 259,020,000 

The Committee recommendation includes $259,020,000 for the 

Departmental Management account. Of this amount, $258,727,000 

is available from general funds and $293,000 is available by transfer from the Employment Security account of the Unemployment 

Trust Fund. In addition, $30,279,000 is available by transfer from 

the Black Lung Disability Trust Fund. 

The departmental management appropriation pays the salaries 

and related expenses of staff responsible for formulating and overseeing the implementation of departmental policy and management 

activities in support of that goal. In addition, this appropriation includes a variety of operating programs and activities that are not 

involved in departmental management functions, but for which 

other appropriations for salaries and expenses are not suitable. The administration requested $2,620,000 and 15 full time staff to 

initiate an Office of Labor Compliance. This request is denied by 

the Committee; no funds in the bill have been provided for this 

purpose. The Committee is concerned that the administration proposes to create additional layers of bureaucracy to duplicate existing functions of government. Violations of Federal labor law are a 

serious matter. Such violations are already illegal by definition, 

and enforcement mechanisms are already in place to adjudicate 

such cases and to levy punishment as appropriate, up to and including debarment. 

The Committee recommendation includes $30,000,000 for the Bureau of International Labor Affairs [ILAB]. ILAB’s appropriation is 

available to help improve working conditions and labor standards 

for workers around the world by carrying out ILAB’s statutory 

mandates and international responsibilities. Funds for new international grants are not provided for fiscal year 2016. 

The Committee recommendation provides $7,236,000 for program 

evaluation and allows these funds to be available for obligation 

through September 30, 2017. The Committee bill also continues the 

authority of the Secretary to transfer these funds to any other account in the Department for evaluation purposes. The Committee 

bill continues authority to use up to 0.5 percent of certain Department appropriations for evaluation activities identified by the chief 

evaluation officer. The Committee expects to be notified of the 

planned uses of funds derived from this authority. 

The Committee recommendation provides $9,465,000 for the 

Women’s Bureau. The Committee continues bill language allowing 

the Bureau to award grants. 
36 

The Committee notes a report issued on March 31, 2015, by the 

Department’s Inspector General Office of Audit which outlines significant failures by the Department to comply with Federal requirements for the costs, approvals, and reporting of employee conferences. These requirements stem from appropriations law, Executive order, and the Office of Management and Budget direction to 

ensure that conference expenses are appropriate, necessary, and 

managed in a manner that minimizes expense to taxpayers. The 

Inspector General found that DOL did not obtain required approval 

for every conference it sponsored costing greater than $100,000, it 

failed to disclose five of these conferences, and two were not reported to the Inspector General as required. The audit also noted 

that other conferences were not reported and that, due to omissions 

of some categories of costs, the Department’s claim that it met total 

conference cost reduction targets could not be verified. The Department is strongly urged to improve its adherence to conference cost 

reduction requirements and to cooperate with the OIG to strengthen internal controls, compliance, and reporting procedures. 

VETERANS EMPLOYMENT AND TRAINING

Appropriations, 2015 ............................................................................. $269,981,000 

Budget estimate, 2016 ........................................................................... 271,110,000 

Committee recommendation ................................................................. 269,981,000 

The Committee recommendation of $269,981,000 for VETS includes $38,109,000 in general revenue funding and $231,872,000 to 

be expended from the Employment Security Administration account of the Unemployment Trust Fund. 

This account provides resources for VETS to maximize employment opportunities for veterans and transitioning service members, 

including protecting their employment rights. VETS carries out its 

mission through a combination of grants to States, competitive 

grants, and Federal enforcement and oversight. 

The Committee provides $175,000,000 for the Jobs for Veterans 

State Grants [JVSG] program. This funding will enable Disabled 

Veterans’ Outreach Program specialists and Local Veterans’ Employment Representatives to continue providing intensive employment services to veterans and eligible spouses; transitioning service 

members early in their separation from military service; wounded 

warriors recuperating in military treatment facilities or transition 

units; and, spouses and family caregivers to help ensure the family 

has income to provide sufficient support. The Committee maintains 

language providing authority for JVSG funding to be used for data 

systems and contract support to allow for the tracking of participant and performance information. 

The Committee provides $14,000,000 for the Transition Assistance Program [TAP]. This funding will support over 6,000 employment workshops at military installations and in virtual classrooms 

worldwide for exiting service members and spouses. 

The Committee recommendation includes $39,458,000 for Federal 

administration costs. This funding level will support oversight and 

administration of the VETS grant programs, TAP employment 

workshops, and compliance and enforcement activities. 

The Committee recommends $38,109,000 for the Homeless Veterans’ Reintegration Program [HVRP] to help homeless veterans 
37 

attain the skills they need to gain meaningful employment. This 

funding will allow DOL to provide HVRP services to as many as 

17,000 homeless veterans nationwide, including homeless women 

veterans. The bill allows Incarcerated Veterans’ Transition funds to 

be awarded through September 30, 2016, and to serve veterans 

who have recently been released from incarceration but are at-risk 

of homelessness. 

The Committee recommendation includes $3,414,000 for the National Veterans’ Training Institute, which provides training to Federal staff and veteran service providers. 

INFORMATION TECHNOLOGY MODERNIZATION

Appropriations, 2015 ............................................................................. $15,394,000 

Budget estimate, 2016 ........................................................................... 119,602,000 

Committee recommendation ................................................................. 12,898,000 

The Committee recommends $12,898,000 for the IT Modernization account. Funds available in this account have been used for 

two primary activities. The first is departmental support systems, 

for which $4,898,000 is provided as requested. These funds help 

align IT investments with the Department’s strategic objectives. 

The second budget activity, for which $8,000,000 is provided, assists the Department in consolidating and optimizing common IT 

infrastructure services, protecting privacy, and improving timely 

and efficient services to the public. The first year of a new activity 

proposed in the budget request involves support for a digital government integrated platform initiative is deferred. It is not funded 

for fiscal year 2016 due to budgetary constraints. 

OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2015 ............................................................................. $81,590,000 

Budget estimate, 2016 ........................................................................... 87,985,000 

Committee recommendation ................................................................. 79,311,000 

The Committee recommends $79,311,000 for the DOL OIG. The 

bill includes $73,721,000 in general funds and authority to transfer 

$5,590,000 from the Employment Security Administration account 

of the Unemployment Trust Fund. In addition, an amount of 

$327,000 is available by transfer from the Black Lung Disability 

Trust Fund. 

Through a comprehensive program of audits, investigations, inspections, and program evaluations, OIG attempts to reduce the incidence of fraud, waste, abuse, and mismanagement, and to promote economy, efficiency, and effectiveness. 

GENERAL PROVISIONS

Section 101. The bill continues a provision limiting the use of Job 

Corps funding for compensation of an individual that is not a Federal employee at a rate not to exceed Executive Level II. 

Section 102. The bill continues a provision providing for general 

transfer authority. 

Section 103. The bill continues a provision prohibiting funding 

for the procurement of goods and services utilizing forced or indentured child labor in industries and host countries already identified 

by the Department in accordance with Executive Order 13126. 
38 

Section 104. The bill modifies a provision requiring that funds 

available under section 414(c) of the American Competitiveness 

and Workforce Innovation and Opportunity Act may only be used 

for competitive grants that train individuals over the age of 16 who 

are not enrolled in school, in occupations and industries for which 

employers are using H–1B visas to hire foreign workers. The provision is expanded to provide an exception, setting aside $13,000,000 

to eliminate the PERM processing backlog. This authority is an alternative to the administration’s request for a direct appropriation 

for this purpose to the Office of Foreign Labor Certification. 

Section 105. The bill continues a provision limiting the use of 

ETA funds by a recipient or subrecipient for compensation of an individual at a rate not to exceed Executive Level II. 

Section 106. The bill continues a provision providing the ETA 

with authority to transfer funds provided for technical assistance 

services to grantees to ‘‘Program Administration’’ when it is determined that those services will be more efficiently performed by 

Federal employees. The provision does not apply to section 171 of 

the WIOA. 

Section 107. The bill continues a provision allowing up to 0.5 percent of discretionary appropriations provided in this act for all Department agencies to be used by the Office of the Chief Evaluation 

Officer for evaluation purposes consistent with the terms and conditions in this act applicable to such office. 

Section 108. The bill modifies the application of the Fair Labor 

Standards Act after the occurrence of a major disaster. 

Section 109. The bill includes a new provision requested by the 

Administration providing for competition for the operation of Civilian Conservation Centers under certain circumstances. 

Section 110. The bill includes a new provision related to regulation from the Department regarding the circumstances under 

which an individual is considered a fiduciary. 

Section 111. The bill includes a new provision related to the 

wage methodology under the H–2B program. 

Section 112. The bill includes a new provision regarding the 

three-fourths guarantee and definitions of corresponding employment and temporary need for purposes of the H–2B program. 

Section 113. The bill includes a new provision related to enforcement of H–2B program regulations. 

Section 114. The bill retains a provision that provides flexibility 

with respect to the crossing of H–2B nonimmigrants. 

Section 115. The bill includes a new provision related to regulation of respirable crystalline silica. 
(39) 

TITLE II 

DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Any references in this title of the report to the ‘‘Secretary’’ or the 

‘‘Department’’ shall be interpreted to mean the Secretary of HHS 

or the Department of HHS, respectively, unless otherwise noted. 

HEALTH RESOURCES AND SERVICES ADMINISTRATION

HRSA activities support programs to provide healthcare services 

for mothers and infants; the underserved, elderly, and homeless; 

rural residents; and disadvantaged minorities. This agency supports cooperative programs in maternal and child health, AIDS 

care, healthcare provider training, and healthcare delivery systems 

and facilities. 

BUREAU OF PRIMARY HEALTH CARE

Appropriations, 2015 ............................................................................. $1,491,522,000 

Budget estimate, 2016 ........................................................................... 1,491,522,000 

Committee recommendation ................................................................. 1,491,522,000 

The Committee recommendation for the activities of the Bureau 

of Primary Health Care is $1,491,522,000. 

Community Health Centers 

The program level for Community Health Centers is 

$5,200,000,000, an increase of $199,367,000 above last year and an 

increase of $830,478,000 above the President’s request for fiscal 

year 2016. 

The Committee provides $1,491,522,000 in this bill, which is 

combined with $3,600,000,000 in mandatory funding appropriated 

for fiscal year 2016, and $138,478,000 in unobligated balances from 

prior years. In addition, the Committee took into account in the 

program level the possibility that $30,000,000 may be transferred 

from the Community Health Centers mandatory funds by Public 

Law 114–22. 

Programs supported by this funding include community health 

centers, migrant health centers, healthcare for the homeless, 

school-based, and public housing health service grants. The Committee continues to support the ongoing effort to increase the number of people who have access to medical services at health centers. 

Health centers play a vital role in ensuring access to primary care 

in underserved areas of the country, including urban, rural, and 

frontier areas. 

Frontier Health.—The Committee recognizes the importance of 

the Frontier Community Health Integration Project Demonstration 

to providing coordinated healthcare to the Nation’s most rural 

counties. The Committee urges the Health Resources and Services 
40 

Administration to use available funds to provide continuing technical assistance and analysis to participants in the demonstration. 

The Committee strongly supports Community Health Centers 

and the high-quality, cost-effective primary healthcare they provide. However, the Committee is concerned by the administration’s 

refusal to put forth a comprehensive plan for the upcoming fiscal 

cliff facing Community Health Centers in fiscal year 2017. HRSA 

is directed to provide a report to the Committees on Appropriations 

of the House of Representatives and the Senate 90 days after enactment of this act that details how the administration will support 

ongoing health center operations at existing sites within current 

appropriations. Further, the Committee notes the importance of 

prudent planning and execution of available unobligated balances 

available for Community Health Centers. Therefore, the Committee 

directs that no more than $138,478,000 in unobligated balances 

from amounts appropriated in prior years is available for obligation 

in fiscal year 2016. 

Of the available funding for fiscal year 2016, bill language directs 

that not less than $50,000,000 shall be awarded for the establishment of new delivery sites. In addition, not less than $40,000,000 

will be awarded for construction, and quality and capital improvement projects. 

In addition, within the amount provided, the Committee provides 

up to $99,893,000 under the Federal Tort Claims Act [FTCA], 

available until expended. These funds are used to pay judgments 

and settlements, occasional witness fees and expenses, and related 

administrative costs. The Committee intends FTCA coverage funded through this bill to be inclusive of all providers, activities, and 

services included within the health centers’ federally approved 

scope of project. 

Native Hawaiian Health Care.—The Committee includes sufficient funding in the Community Health Centers program to support healthcare activities funded under the Native Hawaiian 

Health Care Program, which is specifically cited in the bill. The 

Committee urges that not less than the fiscal year 2015 level be 

provided for these activities. 

School-Based Health Centers [SBHC].—The Committee recognizes school-based health centers are an important part of the 

health center safety net program, as they provide a critical access 

point for vulnerable school-aged children, youth, and their families 

in communities across the country. The Committee urges HRSA to 

prioritize fiscal year 2016 grant awards to include the establishment of new school-based health center delivery sites, and to report 

to the Committee in the fiscal year 2017 CJ how many organizations applied for funding for new delivery sites in SBHC’s and how 

many were funded. 

Tuberculosis [TB].—Cases of TB continue to be reported in every 

State in the United States, and CDC has identified drug resistant 

TB as a serious antibiotic resistant threat to the nation. The Committee urges HRSA to strengthen coordination between Community 

Health Centers and State and local tuberculosis control programs 

to ensure appropriate identification, treatment, and prevention of 

TB among vulnerable populations. 
41 

Free Clinics Medical Malpractice Coverage 

The Committee provides $99,893,000 for payments of claims 

under the FTCA to be made available for free clinic health professionals as authorized by section 224(o) of the PHS Act. 

This appropriation extends FTCA coverage to medical volunteers 

in free clinics to expand access to healthcare services to low-income 

individuals in medically underserved areas. 

BUREAU OF HEALTH PROFESSIONS

Appropriations, 2015 ............................................................................. $751,600,000 

Budget estimate, 2016 ........................................................................... 856,820,000 

Committee recommendation ................................................................. 720,970,000 

The Committee recommendation for the activities of the Bureau 

of Health Professions is $720,970,000. 

The Bureau of Health Professions provides policy leadership and 

grant support for health professions workforce development. The 

mission of the Bureau is to identify shortage areas while working 

to make them obsolete. Its programs are intended to ensure that 

the Nation has the right clinicians, with the right skills, working 

where they are needed. 

In its grant-making under the title VII and VIII health professions programs, HRSA should give priority consideration, in alignment with statutory requirements, to medical schools and health 

professions schools/programs with a strong emphasis on primary 

care, particularly those with programs to foster education and 

training in patient-centered, interdisciplinary team-based primary 

care. Numerous studies show that primary care produces better 

outcomes and reduces the costs of care. 

National Health Service Corps 

The Committee recommendation does not include discretionary 

funding for the National Health Service Corps [Corps], as proposed 

by the administration, because adequate funding was included for 

fiscal year 2016 in Public Law 114–10. The Committee strongly 

supports the Corps’ long and successful record of supporting qualified healthcare providers that are dedicated to working in underserved areas with limited access to healthcare. 

The Committee recognizes the importance of the Corps scholarship and loan-repayment programs for serving medically underserved communities and populations with health professional shortages and/or high unmet needs for health services. The Committee 

notes with concern that the criteria and methodology for designating a Health Professional Shortage Areas [HPSA] has not been 

significantly updated in more than 20 years. The HPSA methodology is outdated and therefore may not be reliably identifying 

areas with primary care shortages or help target Federal resources 

to areas experiencing the greatest shortages. The ability to accurately identify areas experiencing shortages of health workers is essential to the Secretary’s ability to use scarce resources as efficiently as possible. Therefore, the Committee encourages the Secretary to prioritize updating the HPSA designation and scoring 

methodology based on stakeholder recommendations made by the 

Negotiated Rulemaking Committee in 2011. The Committee en-
42 

courages HRSA to consider utilizing all authorized priority categories when granting awards, including prioritizing applicants 

willing to continue to serve in a HPSA area after the period of obligated service, as authorized by 42 U.S.C. 254l–1(d)(2)(B) and 42 

U.S.C. 254l(d)(2)(B) and additional flexibility available to the Secretary to ensure the Corps scholarship and loan-repayment programs serve the underserved communities in every State, to the extent appropriate under the law. 

The Committee recognizes that the Secretary retains the authority to include additional disciplines in the Corps. As such, the Committee urges the Secretary to include pharmacists—individuals recognized as part of the primary care team in medical home demonstration programs—as eligible recipients of scholarships and loan 

repayments through the program. 

The Committee continues to include section 206 of this act to 

modify the rules governing the Corps to allow every Corps member 

60 days to cancel their contract. 

Training for Diversity 

Centers of Excellence 

The Committee recommends $21,711,000 for the Centers of Excellence Program. 

The Committee recognizes that the Centers of Excellence Program increases the supply and competencies of underrepresented 

minorities [URM] in health professions. Funds support programs of 

excellence that enhance the academic performance of URM students, support URM faculty development, and facilitate research on 

minority health issues. Diversity among medical school students is 

associated with higher levels of cultural sensitivity of all students 

and greater willingness to serve diverse populations. There is evidence that suggests that minority health professionals are more 

likely to serve in areas with high rates of uninsured and areas of 

underrepresented racial and ethnic groups. 

Health Careers Opportunity Program 

The Committee eliminates the Health Careers Opportunity Program as proposed by the administration in fiscal years 2015 and 

2016. Due to funding constraints, funding to increase the diversity 

of the health professions workforce in this bill is prioritized by investing in programs that have a more immediate impact on the 

production of health professionals by supporting students who have 

committed to and are in training as healthcare professionals. 

Faculty Loan Repayment 

The Committee provides $1,190,000 for the Faculty Loan Repayment Program. This amount is the same as the fiscal year 2015 enacted level and the budget request. 

Scholarships for Disadvantaged Students 

The Committee provides $50,970,000 for Scholarships for Disadvantaged Students, an increase of $5,000,000 above the fiscal 

year 2015 level. The Committee supports diversity among health 

professionals. This program provides grants to eligible health pro-
43 

fessions and nursing schools to award scholarships to students 

from disadvantaged backgrounds who have financial need. 

Health Workforce Diversity Program 

The Committee recommendation does not include funding for this 

new program, as proposed by the administration, due to budget 

constraints. 

Primary Care Training and Enhancement 

The Committee provides $36,831,000 for Primary Care Training 

and Enhancement programs, which support the expansion of training in internal medicine, family medicine, pediatrics, and physician 

assistance. Funds may be used for developing training programs or 

providing direct financial assistance to students and residents. The 

Committee directs HRSA to prioritize programs that support underserved communities and applicants from disadvantaged background in any new grant competition in fiscal year 2016. 

Training in Oral Health Care 

The Committee provides $32,000,000 for Training in Oral Health 

Care programs, which includes not less than $9,000,000 each for 

general and pediatric dentistry. Funds may be used to expand 

training in general dentistry, pediatric dentistry, public health dentistry, dental hygiene, and other oral health access programs. 

Funds may also be used to plan and operate training programs, as 

well as to provide financial assistance to students and residents. 

The Committee directs HRSA to prioritize programs that support 

underserved communities and applicants from disadvantaged background in any new grant competition. Further, the Committee encourages HRSA to focus on training programs that target vulnerable populations in risk-based clinical disease management of all 

populations. The Committee urges HRSA to work with Centers for 

Medicare and Medicaid Services [CMS] on the evaluation and support of additional models for expanding access to oral healthcare. 

Such models should include emergency room diversion programs 

and efforts under State law to deploy and evaluate new provider 

types. 

The Committee continues long-standing bill language that prohibits funding for section 340G–1 of the PHS Act. 

Rural Physicians Training 

The Committee recommendation does not include funding for this 

new program, as proposed by the administration, due to budget 

constraints. 

Interdisciplinary, Community-Based Linkages 

Area Health Education Centers 

The Committee provides $31,000,000 for Area Health Education Centers [AHECs], an increase of $750,000 above the fiscal year 

2015 level. The Committee once again rejects the administration 

proposal to eliminate AHEC funding. The program links university 

health science centers with community health service delivery systems to provide training sites for students, faculty, and practi-
44 

tioners. The program supports three types of projects: core grants 

to plan and implement programs; special initiative funding for 

schools that have previously received AHEC grants; and model programs to extend AHEC programs with 50 percent Federal funding. 

The AHEC community training model provides a uniquely appropriate opportunity to bring the training of community health workers to scale. HRSA is encouraged to provide technical assistance on 

and disseminate best practices for training community health 

workers to existing AHECs. The Committee requests HRSA provide an update on the AHEC program’s impact to increase the primary healthcare workforce and the AHEC program’s nationwide 

activities in the fiscal year 2017 CJ. 

Geriatric Education 

The Committee provides $35,076,000 for Geriatric Education programs. 

In fiscal year 2015, HRSA combined the Comprehensive Geriatric 

Education Program, Geriatrics Education Centers program, Geriatric Training for Physicians, Dentists, and Behavioral/Mental 

Health Professionals program, and the Geriatric Academic Career 

Awards programs into one competition, the Geriatric Workforce Enhancement Program. HRSA stated the combined competition 

would, ‘‘improve health outcomes for older adults by integrating 

geriatrics with primary care, maximizing patient and family engagement, and transforming the healthcare system.’’ Therefore, the 

Committee has consolidated the Comprehensive Geriatric Education program with the Geriatric Program. 

Mental and Behavioral Health 

The Committee provides $8,916,000 for Mental and Behavioral 

Health programs. These programs provide grants to higher education institutions and accredited training programs to recruit and 

train professionals and faculty in the fields of social work, psychology, psychiatry, marriage and family therapy, substance abuse 

prevention and treatment, and other areas of mental and behavioral health. 

The mental and behavioral healthcare needs of older adults, returning military veterans and their families, those dealing with unemployment, job loss, or income reductions have increased the demand for mental and behavioral health providers. The Committee 

supports efforts by HRSA through the Graduate Psychology Education program that would expand training sites, reinstate the 

geropsychology training component, initiate a veteran-specific education and training component, and better integrate health service 

psychology trainees at federally Qualified Health Centers. 

The Committee supports the Department’s initiative to increase 

the number of social workers and psychologists that will pursue 

clinical work with high need and high demand populations defined 

as rural, vulnerable, and/or underserved populations, and veterans, 

military personnel, and their families through the Mental and Behavioral Health Education and Training Grants Program. The 

Committee is aware that 24 grants were awarded throughout the 

country and approximately half targeted veterans, military personnel, and their families. The Committee is concerned that as 
45 

more servicemembers begin to reintegrate into civilian life after numerous deployments, there will not be adequate numbers of social 

workers and psychologists to assist this population. The Committee 

supports HRSA for its collaboration with SAMHSA to integrate primary care and behavioral health. HRSA should include an update 

on this initiative in the fiscal year 2017 CJ. 

Health Professions Workforce Information and Analysis 

The Committee provides $2,782,000 for health professions workforce information and analysis. The program provides for the collection and analysis of targeted information on the Nation’s 

healthcare workforce, research on high-priority workforce questions, the development of analytic and research infrastructure, and 

program evaluation and assessment. 

Public Health Workforce Development 

The Committee provides $9,864,000 for Public Health Workforce 

Development. This program line, also called Public Health and Preventive Medicine, funds programs that are authorized in titles III 

and VII of the PHS Act and support awards to schools of medicine, 

osteopathic medicine, public health, and integrative medicine programs. 

Due to funding constraints, the Committee recommendation does 

not include funding for Public Health Traineeships, the Preventative Medicine Residency program, or the Integrative Medicine Program. The Public Health Training Centers Program is fully funded 

at the administration’s request level of $9,864,000. 

Nursing Workforce Development Programs 

The Committee provides $220,630,000 for Nursing Workforce Development programs. The program provides funding to address all 

aspects of nursing workforce demand, including education, practice, 

recruitment, and retention. 

The Committee recommends funding for the following activities 

in the following amounts: 

[In thousands of dollars] 

Budget activity Fiscal year 2015 

appropriation 

Fiscal year 2016 

request 

Committee recommendation 

Advanced Education Nursing ..................................................................... 63,581 63,581 61,089 

Nurse Education, Practice, and Retention ................................................ 39,913 39,913 39,913 

Nurse Workforce Diversity .......................................................................... 15,343 15,343 15,343 

Nurse Loan Repayment and Scholarship Program .................................... 81,785 81,785 79,785 

Comprehensive Geriatric Education ........................................................... 4,500 4,500 ........................

Nursing Faculty Loan Program .................................................................. 26,500 26,500 24,500 

Comprehensive Geriatric Education.—In fiscal year 2015, HRSA 

combined the Comprehensive Geriatric Education program, Geriatrics Education Centers program, Geriatric Training for Physicians, Dentists, and Behavioral/Mental Health Professionals program, and the Geriatric Academic Career Awards programs into 

one competition, the Geriatric Workforce Enhancement Program. 

HRSA stated the combined competition would, ‘‘improve health outcomes for older adults by integrating geriatrics with primary care, 

maximizing patient and family engagement, and transforming the 
46 

healthcare system.’’ Therefore, the Committee has consolidated the 

Comprehensive Geriatric Education program with the Geriatric 

Program. 

Children’s Hospitals Graduate Medical Education 

The Committee provides $270,000,000, an increase of $5,000,000, 

for the Children’s Hospitals Graduate Medical Education [CHGME] 

program and rejects the administration’s proposal to only pay direct program costs. The Committee strongly supports the CHGME 

program which provides support for graduate medical education 

training programs in both ambulatory and in-patient settings within freestanding children’s teaching hospitals. CHGME payments 

are determined by a per-resident formula that includes an amount 

for direct training costs added to a payment for indirect costs. Payments support training of resident physicians as defined by Medicare in both ambulatory and inpatient settings. 

National Practitioner Data Bank 

The Committee provides $18,814,000 for the National Practitioner Data Bank. As mandated by the Health Care Quality Improvement Act, the National Practitioner Data Bank does not receive appropriated funds, but instead is financed by the collection 

of user fees. 

The National Practitioner Data Bank collects certain adverse information, medical malpractice payment history, and information 

related to healthcare fraud and abuse. The data bank is open to 

healthcare agencies and organizations that make licensing and employment decisions. 

MATERNAL AND CHILD HEALTH BUREAU

Appropriations, 2015 ............................................................................. $851,738,000 

Budget estimate, 2016 ........................................................................... 851,738,000 

Committee recommendation ................................................................. 828,014,000 

The Committee recommendation for the Maternal and Child 

Health [MCH] Bureau is $828,014,000. The mission of the Bureau 

is to improve the physical and mental health, safety, and wellbeing of the Nation’s women, infants, children, adolescents, and 

their families. This population includes fathers and children with 

special healthcare needs. 

Maternal and Child Health Block Grant 

The Committee provides $615,276,000 for the MCH Block Grant, 

which provides a flexible source of funding that allows States to 

target their most urgent maternal and child health needs. The program supports a broad range of activities including: providing prenatal care, well child services, and immunizations; reducing infant 

mortality; preventing injury and violence; expanding access to oral 

healthcare; addressing racial and ethnic disparities; and providing 

comprehensive care through clinics, home visits, and school-based 

health programs. 

The Committee includes bill language requiring that the State 

grant portion of the block grant be funded at not less than 

$555,000,000, an increase of $5,369,000 above the fiscal year 2015 

level. The Committee also includes bill language identifying 
47 

$50,000,000 for the title V SPRANS set-aside. Within that total, 

the Committee recommendation includes sufficient funding to fully 

fund the set-asides for oral health, epilepsy, sickle cell anemia, and 

fetal alcohol syndrome at the fiscal year 2015 enacted level. 

Children’s Health and Development.—There is increased evidence 

that experiences in early childhood have long-term health consequences over the course of one’s life. These experiences are critical in all areas of children’s educational, social, and physical development, and economic well-being. Children living in States with 

persistently high child poverty rates experience more negative 

health outcomes than their peers in other States. Therefore, the 

Committee directs HRSA to fund studies focused on systemic 

change that would positively affect the policy of child-health-related institutions and systems in States with the highest levels of 

childhood poverty. Recipient programs should consider inter- and 

intra-cultural dynamics to yield best practices for areas across the 

Nation with diverse populations, persistent poverty and child 

health outcomes in need of improvement. The Committee intends 

that this effort will provide a model for other States to utilize in 

improving child health and development outcomes. 

Prenatal Oral Health.—The Committee recognizes the importance of prenatal oral healthcare for the health of both mother and 

child and encourages the MCH Bureau within HRSA to continue 

its efforts to improve the oral health of pregnant women. 

Vision Health.—The Committee is concerned that vision disorders are the leading cause of impaired health in childhood and 

1 in 4 school-aged children has a vision problem significant enough 

to affect learning. The Committee recognizes that early detection 

can help prevent vision loss and blindness and understands many 

serious ocular conditions in children are treatable if diagnosed at 

an early stage. Therefore, the Committee commends and supports 

the work of the National Center for Children’s Vision and Eye 

Health, which through partnerships, sound science, and targeted 

policy initiatives advances the development of public health infrastructure to support a comprehensive, multi-tiered continuum of vision care for young children. 

Sickle Cell Anemia 

The Committee provides $4,455,000 for grants and contracts to 

help coordinate service delivery for individuals with sickle cell disease, including genetic counseling and testing; training of health 

professionals; and coordination of education, treatment, and continuity of care programs. 

Traumatic Brain Injury 

The Committee provides $9,321,000 for the Traumatic Brain Injury program. The program supports implementation and planning 

grants to States for coordination and improvement of services to individuals and families with traumatic brain injuries. Such services 

can include: pre-hospital care, emergency department care, hospital 

care, rehabilitation, transitional services, education, employment, 

long-term support, and protection and advocacy services. 
48 

The Committee includes not less than the fiscal year 2015 funding level for protection and advocacy services, as authorized under 

section 1305 of Public Law 106–310. 

Autism and Other Developmental Disorders 

The Committee provides $47,099,000 for the Autism and Other 

Developmental Disorders program. The program supports surveillance, early detection, education, and intervention activities on autism and other developmental disorders, as authorized in the Combating Autism Act of 2006. 

The Committee is concerned that the Autism and Other Developmental Disorders program’s State System Grants are not of a sufficient size to accomplish their objectives to improve access to comprehensive, coordinated healthcare and related services for children 

and youth with autism spectrum disorder [ASD] and other developmental disabilities. Many rural States need significant assistance 

with diagnosis of ASD and building networks to provide access to 

properly trained health providers. The Committee requests that 

HRSA report in the fiscal year 2017 CJ on which rural States have 

received such grants and what scale of improvement they were able 

to achieve. 

The Committee directs that HRSA provide not less than the fiscal year 2015 level for LEND programs to maintain their capacity 

to train professionals to diagnose, treat, and provide interventions 

to individuals with autism spectrum disorders. 

Newborn Screening for Heritable Disorders 

The Committee provides $11,883,000 for the Newborn Heritable 

Disorders Screening program, as described in section 1109 of the 

Newborn Screening Saves Lives Act of 2008. This program provides 

funding to improve States’ ability to provide newborn and child 

screening for heritable disorders. Newborn screening provides early 

identification and follow-up for treatment of infants affected by certain genetic, metabolic, hormonal, and/or functional conditions. 

Krabbe Disease.—Krabbe Disease is a rare, inherited degenerative disorder of the nervous system that causes severe deterioration 

of mental and motor skills. The disease most often affects infants 

and is generally fatal before the age of 2. There is no cure for 

Krabbe Disease, but early detection and beginning treatment prior 

to the onset of symptoms may help prevent severe health outcomes. 

The Committee encourages HRSA to expand the ability of States 

to screen for Krabbe disease and other leukodystrophies, and to 

continue to educate the public on the importance of newborn 

screening and in some cases supplemental newborn screening. 

Healthy Start 

The Committee provides $102,000,000 for the Healthy Start infant mortality initiative. The primary purpose of Healthy Start is 

to reduce infant mortality and generally improve maternal and infant health in at-risk communities. Grants are awarded to State 

and local health departments and nonprofit organizations to conduct an infant mortality review, develop a package of innovative 

health and social services for pregnant women and infants, and 

evaluate these efforts. 
49 

Fetal Infant Mortality Review [FIMR].—The FIMR program is an 

important component of many Healthy Start Initiatives and providing evidence-based interventions are crucial to improving infant 

health in high risk communities. HRSA is encouraged to continue 

to support the FIMR program with Healthy Start funding while 

educating Healthy Start Programs on the successes of the FIMR. 

Necrotizing Enterocolitis [NEC].—HRSA shall identify best practices and successful interventions for the prevention of NEC, particularly in premature infants. The Committee directs HRSA to 

prioritize prevention of NEC when awarding grants through the 

Healthy Start Initiative program. 

Universal Newborn Hearing Screening and Early Intervention 

The Committee provides $17,818,000 for universal newborn hearing screening and early intervention activities. This program 

awards grants to 53 States and territories that support Statewide 

systems of newborn hearing screening, audiologic diagnostic testing 

before 3 months of age, and enrollment in early intervention programs before the age of 6 months. 

Emergency Medical Services for Children 

The Committee provides $20,162,000 for the Emergency Medical 

Services for Children program which focuses on improving the pediatric components of the emergency medical services system and 

improving the quality of care provided to children in the pre-hospital setting. Funding is available to every State emergency medical services office to improve the quality of emergency care for 

children and to pay for research and dissemination of best practices. 

HIV/AIDS BUREAU

Appropriations, 2015 ............................................................................. $2,318,781,000 

Budget estimate, 2016 ........................................................................... 2,322,781,000 

Committee recommendation ................................................................. 2,293,781,000 

The Committee recommendation includes $2,293,781,000 for the 

HIV/AIDS Bureau. 

The mission of the Bureau is to address the unmet care and 

treatment needs of persons living with HIV/AIDS. The Bureau administers the Ryan White Care Act, which provides a wide range 

of community-based services, including primary and home 

healthcare, case management, substance abuse treatment, mental 

health, and nutritional services. 

Emergency Assistance 

The Committee provides $655,876,000, level with fiscal year 

2015, for emergency assistance grants to eligible metropolitan 

areas disproportionately affected by the HIV/AIDS epidemic. 

Grants are provided to metropolitan areas meeting certain criteria. Two-thirds of the funds are awarded by formula, and the remainder is awarded through supplemental competitive grants. 
50 

Comprehensive Care Programs 

The Committee provides $1,315,005,000, level with fiscal year 

2015, for HIV healthcare and support services. 

Funds are awarded to States to support HIV service delivery consortia, the provision of home- and community-based care services 

for individuals with HIV disease, continuation of health insurance 

coverage for low-income persons with HIV disease, and support for 

State AIDS drug assistance programs [ADAP]. 

The Committee includes bill language providing $900,313,000, 

level with fiscal year 2015, for AIDS medications in ADAP. 

Early Intervention Services 

The Committee provides $201,079,000, level with fiscal year 

2015, for early intervention grants. These funds are awarded competitively to primary healthcare providers to enhance healthcare 

services available to people at risk of HIV and AIDS. Funds are 

used for comprehensive primary care, including counseling, testing, 

diagnostic, and therapeutic services. 

Children, Youth, Women, and Families 

The Committee provides $75,088,000, level with fiscal year 2015, 

for grants for coordinated services to women, infants, children, and 

youth. The President’s request did not include funding for this program. The Committee once again rejects the President’s proposal to 

consolidate this program with the Early Intervention Services program. 

Funds are awarded to a variety of providers, including community health centers, comprehensive hemophilia centers, county and 

municipal health departments, and other nonprofit communitybased programs that provide comprehensive primary healthcare 

services to populations with or at risk for HIV. 

AIDS Dental Services 

The Committee provides $13,122,000, level with fiscal year 2015, 

for the AIDS Dental Services program. This program provides 

grants to dental schools, dental hygiene schools, and postdoctoral 

dental education programs to assist with the cost of providing unreimbursed oral healthcare to patients with HIV. 

AIDS Education and Training Centers 

The Committee provides $33,611,000, level with fiscal year 2015, 

for AIDS Education and Training Centers [AETCs]. AETCs train 

healthcare practitioners, faculty, and students who care for AIDS 

patients outside of the traditional health professions education 

venues and support curriculum development on the diagnosis and 

treatment of HIV infection for health professions schools and training organizations. 

Special Projects of National Significance 

Due to budget constraints, the Committee does not include funding for Special Projects of National Significance. However, the 

Committee continues to preserve the core HIV/AIDS Bureau programs that provide treatment, care, and direct services to patients. 
51 

HEALTH CARE SYSTEMS BUREAU

Appropriations, 2015 ............................................................................. $103,193,000 

Budget estimate, 2016 ........................................................................... 110,193,000 

Committee recommendation ................................................................. 103,193,000 

The Committee recommendation for the Health Care Systems 

Bureau is $103,193,000. 

The Health Care Systems Bureau protects the public health and 

improves the health of individuals through efforts to support and 

enhance the systems by which healthcare is delivered in America. 

Organ Donation and Transplantation 

The Committee provides $23,549,000 for organ donation and 

transplantation activities. 

Funds support a scientific registry of organ transplant recipients 

and the National Organ Procurement and Transplantation Network to match donors and potential recipients of organs. A portion 

of the appropriated funds may be used to educate the public and 

health professionals about organ donations and transplants and to 

support clearinghouse and technical assistance functions. 

National Cord Blood Inventory 

The Committee provides $11,266,000 for the National Cord Blood 

Inventory. The purpose of this program is to provide funds to cord 

blood banks to build an inventory of the highest quality cord blood 

units for transplantation. 

C.W. Bill Young Cell Transplantation Program 

The Committee provides $22,109,000 for the C.W. Bill Young 

Cell Transplantation Program. 

The Committee continues to support cell transplantation through 

the use of cord blood, bone marrow, peripheral blood stem cells, 

and other sources of stem cells that may be available in the future. 

The Committee appreciates HRSA’s efforts to increase the diversity 

of the registry and the program’s research efforts to improve the 

availability, efficiency, safety, and cost of transplants and the effectiveness of program operations. 

Office of Pharmacy Affairs 

The Committee provides $10,238,000 for the Office of Pharmacy 

Affairs [OPA]. OPA administers the 340B drug pricing program, 

which requires drug manufacturers to provide discounts or rebates 

to a set of programs and hospitals that serve a disproportionate 

share of low-income patients. 

The Committee includes a statutory provision to allow a nominal 

cost recovery fee to fund the program integrity provisions recommended by the inspector general. The fee will be set at 0.1 percent for covered entities and is expected to generate $7,500,000 in 

fiscal year 2017. The Committee expects HRSA to report the estimated and actual amounts generated by the fee in HRSA’s annual 

CJ. 
52 

Poison Control Centers 

The Committee provides $18,846,000 for poison control activities. 

The Poison Control Centers program currently supports a mix of 

grantees. Most serve States; a few serve multistate regions; and, in 

a handful of cases, more than one grantee serves a single State. 

In 2014 more than 3.3 million poisoning, toxic exposure, drug, 

food safety, and public health emergency calls were managed by 

the Nation’s 55 accredited poison centers—an average of more than 

9,000 calls per day. Multiple studies have demonstrated that accurate assessment and triage of poisoning, drug, and toxic exposures 

by the Nation’s poison centers save critical healthcare dollars by reducing the severity of illness, preventing deaths, and avoiding the 

expense of unnecessary trips to emergency departments and the 

length of hospital stays. HRSA reports that utilization of poison 

centers by hospitals and healthcare professionals continues to increase as the severity and complexity of poisonings and toxic exposures require the need for increased toxicological expertise in clinical settings. It is estimated that every $1 invested in the national 

poison center program saves $13.39 in medical costs and lost productivity, thus generating annual cost savings exceeding 

$1,800,000,000. The Committee directs the Secretary to continue 

the discussions with the Nation’s poison control centers to develop 

an action plan to achieve these possible new Medicare and Medicaid cost savings. 

National Hansen’s Disease Program 

The Committee includes $15,206,000 for the National Hansen’s 

Disease program. The program consists of inpatient, outpatient, 

long-term care as well as training and research in Baton Rouge, 

Louisiana; a residential facility at Carville, Louisiana; and 11 outpatient clinic sites in the continental United States and Puerto 

Rico. 

National Hansen’s Disease Program Buildings and Facilities 

The Committee provides $122,000 for the repair and maintenance of buildings at the Gillis W. Long Hansen’s Disease Center. 

Payment to Hawaii for Hansen’s Disease Treatment 

The Committee provides $1,857,000 for Hansen’s disease services. Payments are made to the State of Hawaii for the medical 

care and treatment of persons with Hansen’s disease in hospital 

and clinic facilities at Kalaupapa, Molokai, and Honolulu. Expenses 

above the level of appropriated funds are borne by the State of Hawaii. 

RURAL HEALTH

Appropriations, 2015 ............................................................................. $147,471,000 

Budget estimate, 2016 ........................................................................... 127,562,000 

Committee recommendation ................................................................. 150,571,000 

The Committee recommendation for Rural Health programs is 

$150,571,000, an increase of $3,100,000 above the fiscal year 2015 

level. 
53 

The Office of Rural Health Policy [ORHP] administers HHS rural 

health programs, coordinates activities related to rural healthcare 

within HHS, and analyzes the possible effects of policy on the more 

than 42 million residents of rural communities. ORHP advises the 

Secretary on the effects of Medicare and Medicaid on rural citizens’ 

access to care, the viability of rural hospitals, and the availability 

of physicians and other health professionals. 

Reliable Energy Supply for Rural Health Facilities.—The Committee recognizes that health facilities, including dialysis centers, 

in rural parts of the United States are often dependent on inconsistent energy supply that can be interrupted for days or weeks following severe weather events. The lack of consistent power may require that patients travel long distances, often in less than safe 

conditions, for simple, life-saving dialysis procedures. This problem 

could be solved with alternative power generation capacity located 

at health facilities. The Committee encourages HRSA to support 

energy reliability and power generation capacity for health and dialysis facilities in rural areas of the United States. 

Rural Health Outreach 

The Committee provides $63,500,000 for the Rural Health Outreach program, an increase of $4,500,000 above the fiscal year 2015 

level. 

This program supports projects that demonstrate new and innovative modes of outreach in rural areas, such as integration and coordination of health services. The Committee recommendation provides not more than $12,514,000 for Outreach Service Grants; not 

more than $19,412,000 for Rural Network Development Grants; not 

less than $10,000,000 for Delta States Network Grant Program; not 

more than $2,400,000 for Network Planning Grants; and not less 

than $4,148,000 for Small Healthcare Provider Quality Improvement Grants. 

The Committee encourages HRSA to partner with the Delta Regional Authority [DRA] on the awarding and administration of 

grants under the Delta States network grant program and, to the 

extent possible, ensure that such awards are in accordance with 

DRA’s strategic plan. 

Rural Health Research 

The Committee provides $9,351,000 for the Rural Health Research program. Funds are used for rural health research centers, 

the National Advisory Committee on Rural Health, and a reference 

and information service. Supported activities focus on improving 

the delivery of health services to rural communities and populations. 

Rural Hospital Flexibility Grants 

The Committee provides $41,609,000 for Rural Hospital Flexibility grants and the Small Hospital Improvement Program. Under 

these grant programs, HRSA works with States to provide support 

and technical assistance to critical access hospitals to focus on 

quality and performance improvement and to integrate emergency 

medical services. The Committee recommendation continues to re-
54 

ject the administration’s proposal to eliminate the Small Hospital 

Improvement Program. 

Rural Access to Emergency Devices 

The Committee accepts the budget request’s elimination of the 

Rural Access to Emergency Devices program. Activities related to 

access to emergency medical devices and training are available 

through other funding sources available to grantees, such as the 

Rural Outreach and Rural Network Development programs. 

State Offices of Rural Health 

The Committee provides $9,511,000 for State Offices of Rural 

Health. These offices help States strengthen rural healthcare delivery systems by enabling them to coordinate care and improve support and outreach in rural areas. 

Black Lung Clinics 

The Committee provides $6,766,000 for the Black Lung Clinics 

program. This program funds clinics that treat respiratory and pulmonary diseases of active and retired coal miners, steel mill workers, agricultural workers, and others with occupationally related 

respiratory and pulmonary impairments. These clinics reduce the 

incidence of high-cost inpatient treatment for these conditions. 

The Committee is deeply concerned about changes HRSA made 

to the Black Lung Clinic Grants Program in fiscal year 2014, including the adoption of a three-tiered funding system and an overall per-applicant cap. These changes to the program have unnecessarily increased the administrative burden on applicants and may 

result in reductions in funding for States and communities most inneed of the essential healthcare services provided by this program. 

The Secretary is directed to evaluate funding levels for applicants 

based on the needs of the populations those applicants will serve 

and the ability of those applicants to provide healthcare services to 

miners with respiratory illnesses, with preference given to State 

agency applications over other applicants in that State, without regard to the funding tiers and overall per-applicant funding cap established by the Secretary in fiscal year 2014. 

Radiation and Exposure Screening and Education Program 

The Committee provides $1,834,000 for activities authorized by 

the Radiation Exposure Compensation Act. This program provides 

grants for the education, prevention, and early detection of 

radiogenic cancers and diseases resulting from exposure to uranium during mining and milling at nuclear test sites. 

Telehealth 

The Committee provides $18,000,000, an increase of $3,100,000 

above the fiscal year 2015 level, for the Office for the Advancement 

of Telehealth [OAT], which promotes the effective use of technologies to improve access to health services for people who are isolated from healthcare and to provide distance education for health 

professionals. 

The Committee strongly supports OAT and their mission to expand high quality medical care to rural communities that do not 
55 

have adequate access to medical providers including many medical 

specialties. The Committee directs OAT to use these funds to expand existing telehealth networks and to award new grants under 

the Telehealth Network Grant Program while also increasing activities that demonstrate the use and success of telehealth networks across the country. The Committee directs OAT to fund sustainable programs with demonstrable accomplishments, placing 

particular emphasis on programs seeking to aid diverse populations 

in regions with significant chronic disease burden and evident 

health disparities. 

The Committee encourages OAT to strongly consider a pilot program on telemedicine efforts to expand access to key health services in schools in high poverty areas. 

The Committee remains encouraged by the ability of telehealth 

services to provide access to vital care for patients in underserved 

areas. One very promising area for the expansion of telemedicine 

is in the area of stroke treatment, in which patients that are without access to specialty neurological care are at a significant disadvantage in receiving the highest standard of care. Stroke is a 

major cause of death and long-term disability, and the speedy access to appropriate care is the key factor in determining patient 

mortality and recovery. Accordingly, the Committee strongly encourages the inclusion and expansion of telestroke initiatives in the 

Telehealth Network Grant Program to improve patient care in 

rural, urban, and suburban settings. 

FAMILY PLANNING

Appropriations, 2015 ............................................................................. $286,479,000 

Budget estimate, 2016 ........................................................................... 300,000,000 

Committee recommendation ................................................................. 257,832,000 

The Committee provides $257,832,000 for the title X Family 

Planning program. This program supports preventive and primary 

healthcare services at clinics nationwide. 

Funding for family planning services is primarily provided from 

other sources of revenue, specifically Medicaid, State and local Governments, other Federal, State, and private grants, including the 

ACA, and private insurance. As stated in the budget request, these 

sources of funding ‘‘will remain at historical proportions of the total 

Title X revenue.’’ 

The Committee directs HRSA to ensure that any pregnancy options counseling funded under this title includes adoption counseling and is provided by counselors who have knowledge and experience in adoption practices. 

PROGRAM MANAGEMENT

Appropriations, 2015 ............................................................................. $154,000,000 

Budget estimate, 2016 ........................................................................... 157,061,000 

Committee recommendation ................................................................. 151,000,000 

The Committee provides $151,000,000 for program management 

activities. 

The Committee does not include bill language requested by the 

administration to provide additional transfer authority to the Administrator beyond that which is already provided to the Secretary. 
56 

VACCINE INJURY COMPENSATION PROGRAM TRUST FUND

Appropriations, 2015 ............................................................................. $242,500,000 

Budget estimate, 2016 ........................................................................... 244,500,000 

Committee recommendation ................................................................. 244,500,000 

The Committee provides that $244,500,000 be released from the 

Vaccine Injury Compensation Trust Fund in fiscal year 2016. Of 

that amount, $7,500,000 is for administrative costs. 

The National Vaccine Injury Compensation program provides 

compensation for individuals with vaccine-associated injuries or 

deaths. Funds are awarded to reimburse medical expenses, lost 

earnings, pain and suffering, legal expenses, and death benefits. 

The Vaccine Injury Compensation Trust Fund is funded by excise 

taxes on certain childhood vaccines. 

CENTERS FOR DISEASE CONTROL AND PREVENTION

The Committee recommendation provides a program level of $6,710,614,000 in this bill for the Centers for Disease Control and 

Prevention [CDC], which includes $55,358,000 in mandatory funds 

under the terms of the Energy Employees Occupational Illness 

Compensation Program Act [EEOICPA], $892,950,000 in transfers 

from the Prevention and Public Health [PPH] Fund, and 

$15,000,000 in Public Health and Social Services Emergency Fund 

[PHSSEF] unobligated balances from pandemic influenza supplemental appropriations. 

The activities of CDC focus on several major priorities: providing 

core public health functions; responding to urgent health threats; 

monitoring the Nation’s health using sound scientific methods; assuring the Nation’s preparedness for emerging infectious diseases 

and potential pandemics; and providing leadership in the implementation of nationwide prevention strategies that are conducive to 

improving and maintaining health. 

IMMUNIZATION AND RESPIRATORY DISEASES

Appropriations, 2015 ............................................................................. $798,405,000 

Budget estimate, 2016 ........................................................................... 748,066,000 

Committee recommendation ................................................................. 798,405,000 

The Committee recommendation for the activities of the National 

Center for Immunization and Respiratory Diseases is $798,405,000, 

which includes $210,300,000 in transfers from the PPH Fund and 

$15,000,000 in transfers from PHSSEF unobligated balances. 

The mission of the National Center for Immunization and Respiratory Diseases is the prevention of disease, disability, and death 

through immunization and by control of respiratory and related 

diseases. 

The Committee recommendation includes funding for the following activities in the following amounts: 

[In thousands of dollars] 

Budget activity Fiscal year 2015 

appropriation 

Fiscal year 2016 

request 

Committee recommendation 

Section 317 Immunization Program .............................................. 610,847 560,508 610,847 

National Immunization Survey (non-add) ............................. 12,864 12,864 12,864 

Influenza Planning and Response ................................................. 187,558 187,558 187,558 
57 

Adult Vaccinations.—National childhood vaccination rates are 

high, but adult vaccination rates continue to lag. Adult immunizations are important to prevent long-term illness, hospitalization, 

death, and unnecessary healthcare expenditures. Therefore, the 

Committee directs CDC to find new ways to increase adult immunization rates for recommended vaccines to achieve Healthy People 

2020 targets. 

Cost Estimates.—The Committee directs CDC to update its report on estimated funding needs for the Section 317 Immunization 

Program no later than February 1, 2016, to reflect fiscal year 2017 

cost estimates. The updated report shall also include an estimate 

of optimum State and local operations funding, as well as a discussion of the evolving role of the 317 program as expanded coverage 

for vaccination becomes available from private and public sources 

over the next several years. 

Influenza.—The Committee provides the same level as in fiscal 

year 2015 in budget authority and directs the Department to use 

$15,000,000 in pandemic influenza supplemental balances to support CDC’s global influenza activity. The Committee expects in the 

future that CDC and the Department will clearly identify in budget 

documents when and how supplemental appropriations are used. 

In particular, the Committee expects to be notified if any remaining supplemental balances are used by CDC in fiscal year 2016. 

Section 317.—The Committee rejects the reduction to the Section 

317 Immunization program proposed by the administration and 

provides the same level as in fiscal year 2015, $610,847,000. The 

Committee believes a strong public health immunization infrastructure is critical for ensuring high vaccination coverage levels, 

the prevention of vaccine-preventable diseases, and for responding 

to outbreaks. The Committee recommendation includes $8,000,000 

to build the capacity of public health departments to bill insurers 

for immunizations and encourages the continuation of billing demonstration projects in State and local health departments. 

Universal Influenza Vaccine.—The Committee recognizes the significant threat of epidemic and pandemic influenza and encourages 

CDC to support organizations with the research and development 

capacity to combine computational modeling, vaccine development 

including human and animal testing for efficacy, and global threat 

surveillance capabilities to quantify the incidence of secondary infection from influenza. 

HIV, VIRAL HEPATITIS, SEXUALLY TRANSMITTED DISEASES, AND

TUBERCULOSIS PREVENTION

Appropriations, 2015 ............................................................................. $1,117,609,000 

Budget estimate, 2016 ........................................................................... 1,161,747,000 

Committee recommendation ................................................................. 1,090,609,000 

The Committee recommendation for the activities of the National 

Center for HIV, Viral Hepatitis, Sexually Transmitted Diseases 

[STDs], and TB Prevention is $1,090,609,000. 

The Center administers CDC’s activities on HIV/AIDS, viral hepatitis, STDs, and TB, with the exception of the Global AIDS program, which is housed in the Center on Global Health. 

The Committee recommends funding for the following activities 

in the following amounts: 
58 

[In thousands of dollars] 

Budget activity Fiscal year 2015 

appropriation 

Fiscal year 2016 

request 

Committee 

recommendation 

Domestic HIV/AIDS Prevention and Research ................................ 786,712 799,361 786,712 

HIV Prevention by Health Department .................................. 397,161 397,161 397,161 

HIV Surveillance .................................................................... 119,861 119,861 119,861 

Activities to Improve Program Effectiveness ........................ 103,208 109,561 103,208 

National, Regional, Local, Community & Other Organizations .................................................................................. 135,401 135,401 135,401 

School Health ........................................................................ 31,081 37,377 31,081 

Viral Hepatitis ................................................................................ 31,331 62,820 36,331 

Sexually Transmitted Infections ..................................................... 157,310 157,310 125,310 

Tuberculosis ................................................................................... 142,256 142,256 142,256 

Drug Resistant Tuberculosis [TB].—In its 2013 report on antimicrobial resistance, CDC identified drug resistant TB as a serious 

public health threat to the United States. The Committee recognizes the urgent need for shorter, safer, and more tolerable treatments for drug resistant TB. Further, the Committee applauds the 

CDC Division of TB Elimination for its efforts assisting State and 

local public health programs to prevent outbreaks of drug resistant 

TB and urges the Secretary to work with CDC and the Federal TB 

Task Force to ensure that States have the resources to identify, 

treat, and prevent drug resistant TB. 

Hepatitis B.—The Committee is concerned that the Division of 

Viral Hepatitis [DVH] has not been prioritizing Hepatitis B Virus 

[HBV], as evidenced by the Center’s most recent strategic plan that 

neglected to include goals, indicators, or strategies for reducing 

morbidity, mortality, and health disparities associated with chronic 

HBV infection. The Committee encourages DVH to focus on strategies that focus on the elimination of HBV for all populations. 

HIV School Health.—The Committee is concerned by the burden 

of new HIV infections among young people and encourages CDC to 

evaluate and improve school HIV prevention activities and to continue outreach strategies and interventions for youth most disproportionately at risk for HIV infection. 

HIV/AIDS Prevention and Research.—Racial and ethnic minorities continue to have higher rates of HIV/AIDS compared to the 

overall U.S. population. Therefore, the Committee urges CDC to 

continue to prioritize HIV/AIDS funding to target racial and ethnic 

minority communities. 

Prevention Coordinator.—The Committee encourages CDC to 

continue to support the Viral Hepatitis Prevention Coordinator 

Program, restore funding for screening and linkage to care programs, and continue to expand its investment in surveillance 

projects for the creation of a national infrastructure for monitoring 

the viral hepatitis outbreak. Furthermore, the Committee urges 

CDC to target funding for immediate support in the field and 

strengthening health departments and community responses that 

target youth and young adults, with particular emphasis on persons who inject drugs, persons under 30 years old, and persons living in rural areas. 

Primary Care Screening.—The Committee commends CDC for 

working to integrate recommended viral hepatitis screening in primary care services and urges CDC to continue outreach to under-
59 

served populations through screening activities in non-clinical and 

public health settings, including the use of point-of-care tests. 

Viral Hepatitis.—The Committee is concerned that three out of 

four people with hepatitis C are part of the baby boom generation 

and that almost 60 percent of people infected are unaware of their 

condition despite the availability of effective treatments. Furthermore, mother-to-child transmissions of hepatitis B continue to 

occur, potentially leaving infants with serious liver problems. The 

Committee provides an increase over the fiscal year 2015 level to 

help stop viral hepatitis transmission and prevent related illness 

and deaths in accordance with the HHS Action Plan for the Prevention, Care, and Treatment of Viral Hepatitis. 

EMERGING AND ZOONOTIC INFECTIOUS DISEASES

Appropriations, 2015 ............................................................................. $404,990,000 

Budget estimate, 2016 ........................................................................... 699,267,000 

Committee recommendation ................................................................. 440,590,000 

The Committee recommendation for the activities of the National 

Center for Emerging and Zoonotic Diseases is $440,590,000, which 

includes $52,000,000 in transfers from PPH Fund. 

The National Center for Emerging and Zoonotic Infectious Diseases aims to detect, prevent, and control infectious diseases from 

spreading, whether they are naturally occurring, unintentional, or 

the result of terrorism. 

The Committee recommendation includes funding for the following activities in the following amounts: 

[In thousands of dollars] 

Budget activity Fiscal year 2015 

appropriation 

Fiscal year 2016 

request 

Committee 

recommendation 

Core Infectious Diseases ............................................................... 225,393 500,955 254,993 

Antibiotic Resistance Initiative ............................................. ............................ 264,328 30,000 

Lab Safety and Quality ......................................................... ............................ 10,000 5,000 

Vector-borne Diseases .......................................................... 26,410 26,831 26,410 

Lyme Disease ........................................................................ 10,663 10,688 10,663 

Prion Disease ........................................................................ 5,850 5,862 5,850 

Chronic Fatigue Syndrome .................................................... 5,400 5,412 ............................

Emerging Infectious Diseases .............................................. 147,230 147,573 147,230 

All Other Infectious Diseases ............................................... 29,840 30,261 29,840 

Food Safety .................................................................................... 47,993 50,089 48,993 

National HealthCare Safety Network ............................................. 18,032 32,071 23,032 

Quarantine ..................................................................................... 31,572 31,572 31,572 

Advanced Molecular Detection ....................................................... 30,000 30,000 30,000 

Epidemiology and Lab Capacity Program ..................................... 40,000 40,000 40,000 

Healthcare-Associated Infections .................................................. 12,000 14,580 12,000 

Combating Antibiotic-Resistant Bacteria [CARB].—Antibiotic resistant bacteria is a serious public health and economic threat to 

the United States. CDC estimates that 2,000,000 infections and 

23,000 deaths are caused annually by antibiotic-resistant bacteria, 

costing taxpayers up to $20,000,000,000 in excess healthcare costs. 

The Committee supports the CARB initiative and provides 

$30,000,000 for this effort. The Committee encourages CDC to support funding for collaborations between entities such as academic 

medical centers, veterinary schools, schools of public health, State 

public health departments, and other academic institutions whose 

proposals are in line with CDC’s strategy for addressing antibiotic- 
60 

resistant bacteria. The Committee understands the importance of 

addressing antibiotic-resistant bacteria both in human and agricultural areas. Therefore, the Committee directs CDC to collaborate 

with NIH, AHRQ, BARDA, FDA, VA, DOD, and USDA to leverage 

existing resources to increase capacities for research aimed at developing therapeutic treatments, reducing antibiotic use and resistance in animals and humans, and implementing effective infection 

control policies. CDC shall provide a spend plan to the Committee 

within 30 days after enactment of this act and include an update 

on these efforts in the fiscal year 2017 CJ. 

Emerging and Zoonotic Infectious Diseases.—The Committee is 

aware of the arrival of Chikungunya in the Caribbean and encourages the CDC to continue its work to prepare and monitor any potential arrival of Chikungunya in the United States as well as address other neglected tropical diseases found in the United States 

such as Dengue and Chagas disease. CDC should encourage the 

National Center for Emerging and Zoonotic Infectious Diseases to 

work with the Center for Global Health on cross-cutting issues, 

particularly in support of the Global Health Security Program. 

Food Safety.—The Committee is aware that the PulseNet laboratory system is 20 years old and without any modernization, its 

technology will no longer be effective in detecting foodborne disease 

outbreaks and helping CDC stop them in the food supply chain. 

Currently, new diagnostics are replacing the use of traditional cultured bacteria. Therefore, the Committee includes a $1,000,000 increase above the fiscal year 2015 level to upgrade the PulseNet system to ultimately enhance surveillance, detection and response, 

and prevention activities. 

Guideline for Disinfection and Sterilization.—The Committee directs CDC to update its 2008 Guideline for Disinfection and Sterilization in Healthcare Facilities and incorporate recent peer-reviewed literature regarding the role of the healthcare environment 

in the spread of antibiotic-resistant bacteria and the current best 

practices for containment that have been demonstrated in health 

facility environments. 

Healthcare-Associated Infections.—CDC has made significant 

progress on healthcare-associated infection [HAI] prevention and 

data collection at acute care hospitals, but significant gaps in data 

collection and reporting on HAIs persist across non-hospital 

healthcare settings such as ambulatory surgical centers. The Committee encourages CDC to continue to expand its data collection efforts to additional providers in non-hospital settings. 

Laboratory Capacity.—The Epidemiology and Laboratory Capacity for Infectious Diseases Program strengthens the epidemiologic 

and laboratory capacity in 50 States, six local health departments, 

and eight territories by supporting improvements in surveillance 

for infectious diseases, early detection of newly emerging disease 

threats, and identification and response to outbreaks. The Committee encourages CDC to increase core capacity and ensure State 

and local epidemiologists are equipped to rapidly respond to current and emerging threats, including antibiotic resistant bacteria. 

Laboratory Safety and Quality.—As the primary agency responsible for disease prevention, CDC works with some of the world’s 

most dangerous infectious diseases. To safely continue the research 
61 

necessary to protect the public and staff, CDC has begun to modernize and improve safety practices and safeguards currently in 

place. The Committee includes $5,000,000 for these improvements 

which will enable CDC to expand laboratory training, improve 

pathogen identification, and implement changes identified in safety 

reviews. The Committee directs CDC to provide a detailed update 

on these improvements in the fiscal year 2017 CJ. 

National Healthcare Safety Network.—In support of the CARB initiative, the Committee includes a $5,000,000 increase above the 

fiscal year 2015 level for the National Healthcare Safety Network. 

This increase will allow CDC to expand the network of reporting 

healthcare facilities with the ultimate goal of eliminating and preventing hospital acquired infections. 

Prion Diseases.—The Committee commends the work of the National Prion Disease Pathology Surveillance Center and supports 

its work developing better diagnostic tools. Prion diseases are a 

group of fatal neurodegenerative disorders causing dementia. 

Creutzfeldt-Jakob disease is one of the more devastating types of 

prion disease that can be transmitted from disease carriers by tissue transplants or from ingesting beef contaminated with Bovine 

Spongiform Encephalopathy, more commonly known as ‘‘mad cow’’ 

disease. The Center monitors all human and animal prion diseases, 

identifies the origin, and together with CDC develops more efficient 

diagnostic methods to prevent spreading into the human population. 

Sepsis.—Over 200,000 Americans die of sepsis every year. Hospital costs are annually in the billions of dollars, with uncounted 

costs due to organ injury such as kidney failure, disability, and lost 

productivity. With early recognition and treatment with appropriate and aggressive antibiotic therapy, major improvements in 

outcomes can be achieved but there has been no effort to educate 

the public or medical providers as to the signs, symptoms, importance of early diagnosis and treatment. The Committee encourages 

CDC to start efforts in this area. 

Surveillance Strategy.—The Committee urges CDC to expeditiously implement its Surveillance Strategy, including improving 

standardization and commonality of platforms across CDC systems, 

reducing duplication, tackling workforce and informatics challenges 

at CDC and State and local public health systems, and reducing 

the burden of participation in surveillance for healthcare and public health. 

CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION

Appropriations, 2015 ............................................................................. $1,199,220,000 

Budget estimate, 2016 ........................................................................... 1,058,058,000 

Committee recommendation ................................................................. 1,052,922,000 

The Committee recommendation for the activities of the National 

Center for Chronic Disease Prevention and Health Promotion is 

$1,052,922,000, which includes $457,650,000 in transfers from the 

PPH Fund. 

The mission of the National Center for Chronic Disease Prevention is to provide national leadership in promoting health and wellbeing through prevention and control of chronic diseases. Nearly 

one-half of all American adults have at least one chronic illness; 
62 

such diseases account for nearly 70 percent of all U.S. deaths and 

three-quarters of all healthcare costs in the United States. 

Within the total provided for the National Center for Chronic 

Disease Prevention and Health Promotion, the following amounts 

are available for the following categories of funding: 

[In thousands of dollars] 

Budget activity Fiscal year 2015 

appropriation 

Fiscal year 2016 

request 

Committee 

recommendation 

Tobacco .......................................................................................... 216,492 215,492 216,492 

Nutrition, Physical Activity and Obesity ........................................ 47,585 40,092 48,585 

High Obesity Rate Counties (non-add) ................................ 7,500 ............................ 8,500 

School Health ................................................................................. 15,383 15,383 15,383 

Health Promotion ........................................................................... 19,970 19,970 13,622 

Community Health Promotion ............................................... 6,348 6,348 ............................

Glaucoma .............................................................................. 3,294 3,294 3,294 

Visual Screening Education .................................................. 512 512 512 

Alzheimer’s Disease .............................................................. 3,344 3,344 3,344 

Inflammatory Bowel Disease ................................................ 716 716 716 

Interstitial Cystitis ................................................................ 659 659 659 

Excessive Alchohol Use ......................................................... 3,000 3,000 3,000 

Chronic Kidney Disease ........................................................ 2,097 2,097 2,097 

Prevention Research Centers ......................................................... 25,461 25,000 25,461 

Heart Disease and Stroke .............................................................. 130,037 130,037 130,037 

Diabetes ......................................................................................... 140,129 140,129 140,129 

National Diabetes Prevention Program .......................................... 10,000 10,000 10,000 

Cancer Prevention and Control ...................................................... 352,649 297,876 352,649 

Breast and Cervical Cancer ................................................. 206,993 169,204 206,993 

WISEWOMAN (non-add) ................................................ 21,114 21,170 21,114 

Breast Cancer Awareness for Young Women ....................... 4,951 4,951 4,951 

Cancer Registries .................................................................. 49,440 49,440 49,440 

Colorectal Cancer .................................................................. 43,294 39,515 43,294 

Comprehensive Cancer ......................................................... 19,673 19,673 19,673 

Johanna’s Law ...................................................................... 5,500 5,500 5,500 

Ovarian Cancer ..................................................................... 7,000 7,000 7,000 

Prostate Cancer .................................................................... 13,205 ............................ 13,205 

Skin Cancer ........................................................................... 2,121 2,121 2,121 

Cancer Survivorship Resource Center .................................. 472 472 472 

Oral Health ..................................................................................... 15,749 15,749 15,749 

Safe Motherhood/Infant Health ...................................................... 45,473 45,473 45,473 

Arthritis .......................................................................................... 9,598 13,113 9,598 

Epilepsy .......................................................................................... 7,994 7,994 7,994 

National Lupus Registry ................................................................ 5,750 5,750 5,750 

Racial and Ethnic Approach to Community Health ...................... 50,950 ............................ ............................

Partnerships to Improve Community Health ................................. 80,000 60,000 ............................

Million Hearts ................................................................................. 4,000 4,000 4,000 

Workplace Wellness ........................................................................ 10,000 ............................ ............................

National Early Child Care Collaboratives ...................................... 4,000 4,000 4,000 

Hospitals Promoting Breastfeeding ............................................... 8,000 8,000 8,000 

Alzheimer’s and Healthy Aging.—The Committee commends the 

Healthy Brain Initiative for its leadership in bringing attention to 

the public health crisis of Alzheimer’s disease, for its work on cognitive surveillance in 47 States and territories, and for its efforts 

to update the National Public Health Road Map to Maintaining 

Cognitive Health. The Committee encourages CDC to implement 

the action steps listed in the updated Road Map and further develop and expand the surveillance system on cognitive decline and 

caregiving, including widespread dissemination of the data gathered. 

Atrial Fibrillation [AFib].—An estimated 2,000,000 Americans 

have AFib, which puts them at an elevated risk for a fatal or permanently debilitating stroke. The Committee encourages CDC to 
63 

utilize its publications to promote the adoption of best practices in 

AFib treatment, expand patient and family caregiver education on 

AFib-related stroke risk and treatment, leverage existing stroke 

prevention initiatives, and address gaps in research on prediction 

of stroke and bleeding risk in AFib. 

Breast and Cervical Cancer Early Detection Program.—The Committee again rejects the administration’s proposed funding reduction to the Breast and Cervical Cancer program and provides funding at the fiscal year 2015 level of $206,993,000. The ACA has fallen short of insuring every individual through the Exchanges and 

Medicaid. Specifically, recent data shows that up to 4,500,000 

women may remain eligible for CDC’s National Breast and Cervical 

Cancer Early Detection Program. 

Breastfeeding.—The Committee provides sufficient funding for 

CDC to continue supporting breastfeeding as a strategy to reduce 

obesity and promote activities proven to increase breastfeeding 

through the State Public Health Actions to Prevent Chronic Disease. 

Chronic Pain.—The Committee commends CDC for including 

chronic pain in the Healthy People 2020 initiative. The Committee 

encourages CDC to include pain research questions in the 2016 National Health Interview Survey, promptly analyze collected data 

and make this information available to the public, and expand the 

topic area on chronic pain in the Healthy People 2030 initiative. 

Colorectal Cancer.—The Committee rejects the administration’s 

proposed funding reduction to this program and emphasizes the 

importance of continuing to provide screenings for low-income, uninsured, and underinsured adults who may not have benefited from 

the ACA. Furthermore, the Committee is pleased with CDC’s recent activities on the colorectal cancer screening program and requests an update on the impact of the program including screening 

rates in the fiscal year 2017 CJ. 

Community Grants.—Due to tight budget constraints, the Committee eliminates the Partnerships to Improve Community Health 

[PICH] and the Racial and Ethnic Approaches to Community 

Health [REACH] programs. The elimination of REACH was consistent with the administration’s budget request. The Committee 

believes the community grants are duplicative of CDC’s State Public Health Actions program and supports the same goals through 

this program. 

Division of Diabetes Translation [DDT].—The Committee encourages CDC to provide resources to expand State and local community diabetes control and prevention activities while supporting the 

translation of research into better prevention and care, the National Diabetes Prevention Program, the expansion of diabetes surveillance, and other DDT activities. These activities must include 

clear outcomes, ensure transparency and accountability, and specifically how diabetes funding reached State and local communities. 

Epilepsy.—The Committee commends CDC for making considerable progress over the past decade in establishing and advancing 

a public health agenda to meet the needs of Americans with epilepsy. CDC, in partnership with other stakeholders, will determine 

national outcome protocols to use to capture and document infor-
64 

mation related to these issues: employment, school, social life and 

the general well-being of people with epilepsy. 

Food Allergy.—Deaths due to anaphylactic reaction to food allergens are preventable. National medical and school organizations 

recommend that schools maintain a supply of back-up epinephrine 

for emergency treatment of potentially fatal anaphylactic reactions. 

CDC should encourage schools to purchase epinephrine and support implementation of the food allergy school guidelines. 

Heart Disease and Stroke Prevention.—The Committee supports 

the Division for Heart Disease and Stroke Prevention’s efforts 

against cardiovascular disease and supports the Paul Coverdell National Acute Stroke Registry and the projects within State and 

Local Public Health Actions to Prevent Obesity, Diabetes, and 

Heart Disease, and Stroke. 

High Obesity Rate Counties.—The Committee is concerned about 

the growing body of evidence suggesting that obesity is the most 

significant challenge facing the public health system. If this epidemic continues unabated, obesity and the many complications it 

causes will increase the disease burden among Americans, particularly youth. The Committee includes a $1,000,000 increase over the 

fiscal year 2015 level to expand support for the rural extension and 

outreach services to support additional grants for rural counties 

with an obesity prevalence of over 40 percent. The Committee expects CDC to work with State and local public health departments 

to support measurable outcomes through evidenced-based obesity 

research, intervention, and prevention programs. CDC should focus 

its efforts in areas of the country with the highest burden of obesity and with the co-morbidities of hypertension, cardiac disease, 

and diabetes from county level data in the Behavioral Risk Factor 

Surveillance System. The Committee encourages CDC childhood 

obesity efforts to only support activities that are supported by scientific evidence. 

Inflammatory Bowel Disease [IBD].—The Committee commends 

CDC for implementing a robust IBD epidemiology study and communicating study results with the public. The Committee encourages CDC to continue exploring the disease burden of IBD and to 

communicate these findings to patients and providers in an effort 

to improve current interventions and inform best public health 

practices in managing IBD. 

Interstitial Cystitis [IC].—The Committee commends CDC for its 

work on IC and encourages CDC to continue to make IC a priority 

by expanding public awareness through education for healthcare 

providers and the general public, and enhanced information sharing. 

Johanna’s Law.—The Committee is pleased by the agency’s recent launch of Know: BRCA to help increase the public’s awareness 

of hereditary breast and ovarian cancers and improve understanding the individual risk of having a BRCA mutation. The Committee urges CDC to take steps to integrate components of the Inside Knowledge campaign and Know: BRCA to the extent possible, 

to ensure coordination of public health messages related to ovarian 

cancer, leveraging of resources, and maximizing economies of scale. 

Lupus Registry.—The Committee continues to support research 

efforts under the National Lupus Patient Registry program, but 
65 

challenges still remain. Burden of illness studies are lacking in 

lupus and are needed to better understand and evaluate issues 

such as the disease impact on quality of life, productivity, frequency of clinical events, natural history, and the direct and indirect costs associated with lupus. Therefore, the Committee urges 

CDC to support the lupus cohort and burden of illness studies. 

Marfan Syndrome.—Marfan syndrome-related thoracic aortic aneurysm and dissection claims the lives of young athletes across the 

country each year, but few States incorporate Marfan syndrome 

testing into their sports screening for high school athletes. The 

Committee urges CDC to develop a program to support, assist, and 

encourage States to incorporate Marfan syndrome testing into their 

sports screening criteria for at-risk young athletes. 

Melanie Blocker Stokes Act.—The Committee urges CDC to develop a program to assist providers that educate women and their 

families about post-partum depression [PPD], and to help new 

mothers receive screenings during the first year of postnatal checkups. As many as 20 percent of new mothers experience some form 

of PPD. The Committee requests an update on this research in the 

fiscal year 2017 CJ. 

Million Hearts.—The Committee supports the Million Hearts program, a public-private initiative to prevent 1,000,000 heart attacks 

and strokes by 2017, and that provides enhanced prevention, detection, treatment and control of high blood pressure, a key cause of 

heart disease and stroke. 

Mississippi Delta Health Collaborative [MDHC].—The Committee 

commends CDC’s efforts supporting the Mississippi Delta Health 

Collaborative in implementing a successful, evidenced-based strategy to reduce the burden of heart disease and stroke. These advancements were made possible with chronic disease prevention 

interventions through partnerships at the local level, and teambased approaches designed to link communities with clinical care, 

such as education and counseling, medication therapy management, comprehensive medication management, and utilizing health 

information technology to change health outcomes. Taking these 

lessons learned, the Committee wants to build upon the investments and see whether this success can be replicated in other highrisk and underserved areas in the future. Therefore, the Committee 

encourages CDC, working together with the Collaborative and relevant stakeholders, to reach populations at high risk in the Delta 

with effective interventions while maintaining the current strategy. 

CDC shall consider using lifestyle change intervention models like 

the Diabetes Prevention Program; utilizing local pharmacy schools 

with existing community-based research programs that could focus 

on screenings, medication reviews, medication therapy management, comprehensive medication management, and disseminating 

prevention strategies; and working with communities to establish 

health networks to better coordinate and manage community based 

health initiatives. To reach the target population, the Committee 

encourages CDC to take advantage of rapidly evolving healthcare 

technology by leveraging the resources of States with recognized 

leadership in areas of electronic medical records, telehealth, and innovative delivery of education tools. CDC shall provide an update 

on these activities in the fiscal year 2017 CJ. 
66 

Oral Health.—The Committee urges CDC to support clinical and 

public health interventions that target pregnant women and young 

children at highest risk for dental caries. These interventions result in significant cost-savings to State Medicaid programs. CDC is 

encouraged to continue to work across the Department to improve 

coordination of oral health surveillance that reliably measures and 

reports health outcomes. 

Ovarian Cancer.—The Committee commends the CDC for its 

work to evaluate existing risk assessment tools and directs CDC in 

their fiscal year 2017 CJ, to include the findings of this review 

along with recommendations on how CDC can support the deployment of the tools found to have the greatest value and utility. In 

addition, the Committee directs CDC to provide a report within 90 

days after enactment of this act to the Committees on Appropriations of the House of Representatives and Senate on the Institute 

of Medicine’s review of the state of the sciences in ovarian cancer 

research. 

Preterm Birth.—Preterm birth affects more than 500,000 babies 

each year in the United States and is the leading cause of neonatal 

mortality. The Committee commends CDC for funding State-based 

Perinatal Collaboratives that focus on improving birth outcomes 

using known preventative strategies such as reducing early elective 

deliveries. The Committee encourages CDC to increase the number 

of States receiving assistance for perinatal collaboratives. 

Psoriasis and Psoriatic Arthritis.—Psoriasis affects an estimated 

7,500,000 people in the United States. The Committee recognizes 

the growing body of evidence regarding linkages between psoriatic 

disease and cardiovascular disease, alcohol consumption, metabolic 

syndrome, and depression and remains concerned as to the continued gaps in the public health response to such linkages. The Committee encourages CDC to use their Prevention Research Centers 

to build on past investments including the CDC’s Psoriasis and 

Psoriatic Arthritis: A Public Health Agenda to define and implement public health self-management interventions for psoriatic disease. This network would explore the research needed to better understand the relationships between the listed and other possible 

chronic conditions to help position psoriatic disease appropriately 

within the larger world of public health. 

Scleroderma.—The Committee recognizes the serious health challenges faced by patients affected by scleroderma. Due to various 

manifestations of the disease, the Committee encourages CDC to 

consider opportunities to raise awareness and improve recognition 

of scleroderma. 

Visual Screening Education.—The Committee is concerned that 

people with vision impairment often report chronic conditions, such 

as heart disease, stroke, and diabetes, at substantially higher rates 

than individuals without vision impairment. The Committee encourages CDC to increase vision impairment and eye disease surveillance efforts, apply previous CDC vision and eye health research findings to develop effective prevention and early detection 

interventions, and begin to incorporate vision and eye health promotion activities into State and national public health chronic disease initiatives, with an initial focus on early detection of diabetic 

retinopathy. 
67 

WISEWOMAN.—The Committee commends the WISEWOMAN 

program that helps uninsured and under-insured low-income 

women ages 40 to 64 prevent, delay, or control heart disease and 

stroke by providing preventive health services, referrals to local 

healthcare providers, lifestyle programs, and health counseling tailored to identified risk factors to promote lasting, healthy behavior 

change. From July 2008 through June 2013, WISEWOMAN served 

nearly 150,000 women and 90 percent of them had at least one 

heart disease and stroke risk factor. 

Workplace Wellness.—The Committee eliminates the Workplace 

Wellness program as requested by the administration. 

NATIONAL CENTER ON BIRTH DEFECTS, DEVELOPMENTAL

DISABILITIES, DISABILITY AND HEALTH

Appropriations, 2015 ............................................................................. $131,781,000 

Budget estimate, 2016 ........................................................................... 131,781,000 

Committee recommendation ................................................................. 132,781,000 

The Committee recommendation for the activities of the National 

Center on Birth Defects and Developmental Disabilities [NCBDDD] 

is $132,781,000. 

This Center improves the health of children and adults by preventing birth defects, developmental disabilities, and complications 

of heredity blood disorders and by promoting optimal child development and health and wellness among children and adults living 

with disabilities. 

Within the total provided, the following amounts are provided for 

the following categories of funding: 

[In thousands of dollars] 

Budget activity Fiscal year 2015 

appropriation 

Fiscal year 2016 

request Committee recommendation 

Child Health and Development ...................................................... 64,232 64,232 64,232 

Other Birth Defects ............................................................... 18,074 18,074 18,074 

Fetal Death ........................................................................... 891 891 891 

Fetal Alcohol Syndrome ......................................................... 10,505 10,505 10,505 

Folic Acid .............................................................................. 3,121 3,121 3,121 

Infant Health ......................................................................... 8,639 8,639 8,639 

Autism ................................................................................... 23,002 23,002 23,002 

Health and Development with Disabilities .................................... 52,440 52,440 53,440 

Disability and Health ............................................................ 20,042 20,042 21,042 

Tourette Syndrome ................................................................ 2,000 2,000 2,000 

Early Hearing Detection and Intervention ............................ 10,752 10,752 10,752 

Muscular Dystrophy ............................................................... 6,000 6,000 6,000 

Attention Deficit Hyperactivity Disorder ................................ 1,850 1,850 1,850 

Fragile X ................................................................................ 1,800 1,800 1,800 

Spina Bifida .......................................................................... 5,996 5,996 5,996 

Congenital Heart Defects ...................................................... 4,000 4,000 4,000 

Public Health Approach to Blood Disorders .................................. 4,500 4,500 4,500 

Hemophilia CDC Activities ............................................................. 3,504 3,504 3,504 

Hemophilia Treatment Centers ...................................................... 5,000 5,000 5,000 

Thalassemia ................................................................................... 2,105 2,105 2,105 

Birth Defects Prevention.—The Committee commends the Center 

for Birth Defects Research and Prevention for its work toward 

greater understanding of the causes of birth defects and for expanding the National Birth Defects Prevention Network to include 

the work of the BD-STEPS program. The Committee supports further expansion of the BD-STEPS program with the goal of incor-
68 

porating States that do not currently have a birth defects surveillance system. Priority should be given to programs in States with 

diverse populations and a high burden of risk factors for birth defects that have previously submitted meritorious applications but 

did not receive funding due to budget constraints. 

Cerebral Palsy.—The Committee encourages CDC to build on established surveillance and research methods to develop a robust research infrastructure focused on Cerebral Palsy across various geographic U.S. regions. 

Congenital Heart Disease [CHD].—CHD is a serious public health 

concern, and it remains the most common birth defect and leading 

cause of birth defect-related infant mortality. With increasing medical treatment options, survival is improving resulting in a growing 

population that estimates suggest exceeds 2,000,000 people. However, children and adults with congenital heart disease require ongoing, costly, specialized cardiac care and face a lifelong risk of permanent disability and premature death. The Committee commends 

the CDC for its efforts to address the lifelong needs of this growing 

population with CHD, particularly in the areas of critical congenital heart screening and attention to adolescent and adult surveillance needs. The Committee remains concerned that there continues to be a lack of rigorous epidemiological and longitudinal 

data on individuals of all ages with CHD. The Committee encourages CDC to collect and analyze nationally representative, population-based epidemiological and longitudinal data on infants, children, and adults with CHD to improve understanding of CHD incidence, prevalence, and disease burden, further assess the public 

health impact of CHD. 

Fragile X.—The Committee commends the significant progress 

made on the Fragile X Clinical and Research Consortium in growing its FORWARD Database and its Patient Registry and urges 

CDC to continue this effort. The Committee supports the publicprivate partnership which resulted in the Fragile X Research Agenda and the resulting Funding Opportunity Announcement which 

seeks to use longitudinal data to characterize the natural history 

of Fragile X to improve services and outcomes. 

Hemophilia.—The Committee maintains funding for the surveillance and research activities of the national network of hemophilia 

treatment centers and the outreach and education programs of the 

national hemophilia consumer organizations. 

Hereditary Hemorrhagic Telangiectasia [HHT].—HHT is a genetic disorder that can result in life-threatening strokes and other 

complications, but if diagnosed in time is treatable and manageable. The Committee encourages CDC to develop newborn screening initiatives that focus on early detection and intervention methods for newborns from families with a history of HHT. 

Improving the Health of People With Intellectual Disabilities.— 

People with disabilities are more often in poorer health that results 

in billions in additional healthcare costs each year. However, with 

the appropriate help, people living with disabilities can be productive citizens within their communities. Therefore, the Committee 

includes $3,500,000 for the Healthy Athletes program. 

Krabbe Disease.—Krabbe Disease is a rare, inherited degenerative disorder of the nervous systems that causes severe deteriora-
69 

tion of mental and motor skills. The disease most often affects infants and is generally fatal before the age of 2. There is no cure 

for Krabbe Disease, but identifying it early and beginning treatment prior to the onset of symptoms may help to prevent severe 

health outcomes. The Committee encourages CDC to include efforts 

for Krabbe disease and other leukodystrophies when rapid diagnosis may lead to potentially live saving treatments. 

Muscular Dystrophy.—The Committee requests an update on the 

Muscular Dystrophy CARE Act in the fiscal year 2017 CJ. The update shall include CDC’s plans and timeframe to enhance its collection of surveillance data across all forms of muscular dystrophy 

and to develop updated care standards, including for adults with 

Duchenne and for other forms of muscular dystrophy. 

National Center on Health, Physical Activity and Disability 

[NCHPAD].—The Committee supports the work of NCHPAD, and 

its goal of promoting better health for adults and children with disabilities. By mobilizing national networks to provide technical assistance, provide community leaders and organizations with health 

promotion training, and by disseminating effective strategies and 

tools for disability service providers, the NCHPAD plays an important role in encouraging a healthier lifestyle for Americans with 

disabilities. The Committee urges CDC to increase support for 

these efforts. 

Neonatal Abstinence Syndrome Data.—The Committee directs 

CDC to provide technical assistance to States to improve the availability and quality of data collection and surveillance activities regarding neonatal abstinence syndrome, including: (a) the incidence 

and prevalence of neonatal abstinence syndrome; (b) the identification of causes for neonatal abstinence syndrome, including new and 

emerging trends; and (c) the demographics and other relevant information associated with neonatal abstinence syndrome. CDC 

shall also collect any available surveillance data described in the 

previous sentence from States and make it publicly available on an 

appropriate web site. Furthermore, the Committee directs CDC to 

increase utilization of effective public health measures to reduce 

neonatal abstinence syndrome. 

Spina Bifida.—While Spina Bifida and related neural tube defects are highly preventable through education and adequate daily 

folic acid consumption, it is the most common permanently disabling birth defect in the United States. The Committee supports 

the continuation of the Spina Bifida Clinical Care Monitoring and 

Tracking program and commends the National Spina Bifida Program in serving as a model for programs assisting other individuals living with similar complex conditions. 

Thalassemia.—The Committee commends CDC’s thalassemia 

program and encourages CDC to coordinate the efforts of the treatment centers and the nonprofit patient advocacy community as it 

confronts this genetic blood disorder. 

Tourette Syndrome.—The Committee is pleased with CDC’s current activities on Tourette Syndrome and urges CDC to use its resources to increase scientific knowledge of the prevalence and risk 

factors in both children and adults, as well as determine the impact of this disorder on the quality of life of those who are affected. 
70 

Tuberous Sclerosis Complex [TSC].—The Committee encourages 

CDC to take into consideration all the major manifestations of TSC 

in its surveillance network, including epilepsy, autism, renal 

angiomyolipomas, facial angiofibromas, lymphangioleiomyomatosis, 

retinal hamartomas, subependymal giant cell astrocytomas, and 

cardiac rhabdomyomas. 

PUBLIC HEALTH SCIENTIFIC SERVICES

Appropriations, 2015 ............................................................................. $481,061,000 

Budget estimate, 2016 ........................................................................... 538,809,000 

Committee recommendation ................................................................. 471,061,000 

The Committee recommendation for Public Health Scientific 

Services is $471,061,000. 

This funding supports the work of all of the CDC Centers by 

compiling statistical information to inform public health policy. In 

particular, these activities assure the accuracy and reliability of 

laboratory tests; apply digital information technology to help detect 

and manage diseases, injuries, and syndromes; and develop and inform the public health community on sound public health surveillance, laboratory protocols, and epidemiological practices. 

The Committee recommendation includes funding for the following activities in the following amounts: 

[In thousands of dollars] 

Budget activity Fiscal year 2015 

appropriation 

Fiscal year 2016 

request 

Committee 

recommendation 

Health Statistics ............................................................................ 155,397 160,397 145,397 

Surveillance, Epidemiology, and PH Informatics ........................... 273,464 311,008 273,464 

Public Health Workforce ................................................................. 52,200 67,404 52,200 

Alzheimer’s Disease and Dementia.—The Committee is aware of 

recent peer-reviewed studies suggesting that more than 500,000 

U.S. deaths each year are attributable to Alzheimer’s disease and 

dementia, far in excess of the deaths reported by the Center. Such 

statistics would elevate Alzheimer’s disease from the sixth leading 

cause of death to the third leading cause of death. The Committee 

urges CDC to work with stakeholders to develop recommendations 

for obtaining more accurate and complete measurements of Alzheimer’s and dementia death rates and requests a report no later 

than 180 days after enactment of this act. The report shall include 

a consensus on the mortality burden of these diseases. 

Collecting Vital Statistics.—Accurate vital statistics provide complete and continuous data on births, deaths, and fetal deaths that 

are essential for understanding our Nation’s health. The Committee provides the National Center for Health Statistics [NCHS] 

the same level of funding as in fiscal year 2015 for the National 

Vital Statistics System and sufficient funding to purchase data 

items currently collected by States and territories and collect 12 

months of these data within the calendar year. 

Epidemiology Fellowship Program.—A well-trained public health 

workforce is essential to ensuring the highest level of efficiency and 

effectiveness in protecting health. The Committee encourages CDC 

to prioritize investments in established training programs with a 

demonstrated record of success in supporting high-quality, on-thejob training at State and local health agencies and transitioning 
71 

these professionals into public health careers, including the Applied 

Epidemiology Fellowship Program. 

Modernizing the Vital Statistics Infrastructure.—The Committee 

understands that not all States and territories have implemented 

electronic death registration systems which would provide more accurate, timely, and secure death data for use in monitoring our Nation’s health and reducing waste, fraud, and abuse in Federal benefits programs. The Committee urges the NCHS to support States 

in modernizing their infrastructure and directs NCHS to include in 

the fiscal year 2017 CJ a plan for modernizing the vital statistics 

infrastructure, including steps to address States and territories 

that have not yet implemented these systems. 

ENVIRONMENTAL HEALTH

Appropriations, 2015 ............................................................................. $179,404,000 

Budget estimate, 2016 ........................................................................... 178,500,000 

Committee recommendation ................................................................. 145,286,000 

The Committee recommendation for the National Center for Environmental Health is $145,286,000. The Committee recommendation includes $13,000,000 in transfers from the PPH Fund. 

The National Center for Environmental Health addresses emerging pathogens and environmental toxins that pose significant challenges to public health. The Center conducts surveillance and data 

collection to determine which substances in the environment are 

found in people and to what degree. The Center also determines 

whether these substances are harmful to humans and at what level 

of exposure. 

The Committee recommendation includes funding for the following activities: 

[In thousands of dollars] 

Budget activity Fiscal year 2015 

appropriation 

Fiscal year 2016 

request 

Committee recommendation 

Environmental Health Laboratory .................................................. 55,870 55,870 55,870 

Newborn Screening Quality Assurance Program .................. 8,243 8,243 8,243 

Newborn Screening for SCID ................................................. 1,175 1,175 1,175 

Other Environmental Health ................................................. 46,452 46,452 46,452 

Environmental Health Activities .................................................... 45,580 55,580 29,366 

Safe Water ............................................................................ 8,601 8,601 ............................

Amyotrophic Lateral Sclerosis Registry ................................ 7,820 7,820 8,820 

Built Environment & Health Initiative .................................. 2,843 2,843 2,843 

Climate Change .................................................................... 8,613 18,613 ............................

All Other Environmental Health ............................................ 17,703 17,703 17,703 

Environmental and Health Outcome Tracking Network ................. 34,904 24,000 17,000 

Asthma ........................................................................................... 27,528 27,528 27,528 

Childhood Lead Poisoning ............................................................. 15,522 15,522 15,522 

Amyotrophic Lateral Sclerosis [ALS] Registry.—The Committee 

provides a $1,000,000 increase above the fiscal year 2015 level for 

the ALS Registry to further understand and potentially cure and 

prevent this disease. CDC and the Agency for Toxic Substances and 

Disease Registry [ATSDR] should continue their current registry 

activities, including helping to notify people with ALS about research studies for which they may qualify and funding risk factor 

and other ALS research utilizing registry information. The Committee supports the implementation of a nation-wide biorepository 

and encourages CDC and ATSDR to continue to consult with exter-
72 

nal stakeholders and Federal agencies, including NIH, VA, and 

FDA to coordinate efforts, raise awareness of the registry, and help 

ensure that the registry is available as a resource to support ALS 

research and care services and the development of treatments for 

the disease. 

Asthma.—The Committee is concerned by the impact on people 

living with asthma as a result of there being significantly fewer 

States participating in the National Asthma Control Program 

[NACP]. The Committee encourages NACP to increase the number 

of States carrying out programmatic activities and use a population-adjusted burden of disease criterion as a significant factor 

for new competitive awards in the future. 

Healthy Housing.—The Committee recognizes the important role 

that healthy housing can play in reducing the risk of numerous 

conditions, including asthma and lead poisoning. CDC is encouraged to continue to support health housing activities. 

INJURY PREVENTION AND CONTROL

Appropriations, 2015 ............................................................................. $170,447,000 

Budget estimate, 2016 ........................................................................... 256,977,000 

Committee recommendation ................................................................. 187,947,000 

The Committee recommendation for the National Center for Injury Prevention and Control is $187,947,000. 

CDC is the lead Federal agency for injury prevention and control. 

Programs are designed to prevent premature death and disability 

and reduce human suffering and medical costs caused by fires and 

burns, poisoning, drowning, violence, and traffic accidents. The national injury control program at CDC encompasses non-occupational injury and applied research in acute care and rehabilitation 

of the injured. 

The Committee recommendation includes funding for the following activities: 

[In thousands of dollars] 

Budget activity Fiscal year 2015 

appropriation 

Fiscal year 2016 

request 

Committee recommendation 

Intentional Injury ............................................................................ 92,001 107,611 92,001 

Domestic Violence and Sexual Violence ............................... 32,674 32,679 32,674 

Child Maltreatment (non-add) ..................................... 7,250 7,250 7,250 

Youth Violence Prevention .................................................... 15,086 15,086 15,086 

Domestic Violence Community Projects ................................ 5,414 5,414 5,414 

Rape Prevention .................................................................... 38,827 44,432 38,827 

Gun Violence Prevention Research ....................................... ............................ 10,000 ............................

National Violent Death Reporting System ..................................... 11,302 23,570 11,302 

Unintentional Injury ....................................................................... 8,598 8,598 8,598 

Traumatic Brain Injury .......................................................... 6,548 6,548 6,548 

Elderly Falls .......................................................................... 2,050 2,050 2,050 

Injury Prevention Activities ............................................................ 28,950 29,023 28,950 

Prescription Drug Overdose ........................................................... 20,000 68,000 31,921 

Illicit Opioid Use Risk Factors ....................................................... ............................ 5,579 5,579 

Injury Control Research Centers .................................................... 9,596 9,596 9,596 

Combating Opioid Abuse.—The Committee includes $37,500,000, 

an increase of $17,500,000 above fiscal year 2015, for efforts to respond to and reverse the opioid epidemic in the United States. This 

includes $31,921,000 to fund the Prescription Drug Overdose [PDO] 

Prevention for States program, a competitive cooperative agree-
73 

ment that targets those States with the greatest burden of opioid 

overdoses and demonstrated readiness to implement prevention 

strategies, and $5,579,000 to specifically strengthen surveillance efforts for heroin-related deaths. The Committee notes the strong 

connection between prescription opioids and other types of opioids 

like heroin. Activities targeting one area will have a significant impact on the other. Therefore, funding will support activities such as 

implementing guidelines to improve prescribing behaviors and collecting real-time and more accurate data for heroin-related opioid 

deaths. The Committee urges CDC to require applicants applying 

for the PDO Prevention for States Program to collaborate with the 

State substance abuse agency or those agencies managing the 

State’s PDMP to ensure linkages to clinically appropriate substance use disorder services. In addition, the Committee directs 

CDC to use the funds provided to expand the surveillance of heroin-related deaths beyond CDC’s current activities in HHS’ Region 

One by targeting States that have the greatest burden of heroin 

abuse. 

Concussion Surveillance.—The Committee encourages CDC to establish and oversee a national surveillance system to accurately determine the incidence of sports-related concussions, including youth 

ages 5 to 21. 

Opioid Prescribing Guidelines.—The Committee directs CDC to 

complete its work in developing safe opioid prescribing guidelines 

for chronic, non-cancer pain in outpatient settings for release no 

later than July 31, 2016, and a technical package to guide States 

in the implementation of safe opioid prescribing through coordinated care. The guidelines and technical package should include information for providers on the use of opioids for pregnant women 

and women that might become pregnant, as well as the potential 

risks of birth defects and neonatal abstinence syndrome from exposure to such medications. The Committee directs CDC to broadly 

disseminate the guidelines and technical package and to immediately evaluate the effects of the new guidance. Furthermore, the 

Committee urges CDC to work with the VA and the DOD in implementing these guidelines in the appropriate facilities and directs 

CDC to share data and best practices on safe opioid prescribing 

with these agencies. 

Sports Injuries.—The Committee is concerned about the number 

and severity of injuries related to sports activities at every age and 

experience level. Therefore, the Committee encourages CDC to educate coaches at all levels on how to prevent common injuries, how 

to recognize symptoms of potentially dangerous conditions, and 

how to plan for emergency situations is critical to this ever growing 

problem in sports safety. 

OCCUPATIONAL SAFETY AND HEALTH

Appropriations, 2015 ............................................................................. $334,863,000 

Budget estimate, 2016 ........................................................................... 283,418,000 

Committee recommendation ................................................................. 305,887,000 

The Committee recommendation for National Institute for Occupational Safety and Health [NIOSH] programs is $305,887,000. 

NIOSH is the only Federal agency responsible for conducting research and making recommendations for the prevention of work-re-
74 

lated illness and injury. The NIOSH mission is implemented by 

conducting basic and applied scientific research and translating the 

knowledge gained into products and services that impact workers 

in settings from corporate offices to construction sites to coal mines. 

The Committee recommendation includes funding for the following activities at the following amounts: 

[In thousands of dollars] 

Budget activity Fiscal year 2015 

appropriation 

Fiscal year 2016 

request 

Committee recommendation 

National Occupational Research Agenda ...................................... 114,500 90,500 90,500 

Agriculture, Forestry, Fishing (non-add) ............................... 24,000 ............................ ............................

Education and Research Centers .................................................. 27,445 ............................ 27,445 

Personal Protective Technology ...................................................... 19,695 19,695 19,695 

Healthier Workforce Center ............................................................ 4,976 4,976 ............................

Mining Research ............................................................................ 59,420 59,420 59,420 

National Mesothelioma Registry and Tissue Bank ........................ 1,106 1,106 1,106 

Other Occupational Safety and Health Research .......................... 107,721 107,721 107,721 

Agriculture, Forestry, and Fishing [AgFF].—The Committee 

eliminates the AgFF programs as proposed by the administration. 

The Committee recommendation preserves the nine core industry 

sectors within the National Occupational Research Agenda and 

prioritizes funding to support emerging priorities such as nanotechnology and mining hazards. 

ENERGY EMPLOYEES OCCUPATIONAL INJURY COMPENSATION ACT

Appropriations, 2015 ............................................................................. $55,358,000 

Budget estimate, 2016 ........................................................................... 55,358,000 

Committee recommendation ................................................................. 55,358,000 

The Committee recommendation for EEOICPA is $55,358,000. 

This mandatory funding supports NIOSH scientists who reconstruct radiation dose levels to inform compensation decisions. 

GLOBAL HEALTH

Appropriations, 2015 ............................................................................. $416,517,000 

Budget estimate, 2016 ........................................................................... 448,092,000 

Committee recommendation ................................................................. 411,758,000 

The Committee recommends $411,758,000 for global health-related activities at CDC. 

The Center for Global Health leads international programs and 

coordinates CDC’s global efforts with the goal of promoting health 

and preventing disease in the United States and abroad. The Center has a particular focus on ensuring rapid detection and response 

to emerging health threats. 

The Committee recommendation includes funding for the following activities in the following amounts: 

[In thousands of dollars] 

Budget activity Fiscal year 2015 

appropriation 

Fiscal year 2016 

request 

Committee 

recommendation 

Global HIV/AIDS Program ............................................................... 128,421 128,421 128,421 

Global Immunization Program ....................................................... 208,608 218,608 213,608 

Polio Eradication ................................................................... 158,774 168,774 163,774 

Measles and Other Vaccine Preventable Diseases .............. 49,834 49,834 49,834 

Parasitic Diseases and Malaria. ................................................... 24,369 24,369 24,369 

Global Health Security ................................................................... ............................ 11,575 ............................
75 

[In thousands of dollars] 

Budget activity Fiscal year 2015 

appropriation 

Fiscal year 2016 

request 

Committee recommendation 

Global Disease Detection and Emergency Response .................... 45,360 45,360 45,360 

Global Public Health Capacity Development ................................. 9,759 19,759 ............................

Global Diseases.—The Committee is pleased with CDC’s ongoing 

efforts to fight malaria and neglected tropical diseases and encourages CDC to continue to research, monitor, and evaluate efforts for 

malaria and NTDs in collaboration with other divisions and agencies. 

Global Health.—In a constrained budget environment, the Committee chose to preserve the Global Disease Detection and Emergency Response program which remains the core activity within the 

Division of Global Health Protection at CDC to rapidly detect, identify, and control emerging infectious diseases abroad. From 2006– 

2014, this program has responded to over 1,700 disease outbreaks 

and public health emergencies, established 289 new diagnostic 

tests in 59 countries, and covers a population of 13.1 million people 

within its surveillance efforts. In addition, the Committee continues to support the Global Health Security Agenda, but notes this 

program and the National Public Health Institutes received almost 

$600,000,000 in the Ebola emergency supplemental in fiscal year 

2015, and therefore, did not need additional funding in this fiscal 

year. 

Polio.—CDC is the lead U.S. agency in the global effort to eradicate polio and currently works with various organizations by providing expertise in training, vaccines, epidemiology, laboratory capacity, and surveillance. Currently, polio is endemic in only three 

countries, Nigeria, Afghanistan, and Pakistan. However, Nigeria 

has not reported a case since August of 2014 and will be declared 

polio free if no cases are reported by August of 2017. The Committee commends these efforts and includes a $5,000,000 increase 

above the fiscal year 2015 level to help conquer this disease. 

PUBLIC HEALTH PREPAREDNESS AND RESPONSE

Appropriations, 2015 ............................................................................. $1,352,551,000 

Budget estimate, 2016 ........................................................................... 1,381,818,000 

Committee recommendation ................................................................. 1,340,118,000 

The Committee recommendation for the Office of Public Health 

Preparedness and Response [PHPR] is $1,340,118,000. 

The mission of PHPR is to build and strengthen national preparedness for public health emergencies including natural, biological, chemical, radiological, and nuclear incidents. PHPR administers national response programs and assets, as well as grants to 

States and localities to enhance preparedness efforts across the 

country. 

The Committee recommendation includes funding for the following activities in the following amounts: 

[In thousands of dollars] 

Budget activity Fiscal year 2015 

appropriation 

Fiscal year 2016 

request 

Committee 

recommendation 

Public Health Emergency Preparedness Cooperative Agreement .. 643,609 643,609 643,609 
76 

[In thousands of dollars] 

Budget activity Fiscal year 2015 

appropriation 

Fiscal year 2016 

request 

Committee 

recommendation 

Academic Centers for Public Health Preparedness ....................... 8,018 ............................ ............................

All Other State & Local ................................................................. 9,415 ............................ ............................

BioSense ......................................................................................... 23,369 23,369 23,369 

All Other CDC Preparedness .......................................................... 133,797 143,797 138,797 

Strategic National Stockpile .......................................................... 534,343 571,043 534,343 

Emergency Preparedness.—The Committee requests more detailed information on how State Public Health Emergency Preparedness [PHEP] funding is distributed at the local level by 

States. CDC is directed to require States to report how much of 

their Federal PHEP funding is being allocated to local health departments and what basis or formula each State is using to make 

such allocations. The Committee directs CDC to include this in the 

fiscal year 2017 CJ. 

Procurement.—The Committee encourages CDC to consider 

maintaining its planned procurement of anthrax vaccines when adjusting to changes in commercial pricing or PHEMCE requirements. 

Select Agent Program.—To create a safer laboratory setting including the handling of dangerous agents, the Committee includes 

a $5,000,000 increase above the fiscal year 2015 level for CDC’s Select Agent Program. This will allow CDC to upgrade their existing 

databases for tracking select agents and increase the number of inspections. The Committee requests an update on these efforts in 

the fiscal year 2017 CJ. 

State and Local Preparedness and Response.—The Committee 

does not provide funding for the Academic Centers for Public 

Health Preparedness and All Other State and Local Capacity as requested by the administration. CDC will continue to support research and training through its Office of Public Health Preparedness and Response and will provide oversight and technical assistance to health departments through the Public Health Emergency 

Preparedness program. The Committee notes that CDC also received $410,000,000 as part of the Ebola emergency supplemental 

in fiscal year 2015 to expand current domestic preparedness capacities. 

Strategic National Stockpile [SNS].—The Committee encourages 

the CDC to evaluate the latest approved advances in influenza prevention and antiviral treatment for inclusion in the SNS in preparation for pandemic influenza. 

Update of Response Plans.—The Committee is aware that, as a 

result of the success of Project BioShield, several new medical 

countermeasures have been procured for inclusion in the SNS. Additionally, the Committee is aware that CDC has responsibility for 

developing response plans that will guide the public health response to possible outbreaks and threats such anthrax and smallpox. The Committee is concerned that the response plans CDC has 

developed do not include guidance to State and local public health 

officials regarding new acquisitions to the SNS and how those new 

acquisitions should be used in a response effort. To ensure that 

healthcare providers and first responders have the most up-to-date 

guidance to respond to potential threats, the Committee directs 
77 

CDC to update all current response plans within 120 days of enactment to include countermeasures procured with Project BioShield 

funds since its inception. 

BUILDINGS AND FACILITIES

Appropriations, 2015 ............................................................................. $10,000,000 

Budget estimate, 2016 ........................................................................... 10,000,000 

Committee recommendation ................................................................. 10,000,000 

The Committee provides $10,000,000 for capital projects and National Repair and Improvement activities at CDC. 

Demolition.—The Committee includes new demolition authority 

to allow CDC to eliminate structures that are no longer used and 

have gone beyond their intended lifespan, such as small modular 

trailers and storage facilities. Due to the age and condition of some 

of the structures, they pose a significant danger if left in their current state. By eliminating these structures, the Federal government will save almost $90,000 per year in maintenance costs. 

Fort Collins Campus.—The Committee includes new bill language that is needed to provide CDC with the authority to construct a replacement freezer at the Fort Collins, Colorado campus. 

Underground Mine Safety.—The Committee appreciates the requested timeline submitted by CDC and continues to support a replacement facility for the Lake Lynn Experimental Mine and Laboratory. The Committee directs CDC to utilize prior-year funding 

for the planning and design, land acquisition, construction, and 

equipping of the replacement facility. No later than 90 days after 

enactment, the CDC shall submit a detailed accounting of its activities to date to replace the Lake Lynn facility and accompanying 

plan to complete the timely acquisition of a replacement facility to 

the Committees on Appropriations of the House of Representatives 

and the Senate. 

CDC-WIDE ACTIVITIES

Appropriations, 2015 ............................................................................. $273,570,000 

Budget estimate, 2016 ........................................................................... 113,570,000 

Committee recommendation ................................................................. 267,892,000 

The Committee provides $267,892,000 for public health leadership and support activities at CDC. 

The recommendation includes $160,000,000 in transfers from the 

PPH Fund. 

The Committee recommendation includes funding for the following activities in the following amounts: 

[In thousands of dollars] 

Budget activity Fiscal year 2015 

appropriation 

Fiscal year 2016 

request 

Committee recommendation 

Preventive Health and Health Services Block Grant ..................... 160,000 ............................ 160,000 

Public Health Leadership and Support ......................................... 113,570 113,570 107,892 

Preventative Health and Health Services Block Grant.—The Committee continues to reject the administration’s proposal to eliminate this program and provides $160,000,000, the same level as in 

fiscal year 2015. These grants are crucial for States because they 

provide enough flexibility necessary to resolve any emerging health 
78 

issues at the local level while tailoring those activities to best address the diverse, complex, and constantly changing local community. 

Recurring Reports.—The Committee is concerned by the increasing amount of time and money Federal agencies spend on unnecessary administrative tasks. In particular, the Committee is aware of 

several recurring reports requested in past appropriations acts that 

are no longer necessary. Therefore, to reduce government bureaucracy and increase efficiency, the Committee directs CDC to discontinue any recurring reports requested in appropriations bills 

prior to the enactment of this act. 

Respirator Certification Program.—The Committee includes new 

bill language allowing CDC to have an additional fiscal year to 

spend user fees collected late in the year through the Respirator 

Certification program. 

Transfer Authority.—The Committee recommendation does not 

include language requested by the administration to provide additional transfer authority for the Director of CDC. The Committee 

believes that the Director has sufficient transfer authority provided 

in section 205 of this act to implement any transfer of funds he 

deems necessary 

NATIONAL INSTITUTES OF HEALTH

National Institutes of Health [NIH] funded research has raised 

life expectancy, improved quality of life, and is an economic engine 

helping to sustain American competitiveness. Over the past year, 

cutting-edge NIH-supported research identified a set of 10 compounds in blood that might be used to distinguish the risk for developing memory deficits or Alzheimer’s disease; designed and tested a class of new antibiotics to treat tuberculosis; and helped individuals paralyzed because of spinal cord injuries regain some movement after receiving spinal stimulation. The Committee provides $32,084,000,000 for NIH activities, an increase of $2,000,000,000. This is the largest increase the NIH has 

received since the doubling ended in fiscal year 2003. This includes $940,000,000 in transfers available under section 

241 of the PHS Act. The Committee continues a reform to section 

241 allocations such that no NIH funding will be removed from 

NIH under this authority. This reform ensures that section 241 

transfers are a benefit to NIH rather than a liability. In addition, 

it improves the transparency of NIH’s budget, so that the enacted 

total is truly the amount the Committee expects to be used for biomedical research. 

The Committee recommendation provides $650,000,000 in new 

funding from the Department’s Non-recurring Expenses Fund 

[NEF]. Bill language is included to repurpose the NEF, created in 

fiscal year 2008, specifically for biomedical research activities at 

the NIH. The NEF provides a new, additional source of funding for 

biomedical research. 

The Committee also includes $200,000,000 for the new Precision 

Medicine Initiative; approximately $350,000,000 for the National 

Institute on Aging, a significant portion of which the Committee 

expects to be dedicated to Alzheimer’s disease research; 

$135,381,000 for the BRAIN Initiative; $461,000,000 for research to 
79 

combat Antimicrobial Resistance; $12,600,000 for the Gabriella 

Miller Kids First Act; and increases to every Institute and Center 

to continue investments in innovative research that will advance 

fundamental knowledge and speed the development of new therapies, diagnostics, and preventive measures to improve the health of 

all Americans. 

NATIONAL CANCER INSTITUTE

Appropriations, 2015 ............................................................................. $4,953,028,000 

Budget estimate, 2016 ........................................................................... 5,098,479,000 

Committee recommendation ................................................................. 5,204,058,000 

The Committee recommendation includes $5,204,058,000 for the 

National Cancer Institute [NCI]. Of this amount, $16,000,000 is 

available for repairs and improvements to the NCI facility in Frederick, Maryland. 

Breast Cancer Screening.—The Committee is aware of studies regarding mammography screening for breast cancer that evaluate 

the benefits and harms of mammography screening. Research has 

demonstrated value of early detection of breast cancers through 

screening, and also has demonstrated that screening sometimes results in false positives and over treatment. This has created a less 

clear picture of the benefits of screening and may lead women to 

avoid periodic mammography, an experience some women already 

view as uncomfortable. Therefore, the Committee encourages NCI 

to continue to support research on new imaging technologies, as 

well as studies to develop molecular and cellular markers in 

screen-detected lesions, to distinguish cancers that are truly life 

threatening and require aggressive treatment from those for which 

treatment is unnecessary. The NCI should continue to make research and validation data available to the U.S. Preventive Services Task Force as they continue to systematically review the evidence of effectiveness of various breast cancer screening modalities. 

Deadliest Cancers.—While overall cancer incidence and death 

rates are declining, the Committee is concerned that some cancers, 

often referred to as recalcitrant cancers, continue to have a 5-year 

survival rate below 50 percent. The Committee is pleased that NCI 

has released Scientific Frameworks for pancreatic ductal adenocarcinoma [PDAC] and small cell lung cancer, as called for by the Recalcitrant Cancer Research Act. The Committee recognizes that 

NCI supports critical research efforts exploring potential advances 

for other recalcitrant cancers and conducts scientific meetings and 

other horizon scanning efforts to stimulate research in these fields. 

The Committee looks forward to an update in the fiscal year 2017 

CJ on research underway focusing on recalcitrant cancers in addition to PDAC and small cell lung cancer. 

Gastric Cancer.—The Committee continues to be concerned about 

the deadly outcomes of gastric cancer, particularly among young 

people, and is pleased that gastric cancer was included in The Cancer Genome Atlas [TCGA]. This research effort led to the discovery 

that gastric cancers fall into four distinct molecular subtypes. This 

finding, published in July 2014, is changing the way researchers 

think about treatments for gastric cancers, informing the development of targeted therapies for defined sets of patients whose tumors have specific genomic abnormalities. The Committee notes 
80 

that research on gastric cancer is less advanced than that of many 

cancers. The Committee, therefore, encourages NCI to help investigators in this field to make the best possible use of genomic data 

from the TCGA, as well as to pursue other research opportunities. 

Liver Cancer.—The Committee continues to be concerned with 

the increasing incidence of liver cancer and its low 5-year survival 

rate. Therefore, the Committee encourages NCI to continue to support liver cancer research across its portfolio, including research focused on the development of biomarkers to serve as early detection 

markers of cancer to offer the prospect of improved outcomes. 

Melanoma.—Given the rising incidence of melanoma coupled 

with the immense untapped potential for prevention and screening, 

the Committee urges NCI to continue to work across divisions and 

in coordination with other Federal agencies and advocates, aligning 

resources to decrease the impact of this disease on our Nation’s 

public health. The Committee commends NCI’s MATCH Trial and 

Exceptional Responders Initiative—each stand to benefit melanoma 

subpopulations. The Committee continues to urge NCI’s portfolio to 

encompass all molecular subtypes of melanoma. While sequencing 

studies provide significant information about molecular heterogeneity and characteristics of BRAF wildtype tumors, this data has 

yet to result in effective therapies. Further, as melanoma has the 

highest incidence of central nervous system metastases among the 

common cancers, identifying patients at risk and developing prevention and treatment strategies are important. Research into 

mechanisms underlying clinical dormancy is a critical area of cancer biology and could provide effective means of preventing recurrence. The Committee requests an update on these requests in the 

fiscal year 2017 CJ. 

Minority Cancer Rates.—The Committee is concerned that preventable and detectable cancer rates are falling for the general population, but for some cancers, minority communities are still suffering at disproportionate rates. The Committee requests that NCI 

and NIMHD continue to coordinate and support research focused 

on treatment, prevention, communication, and outreach to minority 

communities for early intervention to reduce and eliminate these 

disparities. 

National Clinical Trials Network [NCTN].—The Committee recognizes that the NCTN is critical to the development of improved, 

personalized treatments for cancer. The Committee also recognizes 

that the burden of cancer mortality is felt disproportionately among 

racial and ethnic minorities. Continued research is needed regarding the biological, socioeconomic, environmental, and behavioral 

factors that cause these disparities. The Committee urges NCI to 

continue research in these areas through the NCI Community Oncology Research Program, NCI’s Center to Reduce Cancer Health 

Disparities, minority participation in NCTN clinical trials, and additional NCI-supported research focused on health disparities. 

Pancreatic Cancer.—The Committee understands that the Scientific Framework for Pancreatic Ductal Adenocarcinoma [PDAC] 

released last year will enable NCI to capitalize on the full range 

of its expertise and that of extramural scientists and academic institutions to assess progress against one of the Nation’s deadliest 

cancers. The Committee also appreciates the establishment of the 
81 

NCI’s PDAC Progress Working Group and the release of a funding 

opportunity announcement on the relationship between pancreatic 

cancer and diabetes and the establishment of the RAS program. 

The Committee is aware that pancreatic cancer has a 5 year survival rate of less than 5 percent due largely to a lack of early detection. Given that biomarkers are uniquely powerful tools to effectively screen and provide for early detection of pancreatic cancer, 

the Committee recommends that the NCI support research efforts 

to study non-invasive methods to screen for pancreatic cancers. The 

Committee also encourages NCI to continue to support clinical research focusing on high-risk pancreatic cancer families. In particular, the Committee recommends that the NCI support clinical 

trials utilizing non-invasive methods to screen for pancreatic cancer 

based on protein production. The Committee looks forward to hearing about next steps for the RAS program, as well as progress 

made on the other initiatives outlined in the PDAC Framework in 

the NIH biennial report. 

Pediatric Oncology Research.—The Committee encourages NCI to 

continue its important investments in pediatric oncology research, 

including clinical studies for children with brain tumors, and development of the novel pediatric ‘‘MATCH’’ study, as well as the important pediatric preclinical testing program evaluating new agents 

for treating pediatric malignancies. The Committee supports NCI’s 

longstanding investment in the Childhood Cancer Survivor Study 

and encourages continued childhood cancer survivorship research 

efforts. 

Precision Medicine.—Cancer presents an exceptionally promising 

opportunity to refine the principles and practices that will serve as 

the foundation for Precision Medicine. The Committee strongly supports the new Initiative and provides $70,000,000 for NCI’s portion 

of the program. The Committee understands that NCI’s priorities 

for the fiscal year 2016 Precision Medicine Initiative include accelerating precision oncology studies, undertaking new studies in particular cancers based on the genomic information learned from 

other clinical trials, and expanding efforts to address the persistent 

problem of drug resistance to cancer treatments. Consistent with 

these objectives, the Committee asks NCI to consider exploration of 

cancer models such as In Vitro clinical trials to improve Precision 

Medicine, especially as it relates to complicated cancers and in populations with a significant number of patients who fail to respond 

to traditional treatments. In addition, the Committee notes the 

NCI’s Community Oncology Research Program is an important element of NCI’s ongoing efforts in precision medicine, and will allow 

NCI to incorporate underserved populations into cancer clinical 

trials under the fiscal year 2016 Precision Medicine Initiative. 

Proton Therapy.—The Committee recognizes the value of proton 

therapy in treating many forms of cancer as well as the benefits 

possible from continued research in this space. The Committee encourages NCI to continue its support of proton therapy research, 

comparing protons versus other kinds of modern radiation therapy, 

including initiatives for pediatric populations. 
82 

NATIONAL HEART, LUNG, AND BLOOD INSTITUTE

Appropriations, 2015 ............................................................................. $2,995,865,000 

Budget estimate, 2016 ........................................................................... 3,071,906,000 

Committee recommendation ................................................................. 3,135,519,000 

The Committee recommendation includes $3,135,519,000 for the 

National Heart, Lung, and Blood Institute [NHLBI]. 

Alpha–1 Antitrypsin Deficiency [Alpha–1].—The Committee is 

aware that Alpha-1 is the major genetic risk factor for developing 

Chronic Obstructive Pulmonary Disease [COPD], which is the third 

leading cause of death in the United States. Alpha–1 is often 

undiagnosed or misdiagnosed, leading to a need to raise public 

awareness about Alpha–1 and provide appropriate information to 

health professionals. The Committee encourages NHLBI to convene 

a group of expert stakeholders to establish a treatment algorithm 

for Alpha–1 Antitrypsin related disease to assist physicians in correctly diagnosing and treating it. 

Asthma.—The Committee applauds NHLBI for its efforts to develop new approaches to treat and manage severe asthma and 

urges the Institute to expand clinical trials in this area. 

Centers for Accelerated Innovation.—The Committee is aware of 

recent efforts by NHLBI to assist with the commercialization of its 

basic science research, discoveries, and advancements. The Committee is encouraged by the creation of these pilot National Centers 

for Accelerated Innovation and looks forward to the possible expansion of this model to fully exploit the full spectrum of NIH-supported research. As such, the Committee encourages NIH to assess 

the progress of this NHLBI pilot initiative and investigate the feasibility of developing a broader effort that would foster an ecosystem to support the commercialization of technologies from academic institutions that impact the health and welfare of all Americans. 

Congenital Heart Disease.—Congenital heart disease remains the 

most common birth defect. With increasing medical treatment options, survival is improving, but with likely complications across 

the lifespan. The Committee is aware of NHLBI convening the 

‘‘Working Group on Adult Congenital Heart Disease: Emerging Research Topics’’, and urges NHLBI to address the needs of those 

with the most life-threatening congenital heart defects in the Institute’s research, as well as collaborate with administrators of existing databases and registries, professional societies, industry, advocacy organizations, patients, and the CDC to address research gaps 

noted in the meeting report. The Committee urges NHLBI to continue its work with other Federal agencies and professional and patient organizations to expand collaborative research initiatives and 

other related activities targeted toward prevention and treatment 

of the diverse lifelong needs of children and adults living with congenital heart disease. 

Chronic Obstructive Pulmonary Disease.—The Committee applauds NHLBI for its efforts to develop novel and more precise 

therapeutics and management strategies to address the rising public health burden of this disease. 

Cystic Fibrosis [CF].—The Committee encourages new personalized approaches to CF therapeutics, including new means to iden-
83 

tify and characterize the efficacy of multidrug therapy that addresses the mutant protein that is the underlying cause of CF in 

the majority of those with the disease. These approaches include 

predictive tools to measure individualized responses to treatment, 

which will help capitalize on recent momentum that has led to revolutionizing treatments for a minority of CF patients. Furthermore, 

the Committee encourages the development of additional drugs and 

drug combinations that are even more effective than currently 

available cystic fibrosis transmembrane conductance modulating 

treatments, the extension of protein modulation to the greatest 

number of patients possible, and the study of how best to manage 

patients on protein modulation therapy. The Committee also supports research into nonsense mutations of CF, which impact about 

10 percent of the CF population and also contribute to thousands 

of other genetic diseases. In addition, the Committee urges further 

research into live imaging modalities that are able to characterize 

mucus and monitor mucociliary clearance, defense mechanisms at 

the heart of CF, and many other respiratory diseases. The Committee encourages funding new technologies aimed at genetic repair of CF. This includes technologies for gene editing, lung stem 

cell biology, and nucleic acid delivery. Such technologies are critical 

for developing therapies to reach all CF patients, especially those 

with mutations that are not amenable to protein manipulation with 

CFTR modulating therapies. 

Heart Disease.—The Committee recognizes that heart disease 

presents a grave risk to our Nation’s long-term health and economic stability and notes that the prevalence and costs associated 

with this disease will increase significantly as the population ages. 

The Committee is concerned that NHLBI’s extramural heart research has dropped 17 percent in constant dollars since 2002, and 

the Committee urges NHLBI to increase heart research commensurate with its impact on public health and scientific opportunity. 

Hemophilia.—The Committee encourages NHLBI to investigate 

the use of precision medicine for rare diseases such as hemophilia. 

For patients with hemophilia, there is wide variation in disease severity and therapeutic outcomes not readily explained by the disease-causing gene mutations. Genome-wide studies would yield 

new insights into the pathogenesis of hemophilia and patient responses to therapies, benefiting patients with bleeding disorders 

and broader patient communities. 

Inherited Hematologic Disorders.—Inherited hematologic disorders, such as the hemoglobinopathies (Sickle Cell Disease and 

Thalassemia) and hemophilia are ideal targets for gene correction 

strategies. Recent advances in gene editing technologies and gene 

therapy approaches could lead to cures for these diseases rather 

than life-long treatment. The Committee encourages NHLBI to further research efforts in gene editing and gene therapy to correct inherited blood disorders. 

National Registry of Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Condition [GenTAC].—The Committee 

recognizes NHLBI for its leadership and support of the GenTAC 

Registry. The Committee understands this important initiative will 

be concluding in 2016 and requests an update on the Institute’s 

plans in the fiscal year 2017 CJ. 
84 

Pulmonary Hypertension [PH].—The Committee applauds 

NHLBI for leading research efforts that have helped prolong life for 

individuals affected by PH. NHLBI is encouraged to further study 

the underlying mechanisms of PH, particularly idiopathic pulmonary arterial hypertension, so that additional gains can be made 

that benefit patient health and wellness. 

Women’s Heart Disease.—Heart disease is the number one killer 

of women in the United States, and increased research on women’s 

heart disease, including sex-specific analysis in clinical trials is 

needed to make progress against the disease. Therefore, the Committee urges NHLBI to prioritize research on women and heart disease. Further, the Committee urges NIH, when making research 

awards, to ensure inclusion of women and minority groups in clinical research in a manner that is appropriate to the scientific question under study. For those studies where sex is identified as a primary or secondary outcome measure, with stratification on that 

basis, NIH should continue to ensure that sex-based analysis of results is reported on clinicaltrials.gov. Furthermore, the Committee 

encourages NIH to continue to work with scientific journals to report sex-specific data in its publications. 

NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH

Appropriations, 2015 ............................................................................. $397,700,000 

Budget estimate, 2016 ........................................................................... 406,746,000 

Committee recommendation ................................................................. 415,169,000 

The Committee recommendation includes $415,169,000 for the 

National Institute of Dental and Craniofacial Research [NIDCR]. 

Usher Syndrome.—The Committee supports research into the 

prevention and treatment of Usher Syndrome, including research 

that will lead to improved genetic counseling, early diagnosis, and 

eventually expanded treatment options for individuals suffering 

from severe hearing and vision loss. The Committee requests an 

update in the fiscal year 2017 CJ on the planned and on-going activities related to this syndrome, including the manner in which 

various Institutes and Centers [ICs] coordinate on common goals 

and objectives. 

NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY

DISEASES

Appropriations, 2015 ............................................................................. $1,749,140,000 

Budget estimate, 2016 ........................................................................... 1,788,133,000 

Committee recommendation ................................................................. 1,825,162,000 

The Committee recommendation includes $1,825,162,000 in this 

bill for the National Institute of Diabetes and Digestive and Kidney 

Diseases [NIDDK]. 

Chronic Constipation.—The Committee is pleased with NIDDK’s 

commitment to explore chronic constipation, gastroparesis, and irritable bowel syndrome, and urges NIDDK to continue research in 

these areas to help inform treatment and prevention, especially 

among children. 

Diabetes.—The Committee recognizes the important work of 

NIDDK, the primary Federal agency conducting research to find a 

cure for diabetes and improving diabetes care. The Committee 

urges NIDDK to commit resources commensurate with the severity 
85 

and escalating costs of the epidemic to further diabetes research 

that will build upon past successes, improve prevention and treatment, and bring the Nation closer to a cure. 

End-Stage Renal Disease [ESRD].—The Committee commends 

NIDDK’s commitment to promoting research on an array of common, costly diseases, including kidney disease. More than 20 million Americans, including children, have kidney disease, the ninth 

leading cause of death in the United States, and all are at risk for 

progressing to kidney failure or end-stage renal disease [ESRD]. 

ESRD is the only health condition covered by Medicare regardless 

of age or disability. ESRD is the only health condition covered by 

Medicare regardless of age or disability. Nearly 637,000 Americans 

rely on the Medicare ESRD Program for life-saving dialysis and 

transplants at an annual cost of $35,000,000,000. Even though the 

ESRD population remains less than 1 percent of the total Medicare 

population, it has accounted for about 7 percent of Medicare spending in recent years. Recognizing the unique status and high cost of 

the Medicare ESRD Program, the Committee believes more investments are needed in kidney research to spur innovative therapies 

for preventing, treating, and reducing the significant burden of kidney disease among all patient populations, Medicare, and taxpayers. In particular, the Committee encourages investigation regarding genetic, biological, and environmental causes of the health 

disparities among minority populations. NIDDK should prioritize 

more investments in kidney research in collaboration with other 

Federal stakeholders involved in kidney research, including 

NHLBI, NIA, and the VA. 

Functional Gastrointestinal Disorders [FGID].—The Committee 

continues to be concerned by the prevalence of FGIDs and their impact on children. The Committee urges multi-Institute collaborations on FGID research to understand this disease. 

Gastrointestinal Disorders.—The Committee recognizes NIDDK’s 

work to create a long-term scientific framework for treating pancreatic, celiac disease, and other gastrointestinal disorders. The 

Committee requests NIDDK provide an update in the fiscal year 

2017 CJ that details how NIDDK is accelerating cures for these 

diseases. 

Gestational Diabetes.—The Committee recognizes that women 

with gestational diabetes and their babies face long-term health 

consequences as a result of the disease, including an increased risk 

of developing type 2 diabetes. Therefore, the Committee urges 

NIDDK to explore additional opportunities for research on gestational diabetes, a disease affecting up to 18 percent of all pregnant 

women. 

Hepatitis B.—The Committee urges more work on hepatitis B 

with the goal of curing or discovering more effective treatment of 

hepatitis B. 

Inflammatory Bowel Disease.—The Committee commends 

NIDDK for hosting a conference on inflammatory bowel disease in 

children which could lead to further research in this area. The 

Committee urges NIDDK to continue efforts to identify the etiology 

of the disease to inform the development of cures. 

Interstitial Cystitis.—Interstitial cystitis patients continue to face 

delays receiving an accurate diagnosis, as well as limited treatment 
86 

options. The Committee applauds NIDDK for studying novel diagnostic methods and for supporting industry efforts to develop new 

therapies for patients. 

Pediatric Kidney Disease.—The Committee is encouraged by the 

research funded by NIDDK to support pediatric kidney disease and 

encourages NIDDK to assign a higher priority to research that explores kidney disease through the course of life. By developing and 

testing novel bench research techniques and innovative patient-oriented clinical studies, cutting-edge translational research leads to 

breakthroughs that truly propagate the ‘‘bench-to-bedside’’ ethos. 

To this end, the Committee urges NIDDK to support research endeavors that include funding for collaborative multicenter pediatric 

prospective clinical/translational trials that elucidate the origins of 

disease. These should help direct development of new treatments 

to improve outcomes in children with kidney disease and hinder 

the development of renal and cardiovascular disease in adults. 

NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

Appropriations, 2015 ............................................................................. $1,604,607,000 

Budget estimate, 2016 ........................................................................... 1,660,375,000 

Committee recommendation ................................................................. 1,694,758,000 

The Committee recommendation includes $1,694,758,000 for the 

National Institute of Neurological Disorders and Stroke [NINDS]. 

Amyotrophic Lateral Sclerosis [ALS].—The Committee strongly 

supports NIH’s research in ALS and encourages NINDS to further 

support promising ALS research related to induced pluripotent 

stem cells, whole genome sequencing, biomarkers, precision medicine, natural history studies, and translational research that could 

help identify new treatments for the disease. NINDS also is encouraged to partner with ALS organizations and other Federal 

agencies and programs, including the ALS Research Program at 

DOD and the National ALS Registry at CDC. The Committee further encourages NIH to work with the FDA to identify opportunities to inform and advance the development of treatments for ALS. 

Cerebral Palsy [CP].—Over 800,000 Americans are impacted by 

CP and it is the number one motor disability in children. Currently, there are no identified best practices at diagnosis or 

through the life span, no organized standards of care, no national 

CP registry, and few proven therapy protocols. The Committee 

urges NIH to work with scientists and stakeholders to develop a 5- 

year strategic plan for research on CP prevention, treatment, and 

cure through the lifespan with the goal of reducing the number of 

people impacted by CP overall, as well as improving the opportunity for recovery of those already diagnosed. The Committee 

urges NIH participation in work groups to develop a research registry of individuals with different forms of CP that could facilitate 

research related to the impact of diverse impairments and health 

issues on functioning, participation and well-being across the life 

span. 

Chronic Overlapping Pain Conditions.—The Committee notes 

that evidence-based diagnostic and treatment guidelines do not 

exist for chronic overlapping pain conditions, resulting in routine 

misdiagnosis, ineffective and oftentimes harmful treatment, and a 

significant economic burden on patients, the healthcare system, 
87 

and society at large. The Committee commends NIH for its efforts 

to develop a case definition, and uniform minimal dataset, and its 

support of existing data repositories to collect patient information 

on chronic overlapping pain conditions. The Committee encourages 

NIH to build upon these activities by ensuring that the Interagency 

Pain Research Coordinating Committee [IPRCC] addresses the research needs for chronic overlapping pain conditions in its ongoing 

efforts to develop a Federal pain research strategy that spans 

basic, translational, and clinical research across the Federal agencies that fund pain research. 

Chronic Pain Research.—The Committee applauds NIH for instituting the NIH Office of Pain Policy and for leading the development of the first Federal pain research strategy with the IPRCC. 

The Committee remains concerned that NIH’s investment in pain 

research is incommensurate with the significant public health and 

economic impact of chronic pain. The Committee strongly urges 

NIH to expand its basic, translational, and clinical research efforts 

in this area, as well as include chronic pain in ongoing NIH initiatives that have potential for yielding significant advancements in 

this area. 

Facioscapulohumeral Muscular Dystrophy [FSHD].—The Committee encourages NIH to foster opportunities for multidisciplinary 

research on FSHD, a common and complex form of muscular dystrophy, commensurate with its prevalence and disease burden. 

Muscular Dystrophy.—The Committee is aware that amendments 

to the Muscular Dystrophy CARE Act were enacted into law in 

2014 and requests an update from NIH in the fiscal year 2017 CJ 

as to the implementation of the updated provisions, particularly a 

plan to address emerging research opportunities in non-skeletal 

muscle manifestations such as bone health and endocrine-functioning. The Committee also requests that NIH provide an update 

on its plans to finalize and implement an updated Action Plan for 

the Muscular Dystrophies and to convene at least two meetings per 

calendar year of the Muscular Dystrophy Coordinating Committee. 

Neurodegenerative Disorders.—The Committee recognizes that 

neurodegenerative disorders such as ALS, Parkinson’s disease, progressive supranuclear palsy, multiple system atrophy, the dementias, including Alzheimer’s disease, and related dementias and 

Huntington’s disease, among others, represent an enormous and 

growing burden on the U.S. population in terms of quality of life 

and economic cost and that the incidence of neurodegenerative diseases is expected to soar as the U.S. population ages. Currently 

there are no neuroprotective therapies for these patients. Conventional drug development for neurological diseases has presented 

many challenges due to the lack of validated biomarkers for these 

diseases. The Committee urges NINDS to prioritize research into 

neuroprotective therapies. 

Respiratory Problems and Strokes.—Stroke-induced respiratory 

dysfunction is one of many important challenges facing stroke patients, and abnormal breathing patterns can have a negative impact on recovery and prognosis. The Committee encourages NIH to 

consider supporting basic research to understand the molecular 

and neural mechanisms that regulate breathing and the effect of 

respiratory dysfunction on stroke outcomes, which in turn could 
88 

lead to the development of novel therapies that may dramatically 

improve stroke outcomes and public health. 

Stroke.—The Committee is aware that stroke presents a significant challenge to our Nation’s long-term health and economic stability as a result of the aging of the population. Therefore, the 

Committee encourages that NINDS continue its commitment to implementing the top priorities that emerged from the 2012 stroke 

planning effort for stroke prevention, treatment, and recovery research, particularly enhancement of the Stroke Clinical Trials Network to answer the most pressing clinical questions in stroke. 

NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES

Appropriations, 2015 ............................................................................. $4,417,558,000 

Budget estimate, 2016 ........................................................................... 4,614,779,000 

Committee recommendation ................................................................. 4,710,342,000 

The Committee recommendation includes $4,710,342,000 for the 

National Institute of Allergy and Infectious Diseases [NIAID]. 

Alopecia Areata.—The Committee recognizes the recent breakthroughs in alopecia areata research related to repurposing drugs 

used to treat other autoimmune diseases. NIAID is encouraged to 

study alopecia areata due to the potential cross-cutting benefit of 

these autoimmune disease research activities. 

Antimicrobial Resistance [AMR].—AMR is one of the most significant public health threats facing the world today. The Committee 

is concerned that AMR and the lack of new antibiotics are 

threating the Nation’s health and the healthcare system. The CDC 

reports that antibiotic-resistant infections account for at least 

$20,000,000,000 in excess direct healthcare costs and up to 

$35,000,000,000 in lost productivity due to hospitalizations and 

sick days each year. The Committee provides $461,000,000, an increase of $100,000,000 for AMR research. The Committee commends NIAID on its efforts to increase the drug development pipeline for novel antibiotics, develop rapid diagnostics, assist NCBI in 

creating create a national catalogue of genome sequence data, and 

other recent initiatives to fund research in prevention and treatment of AMR. However, a considerable bottleneck continues at the 

first step in delivering new antibiotics: discovery. The Committee 

encourages NIAID to support basic discovery research to help resolve the bottleneck, in particular: studying unculturable bacteria; 

turning on silent genes; efficiently identifying attractive natural 

products; establishing rules understanding mechanisms for the 

penetration of antibiotics into bacterial cells; and developing platforms of antibiotic discovery. 

Chronic Inflammatory Demyelinating Polyneuropathy [CIDP].— 

The Committee encourages NIAID to initiate research activities 

into CIDP and related rare and debilitating autoimmune conditions 

to improve our scientific understanding of immune dysfunction including the underlying disease process. 

Clinical Specimen Access for Diagnostic Development.—The Committee applauds the establishment of NIAID’s Antibacterial Resistance Leadership Group Virtual Biorepository Catalogue to promote 

clinical specimen access. To further support research and development of desperately needed diagnostics and treatment of nonbacterial pathogens, the Committee urges NIAID to explore opportuni-
89 

ties to support the development of virtual biorepositories for virus, 

fungi, and other pathogens already collected under existing NIAID 

funded research. The Committee also urges NIAID to examine incentives to support institutions to save de-identified specimens and 

participate in the virtual biorepository catalogues when possible. 

Drug Allergy.—The Committee is pleased that NIAID sponsored 

a workshop to develop a research agenda on the diagnosis and 

management of patients with drug hypersensitivity. The Committee requests an update on steps that are being taken to implement the recommendations from the report of that workshop in the 

fiscal year 2017 CJ. 

Gram Negative Bacterial Infections.—The threat of severe or 

fatal pulmonary infections caused by highly resistant Gram-negative bacteria is increasing in the United States and globally. The 

Committee notes the recent multiple successes in the development 

of rapid diagnostics and urges NIAID to continue its efforts, including for acute pulmonary infections in the critically ill and enhanced 

clinical outcomes evaluation of these diagnostic platforms. 

Hepatitis B.—The Committee urges NIAID to take aggressive 

and innovative steps to discover and develop new therapies for hepatitis B that have the potential to be a ‘‘cure.’’ The Committee understands that finding a ‘‘cure’’ will most likely require new direct 

acting antivirals as well as methods that harness the immune system. Based on the success of other NIH coordination initiatives, the 

Committee notes the recompetition of NIDDK’s HBV Research Network, and encourages NIAID to explore potential opportunities to 

engage with the Network. 

Immunotherapy Research.—The Committee is pleased that 

NIAID has joined AHRQ in co-sponsoring a workshop on allergen 

immunotherapy effectiveness. The Committee requests an update 

in the fiscal year 2017 CJ on steps that will be taken to implement 

the recommendations of the workshop and promote research in this 

area. 

Malaria and Other Tropical Diseases.—One-sixth of the world’s 

population suffers from one or more neglected tropical diseases 

[NTDs]. The Committee urges NIH to continue its investment in 

NTDs and malaria research, including work in applied research for 

NTDs, and to continue to work with other agencies as well as philanthropic and private partners to foster research and help ensure 

that basic discoveries are translated into much needed solutions. 

NIAID Biodefense Plan.—The Committee appreciates the Assistant Secretary for Preparedness and Response’s completion of the 5- 

year spend plan for medical countermeasure [MCM] enterprise, but 

remains concerned about the level of detail included for NIAID. 

The Committee requests NIAID include in future annual spend 

plans, as well as the fiscal year 2017 CJ, details on the future goals 

for NIAID’s MCM research investments, including transition to advanced research at Biomedical Advanced Research and Development Authority [BARDA], and NIAID’s coordination with BARDA’s 

advanced development and procurement priorities. Details should 

be provided over the next 5 years and include a specific breakdown 

of priority MCM candidates and a description of future development goals for each of these candidates. 
90 

Non-Tuberculous Mycobacteria [NTM].—According to CDC, the 

incidence of NTM disease is increasing in the United States and 

treatments for this disease are very limited. The Committee notes 

NIAID’s participation in a May 2014 workshop to develop a comprehensive research agenda on this disease and encourages NIAID 

to support the implementation of this agenda. 

NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES

Appropriations, 2015 ............................................................................. $2,372,301,000 

Budget estimate, 2016 ........................................................................... 2,433,780,000 

Committee recommendation ................................................................. 2,511,431,000 

The Committee recommendation includes $2,511,431,000 for the 

National Institute of General Medical Sciences [NIGMS], which includes $940,000,000 in transfers available under section 241 of the 

PHS Act. 

Institutional Development Award [IDeA].—The Committee pro- vides $300,000,000 for the IDeA program, an increase of 

$26,700,000. The Committee believes the IDeA program has made 

significant contributions to biomedical research and has led to the 

creation of a skilled workforce and made the IDeA program an essential component of NIH’s research portfolio. Unfortunately, many 

institutions eligible for funding under the National Science Foundation Experimental Program to Stimulate Competitive Research 

[EPSCoR] program are ineligible for funding under the IDeA program. After several years of specific direction in this bill, the administration continues to refuse to submit legislative information 

to update the eligibility criteria of the IDeA program to bring it in 

line with EPSCoR eligibility. Therefore, new bill language is included to allow entities eligible for participation in the EPSCoR 

program for the past 2 consecutive years to apply for inclusion in 

the IDeA Networks of Biomedical Research Excellence award. 

Small Business Research Funding.—The Committee supports the 

initiative in the President’s budget request for fiscal year 2016 calling for directed small business research funding to IDeA States to 

foster the development of products to advance public health. The 

Committee asks NIGMS to consider allocating funding for one 

shared innovation incubator in each of the 4 IDeA regions that 

would be competitively bid among IDeA States to serve IDeA 

States. NIH should not use funding from the IDeA program to fund 

these grants. 

EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH

AND HUMAN DEVELOPMENT

Appropriations, 2015 ............................................................................. $1,286,869,000 

Budget estimate, 2016 ........................................................................... 1,318,061,000 

Committee recommendation ................................................................. 1,345,355,000 

The Committee recommendation includes $1,345,355,000 for the 

Eunice Kennedy Shriver National Institute of Child Health and 

Human Development [NICHD]. 

Demographic Research.—Recent NICHD-supported research confirms the world’s population will reach 11 billion in 2100—a 2 billion increase over previous estimates. Demographic, or population, 

research is essential for understanding the short and long-term 

consequences of this dramatic growth on individuals and commu-
91 

nities. NICHD-funded longitudinal studies, including the National 

Longitudinal Survey of Adolescent to Adult Health and the Fragile 

Families and Child Well Being Study, are yielding important data 

about the linkages between health, socioeconomic status, family dynamics, genetics, and environment—data that are key to improving 

the health, well-being, and development of future generations. The 

Committee encourages NICHD to continue supporting these and 

other similar studies such as the Human Placenta Project, affecting 

population health and well-being. 

Down Syndrome.—The NIH Research Plan on Down Syndrome, 

updated in December 2014, calls for expanding research on cognitive and behavioral outcomes and potential pharmacologic and 

behavioral therapies for individuals with Down syndrome who, in 

addition to the associated developmental intellectual disability, also 

have a significant and diverse set of comorbid psychiatric and medical conditions that occur throughout the lifespan. The Committee 

supports this priority, and urges NIH to take steps to develop a 

system for measuring the differences in variability related to co-occurring psychiatric or medical conditions and genetic differences 

among individuals. Further, the NIH Research Plan on Down Syndrome, updated in December 2014, proposes that high priority consideration also be given to developing a Down syndrome biobank, 

linked and coordinated with DS–ConnectTM, the Down Syndrome 

Registry to systematically collect, store and distribute brain and 

other tissue samples to Down syndrome researchers. Such a repository could leverage and be linked with the NIH NeuroBioBank and 

the existing Alzheimer’s Disease Brain Banks so that Down syndrome tissues can be compared to those obtained from individuals 

with Alzheimer’s disease and other disorders. The Committee requests an update in the fiscal year 2017 CJ. 

Dual Use/Dual Benefit.—The Dual Purpose with Dual Benefit: 

Research in Biomedicine and Agriculture Using Agriculturally Important Domestic Species is an interagency partnership grants program funded by NICHD and the U.S. Department of Agriculture 

[USDA]. Both the USDA and NIH should be commended for developing this important interagency program. The Committee strongly 

urges continuation of this partnership because it sponsors use of 

farm animals as dual purpose models to better understand developmental origins of disease, fat regulation and obesity, stem cell biology, assisted reproductive technologies, and infectious disease 

which directly benefits both agriculture and biomedicine. This program also strengthens ties between human medicine, veterinary 

medicine, and animal sciences, which is key to success of the One 

Health Initiative. 

Fragile X [FX].—The Committee commends NICHD for leading 

the effort to map the molecular, physiological, biological, and genetic connections between FX, the fragile X protein, and autism. 

The fragile X gene and its protein continue to present important 

insight into discovering the root cause of autism and disease modifying treatments for FX and autism. The Committee urges NIH to 

explore ways to encourage investigator-initiated research applications for FX and autism in tandem to accelerate the pace of research toward identification of the commonality between the two 
92 

conditions and the development of disease modifying treatments 

that will reduce health burdens. 

Intellectual and Developmental Disabilities Research Centers 

[IDDRC].—The Committee recognizes the outstanding contributions of the IDDRC toward understanding why child development 

goes awry, discovering ways to prevent developmental disabilities, 

and discovering treatments and interventions to improve the lives 

of people with developmental disabilities and their families. The 

Committee is particularly pleased with the IDDRC contributions in 

the areas of autism, fragile X syndrome, Down syndrome, and other 

genetic and environmentally induced disorders. These Centers have 

greatly improved our understanding of the causes of developmental 

disabilities and have developed effective treatments consistent with 

their translational science mission. The Committee urges NICHD 

to provide additional resources, if feasible, to the IDDRCs for research infrastructure and expansion of cores, so that they can conduct basic and translational research to develop effective prevention, treatment, and intervention strategies for children and adults 

with developmental disabilities. 

Maternal Morbidity.—Though maternal morbidity rates are rising, there are no uniform definitions of severe maternal morbidity. 

Having uniform definitions would help Federal, State, and local 

agencies and research institutions establish standardized and 

interoperable processes for surveillance, data collection, and research. The collected data could then inform the development and 

deployment of targeted, evidence-based prevention and treatment 

programs to reduce the incidence of severe maternal morbidity. The 

Committee encourages NICHD to work with research institutions 

and professional societies to identify uniform definitions for severe 

maternal morbidity. 

Mother-Infant Relationship.—The Committee applauds the multidisciplinary, cutting-edge research that NICHD conducts on child 

and maternal health and development. The Committee encourages 

a continued focus on basic and applied research to advance our understanding of attachment in mother-infant relationships and its 

impact on development. The Committee urges NICHD to continue 

support for a robust intramural and extramural research portfolio 

identifying and describing the complex interaction of behavioral, social, environmental, and genetic factors on health outcomes with 

the ultimate goal of improved understanding of and interventions 

for disorders such as depression, addiction, and autism. 

Pediatric Research Network.—The Committee is aware that the 

National Pediatric Research Network Act (Public Law 113–55) authorizes an innovative model to accelerate research through infrastructure consortia across the Nation’s pediatric research institutions. The Committee has provided sufficient funds to explore how 

to carry out the provisions of the act, as feasible. 

Preterm Birth.—The Committee applauds NICHD’s work with 

leading global health organizations to develop a research agenda 

aimed at reducing preterm birth. Public and privately funded research that spans the range of discovery, development, and delivery 

science is needed to identify the causes of premature birth. The 

Committee urges NICHD to enhance investments in biomedical 
93 

and clinical research related to the prevention of preterm birth and 

the care and treatment of preterm infants. 

Reading Disability and Genetic Screening.—The failure to identify learning disabilities early, as well as the failure to optimally 

match a specific intervention program to an individual child, can 

have a significant detrimental impact on the lives of individuals, 

cost of education, and the economy more broadly. This is especially 

harmful in the case of reading disabilities, such as Dyslexia, as we 

know from The Nation’s Report Card report in 2013, which revealed that over 55 percent of fourth graders still fail to reach proficiency on standardized tests. While NICHD funds a number of Intellectual and Developmental Disabilities Research Centers, they 

do not focus specifically on research on the genetic and epigenetic 

predictors of reading disability. The Committee encourages NICHD 

to support research to increase our ability to identify the risk, including the role of genetic analyses, early detection, and optimal 

educational interventions for reading disabilities. The Committee 

urges NICHD to explore additional ways to encourage and sustain 

research to achieve meaningful interventions and therapies to help 

those with reading disabilities. 

Vulvodynia.—The Committee encourages NICHD to implement 

the recommendations from the May 2013 NICHD workshop to develop research diagnostic criteria and common data elements to 

standardize vulvodynia research efforts. The Committee is pleased 

with NICHD’s involvement in the Trans-NIH effort to advance research on chronic overlapping pain conditions and encourages the 

Institute’s continued and expanded involvement. 

NATIONAL EYE INSTITUTE

Appropriations, 2015 ............................................................................. $676,764,000 

Budget estimate, 2016 ........................................................................... 695,154,000 

Committee recommendation ................................................................. 709,549,000 

The Committee recommendation includes $709,549,000 for the 

National Eye Institute [NEI]. 

Age-Related Macular Degeneration [AMD].—The Committee recognizes NEI’s leadership in identifying more than 500 genes associated with both common and rare eye diseases. It acknowledges that 

NEI’s AMD Gene Consortium has discovered seven new regions of 

the human genome, called loci, associated with increased risk of 

AMD and confirmed 12 loci identified in previous studies. Further, 

it recognizes that three NEI-funded studies have solidified a link 

between AMD and genes encoding the complement system—a set 

of proteins that plays a central part in immune responses and inflammation—and that initial research suggests that a class of 

medications used to treat the Human Immunodeficiency Virus 

called nucleoside reverse transcriptase inhibitors shows promise to 

treat AMD, and may be repurposed to treat other inflammatory 

disorders. 

Audacious Goals Initiative.—The Committee commends NEI’s 

leadership through its Audacious Goals Initiative, the goal of which 

is to restore vision within the next decade through regeneration of 

the retina by replacing cells that have been damaged by disease 

and injury and restoring their visual connections to the brain. The 

Committee is pleased that NEI has formed a Steering Committee, 
94 

which is identifying knowledge gaps and the scientific expertise 

need to bridge them, and is awarding the first cycle of grants addressing the technical needs and opportunities for imaging the visual system. 

Dry Eye.—The Committee is pleased that NEI’s Small Business 

Innovation Grant Program has supported research into dry eye, 

which is one of the most common of all eye conditions affecting 

adults 45 years and older. This research has resulted in the launch 

of a FDA-approved Phase I clinical trial that is testing the safety 

and efficacy of a novel drug targeting a unique mechanism involved 

in maintaining moisture in the eye. 

Glaucoma.—The Committee recognizes that NEI’s Glaucoma 

Human Genetics Collaboration has identified five regions of the genome that are strongly associated with primary open-angle glaucoma, the most common form of the disease. It acknowledges new 

research that suggests that mutations in the myocilin gene can affect development of the myelin sheath that protects the optic nerve, 

leading to glaucoma, especially the juvenile-onset form of the disease. It is hopeful about new research into a contact lens that releases intraocular pressure-reducing drugs at a steady rate, facilitating better treatment for glaucoma. The Committee requests an 

update on this research in the fiscal year 2017 CJ. 

Usher Syndrome.—The Committee urges NEI to continue to 

prioritize research on Usher syndrome, the leading cause of deafblindness. 

NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES

Appropriations, 2015 ............................................................................. $667,333,000 

Budget estimate, 2016 ........................................................................... 681,782,000 

Committee recommendation ................................................................. 695,900,000 

The Committee recommendation includes $695,900,000 for the 

National Institute of Environmental Health Sciences [NIEHS]. 

Autism Spectrum Disorder [ASD].—The Committee encourages 

NIEHS to continue its collaboration with NICHD and NIMH to 

fund new opportunities for research on ASD. The Committee urges 

NIEHS to enhance its support for research, including experimental 

and observational research, on potential environmental risk factors 

that may play a role in the initiation or promotion of ASD at any 

life stage. Further, with respect to regressive autism, NIEHS is encouraged to focus research on the susceptibility of subpopulations 

to environmental risk factors and consider approaches to the mitigation of environmental risks associated with ASD. 

Healthy Housing.—The Committee encourages NIEHS to consider study of the impact healthy housing has on reducing environmental exposures that lead to health risks like asthma and lead 

poisoning. 

NATIONAL INSTITUTE ON AGING

Appropriations, 2015 ............................................................................. $1,197,523,000 

Budget estimate, 2016 ........................................................................... 1,267,078,000 

Committee recommendation ................................................................. 1,548,494,000 

The Committee recommendation includes $1,548,494,000 for the 

National Institute on Aging [NIA]. 
95 

Alzheimer’s Disease.—In keeping with long-standing tradition, 

the Committee has not earmarked funding for research on specific 

diseases. However, the Committee has included a $350,971,000 increase for the NIA and expects that a significant portion will be 

dedicated to high quality research on Alzheimer’s disease, subject 

to the scientific opportunity presented in the peer review process. 

NIA is encouraged to continue addressing the research goals set 

forth in the National Plan to Address Alzheimer’s Disease, as well 

as the recommendations from the Alzheimer’s Disease Research 

Summit in 2015. The Committee looks forward to receiving a report in the fiscal year 2017 CJ that outlines research conducted on 

Alzheimer’s disease relative to the milestones established in the 

National Plan, as well as the professional judgement budget for 

Alzheimer’s disease for fiscal year 2017. Further, the Committee directs NIA to continue support for existing well-characterized, longitudinal, population-based cohort studies aimed at providing new insights into disease prevention, particularly among minority populations where disease burden is greatest. Finally, the Committee is 

particularly interested in NIH’s plans to place additional emphasis 

on high-risk, high-reward projects using a DARPA-like approach to 

goal-oriented and milestone-driven research. The Committee believes such an approach can be particularly valuable in addressing 

major scientific gaps and encourages NIH to establish clear priorities, including Alzheimer’s disease and dementia and other highcost diseases of aging, particularly given our national goal of preventing and effectively treating Alzheimer’s disease by 2025. 

Atrial Fibrillation [AFib].—The NIA has undertaken an important national initiative focused on preventing falls in older adults. 

Unfortunately, misunderstanding about the impact of falls risk in 

older adults with AFib plays a disproportionate role in treatment 

decision-making, often leading to underuse of oral anticoagulation 

therapies that reduce the risk of stroke. As such, the Committee 

strongly urges the NIA to work with NHLBI, NINDS, and other 

relevant NIH Institutes, Centers, and offices to communicate the 

results of this falls prevention study widely, when available, to inform healthcare providers and patients who are making treatment 

decisions about AFib-related stroke in older persons. 

Population Research.—NIA-supported research confirms that by 

2030, there will be 72 million Americans aged 65 and older. The 

Institute’s current investment in population aging research and 

surveys, including the Demography and Economics of Aging, Roybal Centers for Translational Research, and the Health and Retirement Study, is essential to understanding the implications of an increasing older population. To accelerate current understanding, the 

Committee urges NIA to continue investing in large-scale longitudinal studies that explore how genetic, behavioral, and psychosocial 

factors, including socioeconomic status, interpersonal relationships, 

and social environments, affect health and well-being. The Committee is pleased NIA is developing an initiative to explore why 

other industrialized countries surpass the United States in health 

at older ages and longevity—especially in light of new NIA-supported research findings that more than half of premature deaths 

are due to social and behavioral issues. 
96 

NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN

DISEASES

Appropriations, 2015 ............................................................................. $521,528,000 

Budget estimate, 2016 ........................................................................... 533,232,000 

Committee recommendation ................................................................. 544,274,000 

The Committee recommendation includes $544,274,000 for the 

National Institute of Arthritis and Musculoskeletal and Skin Diseases [NIAMS]. 

Atopic Dermatitis [AD].—The Committee understands that AD is 

the most severe and long-lasting form of eczema which can cause 

significant limitations in everyday activities due to sleep disturbances, fatigue, and psychological distress. The Committee recognizes that AD is a potentially debilitating condition that can severely compromise quality of life. The Committee understands that 

for the 17,800,000 people who have the disease, there are a lack 

of quality measures and clinical guidelines to support appropriate 

treatment of AD. The Committee encourages NIAMS to support research into clinical tools to diagnose and assess the severity of AD. 

Heritable Connective Tissue Disorders.—The Committee appreciates the leadership role that NIAMS has taken in investigating 

heritable connective tissue disorders. The Committee encourages 

NIAMS to continue to support these important activities moving 

forward. 

Lupus Research Plan.—The Committee commends the Institute 

for leading the NIH effort to review the current state of the science, 

evaluate progress on the existing lupus research plan—The Future 

Directions of Lupus Research, originally issued in 2007—and develop a new action plan for lupus research. Significant advances in 

the understanding of disease mechanisms and drug discovery make 

this an appropriate time for re-evaluation of the science. The Committee applauds the broad solicitation of input from across NIH 

and the greater research and advocacy community, and supports 

the inclusion of input from researchers, clinicians, patients, and 

other stakeholders in this process, and urges special attention for 

efforts to fully engage patient volunteers in the full continuum of 

future research. 

Scleroderma.—The Committee notes that while meaningful scientific progress has been made through NIAMS-led scleroderma research, there remains no cure and treatment options are limited. 

NIAMS is encouraged to consider advancing research projects to 

improve the understanding of the mechanisms of this disease. 

NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION

DISORDERS

Appropriations, 2015 ............................................................................. $405,207,000 

Budget estimate, 2016 ........................................................................... 416,241,000 

Committee recommendation ................................................................. 424,860,000 

The Committee recommendation includes $424,860,000 for the 

National Institute on Deafness and Other Communication Disorders [NIDCD]. 
97 

NATIONAL INSTITUTE OF NURSING RESEARCH

Appropriations, 2015 ............................................................................. $140,852,000 

Budget estimate, 2016 ........................................................................... 144,515,000 

Committee recommendation ................................................................. 147,508,000 

The Committee recommendation includes $147,508,000 for the 

National Institute of Nursing Research [NINR]. 

NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM

Appropriations, 2015 ............................................................................. $447,153,000 

Budget estimate, 2016 ........................................................................... 459,833,000 

Committee recommendation ................................................................. 469,355,000 

The Committee recommendation includes $469,355,000 for the 

National Institute on Alcohol Abuse and Alcoholism [NIAAA]. 

Genomic Research and Alcohol Dependence.—The Committee 

commends the NIAAA for its research efforts to increase understanding of the genetic and neurobiological mechanisms underlying 

alcohol use disorder [AUD]. Research shows that genes contribute 

40–60 percent of the risk for developing AUD. Factors such as 

stress may make individuals who carry genomic variations associated with increased risk for AUD more vulnerable to developing 

the disorder. NIAAA-supported studies have identified several 

genes that contribute to susceptibility to AUD and many others 

that show some evidence of involvement; and these research findings are paving the way for new opportunities in prevention and 

treatment. The Committee encourages the NIAAA to capitalize on 

advances in genomic science and ‘‘big data,’’ and explore collaborative opportunities to gain additional insight into the genetics of 

AUD, including its relationship to related problems such as posttraumatic stress disorder in military personnel and veterans. 

NATIONAL INSTITUTE ON DRUG ABUSE

Appropriations, 2015 ............................................................................. $1,015,705,000 

Budget estimate, 2016 ........................................................................... 1,047,397,000 

Committee recommendation ................................................................. 1,069,086,000 

The Committee recommendation includes $1,069,086,000 for the 

National Institute on Drug Abuse [NIDA]. 

NATIONAL INSTITUTE OF MENTAL HEALTH

Appropriations, 2015 ............................................................................. $1,433,651,000 

Budget estimate, 2016 ........................................................................... 1,489,417,000 

Committee recommendation ................................................................. 1,520,260,000 

The Committee recommendation includes $1,520,260,000 for the 

National Institute of Mental Health [NIMH]. 

NATIONAL HUMAN GENOME RESEARCH INSTITUTE

Appropriations, 2015 ............................................................................. $498,677,000 

Budget estimate, 2016 ........................................................................... 515,491,000 

Committee recommendation ................................................................. 526,166,000 

The Committee recommendation includes $526,166,000 for the 

National Human Genome Research Institute [NHGRI]. 
98 

NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING

Appropriations, 2015 ............................................................................. $327,243,000 

Budget estimate, 2016 ........................................................................... 337,314,000 

Committee recommendation ................................................................. 344,299,000 

The Committee recommendation includes $344,299,000 for the 

National Institute of Biomedical Imaging and Bioengineering 

[NIBIB]. 

NATIONAL CENTER FOR COMPLEMENTARY AND INTEGRATIVE HEALTH

Appropriations, 2015 ............................................................................. $124,062,000 

Budget estimate, 2016 ........................................................................... 127,521,000 

Committee recommendation ................................................................. 130,162,000 

The Committee recommendation includes $130,162,000 for the 

National Center for Complementary and Integrative Health 

[NCCIH]. 

Pain Research.—The Committee is encouraged by NCCIH and 

NIDA’s collaboration with the Department of Veteran’s Affairs [VA] 

on a new initiative funding 13 studies examining non-pharmacological management of pain and other symptoms experienced by 

military personnel and veterans. As opioid prescribing rates have 

increased at the VA in recent years, and opioid abuse has risen 

among young veterans, the Committee believes it is critical that we 

support research on complementary and integrative health approaches to ensure the best quality of care for our Nation’s veterans, and urges the NIH and VA to continue this vital research. 

NATIONAL INSTITUTE ON MINORITY HEALTH AND HEALTH DISPARITIES

Appropriations, 2015 ............................................................................. $270,969,000 

Budget estimate, 2016 ........................................................................... 281,549,000 

Committee recommendation ................................................................. 287,379,000 

The Committee recommendation includes $287,379,000 for the 

National Institute on Minority Health and Health Disparities 

[NIMHD]. 

Minority Enrollment in Cohort Studies.—The Committee is 

aware of novel efforts underway in racially and ethnically diverse 

urban, low-income neighborhoods to enroll households for participation in future neighborhood cohort studies. Under these approaches, families are interviewed, consented, and then provided 

information on a range of medical and socioeconomic issues for inclusion in a growing database of such household information. These 

families can then be re-contacted for participation, as appropriate, 

in future clinical trials and other research. The Committee believes 

that the NIMHD should support the development of this type of research infrastructure through its community-based participatory 

research program. 

NIMHD Report.—The Committee requests that NIH and NIMHD 

provide a report to the Committees on Appropriations of the House 

of Representatives and the Senate within 6 months of enactment 

on the implementation of the law establishing the NIMHD. 

Research Centers in Minority Institutions [RCMI].—The Committee continues to recognize the critical role played by minority 

institutions, especially at the graduate level, in addressing the 

health research and training needs of minority populations. In par-
99 

ticular, the RCMI program fosters the development of new generations of minority scientists for the Nation and provides support for 

crucial gaps in the biomedical workforce pipeline, with each dollar 

invested being leveraged to generate an additional five to six dollars in competitive research funding. The Committee requests that 

NIH maintains the RCMI program in its current form and funds 

it at no less than last year’s level. 

JOHN E. FOGARTY INTERNATIONAL CENTER FOR ADVANCED STUDY IN

THE HEALTH SCIENCES

Appropriations, 2015 ............................................................................. $67,634,000 

Budget estimate, 2016 ........................................................................... 69,505,000 

Committee recommendation ................................................................. 70,944,000 

The Committee recommendation includes $70,944,000 for the 

Fogarty International Center [FIC]. 

Global Health Research.—Recent disease outbreaks such as 

Ebola and the flu have shown the importance of the Center’s essential role in global infectious disease health research training and 

health system strengthening. These efforts help developing countries to eventually advance their own research and health solutions 

and tools. FIC also has developed partnerships in countries to fight 

malaria, neglected tropical diseases, and other infectious diseases 

that disproportionately impact the global poor. The Committee 

urges FIC to continue this important work of building relationships 

with scientists abroad to foster a stronger and more effective 

science workforce and health capacity on the ground, and improving the image of the United States though health diplomacy in 

their countries. 

NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES

Appropriations, 2015 ............................................................................. $632,710,000 

Budget estimate, 2016 ........................................................................... 660,131,000 

Committee recommendation ................................................................. 699,319,000 

The Committee recommendation includes $699,319,000 for the 

National Center for Advancing Translational Sciences [NCATS]. 

The Committee includes bill language allowing up to $25,835,000 

of this amount, the same as the budget request, to be used for the 

Cures Acceleration Network [CAN]. The fiscal year 2015 funding 

level for CAN is $9,835,000. 

Academic Partnerships to Support Clinical Development.—The 

Committee recognizes the importance of public-private-academic 

models and partnerships to translate discoveries into treatments 

and cures. To speed the pace of discoveries, the Committee encourages NCATS to seek out and support partnerships between academic-based entities and NCATS’ intramural program, which has 

a strong record of expertise and resources for identifying opportunities, validating leads, and developing the necessary data to build 

the basis for clinical development. Such partnerships should seek 

to connect intramural research ideas and discoveries to specific development efforts, and to assist with the interaction with the pharmaceutical and biotechnology industries. 

Clinical and Translational Science Awards [CTSA].—The Committee supports the goals of the CTSA program and believes the 

principles that serve as the foundation of NCATS—public-private 
100 

partnerships, community outreach, faster access to clinical trials, 

and distributed patient cohorts—have tremendous potential for addressing the long-standing scientific and operational problems associated with getting treatments to patients, including those with 

health disparities. Recognizing the value and importance of supporting the full spectrum of medical research, the Committee encourages NCATS to build meaningful relationships between clinical 

and translational research programs and the various Institutes and 

Centers. NCATS is encouraged to work closely with the CTSA community and related stakeholders moving forward to continue to 

identify emerging opportunities and areas for programmatic improvement. Further, the Committee encourages NIH to fund 

CTSAs with a history of serving health disparity populations, as 

well as CTSAs that address the unmet needs associated with rare 

diseases, so that research funding provided through the various Institutes can be leveraged to address the clinical and translational 

research challenges associated with those populations. The Committee provides $499,746,000 for the CTSA program, an increase of $25,000,000 above the fiscal year 2015 level for NCATS 

to implement the recommendations from the 2013 Institute of Medicine report on the CTSA program. In particular, the Committee 

supports the goal of the CTSA program to build networking capacity and innovative collaborative projects. Additional funding is included to allow the program to retain its merit-based CTSA funding to institutions while expanding the network capacity to conduct 

multi-site clinical studies and collaborative projects. 

Full Spectrum of Medical Research.—The Committee supports 

the progress of clinical and translational research activities, including the CTSA program. The Committee is pleased to see NCATS 

working on treatments for some infectious diseases, including malaria and Lassa fever, and encourages NCATS to focus on additional neglected diseases through the Therapeutics for Rare and 

Neglected Diseases program. Additionally, the Committee requests 

that NCATS’ contributions to neglected disease research be included in the joint CDC, FDA, and NIH global health strategy describing coordination and prioritization of global health research 

activities within the three agencies. 

Minority Populations.—The Committee encourages NCATS to 

consider clinical research efforts in areas that are characterized by 

geographically interspersed minority populations. Clinical and 

translational research with such populations can reveal clinically 

significant differences that drive improvements in diagnosis and 

treatment. 

NATIONAL LIBRARY OF MEDICINE

Appropriations, 2015 ............................................................................. $337,324,000 

Budget estimate, 2016 ........................................................................... 394,090,000 

Committee recommendation ................................................................. 402,251,000 

The Committee recommends $402,251,000 for the National Library of Medicine [NLM]. Of the funds provided, $4,000,000 is for 

the improvement of information systems, to remain available until 

September 30, 2017. 

National Center for Biotechnology Information [NCBI].—The 

Committee recommendation includes funding directly to NLM for 
101 

NCBI to meet the challenge of collecting, organizing, analyzing, 

and disseminating the increasing amounts of data related to research in molecular biology and genomics, and to support the deposit of manuscripts in PubMed Central under the NIH Public Access Policy. Providing the increase specifically to NLM, as opposed 

to previous years where NLM received funding from individual Institutes and Centers for these activities, increases funding transparency and enhances NCBI’s ability to provide an integrated, 

genomic resource for biomedical researches at NIH and around the 

globe. 

OFFICE OF THE DIRECTOR

Appropriations, 2015 ............................................................................. $1,413,734,000 

Budget estimate, 2016 ........................................................................... 1,442,628,000 

Committee recommendation ................................................................. 1,523,537,000 

The Committee recommendation includes $1,523,537,000 for the 

Office of the Director [OD]. Within this total, $544,077,000 is provided for the Common Fund. 

Aging Lungs.—The Committee notes that as the population in 

the United States ages, there is a need for more research data on 

how the aging process affects the lung. The Committee encourages 

NHLBI and NIA to collaborate research efforts in this area. 

Amyloidosis.—The Committee encourages NIH to continue its research efforts into amyloidosis, a group of rare diseases characterized by abnormally folded protein deposits in tissues. Current 

methods of treatment are risky and unsuitable for many patients. 

The Committee asks NIH to keep the Committee informed on the 

steps taken to increase the understanding of the causes of amyloidosis and the measures taken to improve the diagnosis and treatment of this devastating group of diseases. The Committee requests 

an update in the fiscal year 2017 CJ. 

Angiogenesis.—The Committee commends the NIH for holding 

the Trans-NIH Angiogenesis Workshop and understands that recommendations based on the findings of that conference are forthcoming. The Committee urges NIH to implement the recommendations to further angiogenesis research. The Committee understands, as noted in the fiscal year 2015 NIH CJ, that a collection 

of biomarkers needs to be assessed to determine a predictive value 

and to identify responder characteristics for anti-angiogenic and 

pro-angiogenic therapies. The Committee urges the NIH to consider 

the development of a collection of biomarkers to study their correlation with age, sex, ethnicity, and various angiogenesis modifying 

interventions. 

Basic Research.—The Committee urges the Director to continue 

the NIH’s historical focus on the funding and support of basic biomedical research. Basic biomedical research is a critical investment 

in the future health, wealth, and international competitiveness of 

our Nation and plays a vital role in the Nation’s economy. Without 

continued support for this early scientific investigation, future development of treatments and cures will be impossible. The Committee believes that basic biomedical research must remain a key 

component of both the intramural and extramural research portfolio at the NIH. 
102 

Brain Research through Application of Innovative Neuro-technologies [BRAIN] Initiative.—The Committee continues to strongly 

support the BRAIN initiative. The bill provides the full President’s 

request of $135,381,000, an increase of $70,000,000 above fiscal 

year 2015, to be pooled from various ICs. 

Burden of Disease.—The Committee expects NIH to consider the 

burden of a disease when setting priorities and developing strategic 

plans across its Institutes and Centers. Diseases such as Alzheimer’s, diabetes, heart disease, and cancer affect a large portion 

of the population, especially the aging population. Impact of these 

diseases on patients and their families are substantial and costly. 

Targeting biomedical research funding toward these diseases is an 

important strategy to finding better treatments and cures. 

Cannabidiol Research.—The Committee recognizes the potential 

therapeutic benefits that marijuana and its components may bring 

to patients with serious medical conditions, including seizures, 

multiple sclerosis, Parkinson’s disease, Alzheimer’s, substance use 

disorders, and neuropathic and cancer pain. The Committee encourages NIH to coordinate a multi-Institute approach to increase 

research related to potential therapeutic benefits of marijuana and 

its components, specifically cannabidiol. The Committee requests 

an update in the fiscal year 2017 congressional justification on the 

status of research related to this topic. 

Doctors of Veterinary Medicine [DVMs] and Loan Repayment Programs.—The Committee recognizes the important role that DVMs 

play in the biomedical research enterprise because of their background and training in disease processes across all animals, including cross-species virus transmission, and animal models. DVMs 

participate on clinical research teams and are eligible in that capacity for loan repayments under the Clinical Research and Clinical Research for Individuals from Disadvantaged Backgrounds 

loan repayment programs. NIH is encouraged to make this information more widely known to potential applicants. 

Emergency Care Research.—The Committee encourages NIH to 

give greater consideration to the significance of traumatic injury, 

which is the leading cause of death under age 45. Trauma care, at 

$56,000,000,000 annually, is now the most costly medical condition 

to treat under age 65 in the United States. While the Committee 

appreciates the establishment of an Office of Emergency Care Research [OECR] within NIGMS, with a mission to coordinate and 

foster clinical and translational research and research training for 

the emergency setting, that office does not directly fund research 

grants, but must instead work to coordinate and catalyze efforts 

within other Institutes. The Committee encourages the Director of 

NIH to help the OECR effectively promote an expanded NIH-wide 

research agenda on emergency and trauma care. 

Fibrotic Diseases.—The Committee encourages NIH to continue 

to support research into fibrotic diseases affecting different organs, 

including the lung, liver, kidney, heart, and skin, and to ensure appropriation coordination between its Institutes as they conduct single organ or cross-organ fibrotic disease research. 

Gabriella Miller Kids First Research Act.—The bill provides the 

administration’s full request of $12,600,000. The Committee asks 

that NIH provide information on how it has disbursed the fiscal 
103 

year 2015 funding for the Gabriella Miller Kids First Research Act, 

including any personnel that are responsible for overseeing the allocation of designated research dollars, the criteria that NIH employed to ensure awards will advance the objectives of the act, and 

a description of the research projects that were funded at the end 

of fiscal year 2015. Further, the Committee strongly encourages the 

NIH to prioritize research projects relating to childhood cancer 

within the program in fiscal year 2016. 

Genetic Discoveries.—The Committee continues to support NIH 

biomedical research in the area of precision medicine. The Committee encourages NIH to explore the best ways to utilize existing 

large databases, such as those that include large families or are 

tied to genealogical, public health, and medical records. The Committee is particularly interested in the practical application of genetic discoveries, including the development of appropriate data 

analytic tools to make discoveries using genetic data and the discovery of potentially pivotal pathways involved in chronic diseases 

for which novel medicines could be developed. 

Gestational Diabetes.—The Committee recognizes the importance 

of research funded by the NIH related to gestational diabetes, a 

disease affecting 18 percent of all pregnant women. Given that both 

women with gestational diabetes and their babies face long-term 

health consequences as a result of this disease, such as increased 

risk of developing type 2 diabetes, the Committee urges NIH to explore additional opportunities for research on gestational diabetes. 

Government-Wide Collaborations.—NIH, VA, and DOD collaborate frequently and successfully on various research activities. The 

Committee looks forward to the report in the fiscal year 2017 CJ 

focusing on the cooperative and strategic approach the agencies 

take in areas of biomedical research that overlap to maximize the 

potential of the research. 

Hereditary Hemorrhagic Telangiectasia [HHT].—HHT is a genetic disorder that can result in life-threatening strokes and other 

complications, but if diagnosed in time is very treatable and manageable. The Committee encourages multiple NIH Institutes and 

Centers, including NINDS, NHLBI, NICHD, NHGRI, NIDDK, 

NIBIB, and NCATS, to explore collaborative research opportunities 

into improvements for diagnosis and early intervention of HHT and 

treatment of its manifestations. 

Interstitial Cystitis [IC].—IC disproportionately impacts women 

and is prevalent in approximately 6 percent of women in the 

United States. The Committee commends the Office of Women’s 

Health for supporting research on IC and encourages ORWH to 

continue to prioritize IC research. 

Lymphatic Research and Disease.—The Committee once again 

commends the trans-NIH Coordinating Committee for Lymphatic 

Research. The Committee encourages NIH to consider supporting 

extramural interdisciplinary research training programs relevant 

to the lymphatic system in health and disease, and opportunities 

to incorporate reviewer expertise in lymphatic biology/disease in 

the pertinent standing and special study sections within the Center 

for Scientific Review. 

Minority Research.—The Committee applauds the NIH Director’s 

efforts to reverse the trend of underrepresentation of researchers 
104 

from ethnically diverse backgrounds. The Committee encourages 

NIH to continue newly established programs to enhance NIH-funded workforce diversity. 

Mitochondrial Diseases.—Mitochondrial Diseases are now recognized by most clinicians as a major health issue given the essential 

role of impaired mitochondrial function in aging and degenerative 

diseases such as Parkinson’s, diabetes, and hearing loss. It is recognized that research into Mitochondrial Disease provides a window 

into understanding and treating many conditions that afflict large 

segments of the population. The Committee believes that the NIH 

might advance research in this field through the following steps: 

(1) implement, as feasible the recommendations contained in the 

White Paper developed by the March 2012 workshop on 

Translational Research in Mitochondrial Disease; (2) maintain sustained support for the North American Mitochondrial Disease Consortium; (3) support investigator-initiated and collaborative pharmaceutical clinical trials on an increasing cadre of candidate drugs 

that meet funding paylines; and (4) follow up on the December 

2014 workshop on dietary supplements and medical foods in the 

treatment of primary mitochondrial disorders by supporting research on novel, safe, and effective nutritional interventions for 

mitochondrial disease. 

Muscular Dystrophy.—The Committee is aware that amendments 

to the Muscular Dystrophy CARE Act were enacted into law in 

2014 and requests an update from NIH on the implementation of 

the updated provisions, particularly a plan to expand research into 

bone health and endocrine-functioning. The Committee also requests that NIH provide an update on its plans to finalize and implement an updated Action Plan for the Muscular Dystrophies. 

National Children’s Study [NCS].—In December 2014, the NIH 

Director, following the advice of the Advisory Committee to the Director, ended the NCS—a longitudinal study that would have followed 100,000 children from before birth to age 21. The decision 

came after $1.3 billion in Federal investment, and was based on 

the Advisory Committee’s conclusion that the NCS, as planned, 

was not feasible and unlikely to achieve its goals, findings the 

Committee considers deeply troubling. The NCS was authorized to 

(1) gather data from birth to adulthood to evaluate environmental 

influences on diverse populations of children; (2) consider health 

disparities among children; and (3) incorporate behavioral, emotional, educational, and contextual consequences to enable complete 

assessments of the physical, chemical, biological, and psychosocial 

environmental influences on children’s well-being. The discontinuation of the NCS is a significant setback as the NCS had the potential to add substantially to scientific knowledge about the impact 

of environmental exposures on children’s health and development 

in the United States. The Committee urges NIH to recalibrate and 

realign the investment already made in the NCS to initiate new 

and focus existing longitudinal studies to address the objectives 

identified for the NCS. The NIH should rely upon a formal scientific advisory mechanism to coordinate efforts across studies. The 

research efforts should incorporate expertise in population health 

and environmental epidemiology, integrate basic science, and leverage maternal/infant cohorts. For example, it is important to thor-
105 

oughly examine pathways linking chronic and intermittent exposures to the physical and social environments to adverse health 

and developmental outcomes in children. It is also important to 

study the intertwined biological, behavioral, and social transmission of obesity and obesity-related risk factors across generations and to test intergenerational, exposure-disease associations 

by linking maternal and infant/child data. 

Neurofibromatosis [NF].—The Committee supports efforts to enhance research for NF at multiple NIH Institutes, including NCI, 

NINDS, NIDCD, NHLBI, NICHD, and NEI. Children and adults 

with NF are at significant risk for the development of many forms 

of cancer; the Committee encourages NCI to continue its NF research efforts in fundamental basic science, translational research, 

and clinical trials focused on NF. The Committee also encourages 

the NCI to continue to support the development of NF preclinical 

mouse models and NF-associated tumor sequencing efforts. Since 

NF2 accounts for approximately 5 percent of genetic forms of deafness, and NF1 can cause vision loss due to optic gliomas, the Committee encourages NIDCD and NEI to expand their investment in 

NF1 and NF2 basic and clinical research. 

Next Generation Research Initiative.—The National Academy of 

Sciences [NAS] will conduct an evaluation of the legislative, administrative, educational, and cultural barriers to providing for a successful next generation of researchers to be completed no later than 

1 year after the date of enactment of this act. The Committee appropriates $1,200,000 for this purpose. The Committee directs the 

NAS to submit to the Director of NIH and the Committees on Appropriations of the House and Senate the results of the study 

which shall include: (A) an evaluation of the legislative, administrative, educational, and cultural barriers faced by the next generation of researchers; (B) an evaluation of the impact of Federal 

budget constraints on the next generation of researchers; and (C) 

recommendations for the implementation of policies to incentivize, 

improve entry into, and sustain careers in research for the next 

generation of researchers, including proposed policies for agencies 

and academic institutions. 

Non-Recurring Expenses Fund [NEF].—Created in fiscal year 

2008, the NEF permits HHS to transfer unobligated balances of expired discretionary funds into the NEF account for capital acquisitions including information technology and facilities infrastructure. 

Unfortunately, the Department has chosen to use the majority of 

NEF funding over the past several years to supplement funding for 

the Affordable Care Act. Therefore, the Committee includes modified bill language directing funding from the NEF to be expended 

only by the NIH for carrying out section 301 and title IV of the 

PHS Act with respect to biomedical research. According to the Department and past expenditures of the NEF, approximately 

$650,000,000 should be available in fiscal year 2016. NEF funding 

shall be transferred to and merged with the accounts for the various Institutes and Centers and the Office of the Director in proportion to their shares of total NIH appropriations made by this 

act. The NIH shall provide in the fiscal year 2017 CJ actual expenditures from the NEF in fiscal year 2016. 
106 

Pediatric Research Data Collection.—The inclusion of children 

and older populations in clinical research is essential to ensure 

that these groups benefit from important scientific advances. The 

Committee is aware that NIH has had a formal policy mandating 

the inclusion of children in research relevant to child health since 

1998. The Committee recognizes that without a better understanding of age in clinical research, Congress is unable to fully exercise its oversight role and researchers are unable to determine 

whether children as a whole, particular pediatric subpopulations, 

or older populations, are underrepresented in federally funded biomedical research. Using data systems available, the Committee directs NIH to collect, assess, and report publicly information about 

the inclusion of individuals from appropriate age groups throughout the lifespan and on relevant gaps in pediatric and older population involvement in the NIH portfolio of clinical research. 

Pharmaceutical Development Section [PDS].—The Committee is 

concerned about recent reports of unsafe manufacturing practices 

and quality control procedures at NIH’s PDS that were first 

brought to light by a whistleblower. To its credit, as soon as it became aware of the problems in PDS, the NIH Director acted quickly to suspend the section’s operations and determine whether any 

patients were harmed. The agency is investigating further the section’s practices, as well as assessing whether it should continue to 

provide these services in-house or through contracts with outside 

vendors. The Committee will continue to closely monitor NIH’s 

next steps as it continues its analysis. 

Phelan-McDermid Syndrome.—The Committee is pleased that 

the NIH convened a multi-Institute meeting earlier this year to 

discuss collaborative research efforts into gaining a better understanding of Phelan-McDermid Syndrome, a genetic disorder that 

can lead to autism, epilepsy, and other neurological conditions. The 

Committee supports similar future discussions which may advance 

research into this disorder and other ‘‘shankopathies’’ that result in 

the deletions, duplications, and mutations of the SHANK1, 

SHANK2, and SHANK3 genes. Research into the SHANK genes 

holds great promise for gaining a better understanding of more 

prevalent conditions, including intellectual and developmental disorders, autism, ADHD, schizophrenia, bipolar disorder, epilepsy, 

and dementia. 

Physician-Scientist Workforce Report Implementation.—Last year 

the Physician-Scientist Workforce Working Group, which was 

charged with analyzing the current composition and size of the 

physician-scientist biomedical workforce and to make recommendations to sustain and strengthen this group, released its report with 

specific recommendations that impact veterinarian-scientists. A 

committee has been convened to determine how this report’s recommendations should be implemented at NIH. The Committee 

would like NIH to report on the implementation status of this report’s recommendations in the fiscal year 2017 CJ. 

Precision Medicine.—The Committee recommendation strongly 

supports the new Precision Medicine Initiative and has provided 

$70,000,000 to NCI and $130,000,000 to various Institutes and 

Centers in support of this Initiative. The Committee looks forward 

to NIH providing further details and information on the Initiative 
107 

as the Working Group of the Advisory Committee to the NIH Director reports in September 2015. In particular, as further details 

are developed, the Committee remains particularly interested in 

short and long-term milestones of the program and expects these 

milestones to be specified in the fiscal year 2017 CJ. 

Research Facilities.—Much of the Nation’s biomedical research 

infrastructure, including laboratories and research facilities at academic institutions and nonprofit research organizations, is outdated or insufficient. For taxpayers to receive full value from their 

considerable investments in biomedical research, researchers must 

have access to appropriate research facilities. $50,000,000 is provided for grants or contracts to public, nonprofit, and not-for-profit 

entities to expand, remodel, renovate, or alter existing research facilities or construct new research facilities as authorized under 42 

U.S.C. section 283k. The Committee urges NIH to consider recommendations made by the NIH Working Group on Construction 

of Research Facilities, including making awards that are large 

enough to underwrite the cost of a significant portion of newly constructed or renovated facilities. 

Science Education.—The Science Education Partnership Awards 

[SEPA] foster important connections between biomedical researchers and K–12 teachers and their students. These connections establish an education pipeline to careers in biomedical sciences, which 

is one of the most important areas of workforce development for 

the U.S. economy. Therefore, NIH is directed to continue funding 

the SEPA program at no less than last year’s level. 

Sickle Cell Disease [SCD].—SCD is an inherited disorder affecting red blood cells that impacts approximately 100,000 individuals, 

the great majority of whom are African American. Currently, there 

is only one FDA-approved medication for treatment and there is no 

universal cure. The Committee encourages the NIH to create a 

Trans-NIH program focusing on SCD and fund interdisciplinary research initiatives at hospitals and universities experienced in treating SCD patients. 

Sleep and Circadian Disorders.—The Committee recognizes the 

immense public health burden of sleep and circadian disorders and 

encourages the Office of the Director to foster collaboration on sleep 

and circadian research across ICs and to support NCSDR efforts to 

coordinate this important research. 

Small Business Innovation Research.—The Committee encourages NIH to consider new clinical indications that leverage developed devices when soliciting proposals and awarding funds through 

competitive grant programs, including the Small Business Innovation Research program. 

Spina Bifida.—The Committee encourages NIDDK, NICHD, and 

NINDS to study the causes and care of the neurogenic bladder and 

kidney disease to support research to address issues related to the 

treatment and management of Spina Bifida and associated secondary conditions, such as hydrocephalus; and to understand the 

myriad co-morbid conditions experienced by children with Spina 

Bifida, including those associated with both paralysis and developmental delay. 

Temporomandibular Disorders [TMD].—Temporomandibular Disorders affect approximately 35 million Americans; the majority af-
108 

fected are women in their childbearing years. The Committee encourages NIBIB, NIAMS, and NIDCR to consider the recommendations that resulted from their jointly sponsored Roundtable on the 

Temporomandibular Joint in Health and Disease in 2013. Research 

to develop safe and effective techniques for joint repair and regeneration is essential. An analysis of problems associated with current joint replacements should provide guidance in these efforts. 

The Committee commends NIDCR for its ongoing support for the 

OPPERA program, which is yielding valuable information on many 

physiological aspects, not only of temporomandibular disorders, but 

of other pain conditions that overlap with TMD. To capitalize on 

the research to continue the momentum gained from OPPERA, the 

Committee urges NIH to continue research of this caliber and direction, and to consider measures to encourage NIH-funded investigators from related fields to include TMD and comorbid conditions in their studies. 

Tuberous Sclerosis Complex [TSC].—The Committee continues to 

encourage NIH to coordinate a multi-Institute approach to finding 

a cure for TSC. NINDS and NCATS should play leading roles, 

given the promising translational potential of new therapeutics for 

treating the neurological conditions of TSC, including autism and 

epilepsy. The Committee encourages NINDS to lead the development of NIH programs to implement consensus recommendations 

developed at the NIH-sponsored TSC workshop, ‘‘Unlocking Treatments for TSC: 2015 Strategic Plan.’’ 

Usher Syndrome.—As the most common cause of combined deafness and blindness, Usher syndrome is an important research area 

for multiple NIH Institutes. The Committee commends NIH for including Usher syndrome on the Estimates of Funding for Various 

Research, Condition, and Disease Categories list to track the annual support level of this rare disease. The Committee urges NIH 

to prioritize Usher syndrome research at NIDCD and NEI. The 

Committee requests an update in the fiscal year 2017 CJ on the 

planned and on-going activities related to this syndrome, including 

the manner in which various ICs coordinate on common goals and 

objectives. 

BUILDINGS AND FACILITIES

Appropriations, 2015 ............................................................................. $128,863,000 

Budget estimate, 2016 ........................................................................... 128,863,000 

Committee recommendation ................................................................. 128,863,000 

The Committee recommendation includes $128,863,000 for NIH 

buildings and facilities. This funding will remain available for obligation for 5 years. The budget request proposes making the funding available until expended. 

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

The Committee recommends $3,460,484,000 for the Substance 

Abuse and Mental Health Services Administration [SAMHSA]. The 

recommendation includes $133,667,000 in transfers available under 

section 241 of the PHS Act and $12,000,000 in transfers from the 

PPH Fund. 
109 

SAMHSA is responsible for supporting mental health programs 

and alcohol and other drug abuse prevention and treatment services throughout the country, primarily through categorical grants 

and block grants to States. 

Furthermore, racial and ethnic minorities continue to have higher rates of HIV/AIDS compared to the overall U.S. population. 

Therefore, the Committee urges SAMHSA to continue to prioritize 

all HIV/AIDS funding to target racial and ethnic minority communities. 

The Committee recommendation continues bill language that instructs the Administrator of SAMHSA and the Secretary to exempt 

the Mental Health Block Grant [MHBG] and the Substance Abuse 

Prevention and Treatment [SAPT] Block Grant from being used as 

a source for the PHS evaluation set-aside in fiscal year 2016, as 

was done prior to fiscal year 2012. 

MENTAL HEALTH

Appropriations, 2015 ............................................................................. $1,078,975,000 

Budget estimate, 2016 ........................................................................... 1,077,667,000 

Committee recommendation ................................................................. 1,054,340,000 

The Committee recommends $1,054,340,000 for mental health 

services. The recommendation includes $21,039,000 in transfers 

available under section 241 of the PHS Act and $12,000,000 in 

transfers from the PPH Fund. Included in the recommendation is 

funding for programs of regional and national significance [PRNS], 

the MHBG, children’s mental health services, Projects for Assistance in Transition from Homelessness [PATH], and Protection and 

Advocacy for Individual with Mental Illness [PAIMI]. 

SAMHSA is the lead HHS agency responsible for the Federal 

Government’s efforts in combating mental health issues. According 

to SAMHSA, 43,800,000 adults in the United States suffered from 

a mental illness in 2013, 10,000,000 of these adults suffered from 

a serious mental illness. The Committee is disappointed and deeply 

concerned about the findings in two recent GAO reports (GAO–15– 

113 and GAO–15–405) issued in February and May of 2015, respectively, regarding SAMHSA’ mental health programs. The reports 

detailed many critical failures at SAMSHA in leading and overseeing our Nation’s mental health programs. 

The February report specifically highlighted the lack of highlevel coordination between agency leaders that operate mental 

health programs and the absence of oversight in ensuring the evaluations of these programs. Without proper coordination at the leadership level, taxpayers are funding a mixture of mental health programs across several agencies with no overall objective. These programs are ultimately duplicative, fragmented, or overlapping with 

each other’s activities. 

In the May GAO report, SAMHSA failed to document how it applied its own grant criteria before making awards to grantees, and 

the report stated that SAMSHA was missing various pieces of documentation used to oversee the programs. Without the proper 

grant documentation, SAMSHA cannot provide proper oversight of 

its programs to ensure that they are effective and beneficial to individuals with a mental illness. However, the most concerning issue 

pointed out by GAO is that SAMHSA acknowledged they followed 
110 

the Department’s grants manual. The Committee is concerned that 

SAMHSA either may not fully understand the Department’s grants 

manual, or there is a serious lack of training among SAMSHA’s 

grants staff. 

The Committee directs the administrator of SAMHSA to work 

with GAO in implementing the recommendations provided in the 

GAO reports. The Committee expects a detailed update and 

timeline on the progress of these recommendations 90 days after 

enactment of this act. Furthermore, the Committee directs 

SAMHSA to develop a grants compliance plan that will ensure that 

SAMSHA’s grants process is in accordance with the Department’s 

grants manual. The compliance plan shall include periodic, and 

random, internal audits of grant files to confirm all the necessary 

documentation are accounted for and that the compliance plan is 

meeting its objectives. Furthermore, SAMHSA shall provide any 

additional grants training necessary to prevent these issues from 

arising in the future. 

Programs of Regional and National Significance 

The Committee recommends $378,597,000 for PRNS within the 

Center for Mental Health Services [CMHS]. The Committee recommendation includes $12,000,000 in transfers to PRNS from the 

PPH Fund. These programs address priority mental health needs 

by developing and applying evidence-based practices, offering training and technical assistance, providing targeted capacity expansion 

grants, and changing the delivery system through family, client-oriented, and consumer-run activities. 

Within the total provided for PRNS, the Committee recommendation includes funding for the following activities: 

[In thousands of dollars] 

Budget activity Fiscal year 2015 

appropriation 

Fiscal year 2016 

request 

Committee recommendation 

CAPACITY: 

Seclusion & Restraint ........................................................... 1,147 1,147 1,147 

Youth Violence Prevention .................................................... 23,099 23,099 23,099 

Project AWARE State Grants ................................................. 39,902 39,902 39,902 

Mental Health First Aid ........................................................ 14,963 14,963 14,963 

Mental Health First Aid for Veterans’ Families .................... ............................ 4,000 ............................

Healthy Transitions ............................................................... 19,951 19,951 19,951 

National Traumatic Stress Network ...................................... 45,887 45,887 45,887 

Children and Family Programs ............................................. 6,458 6,458 6,458 

Consumer and Family Network Grants ................................. 4,954 4,954 4,954 

MH System Transformation and Health Reform ................... 3,779 3,779 3,779 

Project LAUNCH ..................................................................... 34,555 34,555 34,555 

Primary and Behavioral Health Care Integration ................. 49,877 26,004 49,877 

National Strategy for Suicide Prevention ............................. 2,000 4,000 2,000 

Suicide Lifeline ..................................................................... 7,198 7,198 7,198 

GLS—Youth Suicide Prevention—States ............................. 35,427 35,427 35,427 

GLS—Youth Suicide Prevention—Campus .......................... 6,488 6,488 6,488 

AI/AN Suicide Prevention Initiative ....................................... 2,931 2,931 2,931 

Homelessness Prevention Programs ..................................... 30,696 30,696 30,696 

Tribal Behavioral Grants ....................................................... 4,988 15,000 4,988 

Minority AIDS ......................................................................... 9,224 15,935 9,224 

Grants for Adult Treatment, Screening, and Brief 

Response .......................................................................... ............................ 2,896 ............................

Crisis Systems ...................................................................... ............................ 5,000 ............................

Criminal and Juvenile Justice Programs .............................. 4,269 4,269 4,269 

SCIENCE AND SERVICE: 

GLS—Suicide Prevention Resource Center .......................... 5,988 5,988 5,988 
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[In thousands of dollars] 

Budget activity Fiscal year 2015 

appropriation 

Fiscal year 2016 

request 

Committee 

recommendation 

Practice Improvement and Training ..................................... 7,828 7,828 7,828 

Primary and Behavioral Health Care Integration TA ............ 1,991 1,996 1,991 

Consumer & Consumer Support TA Centers ........................ 1,918 1,918 1,918 

Minority Fellowship Program ................................................. 8,059 ............................ 8,059 

Disaster Response ................................................................ 1,953 1,953 1,953 

Homelessness ........................................................................ 2,296 2,296 2,296 

HIV/AIDS Education ............................................................... 771 771 771 

Access to Mental Health Services for Veterans.—The Committee 

is aware of the success achieved in localities that use locally customized web portals to assist veterans struggling with mental and 

substance use issues. These portals provide veterans with a directory of local mental health providers and services in addition to all 

military and VA funded programs. They also provide quick access 

to local crisis intervention and emergency care programs; comprehensive job search and support; a peer social networking platform, and personal health records. The Committee encourages 

SAMHSA to expand and maintain the capacity of locally customized internet-based Web portals nationwide. 

Primary and Behavioral Healthcare Integration.—The Committee 

provides funding for this program through budget authority rather 

than through transfers from the PPH Fund as requested by the administration. The Committee continues to direct SAMHSA to ensure that new Integration grants awarded for fiscal year 2016 are 

funded under the authorities in section 520K of the PHS Act. 

Community Mental Health Services Block Grant 

The Committee recommends $482,571,000 for the MHBG. The 

recommendation includes $21,039,000 in transfers available under 

section 241 of the PHS Act. 

The MHBG distributes funds to 59 eligible States and territories 

through a formula based on specified economic and demographic 

factors. Grant applications must include an annual plan for providing comprehensive community mental health services to adults 

with a serious mental illness and children with a serious emotional 

disturbance. 

The Committee recommendation continues bill language requiring that at least 5 percent of the funds for the MHBG program be 

set-aside for evidence-based programs that address the needs of individuals with early serious mental illness, including psychotic disorders. The Committee commends SAMHSA for its collaboration 

with NIMH on the implementation of this set-aside. The Committee notes that it usually takes 17 years to translate research 

findings into practice, and hopes that this joint effort between 

NIMH and SAMHSA may be a model for how to reduce this timeframe. The Committee directs SAMHSA to continue its collaboration with NIMH to ensure that funds from this set-aside are only 

used for programs showing strong evidence of effectiveness and targets the first episode of psychosis. SAMHSA shall not expand the 

use of the set-aside to programs outside of the first episode psychosis. The Committee directs SAMHSA to include in the fiscal 

year 2017 CJ a detailed table showing at a minimum each State’s 
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allotment, name of the program being implemented, and a short 

description of the program. 

Children’s Mental Health Services 

The Committee recommends $117,026,000 for the Children’s 

Mental Health Services program. This program provides grants 

and technical assistance to support comprehensive, communitybased systems of care for children and adolescents with serious 

emotional, behavioral, or mental disorders. Grantees must provide 

matching funds and services must be coordinated with the educational, juvenile justice, child welfare, and primary healthcare systems. 

Projects for Assistance in Transition From Homelessness 

The Committee recommends $40,000,000 for PATH, which addresses the needs of individuals with serious mental illness who 

are experiencing homelessness or are at risk of homelessness. 

Funds are used to provide an array of services, such as screening 

and diagnostic services, emergency assistance, case management, 

and referrals to the most appropriate housing environment. 

Protection and Advocacy for Individuals With Mental Illness 

The Committee recommends $36,146,000 for PAIMI. This program helps ensure that the rights of mentally ill individuals are 

protected while they are patients in all public and private facilities, 

or while they are living in the community, including in their own 

homes. Funds are allocated to States according to a formula based 

on population and relative per capita incomes. 

SUBSTANCE ABUSE TREATMENT

Appropriations, 2015 ............................................................................. $2,183,858,000 

Budget estimate, 2016 ........................................................................... 2,140,557,000 

Committee recommendation ................................................................. 2,054,116,000 

The Committee recommends $2,054,116,000 for substance abuse 

treatment programs, including programs of regional and national 

significance and the substance abuse prevention and treatment 

block grant to the States. The recommendation includes 

$81,200,000 in transfers available under section 241 of the PHS 

Act. 

Programs of Regional and National Significance 

The Committee recommends $284,260,000 for PRNS within the 

Center for Substance Abuse Treatment [CSAT]. The recommendation includes $2,000,000 in transfers available under section 241 of 

the PHS Act. 

Programs of regional and national significance include activities 

to increase capacity by implementing service improvements using 

proven evidence-based approaches as well as science-to-services activities that promote the identification of practices thought to have 

potential for broad service improvement. 

Within the total provided for PRNS, the Committee recommendation includes funding for the following activities: 
113 

[In thousands of dollars] 

Budget activity Fiscal year 2015 

appropriation 

Fiscal year 2016 

request 

Committee 

recommendation 

CAPACITY: 

Opioid Treatment Programs/Regulatory Activities ................ 8,724 8,724 8,724 

Screening, Brief Intervention, Referral, & Treatment ........... 46,889 30,000 30,000 

Target Capacity Expansion ................................................... 23,223 36,303 29,223 

Medicated Assisted Treatment for Prescription Drug 

and Opioid Addiction (non-add) ............................. 12,000 25,000 18,000 

Pregnant & Postpartum Women ........................................... 15,931 15,931 15,134 

Strengthening Treatment Access and Retention .................. 1,000 1,000 ............................

Recovery Community Services Program ................................ 2,434 2,434 2,312 

Access to Recovery ............................................................... 38,223 ............................ ............................

Primary Care and Addiction Services Integration ................ ............................ 20,000 ............................

Children and Families .......................................................... 29,605 29,605 28,125 

Treatment Systems for Homeless ......................................... 41,386 41,386 39,317 

Minority AIDS ......................................................................... 65,570 58,859 58,859 

Criminal Justice Activities .................................................... 78,000 61,946 61,946 

SCIENCE AND SERVICE: 

Addiction Technology Transfer Centers ................................ 9,046 8,081 8,081 

Crisis Systems ...................................................................... ............................ 5,000 ............................

Minority Fellowship Program ................................................. 2,539 ............................ 2,539 

Special Initiatives/Outreach .................................................. 1,432 1,432 ............................

Access to Recovery.—The Committee eliminates the Access to Recovery program as proposed by the administration. Activities related to wrap-around treatment services, such as transportation, 

housing, and job support are available through other funding 

sources, including SAMHSA’s Substance Abuse Prevention and 

Treatment block grants. 

Oral Fluid Guidelines.—The Committee commends SAMSHA for 

the progress made on issuing oral fluid guidelines for the Federal 

Workplace Drug Testing Programs and supports the development 

of oral fluid as an alternative specimen for drug testing. The Committee urges SAMSHA to publish the guidelines expeditiously and 

to implement the guidelines in partnership with stakeholders. 

Viral Hepatitis Screening.—The Committee applauds SAMSHA 

for encouraging grantees to screen for viral hepatitis, including the 

use of innovative strategies like rapid testing and urges SAMSHA 

to continue these efforts. 

Addiction Technology Transfer Centers [ATTCs].—The Committee continues to direct SAMHSA to ensure that ATTCs maintain a primary focus on addiction treatment and recovery services. 

Combating Opioid Abuse.—Of the amount provided for Targeted 

Capacity Expansion, the Committee recommendation includes 

$18,000,000 for discretionary grants to States for the purpose of expanding treatment services to those with heroin or opioid dependence. The Committee directs CSAT to ensure that these grants include as an allowable use the support of medication assisted treatment and other clinically appropriate services. These grants should 

target States with the highest rates of admissions and that have 

demonstrated a dramatic increase in admissions for the treatment 

of opioid use disorders. 

Drug Treatment Courts.—The Committee continues to direct 

SAMHSA to ensure that all funding appropriated for Drug Treatment Courts is allocated to serve people diagnosed with a substance use disorder as their primary condition. The Committee expects CSAT to ensure that non-State substance abuse agency appli-
114 

cants for any drug treatment court grant in its portfolio continue 

to demonstrate extensive evidence of working directly and extensively with the corresponding State substance abuse agency in the 

planning, implementation, and evaluation of the grant. 

Screening, Brief Intervention, and Referral to Treatment 

[SBIRT].—The Committee continues to direct SAMHSA to ensure 

that funds provided for SBIRT are used for existing evidence-based 

models of providing early intervention and treatment services to 

those at risk of developing substance abuse disorders. 

Substance Abuse Prevention and Treatment Block Grant 

The Committee recommends $1,769,856,000 for the SAPT block 

grant. The recommendation includes $79,200,000 in transfers available under section 241 of the PHS Act. The block grant provides 

funds to States to support alcohol and drug abuse prevention, 

treatment, and rehabilitation services. Funds are allocated to 

States according to a formula. 

Formula Evaluation.—The Committee understands that States 

are having difficulty interpreting the sources of data used in the 

current formula for the Substance Abuse Prevention and Treatment block grant program. In addition, the formula has not been 

adjusted since 1997 and is overly confusing. States cannot defend 

their positions when SAMHSA does not inform them of the origin 

of the data used for the formula. To increase transparency, the 

Committee directs SAMHSA to include in their fiscal year 2017 CJ 

details on where SAMSHA acquires the data used for the formula 

and how SAMHSA utilizes this information to make funding level 

determinations. It is imperative that SAMHSA uses the most recent and accurate data available and should work with States to 

better understand the best sources for this information. SAMHSA 

shall also include an evaluation on whether the current formula 

should be updated in the future. 

SUBSTANCE ABUSE PREVENTION

Appropriations, 2015 ............................................................................. $175,219,000 

Budget estimate, 2016 ........................................................................... 210,918,000 

Committee recommendation ................................................................. 182,731,000 

The Committee recommends $182,731,000 for the Center for Substance Abuse Prevention [CSAP], the sole Federal organization 

with responsibility for improving accessibility and quality of substance abuse prevention services. 

The Committee directs that all of the money appropriated explicitly for substance abuse prevention purposes both in CSAP’s PRNS 

lines as well as the funding from the 20 percent prevention setaside in the SAPT Block Grant be used only for bona fide substance abuse prevention programs and strategies and not for any 

other purposes. 

Programs of Regional and National Significance 

The Committee provides $182,731,000 for PRNS within CSAP. 

Through these programs, CSAP supports: development of new practice knowledge on substance abuse prevention; identification of 

proven effective models; dissemination of science-based intervention information; State and community capacity building for imple-
115 

mentation of proven, effective substance abuse prevention programs; and programs addressing new needs in the prevention system. 

Within the total provided for PRNS, the Committee recommendation includes funding for the following activities: 

[In thousands of dollars] 

Budget activity Fiscal year 2015 

appropriation 

Fiscal year 2016 

request 

Committee 

recommendation 

CAPACITY: 

Strategic Prevention Framework/Partnership for Success .... 109,484 118,254 114,984 

Strategic Prevention Framework Rx (non-add) ............ ............................ 10,000 5,500 

Grants to Prevent Prescription Drug/Opioid Overdose ......... ............................ 12,000 6,000 

Mandatory Drug Testing ....................................................... 4,894 4,894 4,894 

Minority AIDS ......................................................................... 41,205 41,205 39,145 

Sober Truth on Preventing Underage Drinking (STOP Act) .. 7,000 7,000 6,650 

National Adult-Oriented Media Public Service Campaign ....................................................................... 1,000 1,000 950 

Community-based Coalition Enhancement Grants ...... 5,000 5,000 4,750 

ICCPUD ......................................................................... 1,000 1,000 950 

Tribal Behavioral Health Grants ........................................... ............................ 15,000 ............................

SCIENCE AND SERVICE: 

Fetal Alcohol Spectrum Disorder .......................................... 1,000 1,000 ............................

Center for the Application of Prevention Technologies ........ 7,493 7,493 7,119 

Science and Service Program Coordination ......................... 4,072 4,072 3,868 

Minority Fellowship Program ................................................. 71 ............................ 71 

Combating Opioid Abuse.—The Committee provides $6,000,000 

for grants to prevent opioid overdose related deaths. As part of the 

new initiative to Combat Opioid Abuse, this new program will help 

States equip and train first responders with the use of devices that 

rapidly reverse the effects of opioids. The Committee directs 

SAMHSA to ensure applicants outline how proposed activities in 

the grant would work with treatment and recovery communities in 

addition to first responders. Furthermore, the Committee provides 

$5,500,000 for the Strategic Prevention Framework Rx program to 

increase awareness of opioid abuse and misuse in communities. 

Strategic Prevention Framework State Incentive Grant and Partnerships for Success.—The Committee intends that these two programs continue to focus exclusively on: addressing State- and community-level indicators of alcohol, tobacco, and drug use; targeting 

and implementing appropriate universal prevention strategies; 

building infrastructure and capacity; and preventing substance use 

and abuse. 

STOP Act.—The Committee directs that all funds appropriated 

for STOP Act community-based coalition enhancement grants, shall 

be used for making grants to eligible communities, and not for any 

other purposes or activities. 

HEALTH SURVEILLANCE AND PROGRAM SUPPORT

Appropriations, 2015 ............................................................................. $181,660,000 

Budget estimate, 2016 ........................................................................... 235,145,000 

Committee recommendation ................................................................. 169,297,000 

The Committee recommends $169,297,000 for Health Surveillance and Program Support activities. The recommendation includes $31,428,000 in transfers available under section 241 of the 

PHS Act. 
116 

This activity supports Federal staff and the administrative functions of the agency. It also provides funding to SAMHSA’s surveillance and data collection activities, including national surveys such 

as the National Survey on Drug Use and Health. 

Within the total provided for Health Surveillance and Program 

Support, the Committee recommendation includes funding for the 

following activities: 

[In thousands of dollars] 

Budget activity Fiscal year 2015 

appropriation 

Fiscal year 2016 

request 

Committee 

recommendation 

Health Surveillance ........................................................................ 47,258 49,428 44,895 

Program Management .................................................................... 72,002 79,559 68,402 

Performance & Quality Information Systems ................................ 12,918 12,918 10,000 

Public Awareness and Support ...................................................... 13,482 15,571 10,000 

Peer Professional Workforce Development ..................................... ............................ 10,000 ............................

Behavioral Health Workforce Education and Training Program .... 35,000 56,000 35,000 

Minority Fellowship Program .......................................................... ............................ 10,669 ............................

Behavioral Health Workforce Data ................................................. 1,000 1,000 1,000 

The Committee does not include bill language requested by the 

administration that would provide additional transfer authority to 

the Administrator beyond that which is already provided to the 

Secretary. 

Behavioral Health Workforce Education and Training.—The 

Committee is concerned about the uneven distribution of funds 

among specialties resulting from the initial grant competition in 

2014. Therefore, the Committee directs SAMHSA and HRSA to ensure that funding is distributed relatively equally among the participating health professions, including paraprofessionals, master’s 

level social workers, counselors, marriage and family therapists, 

and doctoral psychology interns. The Committee directs SAMHSA 

and HRSA to consider other strategies to achieve this relative distribution such as issuing separate funding opportunity announcements for each participating health profession. In addition, the 

Committee directs SAMHSA and HRSA to include doctoral psychology schools in the funding opportunities to support doctoral 

level students completing their practicums which are necessary to 

move on to internships. SAMHSA and HRSA shall award meritorious applications for doctoral psychology interns first, before doctoral psychology schools applying to support practicums. 

Minority Fellowship Program.—The Committee maintains the 

separate accounts for the Minority Fellowship Programs at the 

Center for Mental Health Services, Center for Substance Abuse 

Prevention, and the Center for Substance Abuse Treatment like in 

previous fiscal years and does not consolidate them as proposed by 

SAMHSA. Therefore, funding for these programs are reflected in 

the tables for each of the centers. 

AGENCY FOR HEALTHCARE RESEARCH AND QUALITY

Appropriations, 2015 ............................................................................. $363,698,000 

Budget estimate, 2016 ........................................................................... 363,698,000 

Committee recommendation ................................................................. 236,001,000 

The Committee provides $236,001,000 for the Agency for 

Healthcare Research and Quality [AHRQ]. AHRQ was established 

in 1990 to enhance the quality, appropriateness, and effectiveness 
117 

of health services, as well as access to such services. AHRQ conducts, supports, and disseminates scientific and policy-relevant research on topics such as promoting high-quality care, eliminating 

healthcare disparities, using information technology, and evaluating the effectiveness of clinical services. 

HEALTH COSTS, QUALITY, AND OUTCOMES

The Committee provides $151,428,000 for research on health 

costs, quality, and outcomes [HCQO]. The HCQO research activity 

is focused upon improving clinical practice, improving the 

healthcare system’s capacity to deliver quality care, and tracking 

progress toward health goals through monitoring and evaluation. 

Within the total provided for HCQO, the Committee recommendation includes funding for the following activities: 

[In thousands of dollars] 

Budget activity Fiscal year 2015 

appropriation 

Fiscal year 2016 request Committee recommendation 

Prevention/Care Management ........................................................ 11,590 11,649 8,113 

Health Information Technology ...................................................... 28,170 22,877 19,719 

Patient Safety Research ................................................................ 76,584 75,977 65,096 

Health Services Research, Data and Dissemination ..................... 112,207 112,274 58,500 

Central-Line Associated Bloodstream Infections [CLABSI].—The 

Committee notes that while much research on preventing CLASBI 

has been dedicated to the exploration of proper line insertion techniques and line management, little attention has been given to the 

relationship between the connectors utilized in central lines and 

rates of infection. The Committee urges AHRQ to examine whether 

neutral fluid displacement needleless connectors have the potential 

to reduce the incidence of CLABSI as compared to positive fluid 

displacement needleless connectors. AHRQ is encouraged to provide a best practice recommendation for the use of such connectors 

in hospital settings. 

Consumer Assessment of Healthcare Providers and Systems 

[CAHPS].—The CAHPS program supports and promotes the assessment of consumers’ experiences with healthcare. Patient experience data in maternity care is currently not regularly and systematically collected. The Committee urges AHRQ to expand its 

current set of surveys and develop a CAHPS survey for maternity 

care. 

Health IT Safety.—The Committee recommendation includes 

$4,000,000 for AHRQ’s work on safe health IT practices specifically 

related to the design, implementation, usability, and safe use of 

health IT systems. The Committee believes this investment will 

generate new evidence regarding safe health IT practices that will 

ultimately be used by ONC, FDA, CMS, and others to inform policy 

interventions. 

Healthcare-Associated Infections.—Within the Patient Safety 

portfolio, the Committee provides $34,000,000, the same level as in 

fiscal year 2015, for healthcare-associated infection activities. Within this funding level, the Committee includes $10,000,000 for activities as part of the CARB initiative. These funds will support the 

development and expansion of antibiotic stewardship programs specifically focused on ambulatory and long-term care settings. In ad-
118 

dition, the Committee directs AHRQ to collaborate with NIH, 

BARDA, CDC, FDA, VA, DOD, and USDA to leverage existing resources to increase capacities for research aimed at developing 

therapeutic treatments, reducing antibiotic use and resistance in 

animals and humans, and implementing effective infection control 

policies. 

Healthcare Delivery Systems.—Within the Patient Safety portfolio, the Committee recommendation includes $8,000,000 for the 

Healthcare Delivery Systems grants, which apply systems engineering methods to improve patient safety and reduce waste in 

healthcare. 

Immunotherapy and Asthma.—The Committee is pleased that 

AHRQ has joined NIH in co-sponsoring a workshop on 

immunotherapy effectiveness. The Committee requests an update 

from AHRQ in the fiscal year 2017 CJ on research that will be undertaken pursuant to the workshop with the goal of identifying patient, healthcare provider, and systems barriers to initiation and 

adherence to allergy immunotherapy and developing interventions 

to address these problems. This report should include information 

on planned AHRQ initiatives pertaining to the utilization of allergy 

immunotherapy to reduce the prevalence of asthma. 

Investigator-Initiated Research.—The Committee believes that investigator-initiated research is important and AHRQ has the ability to improve healthcare with creative, groundbreaking approaches 

to ongoing and emerging healthcare issues through this mechanism. Within the Health Services Research, Data and Dissemination portfolio, the Committee provides $45,882,000 the same level 

as in fiscal year 2015, for investigator-initiated research. The Committee believes that investigator-initiated research should not be 

targeted to any specific area of health services research to generate 

the best unsolicited ideas from the research community about a 

wide variety of topics. 

Malnutrition.—The Committee is aware that several studies suggest that malnourished hospitalized patients have a significantly 

higher incidence of infection, are at increased risk of mortality, 

have longer median lengths of stay, and are more likely to be readmitted. The Committee requests that AHRQ assess the prevalence of malnutrition in U.S. hospitals and report back to the Committee in its fiscal year 2017 CJ. 

Training Grants.—The Committee appreciates AHRQ’s commitment to providing research training and career development grants 

for young investigators. AHRQ is urged to maintain a strong training and career development pipeline for talented researchers. 

MEDICAL EXPENDITURES PANEL SURVEYS

The Committee provides $39,268,000 for Medical Expenditure 

Panel Surveys [MEPS], which collect detailed information annually 

from households, healthcare providers, and employers regarding 

how Americans use and pay for healthcare. The data from MEPS 

are used to develop estimates of healthcare utilization, expenditures, sources of payment, and the degree of health insurance coverage of the U.S. population. 
119 

PROGRAM SUPPORT

The Committee recommends $45,305,000 for program support. 

This activity funds the overall management of AHRQ, including 

salaries, benefits, and overhead costs such as rent. 

CENTERS FOR MEDICARE AND MEDICAID SERVICES

GRANTS TO STATES FOR MEDICAID

Appropriations, 2015 ......................................................................... $234,608,916,000 

Budget estimate, 2016 ...................................................................... 243,545,410,000 

Committee recommendation ............................................................. 243,545,410,000 

The Committee recommends $243,545,410,000 in mandatory 

funding for Grants to States for Medicaid. 

The fiscal year 2016 recommendation excludes $113,272,140,000 

in fiscal year 2015 advance appropriations for fiscal year 2016. As 

requested by the administration, $115,582,502,000 is provided for 

the first quarter of fiscal year 2017. 

The Medicaid program provides medical care for eligible low-income individuals and families. It is administered by each of the 50 

States, the District of Columbia, Puerto Rico, and the territories. 

Federal funds for medical assistance are made available to the 

States according to a formula that determines the appropriate Federal matching rate for State program costs. This matching rate is 

based on the State’s average per capita income relative to the national average and cannot be less than 50 percent. 

PAYMENTS TO HEALTHCARE TRUST FUNDS

Appropriations, 2015 ......................................................................... $259,212,000,000 

Budget estimate, 2016 ...................................................................... 283,171,800,000 

Committee recommendation ............................................................. 283,171,800,000 

The Committee recommends $283,171,800,000 in mandatory 

funding for payments to healthcare trust funds. 

This entitlement account includes the general fund subsidy to 

the Federal Supplementary Medical Insurance Trust Fund for 

Medicare part B benefits and for Medicare part D drug benefits 

and administration, plus other reimbursements to the Federal Hospital Insurance Trust Fund for part A benefits and related administrative costs that have not been financed by payroll taxes or premium contributions. 

The Committee provides $198,530,000,000 for the Federal payment to the Supplementary Medical Insurance Trust Fund. This 

payment provides matching funds for premiums paid by Medicare 

part B enrollees. 

The Committee further provides $82,453,000,000 for the general 

fund share of benefits paid under Public Law 108–173, the Medicare Prescription Drug, Improvement and Modernization Act of 

2003. As in previous years, the Committee includes bill language 

requested by the administration providing indefinite authority for 

paying the general revenue portion of the part B premium match 

and provides resources for the part D drug benefit program in the 

event that the annual appropriation is insufficient. 

The Committee recommendation also includes $691,000,000 to be 

transferred to the Supplementary Insurance Trust Fund as the 
120 

general fund share of part D administrative expenses. The Committee recommendation includes $291,000,000 in reimbursements 

to the HCFAC fund, which reflects the portion of the HCFAC 

spending to be reimbursed by the General Fund. 

PROGRAM MANAGEMENT

Appropriations, 2015 ............................................................................. $3,669,744,000 

Budget estimate, 2016 ........................................................................... 4,245,186,000 

Committee recommendation ................................................................. 3,027,590,000 

The Committee recommends $3,027,590,000 for CMS program 

management, which includes funding for research, program operations, survey and certification programs, and Federal administration. 

Research, Demonstrations and Evaluations 

The Committee recommends $6,900,000 for research, demonstrations, and evaluation activities. The Committee does not provide 

funding for the Medicare Current Beneficiary Survey [MCBS] but 

includes the administration request for the other activities funded 

by this account, such as the Chronic Condition Warehouse and the 

Research Data Assistance Center. 

The administration requested a total of $24,000,000 to support 

the MCBS and expected this to be provided evenly from this account and the Center for Medicare and Medicaid Innovation 

[CMMI] established under the ACA. However, the Committee is 

aware that the ACA provided the CMMI $10,000,000,000 in mandatory funds and that almost $7,000,000,000 still remains unobligated. Due to budgetary constraints, the Committee supports funding the MCBS through the CMMI. 

Program Operations 

The Committee recommends $1,890,823,000 for the Program Operations account, which covers a broad range of activities including 

claims processing and program safeguard activities performed by 

Medicare contractors. These contractors also provide information, 

guidance, and technical support to both providers and beneficiaries. 

The Committee continues to be concerned funds are diverted by 

the administration from CMS’ core mission and function—maintaining the essential operations for the Medicare, Medicaid, and 

Children’s Health Insurance Program—to implement ACA activities. Specifically, with almost 75 million Americans in the baby 

boom generation and approximately 10,000 of them turning 65 

years old every day, funding for CMS’ Program Management account is even more crucial than in previous years to support the 

growing infrastructure necessary to accommodate this generation. 

In fiscal year 2016, CMS expects Medicare enrollees to total over 

57 million, from 19 million in 1966. Year after year, CMS has requested increases in funding for core activities such as ongoing 

operational costs and beneficiary outreach to keep up with the 

growing aging population. However, the Committee could not provide funding increases because the administration would reallocate 

funds to implement the ACA, including to shore up the failing 

Healthcare.gov. 
121 

With tight budgetary constraints, the Committee made difficult 

choices to reduce funding for programs that were not part of core 

activities. Additionally, CMS expects to collect $1,560,000,000 in 

ACA user fees for fiscal year 2016, almost double the amount obtained for the previous fiscal year. Therefore, the Committee eliminates the budget authority the Department diverted in previous fiscal years to implement and operate ACA activities. Existing funding will maintain CMS’ core mission while bill language included 

will further prevent the diversion of discretionary funds for ACA 

activities. Specifically, the Committee includes bill language to 

proactively prohibit the administration from using any discretionary dollars in this bill from making payments for the Risk Corridor program or propping up failing State-based Exchanges. 

ACA Internal Controls.—The Committee is deeply concerned 

about the findings in the recent HHS Office of Inspector General 

[OIG] report (A–02–14–02006) on CMS’ lack of oversight over the 

payments made to insurance companies. The OIG reported that 

CMS failed to implement adequate internal controls to check the 

accuracy of $2,800,000,000 worth of payments made to health insurers for the advance premium tax credits and cost-sharing reductions for enrollees. This amount only represents the first payment 

that covered January to April of 2014 and is only a tiny fraction 

of the vast amounts of money at risk. Based on the current internal 

controls, the OIG concluded that CMS could not make correct payments to providers resulting in improper payments and jeopardizing taxpayer funds. The Committee is specifically concerned that 

CMS relied primarily on health insurers’ attestations and that 

CMS does not plan on reconciling payments until 2016, 2 years 

after payments were made. The Committee directs CMS to work 

with the OIG to adopt all the recommendations and expeditiously 

implement a permanent process that automates enrollment and 

payment data on a more accurate enrollee-by-enrollee basis. As the 

OIG pointed out in the report, CMS has the authority to recoup improper payments and offset them against future payments. The 

Committee expects CMS to use this authority after reconciling payments. 

ACA Notifications.—The Committee is disappointed that the administration still cannot provide timely Congressional notification 

for ACA enrollment figures even though the Committee included 

report language in fiscal year 2015 requiring such notifications. 

The Committee continued to receive enrollment data minutes before or even after the administration’s public announcement. The 

Committee includes new bill language requiring the administration 

to provide detailed enrollment figures to the Committees on Appropriations of the House of Representatives and the Senate not less 

than two full business days before any public release of the information. 

Alzheimer’s Disease and Dementia Care.—The National Plan to 

Address Alzheimer’s Disease includes the goal of enhancing care 

quality and efficiency and expanding supports for people with Alzheimer’s disease and their families. The Committee is aware of 

promising evidence-based interventions, including the VA’s Resources for Enhancing Alzheimer’s Caregiver Health program and 

the New York University Caregiver Initiative that have been dem-
122 

onstrated to improve the health outcomes and quality of life of persons with Alzheimer’s and other causes of dementia and their caregivers and to have delayed placement of the patient in an institutional care setting. The Committee encourages CMS to evaluate the 

impact of such interventions in improving health outcomes of Medicare beneficiaries with Alzheimer’s and related dementias, including reducing or delaying the use of institutional care services. 

Annual Wellness Exam and Cognitive Impairment.—The Committee is aware that the Annual Wellness Exam is required to include an assessment of any cognitive impairment in the Medicare 

beneficiary. The Committee is concerned about the extent such assessments are occurring within the exams and directs the CMS to 

report in their fiscal year 2017 CJ the rate of provider compliance, 

including impediments for not conducting the assessment, and to 

develop a strategy to increase compliance. 

Collection Claims.—The Medicare Secondary Payer program provides CMS the ability to recover payments it made for beneficiary 

healthcare costs from third parties which are later found responsible for those costs. CMS is encouraged to review its debt collection process to ensure the agency is providing accurate and complete information about past-due and legally enforceable claims, so 

that the U.S. Department of Treasury can appropriately identify 

and adjudicate any appeals. 

Complex Rehabilitation Equipment.—CMS issued Final Rule 

1614–F detailing how CMS will use data from the Medicare Competitive Bidding Program [CBP] for durable medical equipment 

[DME] to adjust the Medicare fee schedule for DME items in noncompetitive bidding areas beginning in 2016. The Committee is 

concerned that this will harm Medicare beneficiaries who will not 

have access to specialized rehabilitation equipment, including adjustable seat cushions, and unnecessarily increase program costs. 

The Committee directs CMS to provide a report within 60 days of 

enactment of this act to the Committees on Appropriations of the 

House of Representatives and the Senate detailing how the application of the CBP pricing from 2009 and data from only nine metropolitan areas are appropriate, why CMS did not include all scenarios in which an adjustable seat cushion are currently furnished, 

and also examine the health outcomes of such changes for patients 

who have pressure ulcers or who are at high risk for developing 

pressure ulcers. 

Continuous Glucose Monitors.—Diabetes technologies known as 

continuous glucose monitors [CGM] have been shown in clinical 

trials to improve health outcomes for people with type 1 diabetes 

and reduce the risk of low blood sugar emergencies which can lead 

to hospitalizations and additional expenses to CMS. These technologies are recommended by national diabetes guidelines and covered by 95 percent of private health plans. The Committee urges 

CMS to modernize its policies to cover CGM technologies to ensure 

access for those seniors with type 1 diabetes or those entering 

Medicare who have benefitted from the technology under their 

prior health plan. 

Coordinated Pharmacist Services.—The Committee encourages 

CMS to expand efforts that incorporate health information technology to provide integrated pharmacist services across care set-
123 

tings and to improve medication reconciliation and management 

that has been demonstrated to improve outcomes, reduce adverse 

events, lower costs, and prevent readmissions. 

Critical Access Hospitals [CAH].—The Committee is disappointed 

that the Administration continues to propose eliminating CAH status from facilities located less than 10 miles from another hospital 

and reducing the reimbursement rate from 101 percent to 100 percent of reasonable cost. A recent Health Affairs study from April 

2015 reviewed the impact of similar minimum distance requirements and found that currently 37.6 percent of CAHs had a negative operating margin, and if such a distance requirement went 

into effect, it would rise to 75.6 percent. If a CAH lost its designation, it would be forced under the applicable prospective payment 

systems which are designed for larger facilities, not small, low volume rural hospitals. The results of the study underscore the importance of factoring clinical expertise, physician distribution, availability of telehealth, sufficient volume to maintain key services, 

and the needs of underserved populations. Coupled with over regulation, decreased reimbursements, and workforce shortages, CAHs 

would be forced to close without their designation, causing patients 

to travel farther, forego preventative care, and ultimately cost more 

in CMS healthcare expenditures. 

Dental Plans.—The Committee directs CMS to include in its Exchange enrollment reports data on children (ages 0 through 18 

years) enrolled or who have re-enrolled in dental coverage through 

the Exchange for both stand-alone dental plans and qualified 

health plans that include pediatric dental benefits. These reports 

shall include data for each State-based, federally facilitated, and 

partnership Exchanges. 

Future of CMS.—The Committee is concerned that the physical 

infrastructure of CMS is insufficient to properly accommodate oversight of the coming demographic growth within its programs. The 

Committee directs CMS to provide a master plan within 180 days 

after enactment of this act to the Committees on Appropriations of 

the House of Representatives and the Senate with four interdependent parts that cover the needs of the agency over the next 

5 years: physical infrastructure; workforce planning; claims data IT 

systems; and overall IT structure and security. 

Health Insurance Exchange Transparency.—The Committee continues to include bill language in section 226 that requires CMS to 

provide cost information for the following categories: Federal Payroll and Other Administrative Costs; Exchange related Information 

Technology [IT]; Non-IT Program Costs, including Health Plan 

Benefit and Rate Review, Exchange Oversight, Payment and Financial Management, Eligibility and Enrollment; Consumer Information and Outreach, including the Call Center, Navigator Grants 

and Consumer Education and Outreach; Exchange Quality Review; 

Small Business Health Options Program [SHOP] and Employer Activities; and Other Exchange Activities. Cost Information should be 

provided for each fiscal year since the enactment of the Patient 

Protection and Affordable Care Act (Public Law 111–148). CMS is 

also required to include the estimated costs for fiscal year 2017. 

Healthcare Fraud Prevention Partnership.—The Healthcare 

Fraud Prevention Partnership is a new fraud prevention initiative 
124 

that includes law enforcement, Federal and State government 

agencies, private health insurers, and other private organizations. 

The Partnership has shown successes in preventing improper payments, but recently reported improper payment levels clearly indicate the need for stronger action. The Committee urges CMS to 

work with its partners in expanding and strengthening the current 

partnerships and directs CMS to provide an update in the fiscal 

year 2017 CJ outlining its plan for the next 2 years including any 

legislative barriers for achieving these goals. 

Healthcare.gov Data Privacy.—The Committee is disappointed 

that CMS allowed third party vendors to access unencrypted consumer information such as age, smoking status, zip code, pregnancy status, and income through Healthcare.gov. The Committee 

directs CMS to encrypt and prevent further sharing of consumer 

information, to review its current security and privacy guidelines 

for this type of data, and to implement appropriate security measures. Furthermore, CMS shall include in the fiscal year 2017 CJ 

an update on these efforts including a timeline for when these activities will be completed. 

Home Health.—CMS identified the implementation of new home 

health documentation requirements as a major contributing factor 

in the fiscal year 2013 Medicare improper payment rate. As a result, CMS proposed modifications which became effective in January of 2015, but these changes will not be reflected in the improper 

payment rate until the fiscal year 2017 measurement. The Committee therefore directs CMS to report, no later than 60 days after 

the enactment of this act to the Committees on Appropriations of 

the House of Representatives and the Senate, an interim update on 

the improper payment rate regarding the home health documentation requirements. 

Hospice.—In its March 2015 report to Congress, MedPAC notes 

that CMS expressed concern that some hospice providers may not 

have the capacity to provide all four of the levels of care, which is 

required by the Medicare hospice Conditions of Participation. CMS 

makes clear that if the patient’s condition needs it, hospices are required to provide intensive around-the-clock nursing and other 

skilled hospice care as necessary, with the goal of having the patient remain in their home if at all possible. Therefore, all hospice 

providers must have the capacity of providing such care. The Committee directs CMS to ensure that all hospices are complying with 

the Conditions of Participation and have the capacity to provide all 

specified hospice services on a 24 hour, 7 days a week basis. 

IT Modernization.—Rapid advances in analytical and information 

technology provide opportunities for CMS to modernize, consolidate, and improve operations with greater efficiency and cost savings over time. CMS has already implemented several such advances, including the Predictive Modeling program, the Healthcare 

General Ledger Accounting System, and the Unified Case Management System. The Committee encourages CMS to continue to modernize, consolidate, and improve analytics and information technology programs to achieve maximum efficiency and cost savings. 

Medicare Advantage.—The Committee is aware that the formula 

to determine Medicare Advantage reimbursement rates is calculated based on the per capita cost of coverage to beneficiaries en-
125 

rolled in Medicare part A and/or part B. However, where there is 

high enrollment in Medicare Advantage and a relatively large proportion of Medicare beneficiaries without part B coverage, Medicare 

Advantage reimbursement rates may be better based on the per 

capita cost of coverage to beneficiaries enrolled in both Medicare 

part A and B. The Committee urges CMS to consider more accurate 

adjustments as soon as practicable in order to include potential 

changes in its 2016 draft Call Letter. 

Medication Synchronization.—Programs that promote Medication 

Synchronization and the Appointment Based Model are an emerging trend in pharmacy practice that improves adherence rates for 

patients taking multiple medications while reducing unnecessary 

visits to the doctor. The Committee encourages CMS to consider 

ways to increase participation in these types of programs and move 

towards greater adherence to medications. 

Mental Health Services.—The Committee recognizes the need for 

improved access to mental healthcare services and directs the CMS 

to identify potential payment-related barriers to the integration of 

mental healthcare services into the primary care context in both 

traditional fee-for-service Medicare and alternative payment models. Specifically, CMS is directed to identify potential payment-related barriers to the adoption of a collaborative care model in 

which primary care providers treat patients with common mental 

health disorders, such as depression or anxiety, with help from a 

care manager and a psychiatrist who acts as a consultant. The 

Committee directs CMS to provide a report within 180 days after 

enactment of this act to the Committees on Appropriations of the 

House of Representatives and the Senate with its findings, as well 

as a proposed plan to address the identified barriers and facilitate 

more widespread integration of mental healthcare services into the 

primary care context. The report shall also include recommendations for any legislative changes. 

Pediatric Dental Reporting.—Although CMS has released guidance on CHIP dental reporting, the data from States are unreliable 

and incomplete. Without consistent, reliable data, it is difficult to 

evaluate the impact of CHIP dental benefits. The Committee directs CMS to include in the fiscal year 2017 CJ a plan to collect 

quality reporting data from States regarding their dental benefit. 

Psychotropic Drugs and Children.—The Committee is aware of 

the Department’s efforts to reduce the inappropriate use of psychotropic medications with children and adolescents in foster care. In 

addition to the potential for serious long-term health and developmental problems for children, this alarming pattern has dramatically increased Medicaid costs. The Committee urges CMS to encourage States to provide evidence-based psychosocial interventions 

to children and youth in foster care to reduce reliance on psychotropic medications. Furthermore, the Committee urges CMS to include in the fiscal year 2017 CJ the reasons for this disparity, including whether current reimbursement policy incentivizes reliance 

on medication rather than evidence-based psychosocial therapies 

instead of, or in combination with, psychotropic medications. 

Quality Improvement.—The Department recently announced payment reform goals that identify a timetable for moving away from 

Medicare fee-for-service payment. The Committee directs CMS to 
126 

include in their fiscal year 2017 CJ the quality improvement goals 

for Medicare. 

Recovery Audit Contractors [RAC].—The Committee expects the 

next round of RAC contracts containing the new RAC requirements 

to be executed and operational as quickly as possible. CMS should 

work expeditiously to resolve any pending issues. The Committee 

appreciates the report submitted by the intra-agency working 

group as requested in fiscal year 2015 and directs the group to continue to monitor the process, provide recommendations, and evaluate the outcomes. The intra-agency working group shall provide an 

update in the fiscal year 2017 CJ. Furthermore, the Committee directs the intra-agency working group to provide quarterly updates 

to the Committees on Appropriations of the House of Representatives and the Senate reflecting the total number of appeals filed, 

appeals pending, and appeals disposed of for all four levels of the 

appeals process. 

Recovery Audit Data Warehouse.—The Committee is disappointed 

that CMS is not properly utilizing the Recovery Audit Data Warehouse [RADW] as highlighted in the GAO report titled, Medicare 

Program Integrity: Increased Oversight and Guidance Could Improve Effectiveness and Efficiency of Postpayment Claims Reviews. 

CMS developed the RADW to prevent RACs from duplicating audits of the other three contractors’ responsible for reviewing 

postpayment claims. By not taking advantage of the RADW, duplicative RAC audits are causing unnecssary burden on providers and 

wasting Federal resources. The Committee directs CMS to implement all the recommendations provided by GAO and to provide an 

update including a timeline on these efforts in the fiscal year 2017 

CJ. 

Relative Values under the Medicare Physician Fee Schedule.— The Committee encourages CMS to increase the representation of 

primary care physicians who are board certified and actively practicing in family medicine, general internal medicine, general pediatrics, preventive medicine, obstetrics and gynecology, or psychiatry on any advisory board or work group that formulates recommendations regarding any annual updates to the physician work 

relative values. 

Risk Corridor Program.—The Committee continues to include bill 

language preventing CMS from using Program Management accounts to support the Risk Corridor Program. The Committee directs CMS to provide a report within 60 days after enactment of 

this act to the Committees on Appropriations of the House of Representatives and the Senate detailing the receipts and transfer of 

payments for the Risk Corridor Program, the transfer calculation 

used for distributing the payments, and a timeline for these activities for plan year 2014 and 2015. 

Robotic Stereotactic Surgery.—The Committee is encouraged by 

CMS’ decision in the calendar year 2015 Medicare Physician Fee 

Schedule Final Rule (79 Fed. Reg. 67548) to maintain G codes and 

contractor pricing for robotic stereotactic radiosurgery procedures 

performed in a freestanding setting. The Committee encourages 

CMS to maintain the current coding and payment methodology for 

at least 3 years to provide stability while determining the most appropriate policy moving forward. 
127 

Rural Health.—According to the National Rural Health Association, 41 percent of Critical Access Hospitals operate at a loss, and 

since 2010, 51 rural hospitals have closed while 283 hospitals are 

in dire financial shape. Almost a quarter of the U.S. population 

lives in rural areas. The majority of rural residents are older, poorer, and less likely to have employer sponsored health plans. As a 

result of hospitals closing in rural communities, many patients end 

up driving long distances to see a doctor, forgo seeking medical 

care, or even worse, wait until it is too late to seek proper medical 

attention. These patients spend more money out of pocket to travel, 

miss out on routine preventative care, and will end up costing taxpayers much more in the long run. The Committee directs CMS to 

work with HRSA’s Office of Rural Health to alleviate the disproportionate impact of regulations, reimbursement cuts, and workforce 

issues on rural hospitals. 

State-Based Exchanges [SBEs].—The Committee is disappointed 

that SBEs may have used and might continue to use section 1311 

funds for operational expenses, which is specifically prohibited by 

law. Section 1311 of the Patient Protection and Affordable Care Act 

provides funding for States to design, develop, and implement 

SBEs. However, these SBEs were expected to be self-sustaining by 

2015 and were specifically prohibited from using the section 1311 

funds for operational costs after January 1, 2015. The Committee 

directs CMS to implement the recommendations put forth by the 

HHS Office of Inspector General [OIG] in their Early Alert Memorandum (A–01–14–02509) issued on April 27, 2015, and expects an 

update on the efforts in the fiscal year 2017 CJ. The Committee expects CMS and the OIG to immediately notify the Committee of 

any unauthorized use of section 1311 funds along with a detailed 

report which shall include how CMS plans to recoup those funds 

from the State. To prevent diverting discretionary funds intended 

to support the operations for CMS, the Committee includes a new 

general provision prohibiting the use of funds to support operational costs of SBEs. 

Traumatic Injury.—The Committee is concerned that CMS has 

not addressed the need to reform the Medicare reimbursement system for hospital trauma care services. Since CMS withdrew a proposal to bundle all Emergency Department [ED] outpatient reimbursement codes 2 years ago, there has been no progress on modeling alternative value-based reforms—such as a proposal to create 

three ED outpatient facility codes that would incorporate the trauma activation fee. The Committee directs CMS to include in the fiscal year 2017 CJ a detailed evaluation analyzing alternative valuebased reforms such as creating ED outpatient facility codes and 

other potential approaches that could reimburse facilities for lifethreatening, time-dependent traumatic injuries based on a facility’s 

readiness level and the nature of the injury. 

Use of Social Security Numbers on Medicare Beneficiaries’ 

Cards.—Under Public Law 114–10, Congress prohibits the use of 

Social Security numbers on Medicare beneficiary cards. The Committee urges CMS to work expeditiously to develop and implement 

a plan to remove Social Security numbers from Medicare cards and 

to have this process completed by the end of fiscal year 2018. The 
128 

Committee directs CMS to provide an update on the progress of 

this initiative in their fiscal year 2017 CJ. 

State Survey and Certification 

The Committee recommends $397,334,000 for State Survey and 

Certification activities, which ensure that institutions and agencies 

providing care to Medicare and Medicaid beneficiaries meet Federal health, safety, and program standards. On-site surveys are 

conducted by State survey agencies, with a pool of Federal surveyors performing random monitoring surveys. 

The Committee continues to support CMS collecting and analyzing the findings from this surveillance tool to inform the agency’s education and surveillance efforts moving forward. 

Federal Administration 

The Committee recommends $732,533,000 for Federal Administration, which funds the majority of CMS’ staff and operating expenses for routine activities such as planning, implementing, evaluating, and ensuring accountability in the programs administered by 

CMS. 

HEALTH CARE FRAUD AND ABUSE CONTROL

Appropriations, 2015 ............................................................................. $672,000,000 

Budget estimate, 2016 ........................................................................... 706,000,000 

Committee recommendation ................................................................. 706,000,000 

The Committee recommends $706,000,000, to be transferred from 

the Medicare trust funds, for Health Care Fraud and Abuse Control [HCFAC] activities. The latest data demonstrates for every $1 

spent on fraud and abuse, $8.10 is recovered by the Treasury. By 

utilizing the cap adjustment provided in the Budget Control Act, 

the Committee recommendation will create over $5,718,000,000 in 

savings to the U.S. Treasury. 

The Committee recommendation includes a base amount of 

$311,000,000 and an additional $395,000,000 through a budget cap 

adjustment authorized by section 251(b) of the Balanced Budget 

and Emergency Deficit Control Act of 1985. 

ADMINISTRATION FOR CHILDREN AND FAMILIES

PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND

FAMILY SUPPORT PROGRAMS

Appropriations, 2015 ............................................................................. $2,438,523,000 

Budget estimate, 2016 ........................................................................... 2,944,906,000 

Committee recommendation ................................................................. 2,944,906,000 

The Committee recommendation includes $2,944,906,000 in fiscal 

year 2016 mandatory funds for Child Support Enforcement and 

Family Support programs. In addition, the Committee recommends 

$1,300,000,000 in advance funding for the first quarter of fiscal 

year 2017. 

These funds support States’ efforts to promote the self-sufficiency 

and economic security of low-income families, including administrative expenses matching funds and incentive payments to States for 

child support enforcement; grants to States to help establish and 

administer access and visitation programs between noncustodial 
129 

parents and their children; payments to territories for benefits to 

certain aged, blind, or disabled individuals; and temporary benefits 

for certain repatriated citizens. 

LOW INCOME HOME ENERGY ASSISTANCE PROGRAM

Appropriations, 2015 ............................................................................. $3,390,304,000 

Budget estimate, 2016 ........................................................................... 3,390,304,000 

Committee recommendation ................................................................. 3,390,304,000 

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

LIHEAP, which provides home heating and cooling assistance to 

low-income households, generally in the form of payments to energy vendors on behalf of the recipient. 

The Committee recommendation provides the full amount under 

the State formula grant. The budget request included 

$3,190,304,000 for the State formula grant, and $200,000,000 for a 

new Utility Innovation Fund. 

Within the total, the Committee recommendation includes up to $2,988,000 for program integrity and oversight efforts, the same as 

the fiscal year 2015 level. 

Since fiscal year 2009 appropriations language has modified the 

statutory formula for allocating funds to States. As a result, the 

vast majority of funding is allocated based on historical allocation 

levels, and a much smaller amount based on dynamic factors such 

as the number of low-income households and home heating and 

cooling costs by State. The Committee directs the Secretary to submit a report within 90 days of enactment of this act to the Committees on Appropriations of the House of Representatives and the 

Senate on the average home heating and cooling costs of low-income households by State and the average LIHEAP assistance payment to households by State. Further, HHS should include in future budget justifications estimated State allocations as proposed 

in the budget request, and, if different, based on the underlying 

statutory formula. 

REFUGEE AND ENTRANT ASSISTANCE

Appropriations, 2015 ............................................................................. $1,559,884,000 

Budget estimate, 2016 ........................................................................... 1,624,612,000 

Committee recommendation ................................................................. 1,405,367,000 

The Committee recommends $1,405,367,000 for Refugee and Entrant Assistance programs. These programs provide a variety of 

benefits and services to refugees, asylees, Cuban and Haitian entrants, immigrants arriving on Special Immigrant Visas, trafficking 

victims, and torture victims (collectively referred to below as ‘‘refugees’’). These programs also provide temporary care and services 

for unaccompanied children apprehended by the Department of 

Homeland Security or other law enforcement agencies, who have no 

lawful immigration status in the United States until they can be 

placed with a parent, guardian, or other sponsor while awaiting adjudication of their immigration status. 

Transitional and Medical Services 

The Committee recommendation includes $426,749,000 for Transitional and Medical Services [TAMS]. This program provides 

grants to States and nonprofit organizations to provide up to 8 
130 

months of cash and medical assistance to arriving refugees, as well 

as foster care services to unaccompanied minors. 

Within the total for TAMS, the Committee strongly supports Office of Refugee Resettlement’s plan to increase funding for the Voluntary Agency Matching Grant program. This program provides 

grants to resettlement agencies to support comprehensive services—including case management, basic job training, job placement, 

and interim housing and cash assistance—for arriving refugees 

with the goal of refugees becoming self-sufficient within their first 

4 months in the United States. Many resettlement agencies exhaust their matching grant slots well before the end of the year. 

While this program may not be appropriate for many arriving refugees, the fact that many agencies quickly use up funds provided 

through this program indicates there is more demand than available resources. Expanding the matching grant program could improve overall services available to refugees in their first few 

months in the United States while saving money elsewhere in the 

TAMS budget. 

Victims of Trafficking 

The Committee recommendation includes $15,755,000 for Victims 

of Trafficking programs. These programs support a national network of organizations that provide a variety of services—including 

case management, counseling, benefit coordination, and housing assistance—for victims of commercial sex and forced labor trafficking. 

Within the total, the Committee recommendation includes 

$13,000,000 for services for foreign national victims, and 

$2,755,000 to improve services available for U.S. citizens and legal 

permanent residents, the same as the fiscal year 2015 funding levels. Victims and individuals at risk of becoming victims of trafficking are likely to come into contact with a variety of different 

service providers at the local level, including runaway and homeless youth shelters, child welfare organizations, and schools. The 

Committee supports efforts to improve the coordination of services 

for victims of trafficking across ACF and HHS programs, and 

across the Federal government consistent with the Federal Strategic Action Plan on human trafficking. 

Social Services 

The Committee recommendation includes $149,927,000 for Social 

Services programs for refugees. These funds include both formula 

and discretionary grants to States and nonprofit organizations to 

provide a variety of employment and support services to recently 

arrived refugees. 

The Committee notes that, due to a reprogramming of funds to 

address a sudden need for resources elsewhere in ORR, the timing 

of Social Services grants was modified in fiscal year 2012. This has 

created administrative challenges for local organizations carrying 

out social services programs for refugees. The Committee strongly 

supports efforts to reduce unnecessary administrative burdens associated with the timing of these grants and will work with ACF 

on possible solutions. 
131 

Preventive Health 

The Committee recommendation includes $4,600,000 for Preventive Health services for refugees. This program funds competitive 

grants to States to provide newly arrived refugees health orientation and education services, referrals for medical and mental 

health services, and access to ongoing healthcare. 

Targeted Assistance 

The Committee recommendation includes $47,601,000 for the 

Targeted Assistance program. This program provides additional 

funds to States and counties with the greatest number of refugee 

arrivals and high concentrations of refugees facing difficulties 

achieving self-sufficiency. 

Unaccompanied Children 

The Committee recommendation includes $750,000,000 for the 

Unaccompanied Children [UC] program. The budget request is 

$948,000,000 in base funding plus up to an additional $400,000,000 

in contingency funding. The UC program provides temporary shelter and basic services to children who have no lawful immigration 

status in the United States and who have been apprehended in the 

United States by the Department of Homeland Security or other 

law enforcement agencies without a parent or guardian. HHS takes 

custody of the children until they can be placed with a parent or 

guardian living in the United States pending resolution of their immigration status, or until their immigration status otherwise 

changes. 

In the spring and summer of fiscal year 2014, the number of unaccompanied children coming to the United States from Central 

America, and apprehended by DHS, dramatically increased. This 

followed a trend of consistent increases starting in fiscal year 2012. 

In June 2014 alone almost 10,200 children were apprehended and 

transferred to HHS’ care, more than four times the number of children as June 2013. However, just as sudden as the increase, the 

number of children coming to the United States significantly decreased starting in July 2014. In the first 6 months of fiscal year 

2015 the number of children transferred to HHS’ care was approximately half the level through the comparable period in 2014. 

In addition, HHS’ actual costs of providing emergency shelter 

and related services for children in fiscal year 2014 were significantly lower than originally estimated. As a result of this sudden 

decrease in children and lower than estimated costs HHS ended fiscal year 2014 with approximately $197,000,000 in unexpended balances that is available for obligation through fiscal year 2016. In 

addition, if current trends continue, HHS will not need the full fiscal year 2015 appropriation and will carry over additional unobligated balances into fiscal year 2016. Therefore, the Committee recommendation rescinds $250,000,000 of prior-year unobligated balances in this account. In total, the Committee recommendation provides adequate resources for HHS to provide temporary shelter and 

services to children transferred to their care in fiscal years 2015 

and 2016. 
132 

Victims of Torture 

The Committee recommendation includes $10,735,000 for the 

Victims of Torture program. This program provides treatment, social, and legal services to victims of torture and training to 

healthcare providers on treating the physical and psychological effects of torture. 

PAYMENTS TO STATES FOR THE CHILD CARE AND DEVELOPMENT

BLOCK GRANT

Appropriations, 2015 ............................................................................. $2,435,000,000 

Budget estimate, 2016 ........................................................................... 2,805,149,000 

Committee recommendation ................................................................. 2,585,000,000 

The Committee recommends $2,585,000,000, an increase of 

$150,000,000 for the Child Care and Development Block Grant 

[CCDBG], a formula grant to States that provides financial assistance to families to help pay for child care, and otherwise improve 

the quality of child care programs. 

Last year, Congress overwhelmingly passed the reauthorization 

of the Child Care and Development Block Grant Act. This reauthorization includes many important reforms to the program, including requiring States to strengthen health and safety standards 

and implement policies focused on promoting the healthy development of young children and supporting working parents. The Committee recommendation provides an increase for CCDBG to help 

States implement these key reforms, and improve working families 

access to quality child care. The total provided for CCDBG is consistent with CBO’s estimate of the discretionary portion of costs to 

implement the law in the first year after enactment. At the same 

time, the Committee notes that discretionary funding for CCDBG 

represents only about 27 percent of total expenditures from the 

Child Care and Development Fund [CCDF], for which CCDBG Act 

governs the use of funds. Funding for CCDF also comes from the 

mandatory Child Care Entitlement program, TANF, and Statematching funds. 

The Committee recommendation supports several existing setasides within CCDBG, including for resource and referral activities; a toll-free referral line and Web site; additional funding for 

quality improvement activities, including a specific amount for improving the quality of infant and toddler care; and research, demonstration, and evaluation activities. The CCDBG Act reauthorization incorporated these set-asides, previously created and carried 

through appropriations language, into the authorizing statute. The 

Committee bill language does not include those set-asides now provided for in the authorizing statute. The Committee maintains bill 

language specifying an additional amount for improving the quality 

of infant and toddler care because the set-aside in statute does not 

take effect until fiscal year 2017. The Committee recommendation 

also includes a technical correction regarding the availability of 

funding for technical assistance and research, demonstration, and 

evaluation activities. 
133 

SOCIAL SERVICES BLOCK GRANT

Appropriations, 2015 ............................................................................. $1,700,000,000 

Budget estimate, 2016 ........................................................................... 1,700,000,000 

Committee recommendation ................................................................. 1,700,000,000 

The Committee recommends $1,700,000,000 in mandatory funds 

for the SSBG, a flexible source of funding that allows States to provide a diverse array of services to low-income children and families, 

the disabled, and the elderly. 

CHILDREN AND FAMILIES SERVICES PROGRAMS

Appropriations, 2015 ............................................................................. $10,346,115,000 

Budget estimate, 2016 ........................................................................... 11,911,242,000 

Committee recommendation ................................................................. 10,388,620,000 

The Committee recommends $10,388,620,000 for Children and 

Family Services programs. These funds support a variety of programs for children, youth, and families; Native Americans; victims 

of child abuse, neglect, and domestic violence; and other vulnerable 

populations. 

Head Start 

The Committee recommendation includes $8,698,095,000 for 

Head Start. Head Start provides grants directly to local organizations to provide comprehensive early childhood education services 

to children and their families, from before birth to age 5. 

Within the total for Head Start, in addition to funds otherwise 

available for Early Head Start, the Committee recommendation includes a total of $600,000,000, an increase of $100,000,000 over the 

fiscal year 2015 level, to support Early Head Start expansion 

grants, including Early Head Start-Child Care Partnerships. 

Early Head Start, which provides services to children and their 

families from before birth to age 3, currently serves less than 5 percent of eligible children, yet research increasingly supports the importance and benefits of high-quality early childhood education beginning at birth, including for families before birth. HHS should allocate these additional funds to States by considering the number 

of young children from families whose income is below the poverty 

line. Further, HHS shall reserve no less than 3 percent for Indian 

Head Start programs and no less than 4.5 percent for migrant and 

seasonal Head Start programs, consistent with the Head Start Act. 

In awarding fiscal year 2016 funds, HHS should give equal priority to grantees proposing to provide more traditional Early Head 

Start services and those proposing to form child care partnerships. 

The Committee supports this partnership model but such partnerships will not be viable in every community and in many places it 

may be more appropriate to simply expand traditional Early Head 

Start, either through current or new grantees. 

Within the total for Head Start, the Committee recommendation 

also includes up to $25,000,000, the same as the comparable fiscal 

year 2015 level and the budget request, for transition-related costs 

associated with the Head Start DRS. The Committee is encouraged 

that HHS plans to evaluate the DRS in the coming year to ensure 

it meets the goals of transparency, validity, reliability, and program improvement—goals that have not yet been met. The Com-
134 

mittee encourages HHS to continue to consider the unique challenges faced by Head Start grantees in remote and frontier areas 

when reviewing such grantees’ compliance with health and dental 

screening requirements as part of the DRS. 

Consolidated Runaway and Homeless Youth Program 

The Committee recommendation includes $99,000,000 for the 

Consolidated Runaway and Homeless Youth program. This program supports the Basic Centers program, which provides temporary shelter, counseling, and after-care services to runaway and 

homeless youth under age 18 and their families; the Transitional 

Living Program, which provides longer-term shelter and services 

for older youth; and a national toll-free runaway and homeless 

youth crisis hotline. 

Within the total, the Committee recommendation includes 

$2,000,000 for the ‘‘Prevalence, Needs and Characteristics of Homeless Youth,’’ study as requested by the administration. 

Education and Prevention Grants To Reduce Sexual Abuse of Runaway Youth 

The Committee recommendation includes $17,141,000 for Education and Prevention Grants to Reduce Sexual Abuse of Runaway 

and Homeless Youth. This program provides competitive grants for 

street-based outreach and education services for runaway and 

homeless youth who are subjected to or are at risk of being subjected to sexual abuse or exploitation. 

Child Abuse Prevention and Treatment State Grants 

The Committee recommendation includes $25,310,000 for the 

Child Abuse Prevention and Treatment State Grant program. This 

program provides formula grants to States to improve their child 

protective service systems. 

Child Abuse Discretionary Activities 

The Committee recommendation includes $28,744,000 for Child 

Abuse Discretionary Activities. This program supports discretionary grants for research, demonstration, and technical assistance to increase the knowledge base of evidence-based practices 

and to disseminate information to State and local child welfare programs. 

Community-Based Child Abuse Prevention 

The Committee recommendation includes $39,764,000 for the 

Community-Based Child Abuse Prevention program. This program 

provides formula grants to States that then disburse funds to local, 

community-based organizations to improve local child abuse prevention and treatment efforts, including providing direct services 

and improving the coordination between State and communitybased organizations. 

Abandoned Infants Assistance 

The Committee recommendation does not include funding for this 

program. The budget request proposes significantly changing the 

focus of this program as part of a reauthorization proposal. The 
135 

Abandoned Infants Assistance program was created in 1988 as a 

response to an acute child welfare crisis associated with the crack 

cocaine and HIV/AIDS epidemics of the 1980s. Specifically, the program funded demonstration projects to prevent the abandonment of 

infants and young children impacted by substance abuse and HIV. 

As the budget request discusses, over the last several decades, in 

part because of these demonstration projects, States have implemented more effective community responses to infants and families 

in these circumstances, the goal of these demonstration projects. 

Child Welfare Services 

The Committee recommendation includes $268,735,000 for Child 

Welfare Services. This formula grant program helps State and tribal public welfare agencies improve their child welfare services with 

the goal of keeping families together. These funds help States and 

tribes provide a continuum of services that prevent child neglect, 

abuse or exploitation; allow children to remain with their families, 

when appropriate; promote the safety and permanence of children 

in foster care and adoptive families; and provide training and professional development to the child welfare workforce. 

Child Welfare Research, Training, and Demonstration 

The Committee recommendation includes $13,984,000 for child 

welfare research, training, and demonstration projects. This program provides grants to public and nonprofit organizations for 

demonstration projects that encourage experimental and promising 

types of child welfare services, as well as projects that improve 

education and training programs for child welfare service providers. 

National Survey of Child and Adolescent Well-Being.—The Committee recommendation includes funding within this program for 

HHS to continue the National Survey of Child and Adolescent 

Well-Being. This survey provides critical, nationally representative, 

longitudinal data on children who have been involved in State child 

protective services programs. This helps examine the current characteristics and needs of children and families involved with child 

protective services, and evaluate the impact of interventions to improve child and family well-being. 

Adoption Opportunities 

The Committee recommends $39,100,000 for the Adoption Opportunities program. This program funds discretionary grants to help 

facilitate the elimination of barriers to adoption and provide technical assistance to help States increase the number of children 

adopted, particularly children with special needs. 

Adoption Incentives 

The Committee recommends $37,943,000 for the Adoption Incentives program. This program provides formula-based incentive payments to States to encourage them to increase the number of adoptions of children from the foster care system, with an emphasis on 

children who are the hardest to place. 
136 

Social Services and Income Maintenance Research 

The Committee recommends $5,762,000 for Social Services and 

Income Maintenance Research. These funds support research and 

evaluation of cost-effective programs that increase the stability and 

economic independence of families and contribute to the healthy 

development of children and youth. 

Native American Programs 

The Committee recommends $46,520,000 for Native American 

programs. These funds support a variety of programs to promote 

self-sufficiency and cultural preservation activities among Native 

American, Native Hawaiian, Alaska Native, and Pacific Islander 

organizations and communities. 

Within the total, the Committee recommendation includes 

$12,000,000 for Native American language preservation activities, 

including no less than $4,000,000 for Native American language 

nests and survival schools, as authorized by sections 803C(b)(7)(A)– 

(B) of the Native American Programs Act. The Committee directs 

HHS to give priority to programs with the most rigorous immersion 

programs. In addition, the Committee directs ACF to coordinate 

with the Department of Education in administering these funds. 

Community Services Block Grant 

The Committee recommendation includes $674,000,000 for the 

Community Services Block Grant [CSBG]. The CSBG is a formula 

grant to States and Indian tribes to provide a wide range of services to alleviate causes of poverty in communities and to assist lowincome individuals in becoming self-sufficient. States are required 

to pass on at least 90 percent of these funds to local communitybased organizations, the vast majority of which are community action agencies. 

Community Economic Development 

The Committee recommendation does not include funding for the 

Community Economic Development [CED] program as proposed by 

the administration. The President’s budget proposed eliminating 

this program because it is similar or duplicative of programs administered by other agencies, including the Department of Treasury. 

Rural Community Facilities 

The Committee recommendation does not include funding for the 

Rural Community Facilities program as proposed by the administration. The President’s budget proposed eliminating this program 

because it is similar or duplicative of programs administered by 

other agencies, including the Department of Agriculture and Environmental Protection Agency. 

Assets for Independence 

The Committee recommendation includes $12,000,000 for the Assets for Independence [AFI] program. The AFI program provides 

discretionary grants to organizations to support individual development accounts that encourage low-income individuals to create sav-
137 

ings accounts for dedicated purposes, such as buying a home, paying for college, or starting a business. 

The Committee remains concerned that grantees have been unable to expend all of their funding under this program, which has 

resulted in a significant amount of funding lapsing. Grantees have 

5 years to expend funds but some have struggled to encourage 

enough savings or to provide a sufficient match to be able to expend their full grant during that time. 

National Domestic Violence Hotline 

The Committee recommendation includes $4,500,000 for the National Domestic Violence Hotline. This national, toll-free hotline 

provides critical emergency assistance and information to victims of 

domestic violence 24 hours a day. 

Family Violence Prevention and Services 

The Committee recommendation includes $135,000,000 for Family Violence Prevention and Services programs. These funds support programs to prevent family violence and provide immediate 

shelter and related assistance for victims of domestic violence and 

their dependents. 

Chafee Education and Training Vouchers 

The Committee recommendation includes $43,257,000 for the 

Chafee Education and Training Voucher program. This program 

supports vouchers to foster care youth to help pay for expenses related to postsecondary education and vocational training. 

Disaster Human Services Case Management 

The Committee recommends $1,864,000 for Disaster Human 

Services Case Management. This program assists States in establishing the capacity to provide case management services in a timely manner in the event of a disaster. It ensures that States are able 

to meet social service needs during disasters by helping disaster 

victims prepare recovery plans, referring them to service providers 

and FEMA contacts to identify needed assistance, and providing 

ongoing support and monitoring through the recovery process. 

Program Administration 

The Committee recommendation includes $197,901,000 for the 

Federal costs of administering ACF programs. 

PROMOTING SAFE AND STABLE FAMILIES

Appropriations, 2015 ............................................................................. $404,765,000 

Budget estimate, 2016 ........................................................................... 434,765,000 

Committee recommendation ................................................................. 404,765,000 

The Committee recommends $404,765,000 for the Promoting Safe 

and Stable Families program. The Committee recommendation includes $345,000,000 in mandatory funds authorized by the Social 

Security Act and $59,765,000 in discretionary appropriations. 

This program supports activities that can prevent the emergence 

of family crises that might require the temporary or permanent removal of a child from his or her home. Grants allow States to operate coordinated programs of family preservation services, time-lim-
138 

ited family reunification services, community-based family support 

services, and adoption promotion and support services. 

PAYMENTS FOR FOSTER CARE AND PERMANENCY

Appropriations, 2015 ............................................................................. $4,832,000,000 

Budget estimate, 2016 ........................................................................... 5,298,000,000 

Committee recommendation ................................................................. 5,298,000,000 

The Committee recommends $5,298,000,000 in mandatory funds 

for Payments for Foster Care and Permanency. In addition, the 

Committee recommends $2,300,000,000 in advance mandatory 

funding for the first quarter of fiscal year 2017. These funds support programs that assist States with the costs of maintaining eligible children in foster care, prepare children for living on their 

own, assist relatives with legal guardianship of eligible children, 

and find and support adoptive homes for children with special 

needs. 

The Committee continues to strongly support efforts to improve 

the coordination and availability of child welfare and housing services for children aging out, or who have recently aged out, of the 

foster care system. Children aging out of foster care face an abrupt 

transition, and improving the quality of services available to them, 

and particularly the coordination of child welfare and housing services, can help improve outcomes for these particularly vulnerable 

youth and reduce total costs to the Government. The Committee 

strongly encourages HHS to work with the Department of Housing 

and Urban Development to improve the coordination of child welfare and housing services at the Federal and local level. 

ADMINISTRATION FOR COMMUNITY LIVING

AGING AND DISABILITY SERVICES PROGRAMS

Appropriations, 2015 ............................................................................. $1,700,956,000 

Budget estimate, 2016 ........................................................................... 2,123,355,000 

Committee recommendation ................................................................. 1,888,139,000 

The Committee recommends an appropriation of $1,888,139,000, 

for the Administration for Community Living [ACL], which includes $30,000,000 in Medicare Trust Funds. The Committee recommendation also includes $27,050,000 to be transferred to ACL 

from the PPH Fund. 

ACL was created with the goal of increasing access to community 

support for older Americans and people with disabilities. It is 

charged with administering programs authorized under the Older 

Americans Act [OAA] and the Developmental Disabilities Act, as 

well as promoting community living policies throughout the Federal Government for older Americans and people with disabilities. 

Home- and Community-Based Supportive Services 

The Committee recommends an appropriation of $347,724,000 for 

the Home- and Community-Based Supportive Services program. 

This program provides formula grants to States and territories to 

fund a wide range of social services that enable seniors to remain 

independent and in their homes for as long as possible. State agencies on aging award funds to designated area agencies on aging 

that, in turn, make awards to local service providers. This activity 
139 

supports services such as transportation, adult day care, physical 

fitness programs, and in-home assistance such as personal care and 

homemaker assistance. The Committee directs ACL to work with 

States to prioritize innovative service models, like naturally occurring retirement communities [NORCs], which help older Americans 

remain independent as they age. The Committee notes that 

NORCs, and similar settings, are a more cost-effective alternative 

to long-term care that enables older Americans to be more engaged 

in their communities while living at home. 

Preventive Health Services 

The Committee recommends $19,848,000 for Preventive Health 

Services. This program funds activities such as medication management and enhanced fitness and wellness programs. These programs 

help seniors stay healthy and avoid chronic disease, thus reducing 

the need for costly medical interventions. The Committee maintains bill language that requires States to use these funds to support evidence-based models that enhance the wellness of seniors. 

Protection of Vulnerable Older Americans 

The Committee recommends $20,658,000 for grants to States for 

the Long-term Care Ombudsman program and the Prevention of 

Elder Abuse program. Both programs provide formula grants to 

States to prevent the abuse, neglect, and exploitation of older individuals. The ombudsman program focuses on the needs of residents 

of nursing homes and other long-term care facilities, while the 

elder abuse prevention program targets the elderly community at 

large. 

National Family Caregiver Support Program 

The Committee recommends $145,586,000 for the National Family Caregiver Support program. Funds appropriated for this activity 

establish a multifaceted support system in each State for family 

caregivers, allowing them to care for their loved ones at home for 

as long as possible. States may use funding to provide information 

to caregivers about available services, assistance to caregivers in 

gaining access to services, caregiver counseling and training, respite care to enable caregivers to be temporarily relieved from their 

caregiving responsibilities, and limited supplemental services that 

fill remaining service gaps. 

Native American Caregiver Support Program 

The Committee recommendation includes $6,031,000 to carry out 

the Native American Caregiver Support program. This program 

provides grants to tribes for the support of American Indian, Alaskan Native, and Native Hawaiian families caring for older relatives 

with chronic illness or disability, as well as for grandparents caring 

for grandchildren. 

Congregate and Home-Delivered Nutrition Services 

The Committee recommends an appropriation of $438,191,000 for 

congregate nutrition services and $216,397,000 for home-delivered 

meals. These programs address the nutritional needs of older individuals, thus helping them to stay healthy and reduce their risk of 
140 

disability. Funded projects must make home-delivered and congregate meals available at least once a day, 5 days a week, and 

each meal must meet a minimum of one-third of daily dietary requirements. While States receive separate allotments of funds for 

congregate meals, home-delivered meals, and supportive services, 

they have flexibility to transfer funds between these programs. 

Healthier Foods.—The Committee encourages ACL to partner 

with organizations to review, identify, and disseminate best practices to provide healthier foods and menu options for seniors. These 

practices could include better food product procurement, preparation techniques, and improved menu planning and recipe documentation to facilitate changes that support healthier meals. Coalitions of manufacturers, food service providers, and food service distributors could also be developed to explore ways to promote best 

practices and provide a more appropriate selection of healthier 

ready-to-use ingredients. 

Nutrition Services Incentives Program.—The Committee recommendation includes $160,069,000 for the Nutrition Services Incentives Program [NSIP]. NSIP augments funding for congregate 

and home-delivered meals provided to older adults. States and 

tribes may choose to receive all or part of their funding in the form 

of commodities from the USDA. 

Aging Grants to Indian Tribes and Native Hawaiian Organizations 

The Committee recommends $24,850,000 for grants to Native 

Americans. This program provides grants to eligible tribal organizations for the delivery of nutrition and supportive services to Native Americans. 

Tribal Advisory Council.—The Committee encourages ACL to 

continue with their plans to establish a Tribal Advisory Council focusing on issues that affect the aging Indian population. ACL shall 

continue to participate in the broader Secretary-level Tribal Advisory Council to present their latest efforts, provide advice with respect to policies and services that affect the older Indian population, help in identifying priorities, and coordinating strategies 

across the Tribal, regional, or national levels. 

Aging Network Support Activities 

The Committee recommends $7,088,000 for Aging Network Support activities. These funds support activities that expand public 

understanding of aging and the aging process, apply social research 

and analysis to improve access to and delivery of services for older 

individuals, test innovative ideas and programs, and provide technical assistance to agencies that administer programs authorized 

by the OAA. 

Alzheimer’s Disease Demonstration Grants to States 

The Committee recommendation includes $3,800,000 for Alzheimer’s Disease Demonstration Grants to States. This program 

funds competitive grants to States to test and implement new models of care for individuals with Alzheimer’s disease. 
141 

Alzheimer’s Disease Initiative 

The Committee recommends $14,700,000 in mandatory funding 

be transferred from the PPH Fund to ACL for the Alzheimer’s Disease Initiative. Of the total, $10,500,000 is provided to expand the 

availability of home- and community-based dementia services and 

supports. The remaining $4,200,000 is provided for a public awareness outreach campaign regarding Alzheimer’s disease. 

Lifespan Respite Care 

The Committee recommends $2,242,000 for the Lifespan Respite 

Care program. The Lifespan Respite Care program provides grants 

to States to expand respite care services to family caregivers, improve the local coordination of respite care resources, and improve 

access to and quality of respite care services, thereby reducing family caregiver strain. 

Chronic Disease Self-Management Program 

The Committee recommends $7,600,000 be transferred from the 

PPH Fund to ACL for the Chronic Disease Self-Management Program [CDSMP]. This program assists those with chronic disease 

manage their conditions and improve their health status. Topics 

covered by the program include nutrition; appropriate use of medications; fitness; and effective communications with healthcare providers. CDSMP has been shown through multiple studies to result 

in significant and measurable improvements in health and quality 

of life, as well as reductions in hospitalizations and emergency 

room visits. 

Elder Falls Prevention 

The Committee recommends that $4,750,000 be transferred from 

the PPH Fund for Elder Falls Prevention activities at ACL. Preventing falls will help seniors stay independent and in their homes 

and avoid costly hospitalizations and hip fractures, which frequently lead to nursing home placement. The Committee intends 

that these funds should be used in coordination with CDC for public education about the risk of these falls, as well as implementation and dissemination of community-based strategies that have 

been proven to reduce the incidence of falls among seniors. 

Senior Medicare Patrol 

Due to budget constraints, the Committee recommendation does 

not include funding for the Senior Medicare Patrol program. The 

Committee recommendation utilizes the budget cap adjustment for 

HCFAC and supports this program and other activities to combat 

fraud and abuse in the Medicare program through that funding 

mechanism. 

Elder Rights Support Activities 

The Committee recommends $7,874,000 for Elder Rights Support 

activities. These activities support programs that provide information, training, and technical assistance to legal and aging services 

organizations in order to prevent and detect elder abuse and neglect. The Committee includes the same level as in fiscal year 2015 

for the Elder Justice Initiative. 
142 

Aging and Disability Resource Centers 

The Committee recommendation includes $5,813,000 for Aging 

and Disability Resource Centers [ADRCs]. These centers provide 

information, one-on-one counseling, and access for individuals to 

learn about their long-term services and support options with the 

goal of allowing seniors and individuals with disabilities to maintain their independence. The Committee urges ACL to improve coordination among ADRCs, area agencies on aging, and centers for 

independent living to ensure that there is ‘‘no wrong door’’ to access 

services. 

State Health Insurance Assistance Program 

The Committee recommendation includes $30,000,000 for State 

Health Insurance Assistance Programs, which provide accurate and 

understandable health insurance information to Medicare beneficiaries and their families. 

Paralysis Resource Center 

The Committee recommendation includes $6,365,000 for the Paralysis Resource Center, which provides comprehensive information 

and referral services to people living with paralysis and their families. These resources and services focus on the promotion of independence and quality of life for the over 6,000,000 Americans living 

with paralysis. 

Limb Loss 

The Committee provides $2,660,000 for the Limb Loss program, 

which supports programs and activities to improve the health of 

people with limb loss and promote their well-being, quality of life, 

prevent disease, and provide support to their families and caregivers. 

Developmental Disabilities State Councils 

The Committee recommendation includes $68,107,000 for State 

councils on developmental disabilities. These councils work to develop, improve, and expand the system of services and supports for 

people with developmental disabilities at the State and local level. 

Councils engage in activities such as training, educating the public, 

building capacity, and advocating for change in State policies with 

the goal of furthering the inclusion and integration of individuals 

with developmental disabilities in all aspects of community life. 

Developmental Disabilities Protection and Advocacy 

The Committee recommendation includes $36,797,000 for protection and advocacy programs for people with developmental disabilities. This formula grant program provides funds to States to establish and maintain protection and advocacy systems that protect the 

legal and human rights of persons with developmental disabilities 

who are receiving treatment, services, or rehabilitation. 

Voting Access for Individuals with Disabilities 

The Committee recommendation includes $4,715,000 to improve 

voting access for individuals with disabilities. This program provides grants to protection and advocacy organizations to ensure 
143 

that individuals with disabilities have the opportunity to participate in every step of the electoral process, including registering to 

vote, accessing polling places, and casting a vote. 

Developmental Disabilities Projects of National Significance 

The Committee recommendation includes $8,414,000 for projects 

of national significance to assist persons with developmental disabilities. This program funds grants and contracts that develop 

new technologies and demonstrate innovative methods to support 

the independence, productivity, and integration into the community 

of persons with developmental disabilities. 

Technical Assistance.—The Committee provides $575,000 for 

technical assistance and training for the State Councils on Developmental Disabilities. 

Transportation.—The Committee includes $1,000,000 to fund 

transportation assistance activities for older adults and persons 

with disabilities. These activities should focus on the most cost-effective and sustainable strategies that can be replicated to other 

communities. 

University Centers for Excellence in Developmental Disabilities 

The Committee recommendation includes $35,790,000 for University Centers for Excellence in Developmental Disabilities 

[UCEDDs]. The UCEDD program supports a network of 67 centers 

that are interdisciplinary education, research, and public service 

units of a university system or public or nonprofit entities associated with universities. These Centers assist States initiate collaborative research, education, training, and service efforts to assist 

youth with disabilities to successfully transition from school to 

postsecondary education, and/or integrated employment. The funding will also allow the Centers to continue to address critical and 

emerging national needs, such as addressing the needs of the rising 

numbers of individuals on the autism spectrum; demonstrating cost 

effective long term services and supports for adults with disabilities 

and those aging with disabilities; supporting returning veterans; 

and providing technical assistance to strengthen and support the 

national network of Centers and to disseminate research and best 

practices nationwide. Within the amount appropriated for UCEDD, 

the Committee provides no less than the fiscal year 2015 level for 

technical assistance for the UCEDD network. 

Independent Living 

The Committee recommendation includes $96,124,000 for the 

Independent Living Program. This program helps ensure that individuals with disabilities can live a productive and independent life 

in society. Funding supports States sustain, improve, and expand 

independent living services and establish and support a network of 

centers for independent living. The Committee includes new bill 

language providing the necessary authorities for this program as 

part of the transfer that occurred in fiscal year 2015. 
144 

National Institute on Disability, Independent Living, and Rehabilitation Research 

The Committee recommendation includes $98,772,000 for the National Institute on Disability, Independent Living, and Rehabilitation Research [NIDILRR]. The NIDILRR supports research and activities that help to maximize the full potential of individuals with 

disabilities in employment, independent living, and social activities. 

The Committee includes new bill language providing the necessary 

authorities for this program as part of the transfer that occurred 

in fiscal year 2015. 

Assistive Technology 

The Committee recommendation includes $31,350,000 for Assistive Technology [AT]. AT provides States with funding to support 

individuals with disabilities of all ages to obtain devices and services that will increase, maintain, or improve their functional capabilities. The Committee includes new bill language providing the 

necessary authorities for this program as part of the transfer that 

occurred in fiscal year 2015. 

Program Administration 

The Committee recommends $35,824,000 for program administration at ACL. These funds support salaries and related expenses 

for program management and oversight activities. 

Business Acumen Learning Collaborative.—The Committee supports ACL in the development of the Business Acumen Learning 

Collaborative and the successful partnerships between its network 

of home and community-based services organizations. The collaborative aims to reduce hospital admissions and readmissions, improve care coordination, improve access to social services and supports, and lower overall healthcare expenditures in the future. The 

Committee urges ACL to continue these efforts and collaborate 

with CMS to maximize further cost savings. 

Muscular Dystrophy.—Since ACL was recently added to the Muscular Dystrophy Coordinating Committee, the Committee requests 

an update in the fiscal year 2017 CJ on all programs relevant to 

the Duchenne population, particularly those focused on supporting 

transitions of persons with Duchenne into adulthood. This report 

shall include the cost-effectiveness of independent living programs 

and supports for persons living with various forms of muscular dystrophy. 

OFFICE OF THE SECRETARY

GENERAL DEPARTMENTAL MANAGEMENT

Appropriations, 2015 ............................................................................. $512,862,000 

Budget estimate, 2016 ........................................................................... 558,594,000 

Committee recommendation ................................................................. 348,262,000 

The Committee recommends $348,262,000 for General Departmental Management [GDM]. The recommendation includes 

$46,762,000 in transfers available under section 241 of the PHS 

Act. 

This appropriation supports activities that are associated with 

the Secretary’s role as policy officer and general manager of the 
145 

Department. It supports health activities performed by the Office 

of the Assistant Secretary for Health [ASH], including the Office of 

the Surgeon General. GDM funds also support the Department’s 

centralized services carried out by several Office of the Secretary 

staff divisions, including personnel management, administrative 

and management services, information resources management, 

intergovernmental relations, legal services, planning and evaluation, finance and accounting, and external affairs. 

Breast Cancer Patient Education Campaign.— Since 1998, health 

plans that offer breast cancer coverage have been required to provide for breast reconstruction and prostheses. Published studies report that an overwhelming majority of women eligible for breast reconstruction following breast cancer are not informed of their care 

options. This is especially problematic for members of racial and 

ethnic minority groups, who are even less likely to be informed but 

have a greater chance of getting breast cancer. According to the 

American Society of Plastic Surgeons, only 33 percent of eligible 

women with breast cancer undergo breast reconstruction and published research reports that nearly 70 percent of women are not informed of their care options by their general surgeon. The Committee directs the Secretary to plan and implement an education 

campaign to inform breast cancer patients anticipating surgery 

about the availability and coverage of breast reconstruction, prostheses, and other options, with a focus on informing patients who 

are members of racial and ethnic minority groups. The campaign 

shall include dissemination of the following information: (A) Breast 

reconstruction is possible at the time of breast cancer surgery, or 

at a later time. (B) Prostheses or breast forms may be available. 

(C) Federal law mandates both public and private health plans to 

include coverage of breast reconstruction and prostheses. (D) The 

patient has a right to choose a provider of reconstructive care, including the potential transfer of care to a surgeon that provides 

breast reconstructive care. (E) The patient may opt to undergo 

breast reconstruction sometime after the time of breast cancer surgery for personal or medical reasons, during treatment or after 

completion of all other breast cancer treatments. (F) Other information as the Secretary determines appropriate. The information 

required to be disseminated shall be posted on the Web sites of relevant Federal agencies, including the Office of Women’s Health, 

the Office of Minority Health, and the Office of Rural Health Policy. The campaign shall not specify, or be designed to serve as a 

tool to limit, the healthcare providers available to patients. In developing the information to be disseminated, the Secretary shall 

consult with appropriate medical societies and patient advocates 

related to breast cancer, breast reconstructive surgery, breast prostheses, and breast forms and with patient advocates representing 

racial and ethnic minority groups with a special emphasis on African-American and Hispanic populations. The Committee directs the 

Secretary to provide an annual update in the CJ describing the activities carried out under this section during the preceding fiscal 

year, and an evaluation of the extent to which such activities have 

been effective in improving the health and well-being of racial and 

ethnic minority groups. 
146 

Breast Density.—The Committee encourages the Secretary to continue the activities of the Department conducting or supporting applied research on breast density; research on the cost-effectiveness 

and feasibility of reimbursement models for supplemental imaging 

relating to breast density; and research in support of clinical guidelines and best practices concerning use of mammograms and supplemental screening for women with dense breast tissue. 

Center for Faith-Based and Neighborhood Partnerships.—The 

Committee recognizes the realignment of the Center for FaithBased and Neighborhood Partnerships from ACF to the Secretary’s 

Office of Intergovernmental and External Affairs. To complete this 

realignment, the Committee transfers the Center for Faith-Based 

and Neighborhood Partnerships’ budget of $1,299,000 from ACF to 

the GDM account as requested in the administration’s budget. 

Cerebral Cavernous Angioma.—The Committee encourages the 

Secretary to coordinate efforts by agencies and patient advocacy organizations to increase the efficiency and effectiveness of the research and clinical drug trials effort. 

Children in Poverty.—The Committee encourages the U.S. Surgeon General to issue a report within 180 days after enactment of 

this act to the Committees on Appropriations of the House of Representatives and the Senate on improving the health of America’s 

children. Too many children still live in poverty, compromising 

their ability to be healthy, to succeed in school and to raise healthy 

families themselves. This report can increase awareness and generate additional efforts on ameliorating this public health problem. 

Conference Attendance.—The Committee remains concerned that 

Congress and the administration have implemented unnecessary 

barriers to scientific research and collaboration through various requirements on administrative tasks, particularly the approval process for conference travel. The NIH reports that they spend approximately $14,000,000 annually to comply with this provision and 

CDC dedicates approximately 1,000 FTE staff hours and 375 contractor support hours per week for travel approval and oversight. 

The Department is directed to provide the Committees on Appropriations of the House of Representatives and the Senate recommendations to help streamline administrative commitments, 

particularly relating to travel, within 90 days of enactment of this 

act. 

Dietary Guidelines.—The Committee is concerned that the advisory committee for the 2015 Dietary Guidelines for Americans considered issues outside of the nutritional focus of the panel. The advisory committee included agriculture production practices and environmental factors into their criteria for establishing the next dietary recommendations. The Committee directs the Secretary to ensure that the advisory committee focuses on nutrient and dietary 

recommendations based upon only a preponderance of nutritional 

and dietary scientific evidence. Furthermore, the Committee includes new bill language directing the Secretary to only include nutrition and dietary information, not extraneous factors, in the final 

2015 Dietary Guidelines for Americans. 

E-Health and Telemedicine.—The Committee urges the Department to increase collaboration and coordination across relevant 

Federal agencies on E-health and telemedicine to assess current ef-
147 

forts, needs, barriers, standards, goals, eliminate duplication and 

incompatibility, and ultimately improve health quality, effectiveness, and outcomes. The Department shall provide a report within 

180 days after enactment of this act to the Committees on Appropriations of the House of Representatives and the Senate with its 

analysis, including any recommendations on improving the existing 

E-health and telemedicine efforts. 

Integrative Health.—The Committee commends the Council, 

which is chaired by the Surgeon General and includes senior representatives of twenty executive departments and agencies, for its 

efforts to guide the prevention, health promotion and public health 

policies and priorities of participating Federal agencies. However, 

the overriding focus of the Council remains substantially tobacco 

use and obesity. The Committee encourages the Department of 

HHS and the Surgeon General to guide the Council to more uniformly address across all Federal agencies each of the National 

Prevention Strategy’s other priorities, including active, injury and 

violence free living, and mental and emotional wellbeing. 

IT Efficiency.—The Committee encourages the Department to 

perform periodic inventories of software licenses in use across 

HHS. HHS should compare those usage numbers to its purchased 

licenses and seek to increase cost savings and efficiencies by using 

this information to obtain HHS-wide acquisitions as opposed to 

component-specific purchases of licenses. 

National Strategy for Combating Antibiotic Resistant Bacteria 

[CARB].—The Committee supports the CARB initiative that will 

strengthen efforts to prevent, detect, and control illness and deaths 

related to infections caused by antibiotic resistant bacteria. The 

Committee directs the Department to work with DOD, USDA, VA, 

and FDA to broaden and expand efforts to track and store both antibiotic resistant bacteria genes and the mobile genetic elements 

from antibiotic resistant bacteria along with metadata. This should 

include such data as geographic information system coordinates describing where the bacteria were isolated to monitor emerging antibiotic resistant bacteria, assess their threat to public health, and 

develop mitigation strategies. The Department shall include in the 

fiscal year 2017 CJ a detailed update on the progress being made 

to implement the CARB national strategy initiative. 

Necrotizing Enterocolitis [NEC].—The Committee directs the Secretary to coordinate the Department’s efforts on NEC, including 

disseminating best practices and successful interventions for the 

prevention of NEC, particularly in premature infants. 

Open Access to Federal Research.—The Committee continues to 

support the Office of Science and Technology Policy’s [OSTP] development and implementation of policies to increase public access to 

federally funded scientific research. The Committee is pleased by 

the progress being made for Departments and Agencies funded 

under this bill, and supports OSTP’s requirement for Agencies to 

have their public access and data management plan requirements 

in place for grants, contracts, and intramural research projects by 

January 1, 2016. Agencies funded in this bill are instructed to continue with their quarterly reporting requirements to the Senate 

Committee on Appropriations to keep Congress apprised of the re-
148 

maining progress that needs to be made in making federally funded research accessible to the public as expeditiously as possible. 

Prenatal Opioid Abuse and Neonatal Abstinence Syndrome.—The 

Committee directs the Secretary to lead a review of planning and 

coordination within the Department related to prenatal opioid use 

and neonatal abstinence syndrome. In carrying out the review of 

the planning and coordination efforts, the Secretary shall develop 

a strategy to address research and program gaps, including such 

gaps identified in findings made by reports of the Government Accountability Office. Such strategy shall address: (1) gaps in research, including with respect to the most appropriate treatment of 

pregnant women with opioid use disorders; the most appropriate 

treatment and management of infants with neonatal abstinence 

syndrome; and the long-term effects of prenatal opioid exposure on 

children; and (2) gaps in programs, including—the availability of 

treatment programs for pregnant and postpartum women and for 

newborns with neonatal abstinence syndrome; and guidance and 

coordination in Federal efforts to address prenatal opioid use or 

neonatal abstinence syndrome. No later than 1 year after the date 

of enactment of this act, the Secretary shall submit a report to the 

Committees on Appropriations of the House of Representatives and 

the Senate on the findings of the review of planning and coordination efforts at the Department and the strategy developed to address any research and program gaps. Furthermore, the Committee 

directs the Secretary to conduct a study and develop recommendations for preventing and treating prenatal opioid abuse and neonatal abstinence syndrome, soliciting input from nongovernmental 

entities, including organizations representing patients, healthcare 

providers, hospitals, other treatment facilities, and other entities, 

as appropriate. The Secretary shall publish on the appropriate Web 

sites a report on the study and recommendations no later than 1 

year after the date of enactment of this act. The study and report 

shall include: (1) a comprehensive assessment of existing research 

with respect to the prevention, identification, treatment, and longterm outcomes of neonatal abstinence syndrome, including the 

identification and treatment of pregnant women or women who 

may become pregnant who use opioids or other drugs; (2) an evaluation of: (A) the causes of and risk factors for opioid use disorders 

among women of reproductive age, including pregnant women; (B) 

the barriers to identifying and treating opioid use disorders among 

women of reproductive age, including pregnant and postpartum 

women and women with young children; (C) current practices in 

the healthcare system to respond to and treat pregnant women 

with opioid use disorders and infants born with neonatal abstinence syndrome; (D) medically indicated use of opioids during pregnancy; (E) access to treatment for opioid use disorders in pregnant 

and postpartum women; and (F) access to treatment for infants 

with neonatal abstinence syndrome; and (3) recommendations on: 

(A) preventing, identifying, and treating neonatal abstinence syndrome in infants; (B) treating pregnant women who are dependent 

on opioids; and (C) preventing opioid dependence among women of 

reproductive age, including pregnant women, who may be at risk 

of developing opioid dependence. 
149 

Prescription Drugs on Infants.—Little is known about the effects 

of most drugs on the mother and her child or the ways in which 

pregnancy and lactation alter the metabolism and effect of medication. The Committee encourages the Department to coordinate all 

activities in this area and requests an update in the fiscal year 

2017 CJ on the progress made on the safety and efficacy of drugs 

in this population, as well as potential projects related to data 

gathering and other relevant initiatives underway related to this 

issue. 

Reducing Health Disparities.—The Committee encourages the 

Secretary to coordinate the capabilities of HHS agencies and partner with NIH to improve recruitment and training of health professionals and biomedical researchers to meet the needs of minority 

and underserved populations and to reduce health disparities in 

local communities. 

Seafood Sustainability.—The Committee prohibits the Department from using or recommending third party, nongovernmental 

certification for seafood sustainability. 

Severe Wounds.—The Committee directs the Secretary, in consultation with relevant stakeholders, to conduct a study on the 

treatment needs of individuals entitled to benefits under part A, or 

enrolled under part B, of Medicare, requiring specialized wound 

care, and the cost, for such individuals and the Medicare program, 

of treating severe wounds in rural and urban areas. The study 

shall include an assessment of: (A) access of such individuals to appropriate levels of care for such cases; (B) the potential impact that 

section 1886(m)(6)(A)(i) of the Social Security Act (42 U.S.C. 

1395ww(m)(6)(A)(i)) will have on the access, quality, and cost of 

care for such individuals; and (C) how to appropriately pay for such 

care under the Medicare program. The Secretary shall submit the 

report within 1 year after enactment of this act to the Committees 

on Appropriations of the House of Representatives and the Senate 

with recommendations for such legislation and administrative actions as the Secretary determines appropriate. 

Sickle Cell Disease [SCD].—The Committee recognizes the Department’s efforts in addressing the burden of SCD and continues 

to support a multi-disciplinary approach to identify new methods to 

disease management, supportive care, and reducing the burden of 

care and premature death. The Committee urges the Secretary to 

continue coordinating the Department’s activities through the 

Interagency Working Group on SCD. 

Technical Assistance for Priority Areas.—The Committee notes 

that the Medicare Access and CHIP Reauthorization Act of 2015 

authorizes the Secretary to provide technical assistance on the 

Merit-based Incentive Payment System to eligible professionals 

with a priority given to practices located in rural, medically underserved, or health professional shortage areas. Due to their extensive experience working with providers in rural and underserved 

areas, the Committee highlights the significance of the State Offices of Rural Health and their ability to provide this type of guidance. 

Transparency in Health Plans.—The Committee is aware of the 

additional guidance issued to qualified health plans to ensure 

greater consistency and full transparency of coverage options in-
150 

cluded in health insurance plans prior to selecting them on the Exchanges during the enrollment process. The Committee expects the 

Secretary to ensure this guidance is followed. 

United States-Mexico Border Health Commission.—The border 

between the United States and Mexico is one of the busiest transit 

points in the world. Therefore, the Committee urges the Secretary 

to continue supporting the United States-Mexico Border Health 

Commission and to focus on infection disease surveillance, epidemiology, and preparedness activities along the borders in order to be 

able to respond to potential outbreaks and epidemics, including 

those caused by potential bioterrorism agents. 

Viral Hepatitis Action Plan.—The Committee continues to be 

concerned by the viral hepatitis epidemic and recognizes that much 

needs to be done to identify the millions of Americans with hepatitis before they reach end stage liver disease. The Committee 

urges the Secretary to continue to implement the Viral Hepatitis 

Action Plan and requests a report on spending by HHS agencies to 

implement the Action Plan in the fiscal year 2017 CJ. The report 

should include descriptions of public private partnerships that will 

enhance Federal efforts to combat viral hepatitis. 

Teen Pregnancy Prevention 

The Committee recommendation includes $20,000,000 for the 

Teen Pregnancy Prevention program. This program supports competitive grants to public and private entities to replicate evidencebased teen pregnancy prevention approaches. 

Office of Minority Health 

The Committee recommends $36,000,000 for the Office of Minority Health [OMH]. This Office focuses on strategies designed to decrease health disparities and to improve the health status of racial 

and ethnic minority populations in the United States. OMH establishes goals and coordinates all departmental activity related to improving health outcomes for disadvantaged and minority individuals. 

The Lupus Initiative.—The Committee continues to provide 

$2,000,000 for Lupus activities at the OMH. The Committee commends the successes of the National Health Education program on 

Lupus for healthcare providers that started in fiscal year 2009. 

Within the funding provided for Lupus activities, the Committee 

includes $1,000,000 to complete the implementation of the health 

education program in fiscal year 2016 to transition to another priority in the Lupus community. The Committee recognizes that clinical trial education and successful recruitment of minorities into 

trials is a significant challenge in the drug development for Lupus. 

Therefore, the Committee directs OMH to initiate a program to develop a clinical trial education action plan for Lupus and begin preliminary steps towards implementation of the action plan. OMH 

shall work with the relevant Lupus stakeholders in this effort. The 

Committee includes the remaining $1,000,000 for this new initiative, and it should focus on developing public-private and community partnerships, evaluate current minority clinical trial education 

and participation programs, and development of a research plan for 

creating new clinical trial education models in lupus. OMH shall 
151 

update the Committee on the progress of this new initiative in the 

fiscal year 2017 CJ. 

Abstinence Education 

The Committee recommends $20,000,000 for abstinence education. This is a competitive grant program that funds evidenced 

based abstinence models for adolescents. 

Office of Women’s Health 

The Committee recommends $29,500,000 for the Office of Women’s Health [OWH]. This office develops, stimulates, and coordinates women’s health research, healthcare services, and public and 

healthcare professional education across the Department. It advances important crosscutting initiatives and develops public-private partnerships, providing leadership and policy direction to address the disparities in women’s health. The Committee recommendation includes $3,100,000 to combat 

the violence against women through the State partnership initiative. This program provides funding to State-level public and private health programs to partner with domestic and sexual violence 

organizations to improve healthcare providers’ ability to help victims of violence and improve prevention programs. 

HIV/AIDS in Minority Communities 

Due to budget constraints, the Committee recommendation does 

not include funding for this program. The Secretary’s Minority 

AIDS Fund [SMAIF] supplements core HIV/AIDS funding provided 

to other HHS agencies. The majority of SMAIF activities supported 

prevention, treatment, outreach, and education activities focused 

on minority populations. The Committee notes that core HIV/AIDS 

activities such as CDC’s HIV Prevention with Health Department 

program and HRSA’s Ryan White programs provide the same services to the same population. In addition, SAMHSA also provides 

similar services but targeted to individuals with co-occurring mental health or substance abuse disorders. 

Embryo Donation and Adoption 

The Committee recommends $1,000,000 for Embryo Donation 

and Adoption. 

OFFICE OF MEDICARE HEARINGS AND APPEALS

Appropriations, 2015 ............................................................................. $87,381,000 

Budget estimate, 2016 ........................................................................... 140,000,000 

Committee recommendation ................................................................. 97,381,000 

The Committee provides $97,381,000 for the Office of Medicare 

Hearings and Appeals [OMHA]. This Office is responsible for hearing Medicare appeals at the administrative law judge level, which 

is the third level of Medicare claims appeals. OMHA ensures that 

Medicare beneficiaries who are dissatisfied with the initial decisions about their benefits or eligibility can appeal and exercise 

their right to a hearing in front of an administrative law judge. 

Appeals Backlog.—The Committee continues to be concerned over 

the substantial backlog in the number of cases pending before the 

administrative law judges at OMHA. The Committee directs 
152 

OMHA to use the additional funds provided to address the current 

backlog and requests a spend plan within 30 days after enactment 

of this act. OMHA shall also provide an update in the fiscal year 

2017 CJ on the pilot programs implemented in 2014, including the 

global settlement offer, statistical sampling, and mediation strategies. 

OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION

TECHNOLOGY

Appropriations, 2015 ............................................................................. $60,367,000 

Budget estimate, 2016 ........................................................................... 91,800,000 

Committee recommendation ................................................................. 60,367,000 

The Committee makes available $60,367,000 to the Office of the 

National Coordinator for Health Information Technology [ONC]. 

The Committee provides funding for ONC entirely through budget 

authority, rather than through both budget authority and transfers 

available under section 241 of the PHS Act. ONC is responsible for 

promoting the use of electronic health records in clinical practice, 

coordinating Federal health information systems, and collaborating 

with the private sector to develop standards for a nationwide interoperable health information technology infrastructure. 

Precision Medicine.—The Committee recommendation includes 

$5,000,000 for the coordination and development of data standards 

necessary to advance the Precision Medicine initiative. ONC will 

engage appropriate stakeholders to identify the standards and policy required to protect user privacy. 

OFFICE OF INSPECTOR GENERAL

Appropriations, 2015 ............................................................................. $71,000,000 

Budget estimate, 2016 ........................................................................... 83,000,000 

Committee recommendation ................................................................. 71,000,000 

The Committee recommends an appropriation of $71,000,000 for 

the HHS Office of Inspector General [OIG]. In addition to discretionary funds provided in this act, the Health Insurance Portability 

and Accountability Act of 1996 provides a permanent appropriation 

of $333,893,000 for OIG. 

OIG conducts audits, investigations, and evaluations of the programs administered by the Department’s operating and staff divisions, including the recipients of the Department’s grant and contract funds. In doing so, OIG addresses issues of waste, fraud, and 

abuse and makes recommendations to improve the efficiency and 

effectiveness of the Department’s programs and operations. 

OFFICE FOR CIVIL RIGHTS

Appropriations, 2015 ............................................................................. $38,798,000 

Budget estimate, 2016 ........................................................................... 42,705,000 

Committee recommendation ................................................................. 38,798,000 

The Committee recommends $38,798,000 for the Office for Civil 

Rights [OCR], which is responsible for enforcing civil rights-related 

statutes in healthcare and human services programs. To enforce 

these statutes, OCR investigates complaints of discrimination, conducts program reviews to correct discriminatory practices, and im-
153 

plements programs to generate voluntary compliance among providers and constituency groups of health and human services. 

Pending Complaints.—OCR is tasked with ensuring that individuals are not subject to unlawful discrimination in healthcare programs. However, since September 2014, three Weldon Amendment 

cases have been filed with OCR without resolution. The OCR process is the only recourse for plaintiffs in these cases. Therefore, the 

Committee directs OCR to properly investigate the pending cases 

and urges OCR to resolve the pending cases expeditiously. 

RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED

OFFICERS

Appropriations, 2015 ............................................................................. $562,241,000 

Budget estimate, 2016 ........................................................................... 586,188,000 

Committee recommendation ................................................................. 586,188,000 

The Committee provides an estimated $586,188,000 in mandatory funds for Retirement Pay and Medical Benefits for Commissioned Officers of the U.S. Public Health Service [PHS]. This account provides for retirement payments to PHS officers who are retired due to age, disability, or length of service; payments to survivors of deceased officers; and medical care to Active Duty and retired officers, as well as their dependents. 

PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND

Appropriations, 2015 ............................................................................. $1,175,069,000 

Budget estimate, 2016 ........................................................................... 1,909,981,000 

Committee recommendation ................................................................. 1,227,277,000 

The Committee recommends $1,227,277,000 for the Public 

Health and Social Services Emergency Fund. This appropriation 

supports the activities of the Assistant Secretary for Preparedness 

and Response [ASPR] and other components within the Office of 

the Secretary to prepare for the health consequences of bioterrorism and other public health emergencies, including pandemic influenza. It also provides funding for the Department’s cybersecurity 

efforts. 

Office of the Assistant Secretary for Preparedness and Response 

The Committee recommendation includes $1,102,928,000 for activities administered by the Assistant Secretary for Preparedness 

and Response [ASPR]. This Office was created by the Pandemic 

and All-Hazards Preparedness Act [PAHPA] to lead the Department’s activities regarding preventing, preparing for, and responding to public health emergencies, including disasters and acts of 

terrorism. 

National Disaster Medical System.—The Committee includes new 

bill language providing coverage under the Federal Employees 

Compensation Act for National Disaster Medical System intermittent employees who are activated for training or deployment. 

Hospital Preparedness Program 

The Committee’s recommendation includes $254,555,000 for the 

Hospital Preparedness Program [HPP]. This program provides 

grants to States to build healthcare coalitions that enhance regional and local hospital preparedness and improve overall surge 

capacity in public health emergencies. The Committee believes this 
154 

funding should continue to provide our Nation’s hospitals and 

emergency responders the necessary tools to respond quickly and 

collaboratively to these and other public health emergencies that 

are inevitable in our Nation’s communities. 

Allocation of Funds.—The Committee urges ASPR and State 

grantees to be strategic about allocation of HPP funds. Under current structures, States may allocate funds to as many healthcare 

coalitions as they deem appropriate. ASPR is encouraged to communicate to grantees the minimum standards a healthcare coalition must meet to be qualified under the program. ASPR should 

also provide oversight and technical assistance to ensure coalitions 

are meeting those standards and States are subgranting funds appropriately. 

Geographic Variation in Mass Casualty Traumatic Injury Treatment Capacity.—The Committee is aware that the present geographic distribution of trauma and burn centers and other similar 

response capabilities are heavily skewed toward urban locations 

and vary significantly among different urban settings. The Committee is concerned that there are vulnerabilities in the Nation’s 

emergency response system for areas not equipped to deal with 

mass casualty incidents with traumatic injuries. According to the 

CDC, 45 million Americans lack access to Level I trauma centers 

within the so-called ‘‘golden hour’’ during which outcomes dramatically improve. Similarly, just 25 percent of the U.S. population 

lives within 1 hour by ground transport of a verified burn center. 

Therefore, the Committee directs ASPR to provide a detailed report 

that analyzes the ability of our current infrastructure to respond 

to a large scale (greater than 20 casualties) traumatic injury event 

that may occur in a rural, exurban, suburban, and urban locations 

that are relatively underserved by the Nation’s trauma system. The 

report should include recommendations on capacity building approaches including the use of the HPP address these capacity 

shortfalls. 

Local Health Departments.—The Committee requests more detailed information in the fiscal year 2017 CJ on how State HPP 

funding is distributed at the local level. ASPR is encouraged to require States to report how much Federal HPP funding is being allocated to local health departments and what basis or formula each 

State is using to make such allocations. 

Rural Areas.—The Committee encourages ASPR to ensure that 

hospital systems in remote and rural areas are benefiting from this 

program and are prepared in cases of emergencies, epidemics, or 

natural disasters. 

Emergency System for Advance Registration of Volunteer Health 

Professionals [ESAR VHP] 

The Committee recommendation does not include funding for the 

ESAR VHP program, consistent with the administration’s request. 

Past funding supported technical assistance to States, but any future request for support will be covered by other ASPR resources. 

This program established a national network of health professionals who provide assistance during an emergency. 
155 

Biomedical Advanced Research and Development 

The Committee recommendation includes $473,000,000 for advanced research and development. The Committee recommendation 

includes $143,000,000 for BARDA’s Broad Spectrum Antimicrobials 

program as part of the Department-wide CARB initiative. The 

Committee directs BARDA to collaborate with NIH, CDC, AHRQ, 

FDA, VA, DOD, and USDA to leverage existing resources to increase capacities for research aimed at developing therapeutic 

treatments. The Committee appreciates the work of BARDA to 

combat antibiotic resistant bacteria through expansion of publicprivate partnerships that invest in the development of new antibiotic therapies. The Committee expects BARDA to continue to use 

its other transactional authority, as granted by PAHPA, to the 

maximum extent possible to further its work in this area. 

Medical Countermeasure Dispensing 

The Committee recommendation does not include funding for the 

Medical Countermeasure Dispensing program, consistent with the 

administration’s request. The Committee notes that prior year balances exist to support any remaining program costs in fiscal year 

2016. 

Project BioShield Special Reserve Fund 

The Committee recommendation includes $255,000,000 for the 

Project BioShield Special Reserve Fund. The Committee is committed to ensuring the Nation is adequately prepared against 

chemical, biological, radiological, and nuclear attacks. The Committee recognizes a public-private partnership to develop medical 

countermeasures [MCMs] is required to successfully prepare and 

defend the Nation against these threats. Where there is little or no 

commercial market, the Committee supports the goal of Government financing providing a market guarantee. 

Other Activities 

The Committee recommendation includes the following amounts 

for the following activities within ASPR: —Operations.—$30,938,000; —Preparedness and Emergency Operations.—$24,654,000; —National Disaster Medical System.—$49,904,000; and —Policy and Planning.—$14,877,000. 

Office of the Assistant Secretary for Administration 

The Committee recommends $41,125,000 for information technology cybersecurity in the Office of the Assistant Secretary for Administration. These funds provide for continuous monitoring and 

security incident response coordination for the Department’s computer systems and networks. 

Office of the Assistant Secretary for Health/Medical Reserve Corps 

The Committee recommendation includes $3,839,000 for the 

Medical Reserve Corps program in ASH. This program is a national network of local volunteers who work to strengthen the public health infrastructure and preparedness capabilities of their communities. 
156 

Office of the Secretary 

The Committee recommendation includes $79,385,000 for activities within the Office of the Secretary. 

Pandemic Influenza Preparedness 

The Committee recommendation includes $71,915,000 for Pandemic Influenza Preparedness. Of the total, $32,009,000 is provided 

in annual funding and $39,906,000 in no-year funding. 

Office of Security and Strategic Information 

The Committee includes $7,470,000 for the Office of Security and 

Strategic Information to maintain the security of the Department’s 

personnel, systems, and critical infrastructure. 

PREVENTION AND PUBLIC HEALTH FUND

In fiscal year 2016, the level transferred from the fund after accounting for sequestration is $932,000,000. The Committee includes 

bill language in section 224 of this act that requires that funds be 

transferred within 45 days of enactment of this act to the following 

accounts, for the following activities, and in the following amounts: 

[In thousands of dollars] 

Agency Account Program Committee 

recommendation 

ACL .............................................. Aging and Disability Services 

Programs.

Alzheimer’s Disease Prevention 

Education and Outreach.

14,700 

ACL .............................................. Aging and Disability Services 

Programs.

Chronic Disease Self Management.7,600 

ACL .............................................. Aging and Disability Services 

Programs.

Falls Prevention .......................... 4,750 

CDC ............................................. Immunization and Respiratory 

Diseases.

Section 317 Immunization 

Grants.

210,300 

CDC ............................................. Emerging and Zoonotic Infectious Diseases.Epidemiology and Laboratory Capacity Grants.40,000 

CDC ............................................. Emerging and Zoonotic Infectious Diseases.Healthcare Associated Infections 12,000 

CDC ............................................. Chronic Disease Prevention and 

Health Promotion.

Office of Smoking and Health 

(Tobacco Prevention/Media & 

Quit Lines).

156,650 

CDC ............................................. Chronic Disease Prevention and 

Health Promotion.

Breast Feeding Grants (Hospitals 

Promoting Breastfeeding).

8,000 

CDC ............................................. Chronic Disease Prevention and 

Health Promotion.

Million Hearts Program ............... 4,000 

CDC ............................................. Chronic Disease Prevention and 

Health Promotion.

Nutrition, Physical Activity, & 

Obesity Base Activities.

35,000 

CDC ............................................. Chronic Disease Prevention and 

Health Promotion.

Heart Disease & Stroke Prevention Program.73,000 

CDC ............................................. Chronic Disease Prevention and 

Health Promotion.

Diabetes ...................................... 73,000 

CDC ............................................. Chronic Disease Prevention and 

Health Promotion.

Cancer Prevention & Control ...... 104,000 

CDC ............................................. Chronic Disease Prevention and 

Health Promotion.

Early Care Collaboratives ........... 4,000 

CDC ............................................. Environmental Health ................. Lead Poisoning Prevention ......... 13,000 

CDC ............................................. CDC–Wide Activities ................... Preventive Health and Health 

Services Block Grants.

160,000 

SAMHSA ....................................... Mental Health ............................. Suicide Prevention (Garrett Lee 

Smith).

12,000 
157 

GENERAL PROVISIONS

Section 201. The bill continues a provision placing a $50,000 ceiling on official representation expenses. 

Section 202. The bill continues a provision limiting the use of 

certain grant funds to pay individuals more than an annual rate 

of executive level II. 

Section 203. The Committee recommendation continues a provision restricting the Secretary’s use of taps for program evaluation 

activities unless a report is submitted to the Appropriations Committees of the House of Representatives and the Senate on the proposed use of funds. 

Section 204. The Committee recommendation continues a provision authorizing the transfer of up to 2.5 percent of PHS Act funds 

for evaluation activities. 

Section 205. The Committee recommendation continues a provision restricting transfers of appropriated funds and requires a 15- 

day notification to the Committees on Appropriations of the House 

of Representatives and the Senate Appropriations Committees. 

Section 206. The bill retains a general provision allowing National Health Service Corps contracts to be canceled up to 60 days 

after award. 

Section 207. The Committee recommendation continues a provision regarding requirements for family planning applicants. 

Section 208. The Committee recommendation retains language 

which states that no provider services under title X of the PHS Act 

may be exempt from State laws regarding child abuse. 

Section 209. The Committee recommendation retains language 

which restricts the use of funds to carry out the Medicare Advantage Program if the Secretary denies participation to an otherwise 

eligible entity. 

Section 210. The bill continues a provision prohibiting the use of 

funds for lobbying activities related to gun control. 

Section 211. The bill continues a provision that limits the assignment of certain public health personnel. 

Section 212. The Committee recommendation retains a provision 

which facilitates the expenditure of funds for international health 

activities. 

Section 213. The Committee continues a provision that permits 

CDC and the Agency for Toxic Substances and Disease Registry to 

transfer funds that are available for Individual Learning Accounts. 

Section 214. The Committee recommendation continues a provision permitting the transfer of up to 3 percent of AIDS funds 

among ICs by the Director of NIH and the Director of the Office 

of AIDS Research at NIH. 

Section 215. The Committee recommendation retains language 

which requires that the use of AIDS research funds be determined 

jointly by the Director of NIH and the Director of the Office of 

AIDS Research and that those funds be allocated directly to the Office of AIDS Research for distribution to the ICs consistent with 

the AIDS research plan. 

Section 216. The Committee recommendation continues a provision authorizing the Director of NIH to enter into certain transactions to carry out research in support of the NIH Common Fund. 
158 

Section 217. The Committee recommendation continues a provi- sion permitting NIH to use up to $3,500,000 per project for improvements and repairs of facilities. 

Section 218. The Committee recommendation retains a provision 

that transfers funds from NIH to HRSA and AHRQ, to be used for 

National Research Service Awards. 

Section 219. The bill includes a new provision related to the NIH 

IDeA program. 

Section 220. The bill includes a new provision related to the 

NEF. 

Section 221. The bill retains a provision related to third party 

payments to NIH. 

Section 222. The Committee recommendation retains a provision 

that provides BARDA with authority to enter into a multiyear contract for up to 10 years and to repurpose unused termination costs 

to pay contract invoices. 

Section 223. The Committee recommendation continues a provision requiring a publicly available Web site that details expenditures from the PPH Fund. 

Section 224. The Committee recommendation continues a provision transferring mandatory funds from section 4002 of the Patient 

Protection and Affordable Care Act to accounts within the Department for activities outlined under the heading ‘‘Prevention and 

Public Health Fund’’ in this report. 

Section 225. The Committee recommendation retains a provision 

requiring CJs to include certain FTE information with respect to 

ACA. 

Section 226. The bill includes a modified provision related to 

ACA exchange funding transparency. 

Section 227. The bill includes a new provision related to ACA enrollment notifications. 

Section 228. The bill continues a provision prohibiting funds for 

the Risk Corridor program. 

Section 229. The bill includes a new provision prohibiting funds 

for the State-Based Exchanges. 

Section 230. The bill includes a new provision prohibiting the use 

of funds for implementing the Dietary Guidelines. 

Section 231. The bill includes a new provision cancelling unobligated balances at HRSA. 

Section 232. The bill includes a new provision rescinding unobligated carry-over balances from previous appropriations acts for 

CDC’s Individual Learning Accounts. 

Section 233. The bill includes a new general provision rescinding 

$250,000,000 in unobligated prior year balances from the unaccompanied children program. 
(159) 

TITLE III 

DEPARTMENT OF EDUCATION 

EDUCATION FOR THE DISADVANTAGED

Appropriations, 2015 ............................................................................. $15,536,107,000 

Budget estimate, 2016 ........................................................................... 16,592,546,000 

Committee recommendation ................................................................. 15,455,802,000 

The Committee recommends an appropriation of $15,455,802,000 

for education for the disadvantaged. 

The programs in the Education for the Disadvantaged account 

help ensure that poor and low-achieving children are not left behind in the Nation’s effort to raise the academic performance of all 

children and youth. Funds appropriated in this account primarily 

support activities in the 2016–2017 school year. 

Grants to Local Educational Agencies 

Title I grants to local educational agencies [LEAs] provide supplemental education funding, especially in high-poverty areas, for 

local programs that provide extra academic support to help raise 

the achievement of eligible students or, in the case of schoolwide 

programs, help all students in high-poverty schools meet challenging State academic standards. Title I grants are distributed 

through four formulas: basic, concentration, targeted, and education finance incentive grant. 

The Committee recommends $14,559,802,000 for the title I 

grants to LEAs program. Of the funds available for title I grants 

to LEAs, up to $3,984,000 shall be available on October 1, 2015 for 

transfer to the Census Bureau for poverty updates; $3,714,641,000 

will become available on July 1, 2016; and $10,841,177,000 will become available on October 1, 2016. The funds that become available on July 1, 2016, and October 1, 2016, will remain available for 

obligation through September 30, 2017. 

The Committee recommendation includes a new general provision affirming that the Department of Education cannot require or 

incentivize, including requiring as a condition of waiver under the 

Elementary and Secondary Education Act [ESEA], the adoption of 

any specific instructional content, academic standards, academic 

assessments, or curriculum. 

School Improvement Grants 

The Committee recommendation includes $450,000,000 for the 

School Improvement Grants [SIG] program. 

The Committee continues authorities provided by prior appropriations acts that address several issues, including: expanding the 

number of schools that may receive funds through the program, 

which allows schools to be eligible for SIG if they are eligible for 
160 

title I and have not made adequate yearly progress for at least 2 

years or are in the State’s lowest quintile of performance based on 

proficiency rates; allowing States to make subgrants of up to 

$2,000,000 to each participating school for an award period of 5 

years, increasing the amount and length of grant awards; allowing 

the Department to set-aside up to 5 percent of the SIG appropriation for national activities; providing flexibility from the prescriptive school improvement strategies previously required by the Department, by allowing LEAs to implement a whole-school reform 

strategy based on at least a moderate level of evidence that it will 

improve student outcomes or an alternative State-determined 

school improvement strategy established by the State and approved 

by the Secretary; and allowing LEAs eligible under the Rural Education Achievement program to modify one element of a SIG model. 

The Committee notes that SIG funds may be used for the coordination and provision of integrated student supports that address 

the non-academic needs of students. 

The Committee is aware of effective and innovative models for 

school-wide reading improvement in rural communities. These 

models use highly individualized approaches to improving early literacy, and further focus on integrating and aligning out of school 

interventions, supplementing the traditional school day with 

aligned afterschool, summer, and parental engagement programs. 

The Committee encourages the Department to consider such interventions, particularly in rural communities, as part of efforts to improve low-performing schools and student outcomes. 

Striving Readers Comprehensive Literacy Program 

Due to budget constraints, the Committee recommendation does 

not include funding for the Striving Readers Comprehensive Literacy program. Fiscal year 2015 funding supported the fifth year 

of 5-year grants under this program. The Committee looks forward 

to results from this round of grants in considering future funding 

requests. 

Migrant Education Program 

The Committee recommends $365,000,000 for the title I Migrant 

Education program. 

This funding supports grants to State Education Agencies [SEAs] 

for programs to meet the special educational needs of the children 

of migrant agricultural workers and fishermen. Funding also supports activities to improve interstate and intrastate coordination of 

migrant education programs, as well as identify and improve services to the migrant student population. 

Neglected and Delinquent 

The Committee recommends $46,000,000 for the title I Neglected 

and Delinquent program. 

This program provides financial assistance to SEAs for education 

services to neglected and delinquent children and youth in Staterun institutions and for juveniles in adult correctional institutions. 

States are authorized to set aside at least 15 percent, but not more 

than 30 percent, of their Neglected and Delinquent funds to help 

students in State-operated institutions make the transition into lo-
161 

cally operated programs and to support the successful reentry of 

youth offenders who are age 20 or younger and have received a secondary school diploma or its recognized equivalent. 

Evaluation 

The Committee recommendation does not include specific funding 

for evaluation, as requested by the administration. Instead, the 

Committee recommendation continues a general provision that 

clarifies the Department’s authority to reserve up to 0.5 percent of 

each ESEA appropriation in the bill, except for titles I and III of 

the ESEA, for evaluation of ESEA programs funded in this act. The 

Department is required to provide the Committees on Appropriations of the House of Representatives and the Senate, the Senate 

HELP Committee, and the House Education and Workforce Committee an operating plan describing the proposed uses of this evaluation authority as well as the source appropriation for such activities. In addition, not later than 45 days prior to the submission of 

the required operating plan, the Department shall brief the Committees above on the programs and activities being considered for 

inclusion in the plan. Further, the Committee expects the Department to continue to include in future CJs a discussion of its 

planned use of this authority. 

Evaluation funds are used to support large-scale national surveys that examine how the title I program is contributing to student academic achievement. Funds also are used to evaluate State 

assessment and accountability systems and analyze the effectiveness of educational programs supported with title I funds. 

Special Programs for Migrant Students 

The Committee recommends $35,000,000 for Special Programs 

for Migrant Students, which consist of HEP and CAMP. 

HEP projects are 5-year grants to institutions of higher education and other nonprofit organizations to recruit migrant students ages 16 and older and provide the academic and support 

services needed to help them obtain a high school equivalency certificate and subsequently gain employment, attain admission to a 

postsecondary institution or a job training program, or join the 

military. 

CAMP projects are 5-year grants to institutions of higher education and nonprofit organizations to provide tutoring, counseling, 

and financial assistance to migrant students during their first year 

of postsecondary education. 

IMPACT AID

Appropriations, 2015 ............................................................................. $1,288,603,000 

Budget estimate, 2016 ........................................................................... 1,288,603,000 

Committee recommendation ................................................................. 1,288,603,000 

The Committee recommends $1,288,603,000 for the Impact Aid 

program. 

Impact Aid provides financial assistance to school districts affected by the presence of Federal activities and federally owned 

land. These school districts face unique challenges because they 

must educate children living on federally owned land, such as mili-
162 

tary bases, while federally owned property is also exempt from 

local taxes, a primary source of revenue for local school districts. 

The Committee bill retains language that provides for continued 

eligibility for students affected by the deployment or death of their 

military parent, as long as these children still attend schools in the 

same school district. 

Basic Support Payments.—The Committee recommends 

$1,151,233,000 for the Basic Support Payments program. Under 

this statutory formula, payments are made on behalf of all categories of federally connected children, with a priority placed on 

making payments first to heavily impacted school districts and providing any remaining funds for regular basic support payments. 

Payments for Children With Disabilities.—The Committee bill includes $48,316,000 for Payments for Children With Disabilities. 

Under this program, additional payments are made for certain federally connected children eligible for services under IDEA. 

Facilities Maintenance.—The Committee recommends $4,835,000 

for Facilities Maintenance. This activity provides funding for emergency repairs and comprehensive capital improvements to certain 

school facilities owned by the Department and used by LEAs to 

serve federally connected military dependent students. Funds appropriated for this purpose are available until expended. 

Construction.—The Committee recommends $17,406,000 for eligible LEAs for emergency repairs and modernization of school facilities. 

The Committee recommendation includes bill language allowing 

these funds to be awarded entirely on a competitive basis and be 

available for obligation through September 30, 2017, as requested 

by the administration. 

Payments for Federal Property.—The Committee recommends 

$66,813,000 for Payments for Federal Property. These payments 

compensate LEAs specifically for revenue lost due to the removal 

of Federal property from local tax rolls, regardless of whether any 

federally connected children attend schools in the district. 

The budget request proposed eliminating this program. The Committee recommendation rejects this elimination and notes that this 

funding represents a key component of fulfilling the Federal Government’s commitment to school districts impacted by the presence 

of federally owned land. 

SCHOOL IMPROVEMENT PROGRAMS

Appropriations, 2015 ............................................................................. $4,402,671,000 

Budget estimate, 2016 ........................................................................... 4,693,171,000 

Committee recommendation ................................................................. 4,134,746,000 

The Committee recommendation includes $4,134,746,000 for the 

School Improvement Programs account. 

State Grants for Improving Teacher Quality 

The Committee recommends $2,246,441,000 for State Grants for 

Improving Teacher Quality. 

The appropriation for this program primarily supports activities 

associated with the 2016–2017 academic year. Of the funds provided, $565,000,000 will become available on July 1, 2016, and 

$1,681,441,000 will become available on October 1, 2016. These 
163 

funds will remain available for obligation through September 30, 

2017. 

States and LEAs may use funds for a range of activities related 

to the certification, recruitment, professional development, and 

support of teachers and administrators. Activities may include reforming teacher certification and licensure requirements, addressing alternative routes to State certification of teachers, recruiting 

teachers and principals, and implementing teacher mentoring systems, teacher testing, merit pay, and merit-based performance systems. These funds may also be used by districts to hire teachers 

to reduce class sizes. 

The Committee recommendation increases the set-aside within 

this program for the Supporting Effective Educator Development 

[SEED] program from 2.3 percent to 5 percent, as requested by the 

administration. The SEED program provides competitive grants to 

national not-for-profit organizations for recruiting, training, or providing professional enhancement activities for teachers and school 

leaders, particularly for high-need schools most likely to face shortages in these areas. These funds may be used to support such activities in civic learning. Up to 10 percent of the set-aside funds 

may be used for related research, outreach, evaluation, dissemination, and technical assistance. 

The Committee continues to note that, based on a recent report 

by the Department of Education, only approximately 4 percent of 

funding under the Teacher Quality State Grants program is used 

for the professional development of school principals. The Committee strongly encourages the Department to provide guidance to 

SEAs about the availability of funding for such activities, including 

technical assistance on best practices in this area. 

Mathematics and Science Partnerships 

The Committee recommends $141,299,000 for the Mathematics 

and Science Partnerships program. 

At the recommended funding level, the ESEA requires the Department to award grants by formula to States for competitive 

awards to eligible partnerships, which must include an engineering, math, or science department of an institution of higher education and a high-need LEA. Partnerships will seek to improve the 

performance of students in the areas of math and science, including 

engineering, by bringing math and science teachers in elementary 

and secondary schools together with scientists, mathematicians, 

and engineers to increase the teachers’ subject-matter knowledge 

and improve their teaching skills. 

The Committee notes that investments in non-traditional STEM 

teaching activities, including robotics competitions, are a means to 

engage and inspire students to pursue further study or careers in 

STEM education. 

Education Technology State Grants 

The Committee recommendation does not include funding for 

Education Technology State Grants. Funding for this program was 

eliminated in fiscal year 2011. The budget request included 

$200,000,000 for this activity. 
164 

Supplemental Education Grants 

The Committee recommendation includes $16,699,000 for supplemental education grants to the Republic of Marshall Islands [RMI] 

and the Federated States of Micronesia [FSM]. 

This grant program was authorized by the Compact of Free Association Amendments Act of 2003. These funds will be transferred 

from the Department to the Secretary of the Interior for grants to 

these entities. The Committee bill includes language requested in 

the budget that allows the Secretary of Education to reserve 5 percent of these funds to provide FSM and RMI with technical assistance. 

21st Century Community Learning Centers 

The Committee recommends an appropriation of $1,035,000,000 

for the 21st Century Community Learning Centers [21st CCLC] 

program. 

Funds are allocated to States by formula, which in turn, award 

at least 95 percent of their allocations to LEAs, community-based 

organizations, and other public and private entities. Grantees use 

these resources to establish or expand community learning centers 

that provide activities offering significant extended learning opportunities, such as before- and after-school programs, recreational activities, drug and violence prevention, and family literacy programs 

for students and related services to their families. Centers must 

target their services to students who attend schools that are eligible to operate a schoolwide program under title I of the ESEA or 

serve high percentages of students from low-income families. 

The Committee directs the Department to submit a report to the 

Committees on Appropriations of the House of Representatives and 

the Senate within 90 days of enactment of this act on how States 

and local school districts are using waiver authority under this program, an optional waiver as part of the broader ESEA flexibility 

waivers, and what specific activities schools are funding with 21st 

CCLC funding under this authority. 

The Committee recognizes that foster youth face unique hardships and challenges in completing their high school education and 

fully participating in the student experience. The Committee 

strongly encourages the Secretary to provide guidance and technical assistance to states to help them develop extracurricular programs specifically targeting foster youth. 

State Assessments and Enhanced Assessment Instruments 

The Committee recommends $350,000,000 for the State Assessments and Enhanced Assessment Instruments program. 

This program provides formula grants to States for developing 

and implementing standards and assessments required by the 

ESEA, and competitive grants to States, including consortia of 

States, to improve the quality, validity, and reliability of academic 

assessments. The Committee recommendation includes the full 

amount for State formula grants and due to budget constraints 

does not include funding for competitive grants. 
165 

Education for Homeless Children and Youth 

For carrying out education activities authorized by title VII, subtitle B of the McKinney-Vento Homeless Assistance Act, the Committee recommends $65,042,000. 

This program provides assistance to each State to support an office of the coordinator of education for homeless children and 

youth, to develop and implement State plans for educating homeless children, and to make subgrants to LEAs to support the education of those children. Grants are made to States based on the 

total that each State receives in title I grants to LEAs. 

Under the McKinney-Vento Homeless Children and Youth Program, SEAs must ensure that homeless children and youth have 

equal access to the same free public education, including a public 

preschool education, as is provided to other children and youth. 

The Committee bill also maintains language under the Education 

for the Disadvantaged account clarifying the availability of title I 

funds for services to homeless children and youths. 

Training and Advisory Services 

For Training and Advisory Services authorized by title IV of the 

Civil Rights Act, the Committee recommends $6,575,000. 

The funds provided will support awards to operate the 10 regional equity assistance centers [EACs]. Each EAC provides services to school districts upon request. Activities include disseminating information on successful practices and legal requirements 

related to nondiscrimination on the basis of race, color, sex, or national origin in education programs. 

Education for Native Hawaiians 

For programs for the education of Native Hawaiians, the Committee recommends $32,397,000. 

The Committee bill continues a provision that allows funding 

provided by this program to be used for construction. 

Alaska Native Educational Equity 

The Committee recommends $31,453,000 for the Alaska Native 

Educational Equity Assistance program. 

These funds address the severe educational handicaps of Alaska 

Native schoolchildren. Funds are used for the development of supplemental educational programs to benefit Alaska Natives. The 

Committee bill continues language that allows funding provided by 

this program to be used for construction. The Committee bill also 

includes language overriding the authorizing statute’s requirement 

to make noncompetitive awards to certain organizations. 

In awarding funds under this program, the Committee directs 

the Department to ensure the maximum participation of Alaska 

Native organizations and other required Alaska Native partners, 

ensure that all grantees have meaningful plans for consultation 

with Alaska Native leaders, and make every effort to ensure that 

Alaska Natives and Alaskans represent a significant proportion of 

peer reviewers for grant applications. 
166 

Rural Education 

The Committee recommends $169,840,000 for rural education 

programs. 

The Committee expects that rural education funding will be 

equally divided between the Small, Rural School Achievement Program, which provides funds to LEAs that serve a small number of 

students, and the Rural and Low-Income School Program, which 

provides funds to LEAs that serve concentrations of poor students, 

regardless of the number of students served. 

Comprehensive Centers 

The Committee recommends $40,000,000 for the Comprehensive 

Centers program. 

These funds provide support to a network of comprehensive centers that are operated by research organizations, agencies, institutions of higher education, or partnerships thereof, and provide 

training and technical assistance on various issues to States, LEAs, 

and schools as identified through needs assessments undertaken in 

each region. The system currently includes 15 regional centers, 

which are charged with providing intensive technical assistance to 

SEAs to increase their capacity to assist LEAs and schools with 

meeting the goals of the ESEA, and 7 content centers, which are 

organized by topic area. 

Due to budget restraints the Committee recommendation includes a decrease in funding for this program. However, the Committee strongly supports the establishment of a comprehensive center on students at risk of not attaining full literacy skills due to 

a disability. Such a center should identify or develop free or low 

cost evidence-based assessment tools for identifying students atrisk of not attaining full literacy skills due to a disability, including 

dyslexia impacting reading and writing, or developmental delay impacting reading, writing, language processing, comprehension, or 

executive function; identify evidence-based literacy instruction, 

strategies, and accommodations; identify or develop evidence-based 

professional development for teachers, paraprofessionals, principals, other school leaders, and specialized instructional support 

personnel to understand early indicators of students at risk of not 

attaining full literacy skills; and disseminate the products to regionally diverse state educational agencies, local educational agencies, regional educational agencies, and schools. The Committee 

looks forward to working with the Department in establishing a 

comprehensive center on this issue. 

INDIAN EDUCATION

Appropriations, 2015 ............................................................................. $123,939,000 

Budget estimate, 2016 ........................................................................... 173,939,000 

Committee recommendation ................................................................. 123,939,000 

The Committee recommends $123,939,000 for Indian education 

programs. 

Grants to Local Educational Agencies 

For grants to LEAs, the Committee recommends $100,381,000. 

These funds provide financial support to elementary and secondary 
167 

school programs that serve Indian students, including preschool 

children. Funds are awarded on a formula basis to LEAs, schools 

supported and operated by the Department of the Interior/Bureau 

of Indian Education, and in some cases directly to Indian tribes. 

Special Programs for Indian Children 

The Committee recommends $17,993,000 for special programs for 

Indian children. 

Funds are used for demonstration grants to improve Indian student achievement from early childhood education through college 

preparation programs, and for professional development grants for 

training Indians who are preparing to begin careers in teaching 

and school administration. 

The Committee urges the Department to focus available resources on Native American language preservation and youth education activities. The Committee believes that Native language 

education programs are essential for tribal self′- determination and 

improving educational outcomes for Native youth. 

National Activities 

The Committee recommends $5,565,000 for national activities. 

Funds are used to expand efforts to improve research, evaluation, 

and data collection on the status and effectiveness of Indian education programs, and to continue grants to tribal educational departments for education administration and planning. 

INNOVATION AND IMPROVEMENT

Appropriations, 2015 ............................................................................. $1,102,111,000 

Budget estimate, 2016 ........................................................................... 1,601,559,000 

Committee recommendation ................................................................. 694,616,000 

The Committee recommends $694,616,000 for programs within 

the Innovation and Improvement account. 

The Committee remains concerned that competitive grant programs often leave out rural areas and other high-need communities 

that sometimes simply do not have the capacity to compete against 

better resourced or national organizations for limited funding. The 

Committee directs the Department to ensure that competitive 

grant programs, including but not limited to the Charter Schools, 

Innovative Approaches to Literacy, Arts in Education, and SEED, 

support activities in rural communities. 

Investing in Innovation 

The Committee recommendation does not include funding for the 

Investing in Innovation [i3] program. The i3 program, which was 

established in the Recovery Act and has never been authorized, 

provides funding for replicating education programs that meet the 

highest level of evidence; expanding those with significant levels of 

evidence; and supporting promising practices for which there is 

some level of appropriate research. The Committee supports such 

evidence-based approaches to improve student outcomes but due to 

budget constraints has not included funding for this program and 

instead focused funding to core education formula grant programs. 

The Committee will consider future funding requests pending authorization of the program. 
168 

High School Redesign 

The Committee recommendation does not include funding for a 

new High School Redesign program. The budget request included 

$125,000,000 for this new activity. 

Teacher and Principal Pathways 

The Committee recommendation does not include funding for a 

new Teacher and Principal Pathways program. The budget request 

proposed to consolidate several teacher and school leadership programs into this new program. 

Transition to Teaching 

The Committee recommendation does not include funding for the 

Transition to Teaching program which provides grants to help support efforts to recruit, train, and place nontraditional teaching candidates into teaching positions and to support them during their 

first years in the classroom. Instead, the Committee recommendation includes an increase in the SEED set-aside within the Teacher 

Quality State Grants program, which similarly provides competitive grants for recruiting, training, or providing professional enhancement activities for teachers and school leaders, particularly in 

high-need LEAs. 

School Leadership 

The Committee recommendation does not include funding for the 

School Leadership program. The program provides competitive 

grants to assist high-need LEAs to recruit and train principals and 

assistant principals through activities such as professional development and training programs. Instead, the Committee recommendation includes an increase in the SEED set-aside within the Teacher 

Quality State Grants program, which similarly provides competitive grants for recruiting, training, or providing professional enhancement activities for teachers and school leaders, particularly in 

high-need LEAs. 

Charter Schools 

The Committee recommends a total of $273,172,000, an increase 

of $20,000,000 above fiscal year 2015 for the support of charter 

schools. 

Within the total, the Committee recommendation includes 

$155,000,000 for SEA grants, including non-SEA eligible applicant 

grants; $85,000,000 for grants to make multiple awards to charter 

management organizations and other entities for the replication 

and expansion of successful charter school models; up to $9,000,000 

for State Facilities incentives; not less than $13,000,000 for the 

Credit Enhancement for Charter Schools Facilities program; and 

not less than $11,000,000 for national activities designed to support local, State, and national efforts to increase the number of 

high-quality charter schools. 

Charter Schools Grants support the planning, development, and 

initial implementation of charter schools. SEAs that have authority 

under State law to approve charter schools that are eligible to compete for grants. If an eligible SEA does not participate, charter 

schools from the State may apply directly to the Secretary. 
169 

Under the State facilities program, the Department awards 5- 

year competitive grants to States that operate per-pupil facilities 

aid programs for charters schools. Federal funds are used to match 

State-funded programs to provide charter schools with additional 

resources for charter school facilities financing. 

The credit enhancement program provides assistance to help 

charter schools meet their facility needs. Funds are provided on a 

competitive basis to public and nonprofit entities to leverage nonFederal funds that help charter schools obtain school facilities 

through purchase, lease, renovation, and construction. 

The Committee bill continues language that allows charter school 

funds to be used for preschool programs in charter schools. 

Magnet Schools Assistance 

The Committee recommends $85,000,000 for the Magnet Schools 

Assistance program. 

This program supports grants to LEAs to establish and operate 

magnet schools that are part of a court-ordered or federally approved voluntary desegregation plan. Magnet schools are designed 

to attract substantial numbers of students from different social, 

economic, ethnic, and racial backgrounds. Grantees may use funds 

for planning and promotional materials, salaries of instructional 

staff, and the purchase of technology, educational materials, and 

equipment. 

Fund for the Improvement of Education 

The Committee recommends an appropriation of $62,815,000 for 

FIE. 

Preschool Development Grants.—The Committee recommendation 

does not include funding for Preschool Development Grants, which 

have never been authorized. This program was funded under FIE 

in fiscal year 2015; the budget request included $750,000,000, funded within a new account. This program, first funded in fiscal year 

2014, provides competitive grants to States to develop or expand 

preschool programs for 4-year-olds. The Committee is concerned 

that funding another discretionary competitive grant program to 

provide early childhood education contributes to an already complicated system of early childhood care and education programs at 

the local level. This bill alone provides funding for Head Start and 

the Child Care and Development Fund, which itself includes funds 

from TANF and SSBG, which provide early childhood care and 

education for children from birth to age 5. States themselves spend 

approximately $5.5 billion on State-funded preschool programs. 

These programs are administered by different agencies and levels 

of government, and each come with their own eligibility and reporting requirements. The Committee continues to support funding for 

these core early childhood care and education programs, and efforts 

to better coordinate these existing programs. 

In 2012, a Government Accountability Office report (GAO–12– 

342SP) identified 45 Federal programs that provide or may support 

related services to children from birth through age 5, as well as 

five tax provisions that subsidize private expenditures in this area. 

The Child Care and Development Block Grant Act of 2014 requires 

the Secretaries of HHS and Education to conduct an interdepart-
170 

mental review of all early learning programs, develop a plan for 

eliminating duplicative programs, and make recommendation to 

Congress for streamlining such programs. The Committee looks forward to this report and believes the administration should complete this review before considering funding relatively new programs in this area. 

Innovative Approaches to Literacy.—Within programs of national 

significance, the Committee includes $25,000,000 for the Innovative 

Approaches to Literacy program, the same as the fiscal year 2015 

funding level. The budget request does not include funding for this 

program. The Innovative Approaches to Literacy program provides 

competitive grants to national not-for-profit organizations and 

school libraries for providing books and childhood literacy activities 

to children and families living in high-need communities. The Committee continues to expect that no less than 50 percent of these 

funds to be awarded to school libraries proposing high-quality 

projects for increasing access to a wide range of print and electronic resources that provide learning opportunities to all students, 

but particularly those less likely to have access to such materials 

at home. 

The Committee directs the Department to include in future CJs 

program performance information for this program covering all applicable years, consistent with data provided for other similar programs. 

Arts in Education.—Within the amount for FIE, the Committee 

includes $25,000,000 for the Arts in Education program, the same 

as the fiscal year 2015 funding level and the budget request. The 

funding is used for competitive awards for national nonprofit organizations engaged in arts education, professional development activities, and model arts education programs. Funds also are used 

for evaluation and dissemination activities, as well as to support a 

partnership with the National Endowment for the Arts. 

Javits Gifted and Talented Students.—Within FIE, the Committee also recommends $11,000,000, an increase of $1,000,000 

above fiscal year 2015, for the Javits Gifted and Talented Students 

Education program. The budget request included $9,650,000. 

Funds are used for awards to State and local educational agencies, 

institutions of higher education, and other public and private agencies for research, demonstration, and training activities designed to 

enhance the capability of elementary and secondary schools to meet 

the special educational needs of gifted and talented students, including those from disadvantaged and underrepresented populations. 

Presidential and Congressional History Teaching Academies.— 

Within the total for FIE, the Committee recommendation includes 

$1,815,000 for Presidential and Congressional History Teaching 

Academies, as authorized by the American History and Civics Education Act of 2004. This supports summer residential academies to 

help teachers and outstanding students learn more about these important subjects and share their knowledge with students and 

classmates. 

Extended Learning Time.—The Committee encourages the Department to consider funding for programs that include extended 
171 

learning time, specifically year-round education, as an innovative 

approach to improving student achievement. 

Teacher Incentive Fund 

The Committee recommendation includes $225,000,000 for TIF. 

The goals of TIF are to improve student achievement by increasing teacher and principal effectiveness; reform compensation systems to reward gains in student achievement; increase the number 

of effective teachers teaching low-income, minority, and disadvantaged students, and students in hard-to-staff subjects; and other activities designed to increase the effectiveness of teachers, principals, and other personnel in high-need schools. 

Ready-To-Learn Television 

The Committee recommendation includes $25,741,000 for the 

Ready-to-Learn Television program. 

This program is intended to use the power and reach of public 

television to help prepare children, especially disadvantaged children, enter and succeed in school. 

Advanced Placement 

The Committee recommends $22,888,000 for Advanced Placement [AP] programs. 

Funds have supported two programs: the AP Test Fee program 

and the AP Incentive [API] program. The purpose of both is to aid 

State and local efforts to increase access to AP and International 

Baccalaureate [IB] classes and tests for low-income students. 

Under the test fee program, the Department makes awards to 

SEAs to enable them to cover part or all of the cost of test fees of 

low-income students who are enrolled in an AP or IB class and 

plan to take an AP or IB test. Under the API program, the Department makes 3-year competitive awards to SEAs, LEAs, or national 

nonprofit educational entities to expand access for low-income individuals to AP programs through activities including teacher training; development of pre-advanced placement courses; coordination 

and articulation between grade levels to prepare students for academic achievement in AP or IB courses; books and supplies; and 

participation in online AP or IB courses. Under the authorizing 

statute, the Department must give priority to funding the test fee 

program. 

SAFE SCHOOLS AND CITIZENSHIP EDUCATION

Appropriations, 2015 ............................................................................. $223,315,000 

Budget estimate, 2016 ........................................................................... 349,561,000 

Committee recommendation ................................................................. 120,314,000 

The Committee recommends a total of $120,314,000 for activities 

to promote safe schools, healthy students, and citizenship education. 

Promise Neighborhoods 

The Committee recommendation includes $37,000,000 for the 

Promise Neighborhoods program. This funding should be used to 

support the continuation costs of current grantees. 
172 

This program awards competitive grants to not-for-profit, community-based organizations for the development of comprehensive 

neighborhood programs designed to combat the effects of poverty 

and improve educational and life outcomes for children and youth, 

from birth through college. Each Promise Neighborhood grantee 

serves a high-poverty urban neighborhood or rural community. 

The Department has awarded 1-year planning grants to develop 

and plan for providing a continuum of services and supports for the 

children and youth in a particular neighborhood, and multiple-year 

implementation grants to organizations with feasible plans for 

achieving the goals of the program. The Committee recommendation will support the continuation costs of the seven remaining implementation grants. 

The Committee continues to note that at least one implementation grantee has included college savings accounts as part of its 

plan for providing a high-quality continuum of integrated cradle to 

college career services. The Committee is interested in understanding the number of grantees that have included college savings 

accounts in their plans and the impact the use of college savings 

accounts is having on the college-going behavior of participating 

students. 

Safe and Drug-Free National Activities 

The Committee recommendation includes $60,000,000 for the national activities portion of the Safe and Drug-Free Schools and 

Communities program, including up to $5,000,000 for Project 

SERV. This funding will help schools address the consequences of 

their students witnessing or being the victim of violence and other 

root causes of unhealthy school climates. 

Elementary and Secondary School Counseling 

The Committee recommendation includes $23,314,000 for elementary and secondary school counseling. The Committee recommendation will help support the continuation costs of current 

grantees. 

Carol M. White Physical Education for Progress Program 

Due to budget constraints the Committee recommendation does 

not include funding for the physical education program. Instead, 

the Committee has focused funding on core and flexible funding 

streams, such as title I, that allow States, LEAs, and local schools 

to determine how to best use limited resources. 

ENGLISH LANGUAGE ACQUISITION

Appropriations, 2015 ............................................................................. $737,400,000 

Budget estimate, 2016 ........................................................................... 773,400,000 

Committee recommendation ................................................................. 712,021,000 

The Committee recommends an appropriation of $712,021,000 for 

the English Language Acquisition program. 

The Department makes formula grants to States based on each 

State’s share of the Nation’s limited-English-proficient and recent 

immigrant student population. The program is designed to increase 

the capacity of States and school districts to address the needs of 

these students. The authorizing statute requires that 6.5 percent of 
173 

the appropriation be used to support national activities, which include professional development activities designed to increase the 

number of highly qualified teachers serving limited-English-proficient students; a National Clearinghouse for English Language 

Acquisition and Language Instructional Programs; and evaluation 

activities. National activities funds shall be available for 2 years. 

The Committee bill continues language that requires the Secretary to use a 3-year average of the most recent data available 

from the American Community Survey for calculating allocations to 

all States under this program. 

The Committee recommendation represents a decrease from the 

fiscal year 2015 funding level, in part, because it does not include 

$14,000,000 provided in fiscal year 2015 specifically to address 

costs associated with a significant increase in unaccompanied children during fiscal year 2015. The budget request did not include 

funding for this activity. 

SPECIAL EDUCATION

Appropriations, 2015 ............................................................................. $12,522,358,000 

Budget estimate, 2016 ........................................................................... 12,822,358,000 

Committee recommendation ................................................................. 12,636,817,000 

The Committee recommends an appropriation of $12,636,817,000 

for special education programs. 

Grants to States 

The Committee recommendation includes $11,597,848,000 for 

IDEA Part B Grants to States. This program provides formula 

grants to assist States, outlying areas, and other entities in meeting the costs of providing special education and related services for 

children with disabilities. States pass along most of these funds to 

LEAs, but may reserve some for program monitoring, enforcement, 

technical assistance, and other activities. 

The appropriation for this program primarily supports activities 

associated with the 2016–2017 academic year. Of the funds available for this program, $2,314,465,000 will become available on July 

1, 2016, and $9,283,383,000 will become available on October 1, 

2016. These funds will remain available for obligation through September 30, 2017. 

As requested by the administration, the Committee continues bill 

language capping the Department of the Interior set-aside at the 

prior year level, adjusted by the lower of the increase in inflation 

or the change in the appropriation for grants to States. This provision also would prevent a decrease in the amount to be transferred 

in case the funding for this program decreases or does not change. 

The bill also continues language included in prior year appropriations acts, and requested by the administration, clarifying several 

provisions of the IDEA, and providing authority concerning certain 

maintenance of effort [MOE] requirements. 

Preschool Grants 

The Committee recommends $363,238,000 for Preschool Grants. 

This program provides formula grants to States to assist them in 

making available special education and related services for children 

with disabilities aged 3 through 5. States distribute the bulk of the 
174 

funds to LEAs. States must serve all eligible children with disabilities aged 3 through 5 and have an approved application under the 

IDEA. 

Grants for Infants and Families 

The Committee recommends $453,556,000 for the Grants for Infants and Families program under part C of the IDEA. Part C of 

the IDEA authorizes formula grants to States, outlying areas, and 

other entities to implement statewide systems for providing early 

intervention services to all children with disabilities, ages 2 and 

younger, and their families. The IDEA also gives States the option 

of extending eligibility for part C services to children 3 and older 

if they were previously served under part C and will continue to 

be served until entrance to kindergarten. 

State Personnel Development 

The Committee recommends $35,000,000 for the State Personnel 

Development program. Ninety percent of funds must be used for 

professional development activities. The program supports grants 

to SEAs to help them reform and improve their personnel preparation and professional development related to early intervention, 

educational, and transition services that improve outcomes for students with disabilities. The bill includes language proposed in the 

budget request that allows funds under the program to be used for 

program evaluation. 

Technical Assistance and Dissemination 

The Committee recommends $51,928,000 for Technical Assistance and Dissemination. This program supports awards for technical assistance, model demonstration projects, the dissemination 

of useful information, and other activities. Funding supports activities that are designed to improve the services provided under the 

IDEA. 

Within the total, the Committee recommendation includes 

$9,500,000, an increase of $1,917,000 above the fiscal year 2015 

funding level and the budget request, to support activities authorized by the Special Olympics Sport and Empowerment Act, including Project UNIFY. This funding supports efforts to expand Special 

Olympics programs and the design and implementation of Special 

Olympics education programs that can be integrated into classroom 

instruction and are consistent with academic content standards. 

Personnel Preparation 

The Committee recommends $81,700,000 for the Personnel Preparation program. 

Funds support competitive awards to help address State-identified needs for personnel who are qualified to work with children 

with disabilities, including special education teachers and related 

services personnel. The program is required to fund several other 

broad areas, including training leadership personnel and personnel 

who work with children with low-incidence disabilities, and providing enhanced support for beginning special educators. 
175 

Parent Information Centers 

The Committee recommends $26,500,000 for Parent Information 

Centers. 

This program makes awards to parent organizations to support 

parent training and information centers, including community parent resource centers. These centers provide training and information to meet the needs of parents of children with disabilities living 

in the areas served by the centers, particularly underserved parents, and parents of children who may be inappropriately identified. 

Technology and Media Services 

The Committee recommends $27,047,000 for Technology and 

Media Services. This program makes competitive awards to support the development, demonstration, and use of technology and 

educational media activities of value to children with disabilities. 

The Committee recognizes the progress made with tools and 

services provided under the Technology and Media Services program that have allowed more than 320,000 students free access to 

more than 280,000 books in multiple digitally accessible formats. 

The Committee continues to support these activities funded within 

this account, and the expansion of these activities to reach additional students, with a focus on underserved areas. 

REHABILITATION SERVICES AND DISABILITY RESEARCH

Appropriations, 2015 ............................................................................. $3,709,853,000 

Budget estimate, 2016 ........................................................................... 3,532,109,000 

Committee recommendation ................................................................. 3,487,864,000 

The Workforce Investment and Opportunity Act [WIOA] of 2014 

moved several programs within Rehabilitation Services and Disability Research from the Department of Education to the Administration for Community Living at the Department of HHS. The 

Committee recommendation supports this reorganization. 

Vocational Rehabilitation State Grants 

The Committee recommends $3,391,770,000 in mandatory funding for Vocational Rehabilitation [VR] State Grants. 

State Grants assist States in providing a range of services to 

help persons with physical and mental disabilities prepare for and 

engage in meaningful employment. 

The Rehabilitation Act requires that not less than 1 percent and 

not more than 1.5 percent of the appropriation for VR State Grants 

be set aside for Grants for American Indians. 

The Committee recommendation continues bill language allowing 

the Department to use unobligated VR State grant funds that remain available subsequent to the reallottment process, to be used 

for innovative activities to improve outcomes for individuals with 

disabilities. 

Client Assistance State Grants 

The Committee recommends $12,000,000 in discretionary funds 

for Client Assistance State Grants. 
176 

This program funds State formula grants to help VR clients or 

client applicants understand the benefits available to them. States 

must operate client assistance programs in order to receive VR 

State Grant funds. 

Training 

The Committee recommends $24,000,000 for training rehabilitation personnel. This program supports grants to provide training to 

new VR staff, or upgrade the qualifications of existing staff. The 

Committee recommendation will support the continuation of current grants. 

Demonstration and Training Programs 

The Committee recommendation does not include funding for 

demonstration and training. This program provides grants to 

States and nonprofit organizations to develop innovative methods 

and comprehensive services to help individuals with disabilities 

achieve satisfactory vocational outcomes. Instead, the Committee 

continues bill language allowing the Department to use unobligated 

VR State Grant funds for innovative approaches to improve outcomes for individuals with disabilities. From fiscal year 2012 to 

2014 approximately $216,000,000 has been made available for such 

activities under that authority. 

Protection and Advocacy of Individual Rights 

The Committee recommends $17,650,000 for the Protection and 

Advocacy of Individual Rights program. 

This program provides grants to agencies to protect and advocate 

for the legal and human rights of persons with disabilities who are 

ineligible for the protection and advocacy services available 

through the Developmental Disabilities Assistance and Bill of 

Rights Act or the Protection and Advocacy for Individuals with 

Mental Illness Act. 

Supported Employment State Grants 

The Committee recommendation does not include funding for the 

Supported Employment State Grants Program. The fiscal year 

2015 budget request proposed eliminating this program because 

supported employment activities funded under this program had 

become an integral part of the larger VR State Grants program, 

funded in large part with mandatory funding, and eliminating this 

program would reduce unnecessary administration burden at the 

national, State and local levels. Despite changes to the Supported 

Employment State Grants program in WIOA, the Committee supports this consolidation and notes that funding for the VR State 

Grants programs, which can be and is used for the same purposes, 

will increase by $56,696,000 in fiscal year 2016. The Committee directs the Department to help ensure that State agencies continue 

to invest appropriate levels of their resources in supported employment, and particularly extended services to youth with the most 

significant disabilities, consistent with the changes in WIOA. 
177 

Independent Living Services for Older Individuals Who Are Blind 

The Committee recommends $33,317,000 for Independent Living 

State Grants. 

This program supports assistance to individuals over age 55 to 

help them adjust to their blindness and continue to live independently, including daily living skills training, counseling, community 

integration information and referral, the provision of low-vision 

and communication devices, and low-vision screening. 

Helen Keller National Center 

The Committee recommends $9,127,000 for the Helen Keller National Center for Deaf-Blind Youth and Adults. 

The Helen Keller National Center consists of a national headquarters in Sands Point, New York, with a residential training and 

rehabilitation facility where deaf-blind persons receive intensive 

specialized services; a network of 10 regional field offices that provide referral and counseling assistance to deaf-blind persons; and 

an affiliate network of agencies. 

SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES

AMERICAN PRINTING HOUSE FOR THE BLIND

Appropriations, 2015 ............................................................................. $24,931,000 

Budget estimate, 2016 ........................................................................... 24,931,000 

Committee recommendation ................................................................. 24,931,000 

The Committee recommends $24,931,000 to help support APH. 

APH provides educational materials to students who are legally 

blind and enrolled in programs below the college level. The Federal 

subsidy provides approximately 72 percent of APH’s total sales income. Materials are distributed free of charge to schools and States 

through per capita allotments based on the total number of students who are blind. Materials provided include textbooks and 

other educational aids in Braille, large type, recorded form, and 

computer applications. Appropriated funds may be used for staff 

salaries and expenses, as well as equipment purchases and other 

acquisitions consistent with the purpose of the Act to Promote the 

Education of the Blind. 

The Committee continues to recognize that students who are 

blind or have a vision loss must have equal access to the same education content and should receive that information at the same 

time as their sighted peers if they are to achieve academically. Accordingly, the Committee continues to support implementation of 

APHs Resources with Enhanced Accessibility for Learning [REAL] 

plan, and includes no less than $475,000 for such activities, the 

same as the fiscal year 2015 level. The REAL plan supports new 

advances in software and hardware technology to ensure that students with vision loss receive high-quality educational material in 

a timely manner and in the appropriate formats required to meet 

individual student learning needs. 

NATIONAL TECHNICAL INSTITUTE FOR THE DEAF

Appropriations, 2015 ............................................................................. $67,016,000 

Budget estimate, 2016 ........................................................................... 67,016,000 

Committee recommendation ................................................................. 69,016,000 
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The Committee recommends $69,016,000 for the National Technical Institute for the Deaf [NTID]. 

NTID, located on the campus of the Rochester Institute of Technology in Rochester, New York, was created by Congress in 1965 

to provide a residential facility for postsecondary technical training 

and education for persons who are deaf. NTID also provides support services for students who are deaf, trains professionals in the 

field of deafness, and conducts applied research. 

The Committee recommendation includes $2,000,000 to establish 

a formal regional partnership with at least one organization to expand the geographic reach of activities and services supported by 

NTID for individuals who are deaf or hard of hearing, leveraging 

NTIDs expertise in this area. This should include a focus on promoting training and post-secondary preparation in STEM fields, 

which could include a focus on exposing students to intense training in targeted subjects; working with NTID faculty to develop and 

deliver post-secondary preparation programs for students; providing professional development for teachers; and developing partnerships with business and industry to promote employment opportunities. 

GALLAUDET UNIVERSITY

Appropriations, 2015 ............................................................................. $120,275,000 

Budget estimate, 2016 ........................................................................... 120,275,000 

Committee recommendation ................................................................. 120,275,000 

The Committee recommends $120,275,000 for Gallaudet University. 

Gallaudet University is a private, not-for-profit institution offering undergraduate and continuing education programs for students 

who are deaf, as well as graduate programs in fields related to 

deafness for students who are hearing and deaf. The university 

conducts basic and applied research related to hearing impairments and provides public service programs for the deaf community. 

This funding also supports the Model Secondary School for the 

Deaf, which serves as a laboratory for educational experimentation 

and development; disseminates curricula, materials, and models of 

instruction for students who are deaf; and prepares adolescents 

who are deaf for postsecondary academic or vocational education or 

the workplace. The university’s Kendall Demonstration Elementary 

School develops and provides instruction for children from infancy 

through age 15. 

CAREER, TECHNICAL, AND ADULT EDUCATION

Appropriations, 2015 ............................................................................. $1,707,686,000 

Budget estimate, 2016 ........................................................................... 1,915,686,000 

Committee recommendation ................................................................. 1,669,731,000 

Career and Technical Education 

The Committee recommends $1,122,019,000 for the Career and 

Technical Education [CTE] account. 

State Grants.—The Committee recommends $1,117,598,000 for 

CTE State grants. The budget request included an increase of 
179 

$200,000,000 for this program for a new American Technical Training Fund, a new competitive grant program as part of a larger reauthorization proposal for the Carl D Perkins Career and Technical 

Education Act. The Committee recommendation does not include 

funding for that activity. 

Funds provided under the State grant program assist States, localities, and outlying areas to expand and improve their CTE program and help ensure equal access to CTE for populations with 

special needs. Persons assisted range from secondary students in 

prevocational courses through adults who need retraining to adapt 

to changing technological and labor market conditions. Funds are 

distributed according to a formula based on State population and 

State per capita income. 

Under the Indian and Hawaiian Natives programs, competitive 

grants are awarded to federally recognized Indian tribes or tribal 

organizations and to organizations primarily serving and representing Hawaiian Natives for services that are additional to what 

these groups receive under other provisions of the Perkins Act. Of the funds available for this program, $326,598,000 will be- come available July 1, 2016, and $791,000,000 will become available on October 1, 2016. These funds will remain available for obligation until September 30, 2017. 

National Programs.—The Committee recommends $4,421,000 to 

support research, development, demonstration, dissemination, evaluation, and assessment of activities aimed at improving the quality 

and effectiveness of CTE. 

Adult Education 

The Committee recommends $547,712,000 for Adult Education 

programs. 

Adult Education State Grants.—The Committee recommendation 

includes $540,000,000 for Adult Education State Grants, which provides grants to States for programs that assist adults in becoming 

literate and in obtaining the skills necessary for employment and 

self-sufficiency. 

National Leadership Activities.—The Committee recommends 

$7,712,000 for adult education national leadership activities. 

STUDENT FINANCIAL ASSISTANCE

Appropriations, 2015 ............................................................................. $24,198,210,000 

Budget estimate, 2016 ........................................................................... 24,198,210,000 

Committee recommendation ................................................................. 24,129,352,000 

The Committee recommends an appropriation of $24,129,352,000 

for programs under the Student Financial Assistance account. 

Federal Pell Grant Program 

The Committee recommends $22,475,352,000 in discretionary 

funding for the Pell grant program. Pell grants provide need-based 

financial assistance that helps undergraduate students and their 

families defray a portion of the costs of postsecondary education. 

Awards are determined according to a statutory need-analysis formula that takes into account a student’s family income and assets, 

household size, and the number of family members, excluding parents, attending postsecondary institutions. 
180 

The Committee recommendation is more than sufficient to support an increase in the maximum Pell grant award, from $5,775 for 

the 2015–16 school year to an estimated $5,915 for the 2016–17 

school year. The Pell grant program is funded partly through the 

discretionary appropriations process and partly through mandatory 

funding. As long as the discretionary portion of funding is sufficient 

to support $4,860 of the maximum award, mandatory funding supports an increase in the overall maximum award based on changes 

in the Consumer Price Index [CPI]. The Department will determine 

the exact amount of the maximum award next year based on CPI 

data available at the end of the 2015 calendar year. 

The Committee notes that CBOs current estimates of Pell Grant 

program costs are significantly lower than their 2014 baseline used 

in developing the fiscal year 2015 appropriations bill. As a result, 

the Department is expected to carry over significantly more funding into fiscal year 2016 than estimated last year. Specifically, actual fiscal year 2014 costs were $554,000,000 lower than estimated, 

meaning additional unobligated balances were carried into fiscal 

year 2015 than was expected last year, and current fiscal year 2015 

estimated costs are $848,000,000 lower than estimated last year. 

Based on these updated estimates for fiscal year 2014 and 2015, 

the Committee recommendation rescinds $300,000,000 in unobligated balances from fiscal year 2015. 

The Pell scoring rule, section 406 of H. Con. Res. 95, requires the 

Committee to fully fund the Pell grant program based on the Congressional Budget Office’s [CBO] program cost estimate for the upcoming award year. Including estimated unobligated balances carried forward from fiscal year 2015 to 2016, the Committee recommendation provides $1,788,000,000 in additional funding above 

what is required to support estimated discretionary program costs 

in fiscal year 2016. This surplus funding will not be used in fiscal 

year 2016 for the 2016–17 school year and will be carried over to 

be used to support program costs in the 2017–18 school year. 

Federal Supplemental Educational Opportunity Grant Program 

The Committee recommends $704,000,000 for the Supplemental 

Educational Opportunity Grant [SEOG] program. 

The SEOG program provides funds to approximately 3,800 postsecondary institutions for need-based grants to more than 1.6 million undergraduate students. Institutions must contribute at least 

25 percent toward SEOG awards. Students qualify for grants of up 

to $4,000 by demonstrating financial need. Priority is given to Pell 

grant recipients with exceptional need. 

Federal Work-Study Program 

The Committee bill provides $950,000,000 for the Federal WorkStudy [FWS] program. 

This program provides grants to approximately 3,400 institutions 

and helps nearly 700,000 undergraduate, graduate, and professional students meet the costs of postsecondary education through 

part-time employment. Institutions must provide at least 25 percent of student earnings. 
181 

Within the total for FWS, the Committee recommendation includes $8,390,000 for the Work Colleges program authorized under 

section 448 of the HEA. 

STUDENT AID ADMINISTRATION

Appropriations, 2015 ............................................................................. $1,396,924,000 

Budget estimate, 2016 ........................................................................... 1,581,854,000 

Committee recommendation ................................................................. 1,361,700,000 

The Committee recommends $1,361,700,000 for the Student Aid 

Administration account. These funds are available until September 

30, 2017, and support the Department’s student aid management 

expenses. The Committee recommendation includes $640,000,000 for administrative costs and $721,700,000 for loan servicing activities. 

The Bipartisan Budget Act of 2013 eliminated mandatory funding that supported the Not-for-Profit [NFP] servicer program and 

two of the TIVAS contracts. To avoid disrupting student borrowers 

whose loan servicing was supported with that mandatory funding, 

Congress provided a total increase of approximately $396,000,000 

for student loan servicing activities in fiscal years 2014 and 2015, 

the vast majority of which is due to the elimination of this mandatory funding source. The Committee notes that this elimination 

does not reduce the Federal responsibility to service student loans 

but only shifts the costs from mandatory funding to discretionary 

funding subject to discretionary spending caps. 

The Committee directs the Department to continue to provide 

quarterly reports detailing its obligation plan by quarter for student aid administrative activities broken out by servicer and activity. Further, any reallocation of funds between administrative costs 

and servicing activities within this account should be treated as a 

reprogramming of funds, and the Committee should be notified in 

advance of any such changes. 

Not-for-Profit Servicers [NFPs].—The Committee includes new 

bill language requiring the Department to allocate no less than 50 

percent of new student loan borrower accounts to NFPs. The Committee commends the Department for developing a single, common 

set of performance metrics for evaluating the performance of the 11 

Federal loan servicers. However, the Department only recently 

began allocating new accounts, limited to 25 percent of new accounts, to NFPs. The Committee strongly supports the allocation of 

new student loan accounts based purely on the performance and 

capacity of servicers, to help ensure high-quality service for borrowers. Until the Department awards a new student loan servicing 

contract, the Committee believes allocating no less than 50 percent 

of new loans, and more if warranted by the performance and capacity of servicers, to NFPs will ensure more comparable portfolios 

across all servicers, consistent with the stated plan of the Department. Similarly, the Committee is also concerned that the Department has unnecessarily restricted consumer choice by only permitting student and parent loan borrowers to select from among the 

four TIVA servicers when choosing a servicer for their consolidation 

loans. The Committee directs the Department to permit borrowers 

to choose from among all 11 Federal loan servicers. Finally, the 

Committee directs the Department to brief the Committees on Ap-
182 

propriations of the House of Representatives and the Senate within 

30 days of enactment of this act on how they are carrying out these 

directives, and how they plan to ensure that student loan allocations, including consolidations, are awarded based on performance 

and capacity, including innovative small business subcontracting 

methods, across all eligible servicers as part of future contracts. 

Higher Education Regulations.—The Committee recommendation 

includes bill language prohibiting funding in this act for several recent regulations, until the Higher Education Act [HEA] is reauthorized, including: developing a post-secondary institution rating system; administratively defining the phrase ‘‘gainful employment’’ included in the HEA; establishing requirements governing the State 

authorization process for higher education programs; establishing a 

Federal definition of the term ‘‘credit hour’’; and establishing a Federal framework for evaluating teacher preparation programs. The 

Committee supports many of the goals of these regulations, but 

each represents a significant expansion of administrative authority, 

and in the case of the post-secondary institution ratings system, a 

misguided use of limited resources. The Committee strongly believes the issues addressed by these regulations should part of the 

normal legislative and authorization process. Accordingly, the Committee prohibits the Department from moving forward with these 

administrative regulations and actions until the HEA is reauthorized. 

Taskforce on Higher Education Regulations.—In 2013, a bipartisan group of Senators commissioned a Task Force on Government 

Regulation of Higher Education to examine the burden of Federal 

regulations on colleges and universities. In February 2015 the task 

force issued a final report concluding that many regulations are unnecessarily long and ambiguous; the cost of compliance has become 

particularly burdensome; many regulations are unrelated to education, student safety, or stewardship of Federal funds; and they 

can be a barrier to access, and innovation in higher education. The 

Committee urges the Department of Education to minimize the 

costs imposed both directly and indirectly on higher education 

through Federal rules and regulations as it seeks to address the 

problems associated with college access and affordability. The Committee further encourages the Department of Education to review 

and implement those recommendations identified in the Task Force 

report that could be addressed through administrative action to alleviate the unnecessary financial burden placed on colleges and 

universities and improve the overall Federal regulatory process. 

Post-Secondary Compliance Calendar.—The Committee is concerned that the Department of Education has failed to implement 

section 482(e) of the Higher Education Act, as amended by the 

Higher Education Opportunity Act of 2008, which directs the Secretary to annually produce a compliance calendar with a schedule 

of all the reporting and disclosure requirements for colleges and 

universities. Publication and distribution of this calendar will 

greatly help colleges and universities understand, plan for, and 

meet their Federal compliance obligations and requirements. The 

Committee therefore strongly encourages the Secretary to produce 

a compliance calendar within 60 days of enactment of this act. 
183 

HIGHER EDUCATION

Appropriations, 2015 ............................................................................. $1,924,839,000 

Budget estimate, 2016 ........................................................................... 2,072,045,000 

Committee recommendation ................................................................. 1,783,510,000 

The Committee recommends an appropriation of $1,783,510,000 

for higher education programs. 

Aid for Institutional Development 

The Committee recommends $514,114,000 for Aid for Institutional Development. 

Strengthening Institutions.—The Committee bill recommends 

$78,048,000 to provide competitive, 1-year planning and 5-year development grants for institutions with a significant percentage of 

financially needy students and low educational and general expenditures per student in comparison with similar institutions. Applicants may use these funds to develop faculty, strengthen academic programs, improve institutional management, and expand 

student services. 

Hispanic-Serving Institutions [HSIs].—The Committee recommends $97,224,000 for competitive grants to institutions at 

which Hispanic students make up at least 25 percent of enrollment. Funds may be used for acquisition, rental, or lease of scientific or laboratory equipment; renovation of instructional facilities; development of faculty; support for academic programs; institutional management; and purchase of educational materials. In 

addition to the Committee-recommended level, the HCERA provides $100,000,000 in mandatory funding in each fiscal year 

through 2019 to support HSIs in the development of STEM and articulation programs. 

Promoting Postbaccalaureate Opportunities for Hispanic Americans.—The Committee recommends $8,722,000 for competitive, 5- 

year grants to HSIs to help Hispanic Americans gain entry into 

and succeed in graduate study. Institutions may use funding to 

support low-income students through outreach programs; academic 

support services; mentoring and financial assistance; acquisition, 

rental, or lease of scientific or laboratory equipment; construction 

and other facilities improvements; and purchase of educational materials. 

Strengthening Historically Black Colleges and Universities.—The 

Committee recommends $220,698,000 for the Strengthening 

HBCUs program. The program makes formula grants to HBCUs 

that may be used to purchase equipment; construct and renovate 

facilities; develop faculty; support academic programs; strengthen 

institutional management; enhance fundraising activities; provide 

tutoring and counseling services to students; and conduct outreach 

to elementary and secondary school students. In addition to the 

Committee-recommended level, this program will receive 

$85,000,000 in mandatory funding through the HCERA in each fiscal year through 2019. 

Strengthening Historically Black Graduate Institutions 

[HBGIs].—The Committee recommends $57,075,000 for the 

Strengthening HBGIs program. This program provides 5-year 

grants to provide scholarships for low-income students and aca-
184 

demic and counseling services to improve student success. Funds 

may also be used for construction, maintenance, and renovation activities; the purchase or lease of scientific and laboratory equipment; and the establishment of an endowment. 

Strengthening Predominately Black Institutions [PBIs].—The 

Committee recommends $8,967,000 for the Strengthening PBIs program. This program provides 5-year grants to PBIs to plan and implement programs to enhance the institutions’ capacity to serve 

more low- and middle-income Black American students. In addition 

to the Committee-recommended level, the HCERA provides 

$15,000,000 in mandatory funding in each fiscal year through 2019 

to support programs at PBIs in the areas of STEM; health education; internationalization or globalization; teacher preparation; 

and improving the educational outcomes of African-American 

males. 

Strengthening Asian American and Native American Pacific Islander-Serving Institutions [AANAPISIs].—The Committee recommends $3,020,000 for competitive grants to AANAPISIs that 

have an enrollment of undergraduate students that is at least 10 

percent Asian American or Native American Pacific Islander students. Grants may be used to improve their capacity to serve Asian 

American and Native American Pacific Islander students and lowincome individuals. In addition to the Committee-recommended 

level, AANAPISIs will receive $5,000,000 in mandatory funding 

through the HCERA in each fiscal year through 2019 to develop 

faculty; strengthen academic programs; improve institutional management; expand student services; and construct classrooms, libraries, laboratories, and other instructional facilities. 

Strengthening Alaska Native and Native Hawaiian-Serving Institutions [ANNHs].—The Committee recommends $12,448,000 for the 

Strengthening ANNHs program. In addition to the Committee recommended level, these institutions receive $15,000,000 in mandatory funding through the HCERA in each fiscal year through 2019. 

The purpose of this program is to improve and expand the capacity of institutions serving Alaska Native and Native Hawaiian students and low-income individuals. Funds may be used to plan, develop, and implement activities that encourage faculty and curriculum development; improve administrative management; renovate educational facilities; enhance student services; purchase library and other educational materials; and, provide education or 

counseling services designed to improve the financial and economic 

literacy of students or their families. 

Strengthening Native American-Serving Non-Tribal Institutions.—The Committee recommends $3,020,000 for this program, 

which serves institutions that enroll at least 10 percent Native 

American students and at least 50 percent low-income students. In 

addition to the Committee recommended level, these institutions 

receive $5,000,000 in mandatory funding through the HCERA in 

each fiscal year through 2019 to help institutions plan, develop, 

and implement activities that encourage faculty and curriculum development; improve administrative management; renovate educational facilities; enhance student services; and purchase library 

and other educational materials. 
185 

Strengthening Tribally Controlled Colleges and Universities.— The Committee recommends $24,892,000 for this program. Tribal 

colleges and universities rely on a portion of the funds provided to 

address developmental needs, including faculty development, curriculum, and student services. In addition to the Committee recommended level, this program receives $30,000,000 in mandatory 

funding through the HCERA in each fiscal year through 2019. 

International Education and Foreign Language Studies 

The bill includes a total of $46,945,000 for International Education and Foreign Language Studies programs. 

Funds are used to increase the number of experts in foreign languages and area or international studies to meet national security 

needs through visits and study in foreign countries. 

Domestic Programs.—The Committee recommends $43,445,000 

for domestic program activities related to international education 

and foreign language studies under title VI of the HEA. Funds are 

used to support centers, programs, and fellowships. The Committee 

urges the Secretary to preserve the program’s longstanding focus 

on activities and institutions that address the Nation’s need for a 

strong training and research capacity in foreign languages and 

international studies, including increasing the pool of international 

experts in areas that are essential to national security and economic competitiveness. 

Overseas Programs.—The Committee recommends $3,500,000 for 

overseas programs authorized under the Mutual Educational and 

Cultural Exchange Act of 1961, popularly known as the FulbrightHays Act. Funding is provided for group, faculty, or doctoral dissertation research abroad as well as special bilateral projects. 

Grants focus on training American instructors and students to improve foreign language and area studies education in the United 

States. 

Fund for the Improvement of Postsecondary Education 

The Committee recommendation does not include funding for the 

Fund for the Improvement of Postsecondary Education [FIPSE]. 

First in the World.—The budget request included $200,000,000, 

the full amount requested under FIPSE, for First in the World. The 

Committee recommendation does not include funding for this program and instead focuses funding on preserving funding for Pell 

grants, the core program funded in this bill aimed at improving college access and affordability. First in the World is a competitive 

grant program to identify innovative solutions to persistent and 

wide-spread challenges facing students in completing post-secondary education. 

Model Comprehensive Transition and Postsecondary Programs for 

Students With Intellectual Disabilities 

The Committee recommendation includes $10,384,000 for competitive grants to postsecondary institutions to support model programs that help students with intellectual disabilities transition to 

and complete college, as authorized by section 767 of the HEA. 

Funds may be used for student support services; academic enrichment, socialization, or independent living; integrated work experi-
186 

ences; and partnerships with LEAs to support students with intellectual disabilities participating in the model program who are still 

eligible for special education and related services under the IDEA. 

Minority Science and Engineering Improvement 

The Committee recommends $8,971,000 for the Minority Science 

and Engineering Improvement program. Funds are used to provide 

discretionary grants to institutions with minority enrollments 

greater than 50 percent to purchase equipment, develop curricula, 

and support advanced faculty training. Grants are intended to improve science and engineering education programs and increase the 

number of minority students in the fields of science, mathematics, 

and engineering. 

Tribally Controlled Postsecondary Career and Technical Institutions 

The Committee recommends $7,705,000 for tribally controlled 

postsecondary vocational institutions. This program provides 

grants for the operation and improvement of tribally controlled 

postsecondary vocational institutions to ensure continued and expanding opportunities for Indian students. 

Federal TRIO Programs 

The Committee recommends $839,752,000 for Federal TRIO programs, which provide a variety of services to improve postsecondary education opportunities for low-income individuals and 

first-generation college students. 

Upward Bound offers disadvantaged high school students academic services to develop the skills and motivation needed to pursue and complete a postsecondary education; Student Support 

Services provides developmental instruction, counseling, summer 

programs, and grant aid to disadvantaged college students to help 

them complete their postsecondary education; Talent Search identifies and counsels individuals between ages 11 and 27 regarding opportunities for completing high school and enrolling in postsecondary education; Educational Opportunity Centers provide information and counseling on available financial and academic assistance to low-income adults who are first-generation college students; 

and the Ronald E. McNair Postbaccalaureate Achievement Program supports research internships, seminars, tutoring, and other 

activities to encourage disadvantaged college students to enroll in 

doctoral programs. 

Gaining Early Awareness and Readiness for Undergraduate Programs 

The Committee recommends $301,639,000 for GEAR UP, which 

provides grants to States and partnerships of colleges, middle and 

high schools, and community organizations to assist cohorts or students in middle and high schools serving a high percentage of lowincome students. Services provided help students prepare for and 

pursue a postsecondary education. 

The Committee continues bill language allowing the Department 

to set aside up to 1.5 percent of the total provided for evaluation 

purposes. 
187 

Graduate Assistance in Areas of National Need and Javits Fellowships 

The Committee recommends $20,000,000 to support the Graduate Assistance in Areas of National Need [GAANN] program. 

GAANN supports fellowships through 3-year competitive grants 

to graduate academic departments and programs in scientific and 

technical fields and other areas of national need as determined by 

the Secretary. Fellowship recipients must have excellent academic 

records and high financial need and must be pursuing doctoral degrees or the highest graduate degrees in their academic field. Each 

fellowship consists of a student stipend to cover living costs and an 

institutional payment to cover each fellow’s tuition and other expenses. Institutions of higher education must match 25 percent of 

the grant amount. 

Teacher Quality Partnership Program 

The Committee recommends $34,000,000 for the Teacher Quality 

Partnership program. The budget request consolidates activities 

supported by this program into a proposed new Teacher and Principals Pathways program. The Teacher Quality Partnership Program helps improve the quality of teachers working in high-need 

schools and early childhood education programs by creating model 

teacher preparation and residency programs. 

Child Care Access Means Parents in Schools 

Due to budget constraints, the Committee recommendation does 

not include funding for the Child Care Access Means Parents in 

School program. Instead of funding this small targeted child care 

program, the Committee focuses funding on core early childhood 

care and education programs at the Department of HHS, including 

CCDBG and Head Start. 

GPRA Data/Higher Education Act Program Evaluation 

The Committee recommendation does not include funding for 

GPRA Data/HEA Program Evaluation. No funding for this program 

was provided in fiscal year 2015. The budget request included 

$30,000,000 in new funding for higher education evaluation activities. 

HOWARD UNIVERSITY

Appropriations, 2015 ............................................................................. $221,821,000 

Budget estimate, 2016 ........................................................................... 221,821,000 

Committee recommendation ................................................................. 219,500,000 

The Committee recommends an appropriation of $219,500,000 for 

Howard University. Located in the District of Columbia, Howard 

offers undergraduate, graduate, and professional degrees through 

12 schools and colleges. The university also administers the Howard University Hospital. Federal funds from this account support 

approximately 38 percent of the university’s operating costs. The 

Committee recommends, within the funds provided, not less than 

$3,350,000 for the endowment program. 

Howard University Hospital.—Within the funds provided, the 

Committee recommends $26,500,000 for Howard University Hos-
188 

pital. The hospital provides inpatient and outpatient care, as well 

as training in the health professions. It also serves as a major 

acute and ambulatory care center for the District of Columbia and 

functions as a major teaching facility attached to the university. 

The Federal appropriation provides partial funding for the hospital’s operations. 

COLLEGE HOUSING AND ACADEMIC FACILITIES LOANS PROGRAM

Appropriations, 2015 ............................................................................. $435,000 

Budget estimate, 2016 ........................................................................... 450,000 

Committee recommendation ................................................................. 435,000 

Federal Administration.—The Committee bill includes $435,000 

for Federal administration of the CHAFL, College Housing Loans, 

and Higher Education Facilities Loans programs. Prior to fiscal 

year 1994, these programs provided financing for the construction, 

reconstruction, and renovation of housing, academic, and other educational facilities. While no new loans have been awarded since fiscal year 1993, costs for administering the outstanding loans will 

continue through 2030. These funds will be used to reimburse the 

Department for administrative expenses incurred in managing the 

existing loan portfolio. 

HISTORICALLY BLACK COLLEGE AND UNIVERSITY CAPITAL

FINANCING PROGRAM ACCOUNT

Appropriations, 2015 ............................................................................. $19,430,000 

Budget estimate, 2016 ........................................................................... 19,436,000 

Committee recommendation ................................................................. 19,430,000 

The Committee recommends $19,430,000 for the HBCU Capital 

Financing Program. 

The Committee recommendation includes $19,096,000 to pay the 

loan subsidy costs in guaranteed loan authority under this program. This amount will support an estimated $286,000,000 in new 

loan volume in fiscal year 2016. The remaining $334,000 will be 

used for administrative expenses. 

The HBCU Capital Financing Program makes capital available 

to HBCUs for construction, renovation, and repair of academic facilities by providing a Federal guarantee for private sector construction bonds. Construction loans will be made from the proceeds 

of the sale of the bonds. 

INSTITUTE FOR EDUCATION SCIENCES

Appropriations, 2015 ............................................................................. $573,935,000 

Budget estimate, 2016 ........................................................................... 675,883,000 

Committee recommendation ................................................................. 562,978,000 

The Committee recommends $562,978,000 for the Institute for 

Education Sciences [IES]. This account supports education research, development, dissemination, and evaluation; data collection 

and analysis activities; and the assessment of student progress. 

Under the Education Sciences Reform Act of 2002, Congress established IES to provide objective and valid research-driven knowledge that was free of political influence or bias so as to better inform effective education practices at the State and local levels. The 

act required IES, in carrying out its mission, ‘‘to compile statistics, 
189 

develop products, and conduct research, evaluations, and wide dissemination activities in areas of demonstrated national need and 

ensure that such activities conform to high standards of quality, integrity, and accuracy and are objective, secular, neutral, and nonideological and are free of partisan political influence.’’ 

The Committee directs the Director to submit an operating plan 

within 90 days of enactment of this act to the Committees on Appropriations of the House of Representatives and the Senate detailing how IES plans to allocate funding available to the Institute for 

research, evaluation, and other activities authorized under law. 

RESEARCH, DEVELOPMENT, AND DISSEMINATION

The Committee recommends $177,860,000 for education research, 

development, and national dissemination activities. Funds are 

available for obligation for 2 fiscal years. These funds support activities that are aimed at expanding fundamental knowledge of 

education and promoting the use of research and development findings in the design of efforts to improve education. 

STATISTICS

The Committee recommends $102,060,000 for data gathering and 

statistical analysis activities at the National Center for Education 

Statistics [NCES]. 

NCES collects, analyzes, and reports statistics on education in 

the United States. Activities are carried out directly and through 

grants and contracts. The Center collects data on educational institutions at all levels, longitudinal data on student progress, and 

data relevant to public policy. NCES also provides technical assistance to SEAs, LEAs, and postsecondary institutions. 

REGIONAL EDUCATIONAL LABORATORIES

The Committee recommends $53,823,000 to continue support for 

the Regional Educational Laboratories program. Funds available in 

this bill will continue to support a network of 10 laboratories. The 

laboratories are responsible for promoting the use and development 

of knowledge and evidence in broad-based systemic strategies to increase student learning and further school improvement efforts. 

The Committee appreciates the efforts of IES to strengthen the 

connections between practitioners and the research community, so 

that federally supported research is timely, relevant, and responsive to the needs of the field. 

RESEARCH AND INNOVATION IN SPECIAL EDUCATION

The Committee recommends $48,000,000 for research and innovation in special education conducted by the National Center for 

Special Education Research [NCSER]. 

The Center addresses gaps in scientific knowledge to improve 

special education and early intervention services and outcomes for 

infants, toddlers, and children with disabilities. Funds provided to 

the Center are available for obligation for 2 fiscal years. 
190 

SPECIAL EDUCATION STUDIES AND EVALUATIONS

The Committee recommends $10,500,000 for special education 

studies and evaluations. 

This program supports competitive grants, contracts, and cooperative agreements to assess the implementation of IDEA. Funds are 

also used to evaluate the effectiveness of State and local efforts to 

deliver special education services and early intervention programs. 

Funds are available for obligation for 2 fiscal years. 

STATEWIDE DATA SYSTEMS

The Committee recommendation includes $33,500,000 for the 

Statewide Data Systems program. 

This program supports competitive grants to SEAs to enable 

such agencies to design, develop, and implement Statewide, longitudinal data systems to manage, analyze, disaggregate, and use individual data for students of all ages. Early childhood, postsecondary, and workforce information systems may be linked to such 

systems or developed with program funds. The Committee believes 

the Department should continue its efforts to ensure every State 

has the base support necessary to develop effective systems. Funds 

are available for obligation for 2 fiscal years. 

ASSESSMENT

The Committee recommends $137,235,000 to provide support for 

the National Assessment of Educational Progress [NAEP], a congressionally mandated assessment created to measure and report 

the educational achievement of American students in a range of 

subjects and analyze trends over time. 

Within the funds appropriated, the Committee recommends 

$8,235,000 for the National Assessment Governing Board [NAGB], 

which is responsible for formulating policy for NAEP. 

The Committee is pleased that the NAGB has reinstated assessments for 8th and 12th grade students in United States History, 

Civics, and Geography. Previous assessments conducted by NAGB 

indicate that fewer than one in four 4th, 8th, and 12th grade students at all grade levels are proficient in United States History. 

Due to budget constraints the Committee recommendation includes 

the same level of funding to support NAEP as in fiscal year 2015. 

Howerver, the Committee encourages the NAGB to continue administering the assessments in these three areas at least every 4 

years, in accordance with the current NAEP schedule. According to 

this schedule, the next administration will be in 2018. In addition, 

the Committee supports NAEP’s proposals to move the math and 

reading assessments to a digital based platform and expand the 

Trial Urban District Assessments to 10 more urban school districts. 

The Committee notes that the NAGB has scheduled the NAEP 

arts assessment for 2016. The Committee encourages the Department to ensure that the arts assessment is completed on time and 

that it measures creating, performing, and responding to art in the 

disciplines of dance, theatre, music, and visual arts. 
191 

DEPARTMENTAL MANAGEMENT

PROGRAM ADMINISTRATION

Appropriations, 2015 ............................................................................. $411,000,000 

Budget estimate, 2016 ........................................................................... 474,089,000 

Committee recommendation ................................................................. 391,326,000 

The Committee recommends $391,326,000 for program administration. The fiscal year 2015 level represents the enacted level, 

prior to the transfer of funds and administration of certain programs to ACL in WIOA. 

Funds support personnel compensation and benefits, travel, rent, 

communications, utilities, printing, equipment and supplies, automated data processing, and other services required to award, administer, and monitor Federal education programs. Support for 

program evaluation and studies and advisory councils is also provided under this account. 

The Committee remains concerned that State and local education 

agencies often submit the exact same data elements to various 

principal offices within the Department. This duplicative reporting 

diverts important State and local resources to filling out paperwork 

rather than to providing direct services to students. Therefore, the 

Committee directs the Department to review the reporting requirements across principal offices and determine ways to reduce confusion and duplication across offices in order to streamline reporting 

requirements in accordance with the Paperwork Reduction Act. 

Performance Partnerships.—The Committee supports the continuation of the Performance Partnerships for Disconnected Youth. 

The Performance Partnerships Pilots will allow States and localities to identify better ways of improving outcomes for disconnected 

youth by giving them additional flexibility in using discretionary 

funds available through multiple Federal programs. The Committee includes a new provision this year to focus activities towards 

communities that have recently faced civil unrest. Recent events in 

communities across the Nation have illustrated, in part, the important need to improve opportunities and services for disconnected 

populations, and Performance Partnerships focused in these communities will allow localities to pilot better ways of improving outcomes. 

The Committee requests the administration provide it with annual reports containing the following information: a detailed summary of all involved pilot programs, an overview of how pilots were 

selected, a summary of findings from the various pilots, and recommendations for Congress on how to apply best practices more 

broadly. 

The Committee is concerned that the Department took approximately 18 months for its appeal of an administrative law judge’s 

decision that Central Kitsap school district is eligible for payments 

under the Heavily Impact Aid program in fiscal year 2010. The 

Committee believes that such delays create avoidable hardship for 

school districts and the students they serve. The Committee directs 

the Department to provide a report not later than 30 days after enactment of this act identifying specific steps going forward that the 

Department will take to prevent any other school district or institution from having to endure such avoidable delays. 
192 

OFFICE FOR CIVIL RIGHTS

Appropriations, 2015 ............................................................................. $100,000,000 

Budget estimate, 2016 ........................................................................... 130,691,000 

Committee recommendation ................................................................. 100,000,000 

The Committee recommends $100,000,000 for the Office of Civil 

Rights [OCR]. 

OCR is responsible for the enforcement of laws that prohibit discrimination on the basis of race, color, national origin, sex, disability, and age in all programs and institutions that receive financial assistance from the Department. To carry out this responsibility, OCR investigates and resolves discrimination complaints, 

monitors desegregation and equal educational opportunity plans, 

reviews possible discriminatory practices by recipients of Federal 

education funds, and provides technical assistance to recipients of 

funds to help them meet these civil rights requirements. 

OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2015 ............................................................................. $57,791,000 

Budget estimate, 2016 ........................................................................... 59,256,000 

Committee recommendation ................................................................. 57,791,000 

The Committee recommends $57,791,000 for OIG. 

OIG has the authority to investigate all departmental programs 

and administrative activities, including those under contract or 

grant, to prevent and detect fraud and abuse, and to ensure the 

quality and integrity of those programs. The Office investigates alleged misuse of Federal funds and conducts audits to determine 

compliance with laws and regulations, efficiency of operations, and 

effectiveness in achieving program goals. 

GENERAL PROVISIONS

Section 301. The bill continues a provision prohibiting the use of 

funds for the transportation of students or teachers in order to 

overcome racial imbalance. 

Section 302. The bill continues a provision prohibiting the involuntary transportation of students other than to the school nearest 

to the student’s home. 

Section 303. The bill continues a provision prohibiting the use of 

funds to prevent the implementation of programs of voluntary 

prayer and meditation in public schools. 

Section 304. The bill continues a provision giving the Secretary 

authority to transfer up to 1 percent of any discretionary funds between appropriations. 

Section 305. The bill continues a provision that allows the outlying areas to consolidate funds under title V of the ESEA. 

Section 306. The bill continues a provision that allows the Republic of Palau to receive certain Federal funds. 

Section 307. The bill continues a provision that clarifies the Department’s authority to reserve up to 0.5 percent of each ESEA appropriation in the bill for evaluation of ESEA programs funded in 

this act. These resources are in addition to any funds specifically 

provided for evaluation purposes. 
193 

Section 308. The bill modifies a general provision allowing certain institutions to continue to use endowment income for student 

scholarships. 

Section 309. The bill includes a new general provision rescinding $300,000,000 in prior year discretionary unobligated balances from 

the Pell grant program. 

Section 310. The bill includes a new general provision prohibiting 

funding for the development, implementation, and enforcement of 

several higher education administrative regulations until the HEA 

is reauthorized. 

Section 311. The bill includes a new general provision affirming 

that the Department cannot mandate or incentivize States, LEAs, 

or schools to adopt any specific set of standards or assessments. 

Section 312. The bill includes a new general provision modifying 

the changes made in division G of Public Law 113–235 concerning 

career pathways programs. 
(194) 

TITLE IV 

RELATED AGENCIES 

COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR

SEVERELY DISABLED

SALARIES AND EXPENSES

Appropriations, 2015 ............................................................................. $5,362,000 

Budget estimate, 2016 ........................................................................... 5,441,000 

Committee recommendation ................................................................. 5,362,000 

The Committee recommends $5,362,000 for the Committee for 

Purchase from People Who Are Blind or Severely Disabled. 

The AbilityOne program provides about 47,000 severely disabled 

Americans with employment opportunities each year. The primary 

purpose of this program is to increase the employment opportunities for people who are blind or have other severe disabilities and, 

whenever possible, to prepare them to engage in competitive employment. Encompassing approximately $3,000,000,000 in contracts, it is the Federal Government’s largest employment program 

for the severely disabled. The Committee is concerned about issues 

identified by both stakeholders and the Government Accountability 

Office [GAO] stemming from the limited authority of the Commission to oversee fully the Central Nonprofit Agencies [CNAs], the 

independent contracted organizations which administer the program. As noted by the GAO, the AbilityOne Commission cannot directly control how CNAs spend funds, set performance goals, compensate their executives, or assess whether they meet the statutory 

requirement that 75 percent of the involved workforce consist of 

people with severe disabilities. To enhance the Commission’s ability to manage the CNAs more fully, the Committee directs the 

Commission to implement the recommendations of the GAO in its 

May 2013 report as expeditiously as possible. The Committee also 

directs the Commission to report to the Committees on Appropriations of the House of Representatives and the Senate within 120 

days of enactment of this act on its progress addressing these concerns and recommendations. 

CORPORATION FOR NATIONAL AND COMMUNITY SERVICE

The Corporation for National and Community Service [CNCS], a 

corporation owned by the Federal Government, was established to 

enhance opportunities for national and community service. CNCS 

administers programs authorized under the Domestic Volunteer 

Service Act, the National and Community Service Trust Act, and 

the SERVE America Act. Grants are awarded to States, public and 

private nonprofit organizations, and other entities to create service 

opportunities for students, out-of-school youth, adults, and seniors. 
195 

The Committee recommendation for CNCS provides a total program level of $844,325,000. 

OPERATING EXPENSES

Appropriations, 2015 ............................................................................. $758,349,000 

Budget estimate, 2016 ........................................................................... 855,208,000 

Committee recommendation ................................................................. 614,075,000 

The Committee recommends $614,075,000 for the operating expenses of CNCS. 

Volunteers in Service to America [VISTA] 

The Committee recommends $90,000,000 for VISTA. This program provides capacity building for small, community-based organizations with a mission of combating poverty. VISTA members 

raise resources, recruit and organize volunteers, and establish and 

expand programs in housing, employment, health, and economic 

development activities. 

National Senior Volunteer Corps 

The Committee recommends $196,637,000 for the National Senior Volunteer Corps programs, a collection of programs that connect 

Americans older than the age of 55 with opportunities to contribute 

their job skills and expertise to community projects and organizations. These programs include the Retired Senior Volunteer Program [RSVP], the Foster Grandparent Program, and the Senior 

Companion Program. 

AmeriCorps State and National Grants 

The Committee recommends $270,000,000 for AmeriCorps State 

and National Grants, which provide funds to local and national organizations and agencies to address community needs in education, 

public safety, health, and the environment. Each of these organizations and agencies, in turn, uses its AmeriCorps funding to recruit, 

place, and supervise AmeriCorps members. AmeriCorps members 

receive a modest living allowance and other benefits proportional 

to their level of time commitment. 

The Committee strongly encourages CNCS to provide 

AmeriCorps grants to support communities that have recently experienced civil unrest. AmeriCorps programs are uniquely situated 

to respond to such sudden crises that have impacted communities 

across the country but also the challenges underlying them. The 

Committee strongly supports activities focused in this area. 

National Civilian Community Corps [NCCC] 

The Committee recommendation includes $30,000,000 for NCCC, 

a full-time, team-based residential program for men and women 

ages 18 to 24. Members are assigned to one of five campuses for 

a 10-month service commitment. 

Innovation, Demonstration, and Assistance Activities 

The Committee recommendation includes $7,400,000 for innovation, demonstration, and assistance activities. 
196 

Social Innovation Fund [SIF].—Due to budget constraints the 

Committee recommendation does not include funding for the Social 

Innovation Fund. 

Volunteer Generation Fund.—Within the total, the Committee 

recommendation includes $3,800,000 for the Volunteer Generation 

Fund authorized under section 198P of the SERVE America Act, 

the same as the comparable fiscal year 2015 funding level. 

Evaluation 

The Committee recommendation includes $4,000,000 for CNCS 

evaluation activities. 

State Commission Grants 

The Committee recommendation includes $16,038,000 for State 

Commission Grants. 

The Committee strongly encourages CNCS to improve coordination with State commissions as part of CNCS’ grant making process, including in announcing the availability and awarding of funds 

under AmeriCorps. State Commissions are a vital local resource 

and primary point of entry for national and community service at 

the local level. Improving coordination between CNCS and local 

State commissions would improve the administration of service 

programs at the local level and promote innovation by supporting 

the organizations that know their communities best. 

PAYMENT TO THE NATIONAL SERVICE TRUST

Appropriations, 2015 ............................................................................. $209,618,000 

Budget estimate, 2016 ........................................................................... 237,077,000 

Committee recommendation ................................................................. 145,000,000 

The Committee recommends an appropriation of $145,000,000 for 

making payments to the National Service Trust. 

The National Service Trust makes payments of Segal education 

awards, pays interest that accrues on qualified student loans for 

AmeriCorps participants during terms of service in approved national service positions, and makes other payments entitled to 

members who serve in the programs of CNCS. 

SALARIES AND EXPENSES

Appropriations, 2015 ............................................................................. $81,737,000 

Budget estimate, 2016 ........................................................................... 86,176,000 

Committee recommendation ................................................................. 80,000,000 

The Committee recommends an appropriation of $80,000,000 for 

CNCS salaries and expenses. The salaries and expenses appropriation provides funds for staff salaries, benefits, travel, training, rent, 

equipment, and other operating expenses necessary for management of CNCS programs and activities. 

OFFICE OF INSPECTOR GENERAL

Appropriations, 2015 ............................................................................. $5,250,000 

Budget estimate, 2016 ........................................................................... 6,000,000 

Committee recommendation ................................................................. 5,250,000 

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

the CNCS OIG. The OIG’s goals are to increase organizational effi-
197 

ciency and effectiveness within the Corporation and to prevent 

fraud, waste, and abuse. 

ADMINISTRATIVE PROVISIONS

The Committee retains language from the fiscal year 2015 appropriations act concerning five administrative provisions: requiring 

the Corporation to make any significant changes to program requirements or policy through rule making (section 401); stipulating 

minimum share requirements (section 402); requiring that donations supplement and not supplant operations (section 403); aligning requirements regarding the use of Education Awards at GI billeligible institutions (section 404); and allowing the required background check of certain applicants to be processed by States under 

terms of the National Child Protection Act (section 405). 

CORPORATION FOR PUBLIC BROADCASTING

Appropriations, 2017 ............................................................................. $445,000,000 

Budget estimate, 2018 ........................................................................... 445,000,000 

Committee recommendation, 2018 ....................................................... 445,000,000 

The Committee recommends $445,000,000 for Corporation for 

Public Broadcasting [CPB] as an advance appropriation for fiscal 

year 2018. 

The majority of these funds go directly to local public television 

and radio stations to support their programming. CPB funds also 

support the creation of content for radio, television, and other platforms; system support activities that benefit the entire public 

broadcasting community; and CPB’s administrative costs. 

The Committee has not provided the additional $40,000,000 in 

fiscal year 2016 requested for the first phase of replacing and upgrading the public television interconnection system due to budget 

constraints. However, language in the bill provides authority to the 

CPB, at its discretion, to obligate up to $40,000,000 of fiscal year 

2016 funds for this purpose notwithstanding the statutory formula 

distribution. The CPB may utilize the amount up to $40,000,000 

only for the purpose of beginning the interconnection project in fiscal year 2016 as requested. 

FEDERAL MEDIATION AND CONCILIATION SERVICE

SALARIES AND EXPENSES

Appropriations, 2015 ............................................................................. $45,666,000 

Budget estimate, 2016 ........................................................................... 48,748,000 

Committee recommendation ................................................................. 47,823,000 

The Committee recommends $47,823,000 for the Federal Mediation and Conciliation Service [FMCS]. FMCS provides mediation, 

conciliation, and arbitration services to labor and management organizations to prevent and minimize work stoppages and promote 

stable labor-management relationships. FMCS is also authorized to 

provide dispute resolution consultation and training to all Federal 

agencies. Within the total, FMCS may utilize up to $400,000 for labormanagement partnership grants. These grants support innovative 

approaches to collaborative labor-management relationships to re-
198 

solve potential problems, explore ways to improve productivity, and 

avert serious work stoppages. 

The Committee recognizes the FMCS must incur costs associated 

with relocating its offices in fiscal year 2016. The Committee provides an increase to FMCS to address this need to reduce the 

amount which must come from within the Service’s base funds for 

relocation costs. 

FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION

SALARIES AND EXPENSES

Appropriations, 2015 ............................................................................. $16,751,000 

Budget estimate, 2016 ........................................................................... 17,085,000 

Committee recommendation ................................................................. 15,950,000 

The Committee recommends $15,950,000 for the Federal Mine 

Safety and Health Review Commission [FMSHRC], which provides 

administrative trial and appellate review of legal disputes under 

the Federal Mine Safety and Health Act of 1977. Most cases involve civil penalties proposed by MSHA. FMSHRC’s administrative 

law judges [ALJs] decide cases at the trial level and the five-member Commission provides review of the ALJ’s decisions. 

INSTITUTE OF MUSEUM AND LIBRARY SERVICES

OFFICE OF MUSEUM AND LIBRARIES: GRANTS AND ADMINISTRATION

Appropriations, 2015 ............................................................................. $227,860,000 

Budget estimate, 2016 ........................................................................... 237,428,000 

Committee recommendation ................................................................. 227,860,000 

The Committee recommends $227,860,000 for the Institute of 

Museum and Library Services [IMLS]. This agency supports programs for museums and libraries that encourage innovation, provide lifelong learning opportunities, promote cultural and civic engagement, and improve access to a variety of services and information. 

Within the total for IMLS, the Committee recommendation includes the amounts below: 

[In thousands of dollars] 

Budget activity Fiscal year 2015 

appropriation 

Fiscal year 2016 

request 

Committee 

recommendation 

Library Services Technology Act: 

Grants to States ............................................................................... 154,848 154,500 154,848 

Native American Library Services ..................................................... 3,861 4,063 3,861 

National Leadership: Libraries .......................................................... 12,200 17,500 13,092 

Laura Bush 21st Century Librarian .................................................. 10,000 10,500 10,000 

Subtotal, LSTA .............................................................................. 180,909 186,563 181,801 

Museum Services Act: 

Museums for America ....................................................................... 20,200 21,457 20,200 

Native American/Hawaiian Museum Services .................................. 924 972 924 

National Leadership: Museums ........................................................ 7,600 11,168 7,741 

Subtotal, MSA ............................................................................... 28,724 33,597 28,865 

African American History and Culture Act ................................................ 1,407 1,481 1,407 

Administration ............................................................................................ 15,000 14,000 14,000 
199 

[In thousands of dollars] 

Budget activity Fiscal year 2015 

appropriation 

Fiscal year 2016 

request 

Committee 

recommendation 

Policy, Research, Program Evaluation, and Statistics .............................. 1,820 1,787 1,787 

MEDICAID AND CHIP PAYMENT AND ACCESS COMMISSION

SALARIES AND EXPENSES

Appropriations, 2015 ............................................................................. $7,650,000 

Budget estimate, 2016 ........................................................................... 8,700,000 

Committee recommendation ................................................................. 7,250,000 

The Committee recommends $7,250,000 for the Medicaid and 

CHIP Payment and Access Commission [MACPAC]. This commission was established in the Children’s Health Insurance Program 

Reauthorization Act of 2009 and is tasked with reviewing State 

and Federal Medicaid and Children’s Health Insurance Program 

access and payment policies and making recommendations to Congress, the Secretary of HHS, and the States on a wide range of 

issues affecting those programs. The Committee recommendation 

will allow MACPAC to continue to carry out these activities. 

MEDICARE PAYMENT ADVISORY COMMISSION

SALARIES AND EXPENSES

Appropriations, 2015 ............................................................................. $11,749,000 

Budget estimate, 2016 ........................................................................... 12,100,000 

Committee recommendation ................................................................. 11,100,000 

The Committee recommends $11,100,000 for the Medicare Payment Advisory Commission [MedPAC], which provides independent 

policy and technical advice on issues affecting the Medicare program. 

NATIONAL COUNCIL ON DISABILITY

SALARIES AND EXPENSES

Appropriations, 2015 ............................................................................. $3,250,000 

Budget estimate, 2016 ........................................................................... 3,432,000 

Committee recommendation ................................................................. 3,075,000 

The Committee recommends $3,075,000 for the National Council 

on Disability [NCD]. NCD is mandated to make recommendations 

to the President, Congress, the Rehabilitation Services Administration, and the National Institute on Disability and Rehabilitation 

Research on issues of concern to individuals with disabilities. The 

Council gathers information on the implementation, effectiveness, 

and impact of the Americans with Disabilities Act and examines 

emerging policy issues as they affect persons with disabilities and 

their ability to enter or re-enter the Nation’s workforce and to live 

independently. 
200 

NATIONAL LABOR RELATIONS BOARD

SALARIES AND EXPENSES

Appropriations, 2015 ............................................................................. $274,224,000 

Budget estimate, 2016 ........................................................................... 278,000,000 

Committee recommendation ................................................................. 246,802,000 

The Committee recommends $246,802,000 for the National Labor 

Relations Board [NLRB], which administers and enforces the National Labor Relations Act and protects employee and employer 

rights provided under that act. 

The Committee is deeply concerned by the Board’s aggressive 

regulatory agenda as well as its departure from long-standing policy and precedent on a variety of matters. The Committee has included new provisions in the bill and reduced the Board’s budget 

authority to constrain its unacceptable overreach. 

The Committee notes that the Board’s fiscal year 2016 CJ contains insufficient detail about its workload, performance, and administrative plans and priorities. The submission contains far less 

information to support the request than in past years. The Board 

is directed to provide justification for its fiscal year 2017 request, 

including at least as much detail as it has traditionally provided 

prior to fiscal year 2016. 

The Committee is concerned that the NLRB has sought in some 

cases to exercise jurisdiction over Indian-owned businesses within 

tribal territories. Under the National Labor Relations Act of 1935 

[NLRA], Federal, State, and local governments are exempted explicitly from the NLRB’s jurisdiction. In the recent Chickasaw Nation case, the NLRB recognized tribal sovereignty for purposes of 

the NLRA for tribes with formal treaties. The Committee believes 

that Indian governments without formal treaties should be treated 

no differently with respect to the jurisdiction of the NLRB. 

ADMINISTRATIVE PROVISIONS

The Committee maintains language from the fiscal year 2015 appropriations act concerning one administrative provision restricting 

the use of electronic voting (section 406) and includes three new 

provisions: prohibiting enforcement of a new representation case 

procedure rule (section 407); prohibiting any change in the interpretation or application of a standard to determine whether entities are ‘‘joint employers’’ (section 408); and prohibiting any form 

of implementation of a new standard for initial bargaining unit determinations that conflicts with the standard articulated in the majority opinion in Wheeling Island Gaming Inc. and United Food and 

Commercial Workers International Union, Local 23 (section 409). 

NATIONAL MEDIATION BOARD

SALARIES AND EXPENSES

Appropriations, 2015 ............................................................................. $13,227,000 

Budget estimate, 2016 ........................................................................... 13,230,000 

Committee recommendation ................................................................. 12,600,000 

The Committee recommends $12,600,000 for the National Mediation Board [NMB], which mediates labor-management relations in 

the railroad and airline industries under the Railway Labor Act. 
201 

The NMB mediates collective bargaining disputes, conducts elections to determine the choice of employee bargaining representatives, and administers arbitration of employee grievances. 

OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION

SALARIES AND EXPENSES

Appropriations, 2015 ............................................................................. $11,639,000 

Budget estimate, 2016 ........................................................................... 13,212,000 

Committee recommendation ................................................................. 11,100,000 

The Committee recommends $11,100,000 for the Occupational 

Safety and Health Review Commission [OSHRC]. OSHRC serves as 

a court to resolve disputes between OSHA and employers charged 

with violations of health and safety standards enforced by OSHA. 

RAILROAD RETIREMENT BOARD

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

Retirement Act and Railroad Unemployment Insurance Act. 

DUAL BENEFITS PAYMENTS ACCOUNT

Appropriations, 2015 ............................................................................. $34,000,000 

Budget estimate, 2016 ........................................................................... 29,000,000 

Committee recommendation ................................................................. 29,000,000 

The Committee recommends $29,000,000 for the Dual Benefits 

Payments Account. This amount includes an estimated $2,000,000 

derived from income taxes on vested dual benefits. This appropriation provides for vested dual benefit payments to beneficiaries covered under both the railroad retirement and Social Security systems. 

FEDERAL PAYMENTS TO THE RAILROAD RETIREMENT ACCOUNT

Appropriations, 2015 ............................................................................. $150,000 

Budget estimate, 2016 ........................................................................... 150,000 

Committee recommendation ................................................................. 150,000 

The Committee recommends $150,000 for Federal Payments to 

the Railroad Retirement Account. These funds reimburse the railroad retirement trust funds for interest earned on non-negotiated 

checks. 

LIMITATION ON ADMINISTRATION

Appropriations, 2015 ............................................................................. $111,225,000 

Budget estimate, 2016 ........................................................................... 119,918,000 

Committee recommendation ................................................................. 111,225,000 

The Committee recommends $111,225,000 for RRB’s costs associated with the administration of railroad retirement/survivor and 

unemployment/sickness benefit programs. This account limits the 

amount of funds in the railroad retirement and railroad unemployment insurance trust funds that may be used by the Board for administrative expenses. 

The Committee maintains bill language giving RRB the authority to hire new attorneys in the excepted service. 
202 

LIMITATION ON THE OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2015 ............................................................................. $8,437,000 

Budget estimate, 2016 ........................................................................... 9,450,000 

Committee recommendation ................................................................. 8,437,000 

The Committee recommends $8,437,000 for the RRB OIG. This 

Office conducts audits and investigations to protect the integrity of 

the RRB trust funds and provides comprehensive oversight of all 

RRB operations and programs. 

SOCIAL SECURITY ADMINISTRATION

PAYMENTS TO SOCIAL SECURITY TRUST FUNDS

Appropriations, 2015 ............................................................................. $16,400,000 

Budget estimate, 2016 ........................................................................... 20,400,000 

Committee recommendation ................................................................. 20,400,000 

The Committee recommends $20,400,000 in mandatory funds for 

payments to Social Security trust funds. This account reimburses 

the Old Age and Survivors Insurance [OASI] and Disability Insurance [DI] trust funds for special payments to certain uninsured 

persons, costs incurred administering pension reform activities, and 

the value of the interest for benefit checks issued but not negotiated. This appropriation restores the trust funds to the same financial position they would have been in had they not borne these 

costs and they were properly charged to general revenues. 

SUPPLEMENTAL SECURITY INCOME PROGRAM

Appropriations, 2015 ............................................................................. $41,232,978,000 

Budget estimate, 2016 ........................................................................... 46,422,000,000 

Committee recommendation ................................................................. 46,110,777,000 

The Committee recommends $46,110,777,000 in fiscal year 2016 

mandatory funds for the SSI program. This is in addition to the 

$19,200,000,000 provided in the fiscal year 2015 appropriations act 

for the first quarter of fiscal year 2016. In addition, the Committee 

recommends $14,500,000,000 in advance funding for the first quarter of fiscal year 2017. Due to the timing of benefit payments, 

which are made on the first of the month unless the first falls on 

a weekend or Federal holiday in which case it’s made on the previous business day, there will be 13 monthly benefit payments in 

fiscal year 2016, compared to 12 in fiscal year 2015. The SSI program guarantees a minimum level of income to individuals who are 

disabled, blind, or older than age 65, and meet certain income and 

resource limitations. 

Federal Benefit Payments 

The Committee recommendation includes a fiscal year 2016 program level of $60,683,000,000 for Federal benefit payments. This 

will support an average monthly benefit of approximately $565 for 

8.2 million recipients. 

Beneficiary Services 

The Committee recommendation includes $70,000,000 in new 

mandatory budget authority for beneficiary services. Including car-
203 

ryover of prior year unobligated balances this will fund a total estimated fiscal year 2016 program level of $86,000,000. 

These funds reimburse VR agencies for successfully rehabilitating disabled SSI recipients by helping them achieve and sustain 

productive, self-supporting work activity. Funds also support the 

Ticket to Work program that provides SSI recipients with a ticket 

to offer employment networks [ENs], including VR agencies, in exchange for employment and support services. Instead of reimbursing ENs for specific services, the Ticket to Work program pays ENs 

based on recipients achieving certain milestones and outcomes. 

Research and Demonstration 

The Committee recommendation includes $101,000,000 in mandatory funds for research and demonstration projects conducted 

under sections 1110, 1115, and 1144 of the Social Security Act. 

These funds support a variety of research and demonstration 

projects designed to improve the disability process, promote selfsufficiency and assist individuals in returning to work, encourage 

savings and retirement planning through financial literacy, and 

generally provide analytical and data resources for use in preparing and reviewing policy proposals. 

Administrative Expenses 

The Committee recommendation includes $4,453,777,000 for SSI 

program administrative expenses. This appropriation funds the SSI 

program’s share of administrative expenses incurred through the 

Limitation on Administrative Expenses [LAE] account. 

LIMITATION ON ADMINISTRATIVE EXPENSES

Appropriations, 2015 ............................................................................. $11,805,945,000 

Budget estimate, 2016 ........................................................................... 12,512,000,000 

Committee recommendation ................................................................. 11,620,945,000 

The Committee recommends $11,620,945,000 for SSA’s LAE account. This account provides resources for SSA to administer the 

OASI, DI, and SSI programs, and to support CMS in administering 

the Medicare program. The LAE account is funded by the Social 

Security and Medicare trust funds for their share of administrative 

expenses, the general fund for the SSI program’s share of administrative expenses, and applicable user fees. These funds support 

core administrative activities including processing retirement and 

disability claims, conducting hearings to review disability determination appeals, issuing Social Security numbers and cards, processing individuals’ annual earnings information, and ensuring the 

integrity of Social Security programs through continuing disability 

reviews [CDR] and SSI redeterminations of non-medical eligibility. 

Continuing Disability Reviews and SSI Redeterminations.—The 

Committee recommendation includes $1,439,000,000 for CDRs and 

SSI redeterminations of non-medical eligibility. This includes 

$273,000,000 in base funding and $1,166,000,000 in cap adjustment funding allowed under the Budget Control Act [BCA] of 2011. 

The Committee recommendation is a $43,000,000 increase over the 

fiscal year 2015 funding level, as specified in the BCA. Combined 

these activities are estimated to save approximately 

$10,000,000,000 for the Social Security, Medicare, and Medicaid 
204 

programs by preventing waste, fraud, abuse, and improper payments. 

Work Incentives Planning and Assistance [WIPA] and Protection 

and Advocacy for Beneficiaries of Social Security [PABSS].—The 

Committee recommendation includes $23,000,000 for WIPA and 

$7,000,000 for PABSS, the same as the comparable fiscal year 2015 

levels respectively. These programs provide valuable services to 

help Social Security disability beneficiaries return to work. 

Representative Payee Oversight.—SSA assigns representative 

payees when beneficiaries are unable to financially manage their 

own benefit payments. The Committee continues to strongly encourage SSA to continue to pursue efforts to improve representative payee oversight, including continuing to partner with outside 

organizations to identify, investigate, and prevent fraud and abuse. 

Medical Improvement Review Standard.—The Committee commends SSA for its work to improve program integrity. However, 

the Committee is concerned about GAO’s testimony to Congress 

that confusion still exists about the Medical Improvement Review 

Standard [MIRS] and its exceptions. The Committee directs SSA to 

submit a report no later than 60 days after the enactment of this 

act to the Committees on Appropriations of the House of Representatives and the Senate, no later than 60 days after the enactment of this act, on its progress in educating Disability Determinations Services in the proper application of the MIRS and its exceptions. 

Disability Hearing Pilot Program.—The Committee notes that 

SSA has made positive statements to Congress about its pilot program in Region I that requires administrative law judges to give 

claimants a 75 day notice before their hearing and requires claimants to submit all evidence 5 days before the hearing subject to 

good cause exception (also known as ‘‘soft’’ closing of the record). 

This policy promotes a smoother hearing process, reducing the time 

it take to hear and adjudicate disability appeals, while still providing assurances that individuals are able to provide all evidence 

in support of their case. The Committee directs SSA to provide to 

the Committees on Appropriations of the House of Representatives 

and the Senate, no later than 60 days after the enactment of this 

act, an update on this pilot program and any plans to expand the 

pilot to other regions. 

Medical Vocational Guidelines.—The Committee is encouraged 

that SSA plans to issue an Advanced Notice of Proposed Rulemaking on the need to update the medical-vocational guidelines, including seeking input from the Disability Research Consortium; the 

Institute of Medicine; and other medical, aging, employment, and 

disability experts. These guidelines play a key role in SSA’s disability determination process but have not been updated since they 

were established in 1978. The Committee directs SSA to provide a 

report to the Committees on Appropriations of the House of Representatives and the Senate, no later than 60 days after the enactment of this act, on its plan for updating the medical vocational 

guidelines. 

Vocational Experts [VE].—The Committee notes that SSA’s OIG 

has recommended that SSA periodically determine whether VE 

fees are appropriate to obtain the required level of VE service, 
205 

which could include benchmark studies with VE fees paid in the 

national economy or elsewhere by government entities. The Committee strongly encourages SSA to conduct such a review, including 

comparing fees paid by SSA to those paid by other governmental 

and non-governmental organizations. The Committee directs SSA 

to brief the Committees on Appropriations of the House of Representatives and the Senate on its plan to comply with these OIG 

recommendations. 

Social Security Advisory Board.—The Committee recommendation includes not less than $2,300,000 for the Social Security Advisory Board. This board advises the Commissioner of Social Security 

and makes recommendations to Congress and the President on 

policies relating to the OASI, DI, and SSI programs. 

User Fees.—Within the total for LAE, the Committee recommendation includes up to $137,000,000 for administrative activities funded from user fees. This includes $136,000,000 in fees collected from States that request SSA to administer State SSI supplementary payments and up to $1,000,000 from fees collected from 

non-attorney claimant representatives. 

Within the total for LAE, the Committee recommendation includes up to $11,900,000 for the planning and design of the renovation and modernization of SSA facilities. 

OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2015 ............................................................................. $103,350,000 

Budget estimate, 2016 ........................................................................... 109,795,000 

Committee recommendation ................................................................. 103,350,000 

The Committee recommends $103,350,000 for SSA’s OIG. This 

includes $74,521,000 funded from the OASI and DI trust funds for 

those programs’ share of OIG’s expenses and $28,829,000 funded 

from general revenues for the SSI program’s share of expenses. 
(206) 

TITLE V 

GENERAL PROVISIONS 

Section 501. The bill continues a provision authorizing transfers 

of unexpended balances. 

Section 502. The bill continues a provision limiting funding to 1- 

year availability unless otherwise specified. 

Section 503. The bill continues a provision limiting lobbying and 

related activities. 

Section 504. The bill continues a provision limiting official representation expenses. 

Section 505. The bill continues a provision clarifying Federal 

funding as a component of State and local grant funds. 

Sections 506 and 507. The bill continues provisions limiting the 

use of funds for abortion. 

Section 508. The bill continues a provision restricting human embryo research. 

Section 509. The bill continues a provision limiting the use of 

funds for promotion of legalization of controlled substances. 

Section 510. The bill continues a provision prohibiting the use of 

funds to promulgate regulations regarding the individual health 

identifier. 

Section 511. The bill continues a provision limiting the use of 

funds to enter into or review contracts with entities subject to the 

requirement in section 4212(d) of title 38, United States Code, if 

the report required by that section has not been submitted. 

Section 512. The bill continues a provision prohibiting the transfer of funds made available in this act to any department, agency, 

or instrumentality of the U.S. Government, except as otherwise 

provided by this or any other act. 

Section 513. The bill continues a provision prohibiting Federal 

funding in this act for libraries unless they are in compliance with 

the Children’s Internet Protection Act. 

Section 514. The bill continues a provision maintaining a procedure for reprogramming of funds. 

Section 515. The bill continues a provision prohibiting candidates 

for scientific advisory committees from having to disclose their political activities. 

Section 516. The bill continues a provision requiring each department and related agency to submit an operating plan. 

Section 517. The bill continues a provision requiring the Secretaries of Labor, Health and Human Services, and Education to submit a report on the number and amounts of contracts, grants, and 

cooperative agreements awarded by the Departments on a noncompetitive basis. 

Section 518. The bill continues a general provision prohibiting 

SSA from processing earnings for work performed under a fraudu-
207 

lent social security number if based on a conviction for a violation 

under section 208(a)(6) or (7) of the Social Security Act. 

Section 519. The bill continues a general provision prohibiting 

SSA from establishing a totalization agreement with Mexico. 

Section 520. The bill includes a modified provision regarding 

funding for programs that carry out distribution of sterile needles 

or syringes. 

Section 521. The bill continues a provision requiring computer 

networks to block pornography. 

Section 522. The bill continues a provision prohibiting funding 

from going to the Association of Community Organizations for Reform Now [ACORN], or any of its affiliates, subsidiaries, allied organizations, or successors. 

Section 523. The bill continues a provision related to reporting 

requirements for conference spending. 

Section 524. The bill includes a new provision related to advertisement costs. In response to Federal agencies spending millions 

of taxpayer dollars on advertising campaigns, the Committee includes language requiring Federal agencies funded in this bill to 

disclose when taxpayer dollars are used to pay for government advertising. On any advertisements, including, but not limited to, 

emails, television, radio, or Internet postings, the Committee requires the agency to disclose within the advertisement itself, that 

it was produced and disseminated with taxpayer dollars. Further, 

the Committee expects each agency to include in their fiscal year 

2017 CJ information detailing how much funding was spent on advertising in fiscal year 2016. 

Section 525. The bill includes a modified provision on Performance Partnerships. 

Section 526. The bill continues a provision regarding reporting 

status of balances of appropriations. 

Section 527. The bill includes a new provision related to the National Disaster Medical System employees. 

Section 528. The bill includes a new provision designed to ensure 

compliance with the ‘‘public charge’’ inadmissibility grounds 

present in the Immigration and Nationality Act. 

Section 529. The bill modifies a provision rescinding funds from 

the Independent Payment Advisory Board. 

Section. 530. The bill includes a new provision rescinding funds 

from the Consumer Operated and Oriented Plans. 

Section 531. The bill modifies a provision rescinding funds from 

the Children’s Health Insurance Program performance bonus fund. 

Section 532. The bill includes a provision rescinding funds from 

section 532 of the Children’s Health Insurance Program. 

Section 533. The bill includes a new provision rescinding carryover funds from Community Health Centers. 
(208) 

COMPLIANCE WITH PARAGRAPH 7, RULE XVI, OF THE 

STANDING RULES OF THE SENATE 

Paragraph 7 of rule XVI requires that Committee reports on general appropriations bills identify each Committee amendment to 

the House bill ‘‘which proposes an item of appropriation which is 

not made to carry out the provisions of an existing law, a treaty 

stipulation, or an act or resolution previously passed by the Senate 

during that session.’’ 

The Committee is filing an original bill, which is not covered 

under this rule, but reports this information in the spirit of full disclosure. 

The Committee recommends funding for the following programs 

and activities which currently lack authorization: Elementary and 

Secondary Education Act; Institute of Education Sciences; parts C 

and D of the Individuals with Disabilities Education Act; Special 

Olympics Sport and Empowerment Act of 2004; Nurse Education 

Loan Repayment; Education and Training Related to Geriatrics; 

Mental and Behavioral Health Training; Children’s Hospital Graduate Medical Education; Title XVII of the PHS Act; Ryan White 

CARE Act; Universal Newborn Hearing Screening; Organ Transplantation; Family Planning; Rural Health programs; Traumatic 

Brain Injury programs; Combating Autism Act; Public Health Improvement Act; Healthy Start; Telehealth; Health Professions Education Partnership Act; Children’s Health Act; Women’s Health Research and Prevention Amendments of 1998; Birth Defects Prevention, Preventive Health Amendments of 1993; Substance Abuse and 

Mental Health Services programs; Low Income Home Energy Assistance Program; Refugee and Entrant Assistance programs (except for Victims of Trafficking); Head Start; Runaway and Homeless Youth programs; Adoption Incentives; Developmental Disabilities programs; Voting Access for Individuals with Disabilities; Native American Programs; Community Services Block Grant Act programs; National Institutes of Health; Assets for Independence; Alzheimer’s Disease Demonstration Grants; Office of Disease Prevention and Health Promotion; YouthBuild Transfer Act; Assistive 

Technology Act; Carl D. Perkins Career and Technical Education 

Improvement Act; Corporation for Public Broadcasting; National 

Council on Disability; Older Americans Act; Second Chance Act; 

Work Incentive Planning and Assistance; and Protection and Advocacy for Beneficiaries of Social Security. 

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

STANDING RULES OF THE SENATE 

Pursuant to paragraph 7(c) of rule XXVI, on June 25, 2015, the 

Committee ordered favorably reported an original bill making appropriations for the Departments of Labor, Health and Human 

Services, and Education, and related agencies for the fiscal year 
209 

ending September 30, 2016, and for other purposes, provided, that 

the bill be subject to amendment and that the bill be consistent 

with its budget allocation, by a recorded vote of 16–14, a quorum 

being present. The vote was as follows: 

Yeas Nays 

Chairman Cochran Ms. Mikulski 

Mr. McConnell Mr. Leahy 

Mr. Shelby Mrs. Murray 

Mr. Alexander Mrs. Feinstein 

Ms. Collins Mr. Durbin 

Ms. Murkowski Mr. Reed 

Mr. Graham Mr. Tester 

Mr. Kirk Mr. Udall 

Mr. Blunt Mrs. Shaheen 

Mr. Moran Mr. Merkley 

Mr. Hoeven Mr. Coons 

Mr. Boozman Mr. Schatz 

Mrs. Capito Ms. Baldwin 

Mr. Cassidy Mr. Murphy 

Mr. Lankford 

Mr. Daines 

COMPLIANCE WITH PARAGRAPH 12, RULE XXVI OF THE 

STANDING RULES OF THE SENATE 

Paragraph 12 of rule XXVI requires that Committee reports on 

a bill or a joint resolution repealing or amending any statute include ‘‘(a) the text of the statute or part thereof which is proposed 

to be repealed; and (b) a comparative print of that part of the bill 

or joint resolution making the amendment and of the statute or 

part thereof proposed to be amended, showing by stricken through 

type and italics, parallel columns, or other appropriate typographical devices the omissions and insertions which would be 

made by the bill or joint resolution if enacted in the form recommended by the committee.’’ 

In compliance with this rule, changes in existing law proposed to 

be made by the bill are shown as follows: existing law to be omitted 

is enclosed in black brackets; new matter is printed in italic; and 

existing law in which no change is proposed is shown in roman. 
210 

TITLE 20—EDUCATION 

CHAPTER 28—HIGHER EDUCATION RESOURCES AND 

STUDENT ASSISTANCE 

SUBCHAPTER IV—STUDENT ASSISTANCE 

PART A—GRANTS TO STUDENTS IN ATTENDANCE AT INSTITUTIONS OF

HIGHER EDUCATION

SUBPART 1—FEDERAL PELL GRANTS

§ 1070a. Federal Pell Grants: amount and determinations; 

applications 

(a) Program authority and method of distribution 

* * * * * * * 

(b) Purpose and amount of grants 

(1) * * * 

(2)(A) The amount of the Federal Pell Grant for a student eligible under this part shall be— 

(i) the maximum Federal Pell Grant, as specified in the 

last enacted appropriation Act applicable to that award year, 

plus 

(ii) the amount of the increase calculated under paragraph 

(7)(B) for that year øexcept that a student eligible only under 

1091(d)(1)(A) of this title who first enrolls in an eligible program of study on or after July 1, 2015 shall not be eligible for 

the amount of the increase calculated under paragraph (7)(B)¿, 

less 

* * * * * * * 

PART F—GENERAL PROVISIONS RELATING TO STUDENT ASSISTANCE

PROGRAMS

§ 1091. Student eligibility 

(a) In general 

* * * * * * * 

(d) Students who are not high school graduates 

(1) Student eligibilty 

* * * * * * * 

ø(2) Eligible career pathway program 

In this subsection, the term ‘‘eligible career pathway program’’ 

means a program that— 

(A) concurrently enrolls participants in connected adult 

education and eligible postsecondary programs; 

(B) provides counseling and supportive services to identify 

and attain academic and career goals; 

(C) provides structured course sequences that- 

(i) are articulated and contextualized; and 

(ii) allow students to advance to higher levels of education and employment; 
211 

(D) provides opportunities for acceleration to attain recognized postsecondary credentials, including degrees, industry 

relevant certifications, and certificates of completion of apprenticeship programs; 

(E) is organized to meet the needs of adults; 

(F) is aligned with the education and skill needs of the regional economy; and 

(G) has been developed and implemented in collaboration 

with partners in business, workforce development, and economic development.¿ 

(2) ELIGIBLE CAREER PATHWAY PROGRAM.— In this subsection, 

the term ‘‘eligible career pathway program’’ means a program that 

combines rigorous and high-quality education, training, and other 

services that— 

(A) aligns with the skill needs of industries in the economy 

of the State or regional economy involved; 

(B) prepares an individual to be successful in any of a full 

range of secondary or postsecondary education options, including apprenticeships registered under the Act of August 16, 1937 

(commonly known as the ‘‘National Apprenticeship Act’’; 50 

Stat. 664, chapter 663; 29 U.S.C. 50 et seq.) (referred to individually in this Act as an ‘‘apprenticeship’’, except in section 171); 

(C) includes counseling to support an individual in achieving the individual’s education and career goals; 

(D) includes, as appropriate, education offered concurrently 

with and in the same context as workforce preparation activities 

and training for a specific occupation or occupational cluster; 

(E) organizes education, training, and other services to 

meet the particular needs of an individual in a manner that accelerates the educational and career advancement of the individual to the extent practicable; 

(F) enables an individual to attain a secondary school diploma or its recognized equivalent, and at least 1 recognized 

postsecondary credential; and 

(G) helps an individual enter or advance within a specific 

occupation or occupational cluster. 

TITLE 29—LABOR 

CHAPTER 8—FAIR LABOR STANDARDS 

§ 207. Maximum hours 

(a) Employees engaged in interstate commerce; additional 

applicability to employees pursuant to subsequent 

amendatory provisions 

* * * * * * * 

(r) Reasonable break time for nursing mothers 

(1) * * * 

* * * * * * * 
212 

(4) Nothing in this subsection shall preempt a State law that provides greater protections to employees than the protections provided for under this subsection. 

(s)(1) The provisions of this section shall not apply for a period 

of 2 years after the occurrence of a major disaster, as defined herein, 

to any employee— 

(A) employed to adjust or evaluate claims resulting from or 

relating to such major disaster, by an employer not engaged, directly or through an affiliate, in underwriting, selling, or marketing property, casualty, or liability insurance policies or contracts; 

(B) who receives on average weekly compensation of not less 

than $591.00 per week or any minimum weekly amount established by the Secretary, whichever is greater, over the number 

of weeks such employee is engaged in any of the activities described in subparagraph (C); and 

(C) whose duties include any of the following: 

(i) interviewing insured individuals, individuals who 

suffered injuries or other damages or losses arising from or 

relating to a disaster, witnesses, or physicians; 

(ii) inspecting property damage or reviewing factual information to prepare damage estimates; 

(iii) evaluating and making recommendations regarding coverage or compensability of claims or determining liability or value aspects of claims; 

(iv) negotiating settlements; or 

(v) making recommendations regarding litigation. 

(2) Notwithstanding any other provision of section 18, in the 

event of a major disaster, this Act exclusively shall govern the payment of overtime to all employees described in paragraph (1) above, 

and shall supersede any other Federal, State, or local law, regulation, or order. 

(3) The exemption in this subsection shall not affect the exemption provided by section 13(a)(1). 

(4) For purposes of this subsection— 

(A) the term ‘‘major disaster’’ means any disaster or catastrophe declared or designated by any State or Federal agency 

or department; 

(B) the term ‘‘employee employed to adjust or evaluate 

claims resulting from or relating to such major disaster’’ means 

an individual who timely secured or secures a license required 

by applicable law to engage in and perform any of the activities 

described in clauses (i) through (v) of paragraph (1)(C) relating 

to a major disaster, and is employed by an employer that maintains worker compensation insurance coverage or protection for 

its employees, if required by applicable law, and withholds applicable Federal, State, and local income and payroll taxes from 

the wages, salaries and any benefits of such employees; and 

(C) the term ‘‘affiliate’’ means a company that, by reason of 

ownership or control of percent or more of the outstanding 

shares of any class of voting securities of one or more compa-
213 

nies, directly or indirectly, controls, is controlled by, or is under 

common control with, another company. 

TITLE 42—THE PUBLIC HEALTH AND WELFARE 

CHAPTER 6A—PUBLIC HEALTH SERVICE

SUBCHAPTER II—NATIONAL RESEARCH INSTITUTES 

PART C—SPECIFIC PROVISIONS RESPECTING NATIONAL RESEARCH

INSTITUTES

SUBPART 11—NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES

§ 285k. National Institute of General Medical Sciences 

(a) General purpose 

* * * * * * * 

(b) Institutional development award program 

(1)(A) In the case of entities described in subparagraph (B), the 

Director of NIH, acting through the Director of the National Institute of General Medical Sciences, shall establish a program to enhance the competitiveness of such entities in obtaining funds from 

the national research institutes for conducting biomedical and behavioral research. 

(B) The entities referred to in subparagraph (A) are entities 

that conduct biomedical øand behavioral research and are located 

in a State in which the aggregate success rate for applications to 

the national research institutes for assistance for such research by 

the entities in the State has historically constituted a low success 

rate of obtaining such funds, relative to such aggregate rate for 

such entities in other States.¿ or behavioral research and are located in a State that is at or below the median of all States with 

respect to the aggregate NIH funding received by entities in that 

State. 

(C) With respect to enhancing competitiveness for purposes of 

subparagraph (A), the Director of NIH, in carrying out the program 

established under such subparagraph, may— 

(i) provide technical assistance to the entities involved, including technical assistance in the preparation of applications 

for obtaining funds from the national research institutes; 

(ii) assist the entities in developing a plan for biomedical 

or behavioral research proposals; and 

(iii) assist the entities in implementing such plan. 

(D) Entities that are designated as Primarily Undergraduate 

Institutions and that are not eligible for funding under the Individuals with Disabilities Education Act, but that have been eligible for 

participation in the National Science Foundation Experimental Program to Stimulate Competitive Research (EPSCoR) program for the 

past 2 consecutive years, may apply to an entity that currently holds 

an IDeA Networks of Biomedical Research Excellence award for inclusion in their Network. 

* * * * * * * 
214 

SUBCHAPTER XXVI—NATIONAL ALL-HAZARDS 

PREPAREDNESS FOR PUBLIC HEALTH EMERGENCIES 

PART B—ALL-HAZARDS EMERGENCY PREPAREDNESS AND RESPONSE

§ 300hh–11. National Disaster Medical System 

(a) National Disaster Medical System 

* * * * * * * 

(d) Certain employment issues regarding intermittent appointments 

* * * * * * * 

(1) Intermittent disaster-response appointee 

* * * * * * * 

(2) Compensation for work injuries 

øAn¿ (A) IN GENERAL.—An intermittent disaster-response 

appointee shall, while acting in the scope of such appointment, 

be considered to be an employee of the Public Health Service 

performing medical, surgical, dental, or related functions, and 

an injury sustained by such an individual shall be deemed ‘‘in 

the performance of duty’’, for purposes of chapter 81 of title 5 

pertaining to compensation for work injuries. 

øWith¿ (B) APPLICATION TO TRAINING PROGRAMS.—With respect to the participation of individuals appointed under subsection (c) of this section in training programs authorized by 

the Assistant Secretary for Preparedness and Response or a 

comparable official of any Federal agency specified in subsection (a)(2)(B) of this section, injuries sustained by such an 

individual, while acting within the scope of such participation, 

also shall be deemed ‘‘in the performance of duty’’ for purposes 

of chapter 81 of title 5 (regardless of whether the individuals 

receive compensation for such participation). 

øIn¿ (C) RESPONSIBILITY OF LABOR SECRETARY.—In the 

event of an injury to such an intermittent disaster-response appointee, the Secretary of Labor shall be responsible for making 

determinations as to whether the claimant is entitled to compensation or other benefits in accordance with chapter 81 of 

title 5. 

(D) COMPUTATION OF PAY.—In the event of an injury to 

such an intermittent disaster response appointee, the position of 

the employee shall be deemed to be ‘‘one which would have afforded employment for substantially a whole year’’, for purposes 

of section 8114(d)(2) of such title. 

(E) CONTINUATION OF PAY.—The weekly pay of such an employee shall be deemed to be the hourly pay in effect on the date 

of the injury multiplied by 40, for purposes of computing benefits under section 8118 of such title. 

* * * * * * * 
215 

CHAPTER 43—DEPARTMENT OF HEALTH AND HUMAN SERVICES

SUBCHAPTER I—GENERAL PROVISIONS 

§ 3514A. Nonrecurring expenses fund 

There is hereby established in the Treasury of the United 

States a fund to be known as the ‘‘Nonrecurring expenses fund’’ 

(the Fund): Provided, That unobligated balances of expired discretionary funds appropriated in this or any succeeding fiscal year 

from the General Fund of the Treasury to the Department of 

Health and Human Services by this or any other Act may be transferred (not later than the end of the fifth fiscal year after the last 

fiscal year for which such funds are available for the purposes for 

which appropriated) into the Fund: Provided further, That amounts 

deposited in the Fund shall be available to the Office of the Director, National Institutes of Health until expended, and in addition 

to such other funds as may be available for øsuch purposes, for 

capital acquisition necessary for the operation of the Department, 

including facilities infrastructure and information technology infrastructure¿ all necessary expenses related to carrying out section 301 

and title IV of the Public Health Service Act, subject to approval by 

the Office of Management and Budget: Provided further, That 

amounts in the Fund may be obligated only after the Committees 

on Appropriations of the House of Representatives and the Senate 

are notified at least 15 days in advance of the planned use of funds. 

TITLE 48—TERRITORIES AND INSULAR POSSESSIONS 

CHAPTER 18—MICRONESIA, MARSHALL ISLANDS, AND PALAU

SUBCHAPTER I—MICRONESIA AND MARSHALL ISLANDS 

PART B—APPROVAL AND IMPLEMENTATION OF COMPACTS, AS

AMENDED

§ 1921d. Supplemental provisions 

(a) Domestic program requirements 

* * * * * * * 

(f) Continuing programs and laws 

(1) Federated States of Micronesia and Republic of the 

Marshall Islands 

* * * * * * * 

(A) Emergency and disaster assistance 

* * * * * * * 

(B) Treatment of additional programs 

(i) Consultation 

* * * * * * * 

(ix) Applicability 

The government, institutions, and people of Palau 

shall remain eligible for appropriations and to receive 

grants under the provisions of law specified in clauses 
216 

(ii) and (iii) until the end of fiscal year ø2009¿ 2016, 

to the extent the government, institutions, and people 

of Palau were so eligible under such provisions in fiscal year 2003. 

CONSOLIDATED APPROPRIATIONS ACT, 2014, 

PUBLIC LAW 113–76 

DIVISION H—DEPARTMENTS OF LABOR, HEALTH AND 

HUMAN SERVICES, AND EDUCATION, AND RELATED 

AGENCIES APPROPRIATIONS ACT, 2014 

TITLE V 

GENERAL PROVISIONS 

SEC. 526. (a) DEFINITIONS.—* * * 

(b) USE OF DISCRETIONARY FUNDS IN øFISCAL YEAR 2014¿ FISCAL YEAR 2016.—Federal agencies may use Federal discretionary 

funds that are made available in this Act to carry out up to 10 Performance Partnership Pilots. Such Pilots shall: 

* * * * * * * 

(c) PERFORMANCE PARTNERSHIP AGREEMENTS.—Federal agencies may use Federal discretionary funds, as authorized in subsection (b), to participate in a Performance Partnership Pilot only 

in accordance with the terms of a Performance Partnership Agreement that— 

(1) is entered into between— 

* * * * * * * 

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

(A) the length of the Agreement (which shall not extend beyond øSeptember 30, 2018¿ September 30, 2020); 

* * * * * * * 

(e) TRANSFER AUTHORITY.—For the purpose of carrying out the 

Pilot in accordance with the Performance Partnership Agreement, 

and subject to the written approval of the Director of the Office of 

Management and Budget, the head of each participating Federal 

agency may transfer Federal discretionary funds that are being 

used in the Pilot to an account of the lead Federal administering 

agency that includes Federal discretionary funds that are being 

used in the Pilot. Subject to the waiver authority under subsection 

(f), such transferred funds shall remain available for the same purposes for which such funds were originally appropriated: Provided, 

That such transferred funds shall remain available for obligation 

by the Federal Government until the expiration of the period of 

availability for those Federal discretionary funds (which are being 

used in the Pilot) that have the longest period of availability, except that any such transferred funds shall not remain available beyond øSeptember 30, 2018¿ September 30, 2020. 
217 

BUDGETARY IMPACT OF BILL 

PREPARED IN CONSULTATION WITH THE CONGRESSIONAL BUDGET OFFICE PURSUANT TO SEC. 

308(a), PUBLIC LAW 93–344, AS AMENDED 

[In millions of dollars] 

Budget authority Outlays 

Committee 

allocation 

Amount 

in bill 

Committee 

allocation 

Amount 

in bill 

Comparison of amounts in the bill with the subcommittee allocation for 2016: Subcommittee on 

Labor, HHS, Education, and Related Agencies: 

Mandatory ............................................................... 726,685 726,685 726,379 1 726,379 

Discretionary ........................................................... 153,188 154,749 165,342 1 166,674 

Security .......................................................... .................... .................... NA NA 

Nonsecurity .................................................... 153,188 154,749 NA NA 

Overseas Contingency Operations/Global War on 

Terrorism ............................................................ .................... .................... .................... ....................

Projections of outlays associated with the recommendation: 

2016 ........................................................................ .................... .................... .................... 2 795,519 

2017 ........................................................................ .................... .................... .................... 67,098 

2018 ........................................................................ .................... .................... .................... 14,527 

2019 ........................................................................ .................... .................... .................... 2,902 

2020 and future years ........................................... .................... .................... .................... 811

Financial assistance to State and local governments 

for 2016 ...................................................................... NA 412,900 NA 2 395,879 

1 Includes outlays from prior-year budget authority. 

2 Excludes outlays from prior-year budget authority. 

NA: Not applicable. 

NOTE.—Consistent with the funding recommended in the bill for continuing disability reviews and redeterminations and for 

healthcare fraud and abuse control and in accordance with subparagraphs (B) and (C) of section 251(b)(2) of the BBEDCA of 1985,

the Committee anticipates that the Budget Committee will provide a revised 302(a) allocation for the Committee on Appropriations 

reflecting an upward adjustment of $1,561,000,000 in budget authority plus associated outlays. 
218 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2015 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2016 

[In thousands of dollars] 

Item 2015 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2015 appropriation Budget estimate 

TITLE I — DEPARTMENT OF LABOR 

EMPLOYMENT AND TRAINING ADMINISTRATION 

Training and Employment Services 

Grants to States: 

Adult Training, current year .............................................................................................................................. 64,736 103,556 25,000 ¥39,736 ¥78,556 

Advance from prior year ........................................................................................................................... (712,000 ) (712,000 ) (712,000 ) ............................ ............................Fiscal year 2017 ....................................................................................................................................... 712,000 712,000 712,000 ............................ ............................

Subtotal ................................................................................................................................................ 776,736 815,556 737,000 ¥39,736 ¥78,556 

Youth Training ................................................................................................................................................... 831,842 873,416 790,000 ¥41,842 ¥83,416 Dislocated Worker Assistance, current year ...................................................................................................... 155,530 160,860 105,000 ¥50,530 ¥55,860 

Advance from prior year ........................................................................................................................... (860,000 ) (860,000 ) (860,000 ) ............................ ............................Fiscal year 2017 ....................................................................................................................................... 860,000 860,000 860,000 ............................ ............................

Subtotal ................................................................................................................................................ 1,015,530 1,020,860 965,000 ¥50,530 ¥55,860 Subtotal, Grants to States ................................................................................................................... 2,624,108 2,709,832 2,492,000 ¥132,108 ¥217,832 

Current Year .................................................................................................................................... (1,052,108 ) (1,137,832 ) (920,000 ) (¥132,108 ) (¥217,832 ) Fiscal year 2017 .............................................................................................................................. (1,572,000 ) (1,572,000 ) (1,572,000 ) ............................ ............................

Federally Administered Programs: 

Dislocated Worker Assistance National Reserve: 

Current year .............................................................................................................................................. 20,859 40,859 ............................ ¥20,859 ¥40,859 Advance from prior year ........................................................................................................................... (200,000 ) (200,000 ) (200,000 ) ............................ ............................Fiscal year 2017 ....................................................................................................................................... 200,000 200,000 200,000 ............................ ............................

Subtotal ................................................................................................................................................ 220,859 240,859 200,000 ¥20,859 ¥40,859 Subtotal, Dislocated Worker Assistance .............................................................................................. 1,236,389 1,261,719 1,165,000 ¥71,389 ¥96,719 
219 

Native American Programs ................................................................................................................................ 46,082 50,000 40,500 ¥5,582 ¥9,500 Disability Employment Programs ...................................................................................................................... ............................ ............................ 23,750 ∂23,750 ∂23,750 Migrant and Seasonal Farmworker programs ................................................................................................... 81,896 81,896 73,000 ¥8,896 ¥8,896 Technical Assistance ......................................................................................................................................... ............................ 3,232 1,000 ∂1,000 ¥2,232 Women in Apprenticeship .................................................................................................................................. 994 ............................ ............................ ¥994 ............................YouthBuild activities ......................................................................................................................................... 79,689 84,534 79,689 ............................ ¥4,845 

Subtotal, Federally Administered Programs [FAP] ........................................................................................ 429,520 460,521 417,939 ¥11,581 ¥42,582 

Current Year ......................................................................................................................................... (229,520 ) (260,521 ) (217,939 ) (¥11,581 ) (¥42,582 ) Fiscal year 2017 .................................................................................................................................. (200,000 ) (200,000 ) (200,000 ) ............................ ............................

National Activities: 

Reintegration of Ex-Offenders .................................................................................................................. 82,078 95,078 22,305 ¥59,773 ¥72,773 Workforce Data Quality Initiative ............................................................................................................. 4,000 37,000 4,000 ............................ ¥33,000 Apprenticeship programs ......................................................................................................................... ............................ 100,000 ............................ ............................ ¥100,000 

Subtotal ................................................................................................................................................ 86,078 235,310 26,305 ¥59,773 ¥209,005 Total, Training and Employment Services [TES] ................................................................................. 3,139,706 3,405,663 2,936,244 ¥203,462 ¥469,419 

Current Year .................................................................................................................................... (1,367,706 ) (1,633,663 ) (1,164,244 ) (¥203,462 ) (¥469,419 ) Fiscal year 2017 .............................................................................................................................. (1,772,000 ) (1,772,000 ) (1,772,000 ) ............................ ............................

Office of Job Corps 

Administration ............................................................................................................................................................ 32,330 43,119 31,147 ¥1,183 ¥11,972 Operations .................................................................................................................................................................. 1,580,825 1,597,825 1,578,008 ¥2,817 ¥19,817 Construction, Rehabilitation and Acquisition ............................................................................................................ 75,000 75,000 74,000 ¥1,000 ¥1,000 

Total, Office of Job Corps ............................................................................................................................. 1,688,155 1,715,944 1,683,155 ¥5,000 ¥32,789 

Current Year ......................................................................................................................................... (1,688,155 ) (1,715,944 ) (1,683,155 ) (¥5,000 ) (¥32,789 ) 

Community Service Employment For Older Americans .............................................................................................. 434,371 434,371 400,000 ¥34,371 ¥34,371 Federal Unemployment Benefits and Allowances ...................................................................................................... 710,600 664,200 664,200 ¥46,400 ............................

STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS 

Unemployment Compensation [UI]: 

State Operations ................................................................................................................................................ 2,777,793 2,883,450 2,725,550 ¥52,243 ¥157,900 National Activities ............................................................................................................................................. 12,892 14,547 12,892 ............................ ¥1,655 

Subtotal, Unemployment Compensation ....................................................................................................... 2,790,685 2,897,997 2,738,442 ¥52,243 ¥159,555 
220 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2015 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2016—Continued 

[In thousands of dollars] 

Item 2015 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2015 appropriation Budget estimate 

Employment Service [ES]: 

Allotments to States: 

Federal Funds ........................................................................................................................................... 21,413 21,413 20,775 ¥638 ¥638 Trust Funds .............................................................................................................................................. 642,771 642,771 614,000 ¥28,771 ¥28,771 

Supplemental grants ....................................................................................................................... ............................ 400,000 ............................ ............................ ¥400,000 

Subtotal, Trust Funds ................................................................................................................. 642,771 1,042,771 614,000 ¥28,771 ¥428,771 Subtotal, Allotments to States ................................................................................................... 664,184 1,064,184 634,775 ¥29,409 ¥429,409 

ES National Activities ........................................................................................................................................ 19,818 19,818 19,000 ¥818 ¥818 

Subtotal, Employment Service ...................................................................................................................... 684,002 1,084,002 653,775 ¥30,227 ¥430,227 

Federal Funds ......................................................................................................................... (21,413 ) (21,413 ) (20,775 ) (¥638 ) (¥638 ) Trust Funds ............................................................................................................................ (662,589 ) (1,062,589 ) (633,000 ) (¥29,589 ) (¥429,589 ) 

Foreign Labor Certification: 

Federal Administration ...................................................................................................................................... 48,028 61,589 47,691 ¥337 ¥13,898 Grants to States ................................................................................................................................................ 14,282 14,282 14,000 ¥282 ¥282 

Subtotal, Foreign Labor Certification ........................................................................................................... 62,310 75,871 61,691 ¥619 ¥14,180 

One-Stop Career Centers/Labor Market Information .................................................................................................. 60,153 80,153 65,653 ∂5,500 ¥14,500 

Total, State UI and ES .................................................................................................................................. 3,597,150 4,138,023 3,519,561 ¥77,589 ¥618,462 

Federal Funds ...................................................................................................................................... (81,566 ) (101,566 ) (86,428 ) (∂4,862 ) (¥15,138 ) Trust Funds .......................................................................................................................................... (3,515,584 ) (4,036,457 ) (3,433,133 ) (¥82,451 ) (¥603,324 ) 

State Paid Leave Fund ............................................................................................................................................... ............................ 35,000 ............................ ............................ ¥35,000 

Program Administration 

Training and Employment .......................................................................................................................................... 60,074 73,158 56,568 ¥3,506 ¥16,590 

Trust Funds ....................................................................................................................................................... 8,639 10,846 7,991 ¥648 ¥2,855 
221 

Employment Security .................................................................................................................................................. 3,469 3,664 3,209 ¥260 ¥455 

Trust Funds ....................................................................................................................................................... 39,264 40,828 36,319 ¥2,945 ¥4,509 

Apprenticeship Services ............................................................................................................................................. 34,000 36,734 31,450 ¥2,550 ¥5,284 Executive Direction ..................................................................................................................................................... 7,034 9,204 6,506 ¥528 ¥2,698 

Trust Funds ....................................................................................................................................................... 2,079 2,130 1,974 ¥105 ¥156 

Total, Program Administration ...................................................................................................................... 154,559 176,564 144,017 ¥10,542 ¥32,547 

Federal Funds ...................................................................................................................................... (104,577 ) (122,760 ) (97,733 ) (¥6,844 ) (¥25,027 ) Trust Funds .......................................................................................................................................... (49,982 ) (53,804 ) (46,284 ) (¥3,698 ) (¥7,520 ) 

Total, Employment and Training Administration .......................................................................................... 9,724,541 10,569,765 9,347,177 ¥377,364 ¥1,222,588 

Federal Funds ...................................................................................................................................... 6,158,975 6,479,504 5,867,760 ¥291,215 ¥611,744 

Current Year ........................................................................................................................... (4,386,975 ) (4,707,504 ) (4,095,760 ) (¥291,215 ) (¥611,744 ) Fiscal year 2017 ..................................................................................................................... (1,772,000 ) (1,772,000 ) (1,772,000 ) ............................ ............................

Trust Funds .......................................................................................................................................... 3,565,566 4,090,261 3,479,417 ¥86,149 ¥610,844 

EMPLOYEE BENEFITS SECURITY ADMINISTRATION [EBSA] 

Salaries and Expenses 

Enforcement and Participant Assistance ................................................................................................................... 147,400 166,362 137,000 ¥10,400 ¥29,362 Policy and Compliance Assistance ............................................................................................................................ 26,901 34,258 25,901 ¥1,000 ¥8,357 Executive Leadership, Program Oversight and Administration ................................................................................. 6,699 6,835 6,029 ¥670 ¥806 

Total, EBSA ................................................................................................................................................... 181,000 207,455 168,930 ¥12,070 ¥38,525 

PENSION BENEFIT GUARANTY CORPORATION [PBGC] 

Pension Benefit Guaranty Corporation Fund 

Pension Insurance Activities ...................................................................................................................................... ............................ (431,799 ) (431,799 ) (∂431,799 ) ............................Pension Insurance Activities ...................................................................................................................................... (79,526 ) ............................ ............................ (¥79,526 ) ............................Pension Plan Termination .......................................................................................................................................... (179,230 ) ............................ ............................ (¥179,230 ) ............................Operational Support ................................................................................................................................................... (156,638 ) ............................ ............................ (¥156,638 ) ............................

Total, PBGC (program level) ......................................................................................................................... (415,394 ) (431,799 ) (431,799 ) (∂16,405 ) ............................

WAGE AND HOUR DIVISION, Salaries and expenses .................................................................................................. 227,500 277,100 210,000 ¥17,500 ¥67,100 OFFICE OF LABOR–MANAGEMENT STANDARDS, Salaries and expenses .................................................................... 39,129 46,981 36,000 ¥3,129 ¥10,981 OFFICE OF FEDERAL CONTRACT COMPLIANCE PROGRAMS, Salaries and expenses ................................................. 106,476 113,687 96,000 ¥10,476 ¥17,687 
222 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2015 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2016—Continued 

[In thousands of dollars] 

Item 2015 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2015 appropriation Budget estimate 

OFFICE OF WORKERS’ COMPENSATION PROGRAMS 

Salaries and Expenses ............................................................................................................................................... 110,823 117,397 107,500 ¥3,323 ¥9,897 

Trust Funds ....................................................................................................................................................... 2,177 2,177 2,177 ............................ ............................

Total, Salaries and Expenses ....................................................................................................................... 113,000 119,574 109,677 ¥3,323 ¥9,897 

Federal Funds ...................................................................................................................................... (110,823 ) (117,397 ) (107,500 ) (¥3,323 ) (¥9,897 ) Trust Funds .......................................................................................................................................... (2,177 ) (2,177 ) (2,177 ) ............................ ............................

Special Benefits 

Federal Employees’ Compensation Benefits .............................................................................................................. 207,000 207,000 207,000 ............................ ............................Longshore and Harbor Workers’ Benefits ................................................................................................................... 3,000 3,000 3,000 ............................ ............................

Total, Special Benefits .................................................................................................................................. 210,000 210,000 210,000 ............................ ............................

Special Benefits for Disabled Coal Miners 

Benefit Payments ....................................................................................................................................................... 96,000 85,040 85,000 ¥11,000 ¥40 Administration ............................................................................................................................................................ 5,262 5,262 5,302 ∂40 ∂40 

Subtotal, Fiscal year 2016 program level .................................................................................................... 101,262 90,302 90,302 ¥10,960 ............................

Less funds advanced in prior year .......................................................................................................... ¥24,000 ¥21,000 ¥21,000 ∂3,000 ............................

Total, Current Year .............................................................................................................................. 77,262 69,302 69,302 ¥7,960 ............................

New advances, 1st quarter, fiscal year 2017 ................................................................................ 21,000 19,000 19,000 ¥2,000 ............................

Total, Special Benefits for Disabled Coal Miners ........................................................................................ 98,262 88,302 88,302 ¥9,960 ............................

Energy Employees Occupational Illness Compensation Fund 

Administrative Expenses ............................................................................................................................................ 56,406 58,552 58,552 ∂2,146 ............................
223 

Black Lung Disability Trust Fund 

Benefit Payments and Interest on Advances ............................................................................................................. 261,548 275,261 275,261 ∂13,713 ............................Workers’ Compensation Programs, Salaries and Expenses ....................................................................................... 33,321 35,244 35,244 ∂1,923 ............................Departmental Management, Salaries and Expenses ................................................................................................. 30,403 30,279 30,279 ¥124 ............................Departmental Management, Inspector General ......................................................................................................... 327 327 327 ............................ ............................

Subtotal, Black Lung Disability .................................................................................................................... 325,599 341,111 341,111 ∂15,512 ............................

Treasury Department Administrative Costs ............................................................................................................... 356 356 356 ............................ ............................

Total, Black Lung Disability Trust Fund ....................................................................................................... 325,955 341,467 341,467 ∂15,512 ............................Total, Workers’ Compensation Programs ...................................................................................................... 803,623 817,895 807,998 ∂4,375 ¥9,897 

Federal Funds ........................................................................................................................................... 801,446 815,718 805,821 ∂4,375 ¥9,897 

Current year ......................................................................................................................................... (780,446 ) (796,718 ) (786,821 ) (∂6,375 ) (¥9,897 ) Fiscal year 2017 .................................................................................................................................. (21,000 ) (19,000 ) (19,000 ) (¥2,000 ) ............................

Trust Funds .............................................................................................................................................. 2,177 2,177 2,177 ............................ ............................

OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION [OSHA] 

Salaries and Expenses 

Safety and Health Standards ..................................................................................................................................... 20,000 23,306 17,000 ¥3,000 ¥6,306 Federal Enforcement ................................................................................................................................................... 208,000 225,608 194,000 ¥14,000 ¥31,608 Whistleblower enforcement ......................................................................................................................................... 17,500 22,628 15,750 ¥1,750 ¥6,878 State Programs ........................................................................................................................................................... 100,850 104,337 98,746 ¥2,104 ¥5,591 Technical Support ....................................................................................................................................................... 24,469 24,614 24,000 ¥469 ¥614 Compliance Assistance: 

Federal Assistance ............................................................................................................................................ 68,433 73,044 66,500 ¥1,933 ¥6,544 State Consultation Grants ................................................................................................................................. 57,775 57,775 56,500 ¥1,275 ¥1,275 Training Grants ................................................................................................................................................. 10,537 10,687 10,149 ¥388 ¥538 

Subtotal, Compliance Assistance ................................................................................................................. 136,745 141,506 133,149 ¥3,596 ¥8,357 

Safety and Health Statistics ...................................................................................................................................... 34,250 38,763 31,681 ¥2,569 ¥7,082 Executive Direction and Administration ..................................................................................................................... 10,973 11,309 10,150 ¥823 ¥1,159 

Total, OSHA ................................................................................................................................................... 552,787 592,071 524,476 ¥28,311 ¥67,595 
224 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2015 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2016—Continued 

[In thousands of dollars] 

Item 2015 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2015 appropriation Budget estimate 

MINE SAFETY AND HEALTH ADMINISTRATION 

Salaries and Expenses 

Coal Enforcement ....................................................................................................................................................... 167,859 175,769 158,052 ¥9,807 ¥17,717 Metal/Non-Metal Enforcement .................................................................................................................................... 91,697 93,841 87,000 ¥4,697 ¥6,841 Standards Development ............................................................................................................................................. 5,416 6,070 4,500 ¥916 ¥1,570 Assessments ............................................................................................................................................................... 6,976 8,122 6,627 ¥349 ¥1,495 Educational Policy and Development ......................................................................................................................... 36,320 40,448 35,412 ¥908 ¥5,036 Technical Support ....................................................................................................................................................... 33,791 34,583 33,546 ¥245 ¥1,037 Program Evaluation and Information Resources [PEIR] ............................................................................................ 17,990 19,783 17,091 ¥899 ¥2,692 Program Administration ............................................................................................................................................. 15,838 16,316 14,650 ¥1,188 ¥1,666 

Total, Mine Safety and Health Administration ............................................................................................. 375,887 394,932 356,878 ¥19,009 ¥38,054 Total, Worker Protection Agencies ................................................................................................................ 1,595,779 1,751,800 1,501,961 ¥93,818 ¥249,839 

Federal Funds ........................................................................................................................................... (1,593,602 ) (1,749,623 ) (1,499,784 ) (¥93,818 ) (¥249,839 ) Trust Funds .............................................................................................................................................. (2,177 ) (2,177 ) (2,177 ) ............................ ............................

BUREAU OF LABOR STATISTICS 

Salaries and Expenses 

Employment and Unemployment Statistics ............................................................................................................... 204,788 219,129 200,383 ¥4,405 ¥18,746 Labor Market Information ........................................................................................................................................... 65,000 65,000 63,700 ¥1,300 ¥1,300 Prices and Cost of Living .......................................................................................................................................... 200,000 216,048 196,000 ¥4,000 ¥20,048 Compensation and Working Conditions ..................................................................................................................... 78,000 85,793 76,000 ¥2,000 ¥9,793 Productivity and Technology ....................................................................................................................................... 11,424 10,795 10,627 ¥797 ¥168 Executive Direction and Staff Services ...................................................................................................................... 33,000 35,972 32,484 ¥516 ¥3,488 

Total, Bureau of Labor Statistics ................................................................................................................. 592,212 632,737 579,194 ¥13,018 ¥53,543 

Federal Funds ...................................................................................................................................... 527,212 567,737 515,494 ¥11,718 ¥52,243 
225 

Trust Funds .......................................................................................................................................... 65,000 65,000 63,700 ¥1,300 ¥1,300 

OFFICE OF DISABILITY EMPLOYMENT POLICY 

Salaries and Expenses ............................................................................................................................................... 38,500 38,203 ............................ ¥38,500 ¥38,203 

DEPARTMENTAL MANAGEMENT 

Salaries and Expenses 

Executive Direction ..................................................................................................................................................... 31,010 35,302 28,684 ¥2,326 ¥6,618 Departmental Program Evaluation ............................................................................................................................. 8,040 9,500 7,236 ¥804 ¥2,264 Legal Services ............................................................................................................................................................ 126,136 139,680 116,000 ¥10,136 ¥23,680 

Trust Funds ....................................................................................................................................................... 308 308 293 ¥15 ¥15 

International Labor Affairs ......................................................................................................................................... 91,125 94,517 30,000 ¥61,125 ¥64,517 Administration and Management ............................................................................................................................... 28,413 35,835 27,750 ¥663 ¥8,085 Adjudication ................................................................................................................................................................ 29,420 35,854 28,500 ¥920 ¥7,354 Women’s Bureau ......................................................................................................................................................... 11,536 11,788 9,465 ¥2,071 ¥2,323 Civil Rights Activities ................................................................................................................................................. 6,880 7,996 6,192 ¥688 ¥1,804 Chief Financial Officer ............................................................................................................................................... 5,061 5,205 4,900 ¥161 ¥305 

Total, Departmental Management ................................................................................................................ 337,929 375,985 259,020 ¥78,909 ¥116,965 

Federal Funds ...................................................................................................................................... (337,621 ) (375,677 ) (258,727 ) (¥78,894 ) (¥116,950 ) Trust Funds .......................................................................................................................................... (308 ) (308 ) (293 ) (¥15 ) (¥15 ) 

Veterans Employment and Training 

State Administration, Grants ..................................................................................................................................... 175,000 175,000 175,000 ............................ ............................Transition Assistance Program .................................................................................................................................. 14,000 14,100 14,000 ............................ ¥100 Federal Administration ............................................................................................................................................... 39,458 40,487 39,458 ............................ ¥1,029 National Veterans Training Institute .......................................................................................................................... 3,414 3,414 3,414 ............................ ............................Homeless Veterans Program ...................................................................................................................................... 38,109 38,109 38,109 ............................ ............................

Total, Veterans Employment and Training ................................................................................................... 269,981 271,110 269,981 ............................ ¥1,129 

Federal Funds ...................................................................................................................................... 38,109 38,109 38,109 ............................ ............................Trust Funds .......................................................................................................................................... 231,872 233,001 231,872 ............................ ¥1,129 

IT Modernization 

Departmental support systems .................................................................................................................................. 4,898 4,898 4,898 ............................ ............................Infrastructure technology modernization .................................................................................................................... 10,496 53,880 8,000 ¥2,496 ¥45,880 Digital Government Integrated Platform .................................................................................................................... ............................ 60,824 ............................ ............................ ¥60,824 
226 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2015 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2016—Continued 

[In thousands of dollars] 

Item 2015 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2015 appropriation Budget estimate 

Total, IT Modernization ................................................................................................................................. 15,394 119,602 12,898 ¥2,496 ¥106,704 

Office of Inspector General 

Program Activities ...................................................................................................................................................... 76,000 82,325 73,721 ¥2,279 ¥8,604 

Trust Funds ....................................................................................................................................................... 5,590 5,660 5,590 ............................ ¥70 

Total, Office of Inspector General ................................................................................................................ 81,590 87,985 79,311 ¥2,279 ¥8,674 Total, Departmental Management ................................................................................................................ 704,894 854,682 621,210 ¥83,684 ¥233,472 

Federal Funds ...................................................................................................................................... 467,124 615,713 383,455 ¥83,669 ¥232,258 Current Year ......................................................................................................................................... (467,124 ) (615,713 ) (383,455 ) (¥83,669 ) (¥232,258 ) Trust Funds .......................................................................................................................................... 237,770 238,969 237,755 ¥15 ¥1,214 

Total, Workforce Investment Act Programs .................................................................................................. 4,826,867 5,121,607 4,619,399 ¥207,468 ¥502,208 

Current Year ......................................................................................................................................... (3,054,867 ) (3,349,607 ) (2,847,399 ) (¥207,468 ) (¥502,208 ) Fiscal year 2017 .................................................................................................................................. (1,772,000 ) (1,772,000 ) (1,772,000 ) ............................ ............................

Total, Title I, Department of Labor ............................................................................................................... 13,346,549 14,545,508 12,747,863 ¥598,686 ¥1,797,645 

Federal Funds ........................................................................................................................................... 9,476,036 10,149,101 8,964,814 ¥511,222 ¥1,184,287 

Current Year ......................................................................................................................................... (7,683,036 ) (8,358,101 ) (7,173,814 ) (¥509,222 ) (¥1,184,287 ) Fiscal year 2017 .................................................................................................................................. (1,793,000 ) (1,791,000 ) (1,791,000 ) (¥2,000 ) ............................

Trust Funds .............................................................................................................................................. 3,870,513 4,396,407 3,783,049 ¥87,464 ¥613,358 

TITLE II—DEPARTMENT OF HEALTH AND HUMAN SERVICES 

HEALTH RESOURCES AND SERVICES ADMINISTRATION [HRSA] 

HEALTH RESOURCES AND SERVICES 

Primary Health Care 

Community Health Centers ........................................................................................................................................ 1,491,422 1,491,422 1,491,422 ............................ ............................
227 

Free Clinics Medical Malpractice ............................................................................................................................... 100 100 100 ............................ ............................

Total, Primary Health Care ........................................................................................................................... 1,491,522 1,491,522 1,491,522 ............................ ............................

Health Workforce 

National Health Service Corps ................................................................................................................................... ............................ 287,370 ............................ ............................ ¥287,370 Training for Diversity: 

Centers of Excellence ........................................................................................................................................ 21,711 25,000 21,711 ............................ ¥3,289 Health Careers Opportunity Program ................................................................................................................ 14,189 ............................ ............................ ¥14,189 ............................Faculty Loan Repayment ................................................................................................................................... 1,190 1,190 1,190 ............................ ............................Scholarships for Disadvantaged Students ........................................................................................................ 45,970 45,970 50,970 ∂5,000 ∂5,000 Health workforce diversity ................................................................................................................................. ............................ 14,000 ............................ ............................ ¥14,000 

Subtotal, Training for Diversity .................................................................................................................... 83,060 86,160 73,871 ¥9,189 ¥12,289 

Training in Primary Care Medicine ............................................................................................................................ 38,924 38,924 36,831 ¥2,093 ¥2,093 Rural Physician Training Grants ................................................................................................................................ ............................ 4,000 ............................ ............................ ¥4,000 Oral Health Training ................................................................................................................................................... 33,928 33,928 32,000 ¥1,928 ¥1,928 

Subtotal, Oral Health programs ................................................................................................................... 33,928 33,928 32,000 ¥1,928 ¥1,928 

Interdisciplinary Community-Based Linkages: 

Area Health Education Centers ......................................................................................................................... 30,250 ............................ 31,000 ∂750 ∂31,000 Geriatric Programs ............................................................................................................................................ 34,237 34,237 35,076 ∂839 ∂839 

Clinical Training in Interprofessional Practice ........................................................................................ ............................ 10,000 ............................ ............................ ¥10,000 

Mental and Behavorial Health .......................................................................................................................... 8,916 8,916 8,916 ............................ ............................

Subtotal, Interdisciplinary Community Linkages .......................................................................................... 73,403 53,153 74,992 ∂1,589 ∂21,839 Total, Interdisciplinary Community Linkages ............................................................................................... 73,403 53,153 74,992 ∂1,589 ∂21,839 

Workforce Information and Analysis .......................................................................................................................... 4,663 4,663 2,782 ¥1,881 ¥1,881 Public Health and Preventive Medicine programs ..................................................................................................... 21,000 17,000 9,864 ¥11,136 ¥7,136 

Subtotal ......................................................................................................................................................... 21,000 17,000 9,864 ¥11,136 ¥7,136 

Nursing Programs: 

Advanced Education Nursing ............................................................................................................................ 63,581 63,581 61,089 ¥2,492 ¥2,492 Nurse Education, Practice, and Retention ........................................................................................................ 39,913 39,913 39,913 ............................ ............................Nursing Workforce Diversity .............................................................................................................................. 15,343 15,343 15,343 ............................ ............................Loan Repayment and Scholarship Program ...................................................................................................... 81,785 81,785 79,785 ¥2,000 ¥2,000 
228 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2015 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2016—Continued 

[In thousands of dollars] 

Item 2015 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2015 appropriation Budget estimate 

Comprehensive Geriatric Education .................................................................................................................. 4,500 4,500 ............................ ¥4,500 ¥4,500 Nursing Faculty Loan Program .......................................................................................................................... 26,500 26,500 24,500 ¥2,000 ¥2,000 

Total, Nursing programs ............................................................................................................................... 231,622 231,622 220,630 ¥10,992 ¥10,992 

Children’s Hospitals Graduate Medical Education .................................................................................................... 265,000 100,000 270,000 ∂5,000 ∂170,000 National Practitioner Data Bank ................................................................................................................................ 18,814 19,728 18,814 ............................ ¥914 

User Fees ........................................................................................................................................................... ¥18,814 ¥19,728 ¥18,814 ............................ ∂914 

Total, Health Workforce ................................................................................................................................. 751,600 856,820 720,970 ¥30,630 ¥135,850 

Maternal and Child Health 

Maternal and Child Health Block Grant .................................................................................................................... 637,000 637,000 615,276 ¥21,724 ¥21,724 Sickle Cell Anemia Demonstration Program .............................................................................................................. 4,455 4,455 4,455 ............................ ............................Traumatic Brain Injury ............................................................................................................................................... 9,321 9,321 9,321 ............................ ............................Autism and Other Developmental Disorders .............................................................................................................. 47,099 47,099 47,099 ............................ ............................Heritable Disorders ..................................................................................................................................................... 13,883 13,883 11,883 ¥2,000 ¥2,000 Healthy Start .............................................................................................................................................................. 102,000 102,000 102,000 ............................ ............................Universal Newborn Hearing Screening ....................................................................................................................... 17,818 17,818 17,818 ............................ ............................Emergency Medical Services for Children .................................................................................................................. 20,162 20,162 20,162 ............................ ............................

Total, Maternal and Child Health ................................................................................................................. 851,738 851,738 828,014 ¥23,724 ¥23,724 

Ryan White HIV/AIDS 

Ryan White HIV/AIDS: 

Emergency Assistance ....................................................................................................................................... 655,876 655,876 655,876 ............................ ............................Comprehensive Care Programs ......................................................................................................................... 1,315,005 1,315,005 1,315,005 ............................ ............................

AIDS Drug Assistance Program [ADAP] (NA) ........................................................................................... (900,313 ) (900,313 ) (900,313 ) ............................ ............................

Early Intervention Program ................................................................................................................................ 201,079 280,167 201,079 ............................ ¥79,088 Children, Youth, Women, and Families ............................................................................................................. 75,088 ............................ 75,088 ............................ ∂75,088 
229 

AIDS Dental Services ......................................................................................................................................... 13,122 13,122 13,122 ............................ ............................Education and Training Centers ....................................................................................................................... 33,611 33,611 33,611 ............................ ............................Special Projects of National Significance ......................................................................................................... 25,000 25,000 ............................ ¥25,000 ¥25,000 

Total, Ryan White HIV/AIDS program level ................................................................................................... (2,318,781 ) (2,322,781 ) (2,293,781 ) (¥25,000 ) (¥29,000 ) 

Health Care Systems 

Organ Transplantation ............................................................................................................................................... 23,549 23,549 23,549 ............................ ............................National Cord Blood Inventory ................................................................................................................................... 11,266 11,266 11,266 ............................ ............................Bone Marrow Program ................................................................................................................................................ 22,109 22,109 22,109 ............................ ............................Office of Pharmacy Affairs ......................................................................................................................................... 10,238 17,238 10,238 ............................ ¥7,000 340B Drug Pricing User Fees ..................................................................................................................................... ............................ 7,500 7,500 ∂7,500 ............................

User Fees ........................................................................................................................................................... ............................ ¥7,500 ¥7,500 ¥7,500 ............................

Poison Control ............................................................................................................................................................ 18,846 18,846 18,846 ............................ ............................National Hansen’s Disease Program .......................................................................................................................... 15,206 15,206 15,206 ............................ ............................Hansen’s Disease Program Buildings and Facilities ................................................................................................. 122 122 122 ............................ ............................Payment to Hawaii, Treatment of Hansen’s .............................................................................................................. 1,857 1,857 1,857 ............................ ............................

Subtotal, Health Care Systems ..................................................................................................................... 103,193 110,193 103,193 ............................ ¥7,000 

Rural Health 

Rural Outreach Grants ............................................................................................................................................... 59,000 59,000 63,500 ∂4,500 ∂4,500 Rural Health Research/Policy Development ............................................................................................................... 9,351 9,351 9,351 ............................ ............................Rural Hospital Flexibility Grants ................................................................................................................................ 41,609 26,200 41,609 ............................ ∂15,409 Rural and Community Access to Emergency Devices ............................................................................................... 4,500 ............................ ............................ ¥4,500 ............................State Offices of Rural Health .................................................................................................................................... 9,511 9,511 9,511 ............................ ............................Black Lung Clinics ..................................................................................................................................................... 6,766 6,766 6,766 ............................ ............................Radiation Exposure Screening and Education Program ............................................................................................ 1,834 1,834 1,834 ............................ ............................Telehealth ................................................................................................................................................................... 14,900 14,900 18,000 ∂3,100 ∂3,100 

Total, Rural Health ....................................................................................................................................... 147,471 127,562 150,571 ∂3,100 ∂23,009 

Family Planning .......................................................................................................................................................... 286,479 300,000 257,832 ¥28,647 ¥42,168 Program Management ................................................................................................................................................ 154,000 157,061 151,000 ¥3,000 ¥6,061 

Vaccine Injury Compensation Program Trust Fund 

Post-fiscal year 1988 Claims .................................................................................................................................... 235,000 237,000 237,000 ∂2,000 ............................HRSA Administration .................................................................................................................................................. 7,500 7,500 7,500 ............................ ............................
230 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2015 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2016—Continued 

[In thousands of dollars] 

Item 2015 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2015 appropriation Budget estimate 

Total, Vaccine Injury Compensation Trust Fund .......................................................................................... 242,500 244,500 244,500 ∂2,000 ............................Total, Health Resources & Services Administration ..................................................................................... 6,347,284 6,462,177 6,241,383 ¥105,901 ¥220,794 

CENTERS FOR DISEASE CONTROL AND PREVENTION 

Immunization and Respiratory Diseases .................................................................................................................... 573,105 537,766 573,105 ............................ ∂35,339 

Pandemic Flu balances (Public Law 111–32) .................................................................................................. (15,000 ) ............................ (15,000 ) ............................ (∂15,000 ) Prevention and Public Health Fund 1 ................................................................................................................ (210,300 ) (210,300 ) (210,300 ) ............................ ............................

Subtotal ......................................................................................................................................................... (798,405 ) (748,066 ) (798,405 ) ............................ (∂50,339 ) 

HIV/AIDS, Viral Hepatitis, STD, and TB Prevention .................................................................................................... 1,117,609 1,161,747 1,090,609 ¥27,000 ¥71,138 Emerging and Zoonotic Infectious Diseases .............................................................................................................. 352,990 644,687 388,590 ∂35,600 ¥256,097 

Prevention and Public Health Fund 1 ................................................................................................................ (52,000 ) (54,580 ) (52,000 ) ............................ (¥2,580 ) 

Subtotal ......................................................................................................................................................... 404,990 699,267 440,590 ∂35,600 ¥258,677 Subtotal, Emerging and Zoonotic Infectious ................................................................................................ 352,990 644,687 388,590 ∂35,600 ¥256,097 Subtotal, Prevention and Public Health Fund 1 ............................................................................................ (52,000 ) (54,580 ) (52,000 ) ............................ (¥2,580 ) Total .............................................................................................................................................................. 404,990 699,267 440,590 ∂35,600 ¥258,677 

Chronic Disease Prevention and Health Promotion ................................................................................................... 747,220 577,854 595,272 ¥151,948 ∂17,418 

Prevention and Public Health Fund 1 ................................................................................................................ (452,000 ) (480,204 ) (457,650 ) (∂5,650 ) (¥22,554 ) 

Subtotal ......................................................................................................................................................... 1,199,220 1,058,058 1,052,922 ¥146,298 ¥5,136 

Birth Defects, Developmental Disabilities, Disabilities, and Health ......................................................................... 131,781 63,815 132,781 ∂1,000 ∂68,966 

Prevention and Public Health Fund 1 ................................................................................................................ ............................ (67,966 ) ............................ ............................ (¥67,966 ) 

Subtotal ......................................................................................................................................................... 131,781 131,781 132,781 ∂1,000 ∂1,000 
231 

Public Health Scientific Services ............................................................................................................................... 481,061 474,559 471,061 ¥10,000 ¥3,498 

Prevention and Public Health Fund 1 ................................................................................................................ ............................ (64,250 ) ............................ ............................ (¥64,250 ) 

Subtotal ......................................................................................................................................................... (481,061 ) (538,809 ) (471,061 ) (¥10,000 ) (¥67,748 ) 

Environmental Health ................................................................................................................................................. 166,404 141,500 132,286 ¥34,118 ¥9,214 

Prevention and Public Health Fund 1 ................................................................................................................ (13,000 ) (37,000 ) (13,000 ) ............................ (¥24,000 ) 

Subtotal ......................................................................................................................................................... 179,404 178,500 145,286 ¥34,118 ¥33,214 

Injury Prevention and Control .................................................................................................................................... 170,447 256,977 187,947 ∂17,500 ¥69,030 National Institute for Occupational Safety & Health 1 .............................................................................................. 334,863 283,418 305,887 ¥28,976 ∂22,469 

Evaluation Tap Funding .................................................................................................................................... ............................ ............................ ............................ ............................ ............................

Subtotal ......................................................................................................................................................... (334,863 ) (283,418 ) (305,887 ) (¥28,976 ) (∂22,469 ) 

Energy Employees Occupational Illness Compensation Program .............................................................................. 55,358 55,358 55,358 ............................ ............................Global Health .............................................................................................................................................................. 416,517 448,092 411,758 ¥4,759 ¥36,334 

Ebola funding (Public Law 113–164) ............................................................................................................... (30,000 ) ............................ ............................ (¥30,000 ) ............................

Subtotal ......................................................................................................................................................... (446,517 ) (448,092 ) (411,758 ) (¥34,759 ) (¥36,334 ) 

Public Health Preparedness and Response ............................................................................................................... 1,352,551 1,381,818 1,340,118 ¥12,433 ¥41,700 Buildings and Facilities ............................................................................................................................................. 10,000 10,000 10,000 ............................ ............................

CDC-wide Activities and Program Support 

Prevention and Public Health Fund 1 ......................................................................................................................... (160,000 ) ............................ (160,000 ) ............................ (∂160,000 ) Office of the Director ................................................................................................................................................. 113,570 113,570 107,892 ¥5,678 ¥5,678 Title VI Ebola funding ................................................................................................................................................ (1,771,000 ) ............................ ............................ (¥1,771,000 ) ............................

Subtotal, CDC-Wide Activities ...................................................................................................................... (273,570 ) (113,570 ) (267,892 ) (¥5,678 ) (∂154,322 ) Total, Centers for Disease Control ............................................................................................................... 6,023,476 6,151,161 5,802,664 ¥220,812 ¥348,497 

Discretionary ........................................................................................................................................ 5,968,118 6,095,803 5,747,306 ¥220,812 ¥348,497 Pandemic Flu balances (Public Law 111–32) .................................................................................... (15,000 ) ............................ (15,000 ) ............................ (∂15,000 ) Prevention and Public Health Fund 1 .................................................................................................. (887,300 ) (914,300 ) (892,950 ) (∂5,650 ) (¥21,350 ) Title VI Ebola funding .......................................................................................................................... (1,771,000 ) ............................ ............................ (¥1,771,000 ) ............................

Total, Centers for Disease Control Program Level .......................................................................... (6,925,776 ) (7,065,461 ) (6,710,614 ) (¥215,162 ) (¥354,847 ) 

NATIONAL INSTITUTES OF HEALTH 

National Cancer Institute ........................................................................................................................................... 4,953,028 5,098,479 5,204,058 ∂251,030 ∂105,579 
232 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2015 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2016—Continued 

[In thousands of dollars] 

Item 2015 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2015 appropriation Budget estimate 

National Heart, Lung, and Blood Institute ................................................................................................................ 2,995,865 3,071,906 3,135,519 ∂139,654 ∂63,613 National Institute of Dental & Craniofacial Research .............................................................................................. 397,700 406,746 415,169 ∂17,469 ∂8,423 National Institute of Diabetes and Digestive and Kidney Diseases [NIDDK] ............................................................ 1,749,140 1,788,133 1,825,162 ∂76,022 ∂37,029 

Juvenile Diabetes (mandatory) .......................................................................................................................... (150,000 ) (150,000 ) (150,000 ) ............................ ............................

Subtotal, NIDDK program level ..................................................................................................................... 1,899,140 1,938,133 1,975,162 ∂76,022 ∂37,029 

National Institute of Neurological Disorders & Stroke .............................................................................................. 1,604,607 1,660,375 1,694,758 ∂90,151 ∂34,383 National Institute of Allergy and Infectious Diseases ............................................................................................... 4,417,558 4,614,779 4,710,342 ∂292,784 ∂95,563 Title VI Ebola funding ................................................................................................................................................ (238,000 ) ............................ ............................ (¥238,000 ) ............................National Institute of General Medical Sciences ........................................................................................................ 1,657,301 1,586,291 1,571,431 ¥85,870 ¥14,860 

Evaluation Tap Funding .................................................................................................................................... (715,000 ) (847,489 ) (940,000 ) (∂225,000 ) (∂92,511 ) 

Subtotal, NGMS program level ..................................................................................................................... 2,372,301 2,433,780 2,511,431 ∂139,130 ∂77,651 

Eunice Kennedy Shriver National Institute of Child Health & Human Development ................................................ 1,286,869 1,318,061 1,345,355 ∂58,486 ∂27,294 National Eye Institute ................................................................................................................................................. 676,764 695,154 709,549 ∂32,785 ∂14,395 National Institute of Environmental Health Sciences ................................................................................................ 667,333 681,782 695,900 ∂28,567 ∂14,118 National Institute on Aging ........................................................................................................................................ 1,197,523 1,267,078 1,548,494 ∂350,971 ∂281,416 National Institute of Arthritis and Musculoskeletal and Skin Diseases ................................................................... 521,528 533,232 544,274 ∂22,746 ∂11,042 National Institute on Deafness and Other Communication Disorders ...................................................................... 405,207 416,241 424,860 ∂19,653 ∂8,619 National Institute of Nursing Research ..................................................................................................................... 140,852 144,515 147,508 ∂6,656 ∂2,993 National Institute on Alcohol Abuse and Alcoholism ................................................................................................ 447,153 459,833 469,355 ∂22,202 ∂9,522 National Institute on Drug Abuse .............................................................................................................................. 1,015,705 1,047,397 1,069,086 ∂53,381 ∂21,689 National Institute of Mental Health ........................................................................................................................... 1,433,651 1,489,417 1,520,260 ∂86,609 ∂30,843 National Human Genome Research Institute ............................................................................................................. 498,677 515,491 526,166 ∂27,489 ∂10,675 National Institute of Biomedical Imaging and Bioengineering ................................................................................. 327,243 337,314 344,299 ∂17,056 ∂6,985 National Center for Complementary and Integrative Health ..................................................................................... 124,062 127,521 130,162 ∂6,100 ∂2,641 National Institute on Minority Health and Health Disparities ................................................................................... 270,969 281,549 287,379 ∂16,410 ∂5,830 John E. Fogarty International Center ......................................................................................................................... 67,634 69,505 70,944 ∂3,310 ∂1,439 National Center for Advancing Translational Sciences ............................................................................................. 632,710 660,131 699,319 ∂66,609 ∂39,188 National Library of Medicine [NLM] ........................................................................................................................... 337,324 394,090 402,251 ∂64,927 ∂8,161 
233 

Office of the Director ................................................................................................................................................. 1,401,134 1,430,028 860,937 ¥540,197 ¥569,091 

Common Fund (non-add) .................................................................................................................................. (533,039 ) (544,077 ) (544,077 ) (∂11,038 ) ............................Gabriella Miller Kids First Research Act (Common Fund non-add) ................................................................. 12,600 12,600 12,600 ............................ ............................Transfers from non-recurring expenses fund ................................................................................................... ............................ ............................ (650,000 ) (∂650,000 ) (∂650,000 ) 

Subtotal ......................................................................................................................................................... 1,413,734 1,442,628 1,523,537 ∂109,803 ∂80,909 

Buildings and Facilities ............................................................................................................................................. 128,863 128,863 128,863 ............................ ............................

Total, National Institutes of Health [NIH] .................................................................................................... 29,369,000 30,236,511 30,494,000 ∂1,125,000 ∂257,489 (Evaluation Tap Funding) ............................................................................................................................. (715,000 ) (847,489 ) (940,000 ) (∂225,000 ) (∂92,511 ) (Transfers from non-recurring expenses fund) ............................................................................................ ............................ ............................ (650,000 ) (∂650,000 ) (∂650,000 ) (Title VI Ebola funding) ................................................................................................................................ (238,000 ) ............................ ............................ (¥238,000 ) ............................Total, NIH Program Level .............................................................................................................................. (30,084,000 ) (31,084,000 ) (32,084,000 ) (∂2,000,000 ) (∂1,000,000 ) 

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION [SAMHSA] 

Mental Health 

Programs of Regional and National Significance ..................................................................................................... 366,597 334,289 366,597 ............................ ∂32,308 

Evaluation Tap Funding .................................................................................................................................... ............................ (5,000 ) ............................ ............................ (¥5,000 ) Prevention and Public Health Fund 1 ................................................................................................................ (12,000 ) (38,000 ) (12,000 ) ............................ (¥26,000 ) 

Subtotal ......................................................................................................................................................... 378,597 377,289 378,597 ............................ ∂1,308 

Mental Health block grant ......................................................................................................................................... 461,532 461,532 461,532 ............................ ............................

Evaluation Tap Funding .................................................................................................................................... (21,039 ) (21,039 ) (21,039 ) ............................ ............................

Subtotal ......................................................................................................................................................... (482,571 ) (482,571 ) (482,571 ) ............................ ............................

Children’s Mental Health ........................................................................................................................................... 117,026 117,026 117,026 ............................ ............................Grants to States for the Homeless (PATH) ................................................................................................................ 64,635 64,635 40,000 ¥24,635 ¥24,635 Protection and Advocacy ............................................................................................................................................ 36,146 36,146 36,146 ............................ ............................

Subtotal, Mental Health ................................................................................................................................ 1,045,936 1,013,628 1,021,301 ¥24,635 ∂7,673 

(Evaluation Tap Funding) .................................................................................................................... (21,039 ) (26,039 ) (21,039 ) ............................ (¥5,000 ) (Prevention and Public Health Fund 1) ................................................................................................ (12,000 ) (38,000 ) (12,000 ) ............................ (¥26,000 ) 

Subtotal, Mental Health program level ........................................................................................... (1,078,975 ) (1,077,667 ) (1,054,340 ) (¥24,635 ) (¥23,327 ) 

Substance Abuse Treatment 

Programs of Regional and National Significance ..................................................................................................... 362,002 290,701 282,260 ¥79,742 ¥8,441 
234 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2015 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2016—Continued 

[In thousands of dollars] 

Item 2015 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2015 appropriation Budget estimate 

Evaluation Tap Funding .................................................................................................................................... (2,000 ) (30,000 ) (2,000 ) ............................ (¥28,000 ) 

Subtotal ......................................................................................................................................................... (364,002 ) (320,701 ) (284,260 ) (¥79,742 ) (¥36,441 ) 

Substance Abuse block grant .................................................................................................................................... 1,740,656 1,740,656 1,690,656 ¥50,000 ¥50,000 

Evaluation Tap Funding .................................................................................................................................... (79,200 ) (79,200 ) (79,200 ) ............................ ............................

Subtotal, Block grant .................................................................................................................................... (1,819,856 ) (1,819,856 ) (1,769,856 ) (¥50,000 ) (¥50,000 ) Subtotal, Substance Abuse Treatment ......................................................................................................... 2,102,658 2,031,357 1,972,916 ¥129,742 ¥58,441 

(Evaluation Tap Funding) ......................................................................................................................... (81,200 ) (109,200 ) (81,200 ) ............................ (¥28,000 ) 

Subtotal, Program level ....................................................................................................................... (2,183,858 ) (2,140,557 ) (2,054,116 ) (¥129,742 ) (¥86,441 ) 

Substance Abuse Prevention 

Programs of Regional and National Significance ..................................................................................................... 175,219 194,450 182,731 ∂7,512 ¥11,719 

Evaluation Tap Funding .................................................................................................................................... ............................ (16,468 ) ............................ ............................ (¥16,468 ) 

Subtotal ......................................................................................................................................................... 175,219 210,918 182,731 ∂7,512 ¥28,187 

Health Surveillance and Program Support ................................................................................................................ 150,232 156,228 137,869 ¥12,363 ¥18,359 

Evaluation Tap Funding (NA) ............................................................................................................................ (31,428 ) (58,917 ) (31,428 ) ............................ (¥27,489 ) Prevention and Public Health Fund 1 ................................................................................................................ ............................ (20,000 ) ............................ ............................ (¥20,000 ) 

Subtotal ......................................................................................................................................................... 181,660 235,145 169,297 ¥12,363 ¥65,848 Total, SAMHSA ............................................................................................................................................... 3,474,045 3,395,663 3,314,817 ¥159,228 ¥80,846 

(Evaluation Tap Funding) .................................................................................................................... (133,667 ) (210,624 ) (133,667 ) ............................ (¥76,957 ) (Prevention and Public Health Fund 1) ................................................................................................ (12,000 ) (58,000 ) (12,000 ) ............................ (¥46,000 ) 

Total, SAMHSA Program Level ......................................................................................................... (3,619,712 ) (3,664,287 ) (3,460,484 ) (¥159,228 ) (¥203,803 ) 
235 

AGENCY FOR HEALTHCARE RESEARCH AND QUALITY [AHRQ] 

Healthcare Research and Quality 

Research on Health Costs, Quality, and Outcomes: Federal Funds ............................................................................................................................................................. 228,551 134,889 151,428 ¥77,123 ∂16,539 

Evaluation Tap funding ............................................................................................................................ ............................ (87,888 ) ............................ ............................ (¥87,888 ) Patient-Centered Outcomes Research transfer ........................................................................................ ............................ (115,636 ) ............................ ............................ (¥115,636 ) 

Preventive/Care Management (NA) ................................................................................................................... ............................ (203,524 ) ............................ ............................ (¥203,524 ) 

Subtotal, Health Costs, Quality, and Outcomes ........................................................................................... (228,551 ) (338,413 ) (151,428 ) (¥77,123 ) (¥186,985 ) 

(Evaluation Tap Funding) .................................................................................................................... ............................ (87,888 ) ............................ ............................ (¥87,888 ) 

Medical Expenditures Panel Surveys: 

Federal Funds .................................................................................................................................................... 65,447 68,877 39,268 ¥26,179 ¥29,609 Evaluation Tap Funding (NA) ............................................................................................................................ ............................ ............................ ............................ ............................ ............................

Subtotal, Medical Expenditures Panel Surveys ............................................................................................ (65,447 ) (68,877 ) (39,268 ) (¥26,179 ) (¥29,609 ) 

Program Support: 

Federal Funds .................................................................................................................................................... 69,700 72,044 45,305 ¥24,395 ¥26,739 

Total, AHRQ Program Level ........................................................................................................................... (363,698 ) (363,698 ) (236,001 ) (¥127,697 ) (¥127,697 ) 

Federal funds ....................................................................................................................................... (363,698 ) (275,810 ) (236,001 ) (¥127,697 ) (¥39,809 ) (Evaluation Tap Funding) .................................................................................................................... ............................ (87,888 ) ............................ ............................ (¥87,888 ) 

Total, Public Health Service (PHS) appropriation ........................................................................................ 45,577,503 46,521,322 46,088,865 ∂511,362 ¥432,457 Total, Public Health Service Program Level (excluding Ebola funding) ...................................................... (49,111,470 ) (48,755,259 ) (48,732,482 ) (¥378,988 ) (¥22,777 ) 

CENTERS FOR MEDICARE AND MEDICAID SERVICES 

Grants to States for Medicaid 

Medicaid Current Law Benefits .................................................................................................................................. 315,238,600 334,936,328 334,936,328 ∂19,697,728 ............................State and Local Administration ................................................................................................................................. 18,766,022 17,771,915 17,771,915 ¥994,107 ............................Vaccines for Children ................................................................................................................................................. 4,076,617 4,109,307 4,109,307 ∂32,690 ............................

Subtotal, Medicaid Program Level ................................................................................................................ 338,081,239 356,817,550 356,817,550 ∂18,736,311 ............................

Less funds advanced in prior year ..................................................................................................... ¥103,472,323 ¥113,272,140 ¥113,272,140 ¥9,799,817 ............................

Total, Grants to States for Medicaid .............................................................................................. 234,608,916 243,545,410 243,545,410 ∂8,936,494 ............................
236 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2015 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2016—Continued 

[In thousands of dollars] 

Item 2015 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2015 appropriation Budget estimate 

New advance, 1st quarter, fiscal year 2017 .................................................................................. 113,272,140 115,582,502 115,582,502 ∂2,310,362 ............................

Payments to Health Care Trust Funds 

Supplemental Medical Insurance ............................................................................................................................... 194,343,000 198,530,000 198,530,000 ∂4,187,000 ............................Federal Uninsured Payment ....................................................................................................................................... 187,000 158,000 158,000 ¥29,000 ............................Program Management ................................................................................................................................................ 763,000 1,044,000 1,044,000 ∂281,000 ............................General Revenue for Part D Benefit .......................................................................................................................... 63,342,000 82,453,000 82,453,000 ∂19,111,000 ............................General Revenue for Part D Administration .............................................................................................................. 418,000 691,000 691,000 ∂273,000 ............................HCFAC Reimbursement ............................................................................................................................................... 153,000 291,000 291,000 ∂138,000 ............................State Low-Income Determination for Part D .............................................................................................................. 6,000 4,800 4,800 ¥1,200 ............................

Total, Payments to Trust Funds, Program Level .......................................................................................... 259,212,000 283,171,800 283,171,800 ∂23,959,800 ............................

Program Management 

Research, Demonstration, Evaluation ........................................................................................................................ 20,054 ............................ 6,900 ¥13,154 ∂6,900 Program Operations .................................................................................................................................................... 2,519,823 3,024,386 1,890,823 ¥629,000 ¥1,133,563 State Survey and Certification ................................................................................................................................... 397,334 437,200 397,334 ............................ ¥39,866 Federal Administration ............................................................................................................................................... 732,533 783,600 732,533 ............................ ¥51,067 

Total, Program management ........................................................................................................................ 3,669,744 4,245,186 3,027,590 ¥642,154 ¥1,217,596 

Health Care Fraud and Abuse Control Account 

Centers for Medicare and Medicaid Services ............................................................................................................ 477,120 474,175 474,175 ¥2,945 ............................HHS Office of Inspector General ................................................................................................................................ 67,200 118,631 77,275 ∂10,075 ¥41,356 Medicaid/CHIP ............................................................................................................................................................ 67,200 ............................ 77,275 ∂10,075 ∂77,275 Department of Justice ................................................................................................................................................ 60,480 113,194 77,275 ∂16,795 ¥35,919 

Total, Health Care Fraud and Abuse Control ............................................................................................... 672,000 706,000 706,000 ∂34,000 ............................
237 

Total, Centers for Medicare and Medicaid Services .................................................................................... 611,434,800 647,250,898 646,033,302 ∂34,598,502 ¥1,217,596 

Federal funds ........................................................................................................................................... 607,093,056 642,299,712 642,299,712 ∂35,206,656 ............................

Current year ......................................................................................................................................... (493,820,916 ) (526,717,210 ) (526,717,210 ) (∂32,896,294 ) ............................New advance, fiscal year 2017 ........................................................................................................... (113,272,140 ) (115,582,502 ) (115,582,502 ) (∂2,310,362 ) ............................

Trust Funds .............................................................................................................................................. 4,341,744 4,951,186 3,733,590 ¥608,154 ¥1,217,596 

ADMINISTRATION FOR CHILDREN AND FAMILIES [ACF] 

Payments to States for Child Support Enforcement and Family Support Programs 

Payments to Territories .............................................................................................................................................. 33,000 33,000 33,000 ............................ ............................Repatriation ................................................................................................................................................................ 1,000 1,000 1,000 ............................ ............................

Subtotal ......................................................................................................................................................... 34,000 34,000 34,000 ............................ ............................

Child Support Enforcement: 

State and Local Administration ........................................................................................................................ 3,117,555 3,541,359 3,541,359 ∂423,804 ............................Federal Incentive Payments .............................................................................................................................. 526,968 519,547 519,547 ¥7,421 ............................Access and Visitation ........................................................................................................................................ 10,000 10,000 10,000 ............................ ............................

Subtotal, Child Support Enforcement ........................................................................................................... 3,654,523 4,070,906 4,070,906 ∂416,383 ............................Total, Family Support Payments Program Level ........................................................................................... 3,688,523 4,104,906 4,104,906 ∂416,383 ............................

Less funds advanced in previous years .............................................................................................. ¥1,250,000 ¥1,160,000 ¥1,160,000 ∂90,000 ............................

Total, Family Support Payments, current year ............................................................................................. 2,438,523 2,944,906 2,944,906 ∂506,383 ............................

New advance, 1st quarter, fiscal year 2017 ...................................................................................... 1,160,000 1,300,000 1,300,000 ∂140,000 ............................

Low Income Home Energy Assistance [LIHEAP] 

Formula Grants ........................................................................................................................................................... 3,390,304 3,190,304 3,390,304 ............................ ∂200,000 Utility Innovation Fund ............................................................................................................................................... ............................ 200,000 ............................ ............................ ¥200,000 

Total, LIHEAP, Program Level ....................................................................................................................... 3,390,304 3,390,304 3,390,304 ............................ ............................

Refugee and Entrant Assistance 

Transitional and Medical Services ............................................................................................................................. 383,266 426,749 426,749 ∂43,483 ............................Victims of Trafficking ................................................................................................................................................. 15,755 22,000 15,755 ............................ ¥6,245 Social Services ........................................................................................................................................................... 149,927 149,927 149,927 ............................ ............................Preventive Health ....................................................................................................................................................... 4,600 4,600 4,600 ............................ ............................
238 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2015 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2016—Continued 

[In thousands of dollars] 

Item 2015 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2015 appropriation Budget estimate 

Targeted Assistance ................................................................................................................................................... 47,601 47,601 47,601 ............................ ............................Unaccompanied Minors .............................................................................................................................................. 948,000 948,000 750,000 ¥198,000 ¥198,000 Unaccompanied Minors Contingency Fund (CBO estimate) ...................................................................................... ............................ 15,000 ............................ ............................ ¥15,000 Victims of Torture ....................................................................................................................................................... 10,735 10,735 10,735 ............................ ............................

Total, Refugee and Entrant Assistance ........................................................................................................ 1,559,884 1,624,612 1,405,367 ¥154,517 ¥219,245 

Payments to States for the Child Care and Development Block Grant .................................................................... 2,435,000 2,805,149 2,585,000 ∂150,000 ¥220,149 Social Services Block Grant (Title XX) ....................................................................................................................... 1,700,000 1,700,000 1,700,000 ............................ ............................

Children and Families Services Programs 

Programs for Children, Youth and Families: 

Head Start, current funded ............................................................................................................................... 8,598,095 10,117,706 8,698,095 ∂100,000 ¥1,419,611 Consolidated Runaway, Homeless Youth Program ........................................................................................... 97,000 105,980 99,000 ∂2,000 ¥6,980 Prevention Grants to Reduce Abuse of Runaway Youth ................................................................................... 17,141 17,491 17,141 ............................ ¥350 Child Abuse State Grants ................................................................................................................................. 25,310 25,310 25,310 ............................ ............................Child Abuse Discretionary Activities ................................................................................................................. 28,744 48,744 28,744 ............................ ¥20,000 Community Based Child Abuse Prevention ....................................................................................................... 39,764 39,764 39,764 ............................ ............................Abandoned Infants Assistance .......................................................................................................................... 11,063 11,063 ............................ ¥11,063 ¥11,063 Child Welfare Services ...................................................................................................................................... 268,735 268,735 268,735 ............................ ............................Child Welfare Training, Research, or Demonstration projects ......................................................................... 15,984 15,984 13,984 ¥2,000 ¥2,000 Adoption Opportunities ...................................................................................................................................... 39,100 42,622 39,100 ............................ ¥3,522 Adoption Incentive ............................................................................................................................................. 37,943 37,943 37,943 ............................ ............................

Social Services and Income Maintenance Research ................................................................................................. 5,762 17,762 5,762 ............................ ¥12,000 Native American Programs ......................................................................................................................................... 46,520 50,000 46,520 ............................ ¥3,480 Community Services: 

Community Services Block Grant Act programs: 

Grants to States for Community Services ............................................................................................... 674,000 674,000 674,000 ............................ ............................Economic Development ............................................................................................................................. 29,883 ............................ ............................ ¥29,883 ............................Rural Community Facilities ...................................................................................................................... 6,500 ............................ ............................ ¥6,500 ............................
239 

Subtotal ................................................................................................................................................ 710,383 674,000 674,000 ¥36,383 ............................

Individual Development Account Initiative .............................................................................................. 18,950 18,950 12,000 ¥6,950 ¥6,950 

Subtotal, Community Services ............................................................................................................. 729,333 692,950 686,000 ¥43,333 ¥6,950 

Domestic Violence Hotline .......................................................................................................................................... 4,500 12,300 4,500 ............................ ¥7,800 Family Violence/Battered Women’s Shelters .............................................................................................................. 135,000 150,000 135,000 ............................ ¥15,000 Independent Living Training Vouchers ....................................................................................................................... 43,257 43,257 43,257 ............................ ............................Faith-Based Center .................................................................................................................................................... 1,299 ............................ ............................ ¥1,299 ............................Disaster Human Services Case Management ............................................................................................................ 1,864 1,864 1,864 ............................ ............................Program Direction ....................................................................................................................................................... 199,701 211,767 197,901 ¥1,800 ¥13,866 

Total, Children and Families Services Programs ......................................................................................... 10,346,115 11,911,242 10,388,620 ∂42,505 ¥1,522,622 

Current Year ......................................................................................................................................... (10,346,115 ) (11,911,242 ) (10,388,620 ) (∂42,505 ) (¥1,522,622 ) 

Promoting Safe and Stable Families ......................................................................................................................... 345,000 345,000 345,000 ............................ ............................

Discretionary Funds ........................................................................................................................................... 59,765 89,765 59,765 ............................ ¥30,000 

Total, Promoting Safe and Stable Families ................................................................................................. 404,765 434,765 404,765 ............................ ¥30,000 

Payments for Foster Care and Permanency 

Foster Care ................................................................................................................................................................. 4,289,000 4,772,100 4,772,100 ∂483,100 ............................Adoption Assistance ................................................................................................................................................... 2,504,000 2,562,900 2,562,900 ∂58,900 ............................Guardianship .............................................................................................................................................................. 99,000 123,000 123,000 ∂24,000 ............................Independent Living ..................................................................................................................................................... 140,000 140,000 140,000 ............................ ............................

Total, Payments to States ............................................................................................................................ 7,032,000 7,598,000 7,598,000 ∂566,000 ............................

Less Advances from Prior Year ................................................................................................................ ¥2,200,000 ¥2,300,000 ¥2,300,000 ¥100,000 ............................

Total, payments, current year .............................................................................................................. 4,832,000 5,298,000 5,298,000 ∂466,000 ............................

New Advance, 1st quarter, fiscal year 2017 .................................................................................. 2,300,000 2,300,000 2,300,000 ............................ ............................

Total, ACF ...................................................................................................................................................... 30,566,591 33,708,978 31,716,962 ∂1,150,371 ¥1,992,016 

Current year ......................................................................................................................................... (27,106,591 ) (30,108,978 ) (28,116,962 ) (∂1,010,371 ) (¥1,992,016 ) Fiscal year 2017 .................................................................................................................................. (3,460,000 ) (3,600,000 ) (3,600,000 ) (∂140,000 ) ............................

(Evaluation Tap Funding) ......................................................................................................................... ............................ ............................ ............................ ............................ ............................

Total, ACF Program Level .................................................................................................................... 30,566,591 33,708,978 31,716,962 ∂1,150,371 ¥1,992,016 
240 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2015 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2016—Continued 

[In thousands of dollars] 

Item 2015 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2015 appropriation Budget estimate 

ADMINISTRATION FOR COMMUNITY LIVING 

Aging and Disability Services Programs 

Grants to States: 

Home and Community-based Supportive Services ........................................................................................... 347,724 386,182 347,724 ............................ ¥38,458 Preventive Health .............................................................................................................................................. 19,848 19,848 19,848 ............................ ............................Protection of Vulnerable Older Americans-Title VII .......................................................................................... 20,658 20,658 20,658 ............................ ............................

Subtotal ......................................................................................................................................................... 388,230 426,688 388,230 ............................ ¥38,458 

Family Support Initiative ................................................................................................................................... ............................ 15,000 ............................ ............................ ¥15,000 Family Caregivers .............................................................................................................................................. 145,586 150,586 145,586 ............................ ¥5,000 Native American Caregivers Support ................................................................................................................ 6,031 6,800 6,031 ............................ ¥769 

Subtotal, Caregivers ..................................................................................................................................... 151,617 172,386 151,617 ............................ ¥20,769 

Nutrition: 

Congregate Meals ..................................................................................................................................... 438,191 458,091 438,191 ............................ ¥19,900 Home Delivered Meals .............................................................................................................................. 216,397 236,397 216,397 ............................ ¥20,000 Nutrition Services Incentive Program ....................................................................................................... 160,069 160,069 160,069 ............................ ............................Nutrition Initiative .................................................................................................................................... ............................ 20,000 ............................ ............................ ¥20,000 

Subtotal ................................................................................................................................................ 814,657 874,557 814,657 ............................ ¥59,900 Subtotal, Grants to States ................................................................................................................... 1,354,504 1,473,631 1,354,504 ............................ ¥119,127 

Grants for Native Americans ...................................................................................................................................... 26,158 29,100 24,850 ¥1,308 ¥4,250 Aging Network Support Activities ............................................................................................................................... 9,961 9,961 7,088 ¥2,873 ¥2,873 Alzheimer’s Disease Demonstrations ......................................................................................................................... 3,800 3,800 3,800 ............................ ............................

Prevention and Public Health Fund 1 ................................................................................................................ (14,700 ) (14,700 ) (14,700 ) ............................ ............................

Lifespan Respite Care ................................................................................................................................................ 2,360 5,000 2,242 ¥118 ¥2,758 

Prevention and Public Health Fund 1 ................................................................................................................ (8,000 ) (8,000 ) (7,600 ) (¥400 ) (¥400 ) Prevention and Public Health Fund 1 ................................................................................................................ (5,000 ) (5,000 ) (4,750 ) (¥250 ) (¥250 ) 
241 

Senior Medicare Patrol Program ................................................................................................................................ 8,910 8,910 ............................ ¥8,910 ¥8,910 Elder Rights Support Activities .................................................................................................................................. 7,874 28,874 7,874 ............................ ¥21,000 Aging and Disability Resources ................................................................................................................................. 6,119 20,000 5,813 ¥306 ¥14,187 State Health Insurance Program ................................................................................................................................ 52,115 52,115 30,000 ¥22,115 ¥22,115 National Clearinghouse for Long-Term Care Information .......................................................................................... ............................ 1,000 ............................ ............................ ¥1,000 Paralysis Resource Center .......................................................................................................................................... 6,700 6,700 6,365 ¥335 ¥335 Limb loss .................................................................................................................................................................... 2,800 2,810 2,660 ¥140 ¥150 Developmental Disabilities Programs: 

State Councils ................................................................................................................................................... 71,692 71,692 68,107 ¥3,585 ¥3,585 Protection and Advocacy ................................................................................................................................... 38,734 38,734 36,797 ¥1,937 ¥1,937 Voting Access for Individuals with Disabilities ................................................................................................ 4,963 4,963 4,715 ¥248 ¥248 Developmental Disabilities Projects of National Significance .......................................................................... 8,857 14,500 8,414 ¥443 ¥6,086 University Centers for Excellence in Developmental Disabilities ..................................................................... 37,674 38,619 35,790 ¥1,884 ¥2,829 

Subtotal, Developmental Disabilities Programs ........................................................................................... 161,920 168,508 153,823 ¥8,097 ¥14,685 

Workforce Innovation and Opportunity Act Independent Living ................................................................................ ............................ 106,183 96,124 ∂96,124 ¥10,059 

National Institute on Disability, Independent Living, and Rehabilitation Research ........................................ ............................ 108,000 98,772 ∂98,772 ¥9,228 Assistive Technology .......................................................................................................................................... ............................ 31,000 31,350 ∂31,350 ∂350 

Subtotal, Workforce Innovation and Opportunity Act ................................................................................... ............................ 245,183 226,246 ∂226,246 ¥18,937 

Program Administration ............................................................................................................................................. 30,035 40,063 35,824 ∂5,789 ¥4,239 

Total, Administration for Community Living [ACL] ...................................................................................... 1,673,256 2,095,655 1,861,089 ∂187,833 ¥234,566 

Federal funds ....................................................................................................................................... 1,621,141 2,043,540 1,831,089 ∂209,948 ¥212,451 Trust Funds .......................................................................................................................................... (52,115 ) (52,115 ) (30,000 ) (¥22,115 ) (¥22,115 ) (Prevention and Public Health Fund 1) ................................................................................................ (27,700 ) (27,700 ) (27,050 ) (¥650 ) (¥650 ) 

Total, ACL program level ................................................................................................................. 1,700,956 2,123,355 1,888,139 ∂187,183 ¥235,216 

OFFICE OF THE SECRETARY 

General Departmental Management 

General Departmental Management, Federal Funds ................................................................................................. 200,000 225,336 195,000 ¥5,000 ¥30,336 

Subtotal ......................................................................................................................................................... 200,000 225,336 195,000 ¥5,000 ¥30,336 

Teen Pregnancy Prevention and Abstinence Education 101,000 104,790 20,000 ¥81,000 ¥84,790 

Evaluation Tap Funding .................................................................................................................................... (6,800 ) (6,800 ) ............................ (¥6,800 ) (¥6,800 ) 
242 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2015 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2016—Continued 

[In thousands of dollars] 

Item 2015 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2015 appropriation Budget estimate 

Subtotal, Grants ............................................................................................................................................ (107,800 ) (111,590 ) (20,000 ) (¥87,800 ) (¥91,590 ) 

Abstinence Education ................................................................................................................................................. 5,000 ............................ 20,000 ∂15,000 ∂20,000 Minority Health ........................................................................................................................................................... 56,670 56,670 36,000 ¥20,670 ¥20,670 Office of Women’s Health .......................................................................................................................................... 32,140 31,500 29,500 ¥2,640 ¥2,000 Minority HIV/AIDS ........................................................................................................................................................ 52,224 53,900 ............................ ¥52,224 ¥53,900 Embryo Adoption Awareness Campaign ..................................................................................................................... 1,000 ............................ 1,000 ............................ ∂1,000 DATA Act activities ..................................................................................................................................................... ............................ 10,320 ............................ ............................ ¥10,320 HHS Digital Service Team .......................................................................................................................................... ............................ 10,000 ............................ ............................ ¥10,000 Planning and Evaluation, Evaluation Tap Funding ................................................................................................... (58,028 ) (59,278 ) (46,762 ) (¥11,266 ) (¥12,516 ) 

Total, General Departmental Management ................................................................................................... 448,034 492,516 301,500 ¥146,534 ¥191,016 

Federal Funds ...................................................................................................................................... (448,034 ) (492,516 ) (301,500 ) (¥146,534 ) (¥191,016 ) (Evaluation Tap Funding) .................................................................................................................... (64,828 ) (66,078 ) (46,762 ) (¥18,066 ) (¥19,316 ) 

Total, General Departmental Management Program ...................................................................... 512,862 558,594 348,262 ¥164,600 ¥210,332 

Office of Medicare Hearings and Appeals ................................................................................................................. 87,381 140,000 97,381 ∂10,000 ¥42,619 Office of the National Coordinator for Health Information Technology ..................................................................... 60,367 ............................ 60,367 ............................ ∂60,367 

Evaluation Tap Funding .................................................................................................................................... ............................ (91,800 ) ............................ ............................ (¥91,800 ) 

Total, Program Level ..................................................................................................................................... (60,367 ) (91,800 ) (60,367 ) ............................ (¥31,433 ) 

Office of Inspector General 

Inspector General Federal Funds ............................................................................................................................... 71,000 83,000 71,000 ............................ ¥12,000 

HIPAA/HCFAC funding (NA) ............................................................................................................................... (240,455 ) (333,893 ) (333,893 ) (∂93,438 ) ............................

Total, Inspector General Program Level ....................................................................................................... (311,455 ) (416,893 ) (404,893 ) (∂93,438 ) (¥12,000 ) 

Office for Civil Rights 

Federal Funds ............................................................................................................................................................. 38,798 42,705 38,798 ............................ ¥3,907 
243 

Retirement Pay and Medical Benefits for Commissioned Officers 

Retirement Payments ................................................................................................................................................. 432,177 441,977 441,977 ∂9,800 ............................Survivors Benefits ...................................................................................................................................................... 28,186 28,603 28,603 ∂417 ............................Dependents’ Medical Care ......................................................................................................................................... 101,878 115,608 115,608 ∂13,730 ............................

Total, Medical Benefits for Commissioned Officers ..................................................................................... 562,241 586,188 586,188 ∂23,947 ............................

Public Health and Social Services Emergency Fund [PHSSEF] 

Assistant Secretary for Preparedness and Response 

Operations .................................................................................................................................................................. 31,305 30,938 30,938 ¥367 ............................Preparedness and Emergency Operations .................................................................................................................. 24,789 24,654 24,654 ¥135 ............................National Disaster Medical System ............................................................................................................................. 50,054 49,904 49,904 ¥150 ............................Hospital Preparedness Cooperative Agreement Grants: 

Formula Grants .................................................................................................................................................. 254,555 254,555 254,555 ............................ ............................

Biomedical Advanced Research and Development Authority [BARDA] ...................................................................... 415,000 521,732 473,000 ∂58,000 ¥48,732 

Ebola funding (Public Law 113–164) ............................................................................................................... (58,000 ) ............................ ............................ (¥58,000 ) ............................

Title VI Ebola funding ................................................................................................................................................ (733,000 ) ............................ ............................ (¥733,000 ) ............................Policy and Planning ................................................................................................................................................... 14,877 14,877 14,877 ............................ ............................Project BioShield ........................................................................................................................................................ 255,000 646,425 255,000 ............................ ¥391,425 

Subtotal, Preparedness and Response ......................................................................................................... 1,045,580 1,543,085 1,102,928 ∂57,348 ¥440,157 

Assistant Secretary for Administration 

Assistant Secretary for Administration, Cybersecurity ............................................................................................... 41,125 73,417 41,125 ............................ ¥32,292 Office of Security and Strategic Information ............................................................................................................. 7,470 7,470 7,470 ............................ ............................

Public Health and Science 

Medical Reserve Corps ............................................................................................................................................... 8,979 6,000 3,839 ¥5,140 ¥2,161 

Office of the Secretary 

Pandemic Influenza Preparedness ............................................................................................................................. 71,915 170,009 71,915 ............................ ¥98,094 Emergency response initiative ................................................................................................................................... ............................ 110,000 ............................ ............................ ¥110,000 Health insurance initiative (PHS evaluation funding) ............................................................................................... ............................ (30,000 ) ............................ ............................ (¥30,000 ) 

Subtotal, Non-pandemic flu/BioShield/Parklawn/Other construction ........................................................... ¥326,915 ¥816,434 ¥326,915 ............................ ∂489,519 Total, PHSSEF ................................................................................................................................................ 1,175,069 1,909,981 1,227,277 ∂52,208 ¥682,704 
244 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2015 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2016—Continued 

[In thousands of dollars] 

Item 2015 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2015 appropriation Budget estimate 

Total, Office of the Secretary ....................................................................................................................... 2,442,890 3,254,390 2,382,511 ¥60,379 ¥871,879 

Federal Funds ...................................................................................................................................... 2,355,509 3,114,390 2,285,130 ¥70,379 ¥829,260 Trust Funds .......................................................................................................................................... 87,381 140,000 97,381 ∂10,000 ¥42,619 (Evaluation Tap Funding) .................................................................................................................... (64,828 ) (187,878 ) (46,762 ) (¥18,066 ) (¥141,116 ) (Title VI Ebola funding) ....................................................................................................................... (733,000 ) ............................ ............................ (¥733,000 ) ............................

Total, Office of the Secretary Program Level .................................................................................. 2,507,718 3,442,268 2,429,273 ¥78,445 ¥1,012,995 

Total, Title II, Health and Human Services .................................................................................................. 691,695,040 732,831,243 728,082,729 ∂36,387,689 ¥4,748,514 

Federal Funds ...................................................................................................................................... 687,213,800 727,687,942 724,221,758 ∂37,007,958 ¥3,466,184 

Current year ............................................................................................................................ (570,481,660 ) (608,505,440 ) (605,039,256 ) (∂34,557,596 ) (¥3,466,184 ) Fiscal year 2017 ..................................................................................................................... (116,732,140 ) (119,182,502 ) (119,182,502 ) (∂2,450,362 ) ............................

Trust Funds .......................................................................................................................................... 4,481,240 5,143,301 3,860,971 ¥620,269 ¥1,282,330 Pandemic Flu balances (Public Law 111–32) .................................................................................... (927,000 ) (1,000,000 ) (932,000 ) (∂5,000 ) (¥68,000 ) 

Total, Prevention and Public Health Fund 1 .................................................................................... (927,000 ) (1,000,000 ) (932,000 ) (∂5,000 ) (¥68,000 ) 

TITLE III—DEPARTMENT OF EDUCATION 

EDUCATION FOR THE DISADVANTAGED 

Grants to Local Educational Agencies [LEAs] Basic Grants: 

Advance from prior year ........................................................................................................................... (2,915,776 ) (2,890,776 ) (2,890,776 ) (¥25,000 ) ............................Forward funded ........................................................................................................................................ 3,564,641 4,568,625 3,714,641 ∂150,000 ¥853,984 Current funded ......................................................................................................................................... 3,984 ............................ 3,984 ............................ ∂3,984 

Subtotal, Basic grants current year approp ....................................................................................... 3,568,625 4,568,625 3,718,625 ∂150,000 ¥850,000 Subtotal, Basic grants total funds available ..................................................................................... (6,484,401 ) (7,459,401 ) (6,609,401 ) (∂125,000 ) (¥850,000 ) 

Basic Grants fiscal year 2017 Advance ........................................................................................................... 2,890,776 1,890,776 2,740,776 ¥150,000 ∂850,000 

Subtotal, Basic grants, program level ......................................................................................................... 6,459,401 6,459,401 6,459,401 ............................ ............................
245 

Concentration Grants: 

Advance from prior year ........................................................................................................................... (1,362,301 ) (1,362,301 ) (1,362,301 ) ............................ ............................Fiscal year 2017 Advance ........................................................................................................................ 1,362,301 1,362,301 1,362,301 ............................ ............................

Targeted Grants: 

Advance from prior year ........................................................................................................................... (3,281,550 ) (3,294,050 ) (3,294,050 ) (∂12,500 ) ............................Fiscal year 2017 Advance ........................................................................................................................ 3,294,050 3,794,050 3,369,050 ∂75,000 ¥425,000 

Subtotal ................................................................................................................................................ 3,294,050 3,794,050 3,369,050 ∂75,000 ¥425,000 

Education Finance Incentive Grants: 

Advance from prior year ........................................................................................................................... (3,281,550 ) (3,294,050 ) (3,294,050 ) (∂12,500 ) ............................Fiscal year 2017 Advance ........................................................................................................................ 3,294,050 3,794,050 3,369,050 ∂75,000 ¥425,000 

Subtotal ................................................................................................................................................ 3,294,050 3,794,050 3,369,050 ∂75,000 ¥425,000 

Subtotal, Grants to LEAs, program level ...................................................................................................... 14,409,802 15,409,802 14,559,802 ∂150,000 ¥850,000 Subtotal, Grants to LEAs, program level ...................................................................................................... 14,409,802 15,409,802 14,559,802 ∂150,000 ¥850,000 

School Improvement Grants ....................................................................................................................................... 505,756 555,756 450,000 ¥55,756 ¥105,756 Striving Readers ......................................................................................................................................................... 160,000 160,000 ............................ ¥160,000 ¥160,000 State Agency Programs: 

Migrant .............................................................................................................................................................. 374,751 374,751 365,000 ¥9,751 ¥9,751 Neglected and Delinquent/High Risk Youth ...................................................................................................... 47,614 47,614 46,000 ¥1,614 ¥1,614 

Subtotal, State Agency programs ................................................................................................................. 422,365 422,365 411,000 ¥11,365 ¥11,365 

Evaluation ................................................................................................................................................................... 710 ............................ ............................ ¥710 ............................Migrant Education: 

High School Equivalency Program .................................................................................................................... 37,474 44,623 35,000 ¥2,474 ¥9,623 

Total, Education for the disadvantaged ....................................................................................................... 15,536,107 16,592,546 15,455,802 ¥80,305 ¥1,136,744 

Current Year ......................................................................................................................................... (4,694,930 ) (5,751,369 ) (4,614,625 ) (¥80,305 ) (¥1,136,744 ) Fiscal year 2017 .................................................................................................................................. (10,841,177 ) (10,841,177 ) (10,841,177 ) ............................ ............................

Subtotal, Forward Funded ............................................................................................................................. (4,652,762 ) (5,706,746 ) (4,575,641 ) (¥77,121 ) (¥1,131,105 ) 

PRESCHOOL DEVELOPMENT GRANTS .......................................................................................................................... ............................ 750,000 ............................ ............................ ¥750,000 

IMPACT AID 

Basic Support Payments ............................................................................................................................................ 1,151,233 1,151,233 1,151,233 ............................ ............................
246 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2015 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2016—Continued 

[In thousands of dollars] 

Item 2015 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2015 appropriation Budget estimate 

Payments for Children with Disabilities .................................................................................................................... 48,316 48,316 48,316 ............................ ............................Facilities Maintenance (Sec. 8008) ........................................................................................................................... 4,835 71,648 4,835 ............................ ¥66,813 Construction (Sec. 8007) ........................................................................................................................................... 17,406 17,406 17,406 ............................ ............................Payments for Federal Property (Sec. 8002) ............................................................................................................... 66,813 ............................ 66,813 ............................ ∂66,813 

Total, Impact aid .......................................................................................................................................... 1,288,603 1,288,603 1,288,603 ............................ ............................

SCHOOL IMPROVEMENT PROGRAMS 

State Grants for Improving Teacher Quality .............................................................................................................. 668,389 668,389 565,000 ¥103,389 ¥103,389 

Advance from prior year .................................................................................................................................... (1,681,441 ) (1,681,441 ) (1,681,441 ) ............................ ............................Fiscal year 2017 ................................................................................................................................................ 1,681,441 1,681,441 1,681,441 ............................ ............................

Subtotal, State Grants for Improving Teacher Quality, program level ........................................................ 2,349,830 2,349,830 2,246,441 ¥103,389 ¥103,389 

Mathematics and Science Partnerships .................................................................................................................... 152,717 202,717 141,299 ¥11,418 ¥61,418 Educational Technology State Grants ........................................................................................................................ ............................ 200,000 ............................ ............................ ¥200,000 Supplemental Education Grants ................................................................................................................................ 16,699 16,699 16,699 ............................ ............................21st Century Community Learning Centers ............................................................................................................... 1,151,673 1,151,673 1,035,000 ¥116,673 ¥116,673 State Assessments/Enhanced Assessment Instruments ............................................................................................ 378,000 403,000 350,000 ¥28,000 ¥53,000 Education for Homeless Children and Youth ............................................................................................................. 65,042 71,542 65,042 ............................ ¥6,500 Training and Advisory Services (Civil Rights) ........................................................................................................... 6,575 6,575 6,575 ............................ ............................Education for Native Hawaiians ................................................................................................................................ 32,397 33,397 32,397 ............................ ¥1,000 Alaska Native Education Equity ................................................................................................................................. 31,453 32,453 31,453 ............................ ¥1,000 Rural Education .......................................................................................................................................................... 169,840 169,840 169,840 ............................ ............................Comprehensive Centers .............................................................................................................................................. 48,445 55,445 40,000 ¥8,445 ¥15,445 

Total, School Improvement Programs ........................................................................................................... 4,402,671 4,693,171 4,134,746 ¥267,925 ¥558,425 

Current Year ......................................................................................................................................... (2,721,230 ) (3,011,730 ) (2,453,305 ) (¥267,925 ) (¥558,425 ) Fiscal year 2017 .................................................................................................................................. (1,681,441 ) (1,681,441 ) (1,681,441 ) ............................ ............................

Subtotal, Forward Funded ............................................................................................................... (2,585,661 ) (2,867,161 ) (2,326,181 ) (¥259,480 ) (¥540,980 ) 
247 

INDIAN EDUCATION 

Grants to Local Educational Agencies ....................................................................................................................... 100,381 100,381 100,381 ............................ ............................Federal Programs: 

Special Programs for Indian Children .............................................................................................................. 17,993 67,993 17,993 ............................ ¥50,000 National Activities ............................................................................................................................................. 5,565 5,565 5,565 ............................ ............................

Subtotal, Federal Programs .......................................................................................................................... 23,558 73,558 23,558 ............................ ¥50,000 Total, Indian Education ................................................................................................................................ 123,939 173,939 123,939 ............................ ¥50,000 

INNOVATION AND IMPROVEMENT 

Investing in Innovation Fund ..................................................................................................................................... 120,000 300,000 ............................ ¥120,000 ¥300,000 Teacher and Principal Pathways (proposed legislation) ........................................................................................... ............................ 138,762 ............................ ............................ ¥138,762 Transition to Teaching ............................................................................................................................................... 13,700 ............................ ............................ ¥13,700 ............................School Leadership ...................................................................................................................................................... 16,368 ............................ ............................ ¥16,368 ............................Charter Schools Grants .............................................................................................................................................. 253,172 375,000 273,172 ∂20,000 ¥101,828 Magnet Schools Assistance ........................................................................................................................................ 91,647 91,647 85,000 ¥6,647 ¥6,647 Fund for the Improvement of Education [FIE] ........................................................................................................... 323,000 166,926 62,815 ¥260,185 ¥104,111 Teacher Incentive Fund (Excellent Educators Grants) ............................................................................................... 230,000 350,000 225,000 ¥5,000 ¥125,000 Ready-to-Learn television ........................................................................................................................................... 25,741 25,741 25,741 ............................ ............................Next Generation High Schools (proposed legislation) ................................................................................................ ............................ 125,000 ............................ ............................ ¥125,000 Advanced Placement .................................................................................................................................................. 28,483 28,483 22,888 ¥5,595 ¥5,595 

Total, Innovation and Improvement .............................................................................................................. 1,102,111 1,601,559 694,616 ¥407,495 ¥906,943 

Current Year ......................................................................................................................................... (1,102,111 ) (1,601,559 ) (694,616 ) (¥407,495 ) (¥906,943 ) 

SAFE SCHOOLS AND CITIZENSHIP EDUCATION 

Promise Neighborhoods .............................................................................................................................................. 56,754 150,000 37,000 ¥19,754 ¥113,000 National Programs ...................................................................................................................................................... 70,000 90,000 60,000 ¥10,000 ¥30,000 Elementary and Secondary School Counseling .......................................................................................................... 49,561 49,561 23,314 ¥26,247 ¥26,247 Carol M. White Physical Education Program ............................................................................................................. 47,000 60,000 ............................ ¥47,000 ¥60,000 

Total, Safe Schools and Citizenship Education ........................................................................................... 223,315 349,561 120,314 ¥103,001 ¥229,247 

ENGLISH LANGUAGE ACQUISITION 

Current funded ........................................................................................................................................................... 47,931 50,271 46,281 ¥1,650 ¥3,990 
248 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2015 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2016—Continued 

[In thousands of dollars] 

Item 2015 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2015 appropriation Budget estimate 

Forward funded .......................................................................................................................................................... 689,469 723,129 665,740 ¥23,729 ¥57,389 

Total, English Language Acquisition ............................................................................................................ 737,400 773,400 712,021 ¥25,379 ¥61,379 

SPECIAL EDUCATION 

State Grants: 

Grants to States Part B current year ............................................................................................................... 2,214,465 2,389,465 2,314,465 ∂100,000 ¥75,000 

Part B advance from prior year ............................................................................................................... (9,283,383 ) (9,283,383 ) (9,283,383 ) ............................ ............................

Grants to States Part B (fiscal year 2017) ...................................................................................................... 9,283,383 9,283,383 9,283,383 ............................ ............................

Subtotal, program level ................................................................................................................................ 11,497,848 11,672,848 11,597,848 ∂100,000 ¥75,000 

Preschool Grants ............................................................................................................................................... 353,238 403,238 363,238 ∂10,000 ¥40,000 Grants for Infants and Families ....................................................................................................................... 438,556 503,556 453,556 ∂15,000 ¥50,000 

Subtotal, program level ................................................................................................................................ 12,289,642 12,579,642 12,414,642 ∂125,000 ¥165,000 

IDEA National Activities (current funded): 

State Personnel Development ............................................................................................................................ 41,630 41,630 35,000 ¥6,630 ¥6,630 Technical Assistance and Dissemination ......................................................................................................... 51,928 61,928 51,928 ............................ ¥10,000 Personnel Preparation ....................................................................................................................................... 83,700 83,700 81,700 ¥2,000 ¥2,000 Parent Information Centers ............................................................................................................................... 27,411 27,411 26,500 ¥911 ¥911 Technology and Media Services ........................................................................................................................ 28,047 28,047 27,047 ¥1,000 ¥1,000 

Subtotal, IDEA special programs .................................................................................................................. 232,716 242,716 222,175 ¥10,541 ¥20,541 Total, Special education ............................................................................................................................... 12,522,358 12,822,358 12,636,817 ∂114,459 ¥185,541 

Current Year ......................................................................................................................................... (3,238,975 ) (3,538,975 ) (3,353,434 ) (∂114,459 ) (¥185,541 ) Fiscal year 2017 .................................................................................................................................. (9,283,383 ) (9,283,383 ) (9,283,383 ) ............................ ............................

Subtotal, Forward Funded ............................................................................................................... (3,006,259 ) (3,296,259 ) (3,131,259 ) (∂125,000 ) (¥165,000 ) 
249 

REHABILITATION SERVICES AND DISABILITY RESEARCH 

Vocational Rehabilitation State Grants ..................................................................................................................... 3,295,914 3,350,594 3,350,594 ∂54,680 ............................Vocational Rehabilitation Grants to Indians ............................................................................................................. 39,160 41,176 41,176 ∂2,016 ............................

Subtotal, Vocational Rehabilitation Grants program level .......................................................................... 3,335,074 3,391,770 3,391,770 ∂56,696 ............................

Client Assistance State grants .................................................................................................................................. 13,000 13,000 12,000 ¥1,000 ¥1,000 Training ...................................................................................................................................................................... 30,188 30,188 24,000 ¥6,188 ¥6,188 Demonstration and Training programs ...................................................................................................................... 5,796 5,796 ............................ ¥5,796 ¥5,796 Protection and Advocacy of Individual Rights [PAIR] ............................................................................................... 17,650 17,650 17,650 ............................ ............................Supported Employment State grants ......................................................................................................................... 27,548 30,548 ............................ ¥27,548 ¥30,548 Independent Living: 

State Grants ...................................................................................................................................................... 22,878 ............................ ............................ ¥22,878 ............................Centers .............................................................................................................................................................. 78,305 ............................ ............................ ¥78,305 ............................Services for Older Blind Individuals ................................................................................................................. 33,317 33,317 33,317 ............................ ............................

Subtotal ......................................................................................................................................................... 134,500 33,317 33,317 ¥101,183 ............................

Helen Keller National Center for Deaf/Blind Youth and Adults ................................................................................ 9,127 9,840 9,127 ............................ ¥713 National Inst. Disability and Rehab. Research [NIDRR] ........................................................................................... 103,970 ............................ ............................ ¥103,970 ............................Assistive Technology ................................................................................................................................................... 33,000 ............................ ............................ ¥33,000 ............................

Subtotal, Discretionary programs ................................................................................................................. 374,779 140,339 96,094 ¥278,685 ¥44,245 Total, Rehabilitation services ....................................................................................................................... 3,709,853 3,532,109 3,487,864 ¥221,989 ¥44,245 

SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES 

American Printing House for the Blind ...................................................................................................................... 24,931 24,931 24,931 ............................ ............................National Technical Institute for the Deaf [NTID]: 

Operations ......................................................................................................................................................... 67,016 67,016 69,016 ∂2,000 ∂2,000 

Total, NTID .................................................................................................................................................... 67,016 67,016 69,016 ∂2,000 ∂2,000 

Gallaudet University: 

Operations ......................................................................................................................................................... 120,275 120,275 120,275 ............................ ............................

Total, Gallaudet University ........................................................................................................................... 120,275 120,275 120,275 ............................ ............................
250 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2015 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2016—Continued 

[In thousands of dollars] 

Item 2015 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2015 appropriation Budget estimate 

Total, Special Institutions for Persons with Disabilities .............................................................................. 212,222 212,222 214,222 ∂2,000 ∂2,000 

CAREER, TECHNICAL, AND ADULT EDUCATION 

Career Education: 

Basic State Grants/Secondary & Technical Education State Grants, current funded ..................................... 326,598 526,598 326,598 ............................ ¥200,000 

Advance from prior year ........................................................................................................................... (791,000 ) (791,000 ) (791,000 ) ............................ ............................Fiscal year 2017 ....................................................................................................................................... 791,000 791,000 791,000 ............................ ............................

Subtotal, Basic State Grants, program level ...................................................................................... 1,117,598 1,317,598 1,117,598 ............................ ¥200,000 

National Programs ............................................................................................................................................. 7,421 9,421 4,421 ¥3,000 ¥5,000 

Subtotal, Career Education ........................................................................................................................... 1,125,019 1,327,019 1,122,019 ¥3,000 ¥205,000 

Adult Education: 

State Grants/Adult Basic and Literacy Education: 

State Grants, current funded ................................................................................................................... 568,955 568,955 540,000 ¥28,955 ¥28,955 

National Leadership Activities ................................................................................................................................... 13,712 19,712 7,712 ¥6,000 ¥12,000 

Subtotal, Adult education ............................................................................................................................. 582,667 588,667 547,712 ¥34,955 ¥40,955 Total, Career, Technical, and Adult Education ............................................................................................ 1,707,686 1,915,686 1,669,731 ¥37,955 ¥245,955 

Current Year ......................................................................................................................................... (916,686 ) (1,124,686 ) (878,731 ) (¥37,955 ) (¥245,955 ) Fiscal year 2017 .................................................................................................................................. (791,000 ) (791,000 ) (791,000 ) ............................ ............................

Subtotal, Forward Funded ............................................................................................................... (916,686 ) (1,124,686 ) (878,731 ) (¥37,955 ) (¥245,955 ) 

STUDENT FINANCIAL ASSISTANCE 

Pell Grants—maximum grant (NA) ........................................................................................................................... (4,860 ) (4,860 ) (4,860 ) ............................ ............................Pell Grants .................................................................................................................................................................. 22,475,352 22,475,352 22,475,352 ............................ ............................Federal Supplemental Educational Opportunity Grants ............................................................................................. 733,130 733,130 704,000 ¥29,130 ¥29,130 
251 

Federal Work Study ..................................................................................................................................................... 989,728 989,728 950,000 ¥39,728 ¥39,728 

Total, Student Financial Assistance [SFA] ................................................................................................... 24,198,210 24,198,210 24,129,352 ¥68,858 ¥68,858 

STUDENT AID ADMINISTRATION 

Salaries and Expenses ............................................................................................................................................... 675,224 726,643 640,000 ¥35,224 ¥86,643 Servicing Activities ..................................................................................................................................................... 721,700 855,211 721,700 ............................ ¥133,511 

Total, Student Aid Administration ................................................................................................................ 1,396,924 1,581,854 1,361,700 ¥35,224 ¥220,154 

HIGHER EDUCATION 

Aid for Institutional Development: 

Strengthening Institutions ................................................................................................................................. 80,462 80,462 78,048 ¥2,414 ¥2,414 Hispanic Serving Institutions ............................................................................................................................ 100,231 100,231 97,224 ¥3,007 ¥3,007 Promoting Post-Baccalaureate Opportunities for Hispanic Americans ............................................................ 8,992 10,565 8,722 ¥270 ¥1,843 Strengthening Historically Black Colleges [HBCUs] ......................................................................................... 227,524 227,524 220,698 ¥6,826 ¥6,826 Strengthening Historically Black Graduate Institutions ................................................................................... 58,840 58,840 57,075 ¥1,765 ¥1,765 Strengthening Predominantly Black Institutions .............................................................................................. 9,244 9,244 8,967 ¥277 ¥277 Asian American Pacific Islander ....................................................................................................................... 3,113 3,113 3,020 ¥93 ¥93 Strengthening Alaska Native and Native Hawaiian-Serving Institutions ......................................................... 12,833 12,833 12,448 ¥385 ¥385 Strengthening Native American-Serving Nontribal Institutions ........................................................................ 3,113 3,113 3,020 ¥93 ¥93 Strengthening Tribal Colleges ........................................................................................................................... 25,662 25,662 24,892 ¥770 ¥770 

Subtotal, Aid for Institutional development ................................................................................................. 530,014 531,587 514,114 ¥15,900 ¥17,473 

International Education and Foreign Language: 

Domestic Programs ........................................................................................................................................... 65,103 67,103 43,445 ¥21,658 ¥23,658 Overseas Programs ............................................................................................................................................ 7,061 9,061 3,500 ¥3,561 ¥5,561 

Subtotal, International Education & Foreign Lang ...................................................................................... 72,164 76,164 46,945 ¥25,219 ¥29,219 

Fund for the Improvement of Postsec. Ed. [FIPSE] ................................................................................................... 67,775 200,000 ............................ ¥67,775 ¥200,000 Postsecondary Program for Students with Intellectual Disabilities .......................................................................... 11,800 11,800 10,384 ¥1,416 ¥1,416 Minority Science and Engineering Improvement ........................................................................................................ 8,971 8,971 8,971 ............................ ............................Tribally Controlled Postsec Voc/Tech Institutions ...................................................................................................... 7,705 7,705 7,705 ............................ ............................Federal TRIO Programs ............................................................................................................................................... 839,752 859,752 839,752 ............................ ¥20,000 GEAR UP ..................................................................................................................................................................... 301,639 301,639 301,639 ............................ ............................Graduate Assistance in Areas of National Need ....................................................................................................... 29,293 29,293 20,000 ¥9,293 ¥9,293 Teacher Quality Partnerships ..................................................................................................................................... 40,592 ............................ 34,000 ¥6,592 ∂34,000 Child Care Access Means Parents in School ............................................................................................................. 15,134 15,134 ............................ ¥15,134 ¥15,134 
252 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2015 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2016—Continued 

[In thousands of dollars] 

Item 2015 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2015 appropriation Budget estimate 

GPRA Data/HEA Program Evaluation ......................................................................................................................... ............................ 30,000 ............................ ............................ ¥30,000 

Total, Higher Education ................................................................................................................................ 1,924,839 2,072,045 1,783,510 ¥141,329 ¥288,535 

HOWARD UNIVERSITY 

Academic Program ..................................................................................................................................................... 191,091 194,496 189,650 ¥1,441 ¥4,846 Endowment Program .................................................................................................................................................. 3,405 ............................ 3,350 ¥55 ∂3,350 Howard University Hospital ........................................................................................................................................ 27,325 27,325 26,500 ¥825 ¥825 

Total, Howard University ............................................................................................................................... 221,821 221,821 219,500 ¥2,321 ¥2,321 

COLLEGE HOUSING AND ACADEMIC FACILITIES LOANS .............................................................................................. 435 450 435 ............................ ¥15 

HISTORICALLY BLACK COLLEGE AND UNIVERSITY [HBCU] 

CAPITAL FINANCING PROGRAM 

HBCU Federal Administration ..................................................................................................................................... 334 340 334 ............................ ¥6 HBCU Loan Subsidies ................................................................................................................................................. 19,096 19,096 19,096 ............................ ............................

Total, HBCU Capital Financing Program ...................................................................................................... 19,430 19,436 19,430 ............................ ¥6 

INSTITUTE OF EDUCATION SCIENCES [IES] 

Research, Development and Dissemination ............................................................................................................... 179,860 202,273 177,860 ¥2,000 ¥24,413 Statistics .................................................................................................................................................................... 103,060 124,744 102,060 ¥1,000 ¥22,684 Regional Educational Laboratories ............................................................................................................................ 54,423 54,423 53,823 ¥600 ¥600 Research in Special Education .................................................................................................................................. 54,000 54,000 48,000 ¥6,000 ¥6,000 Special Education Studies and Evaluations .............................................................................................................. 10,818 13,000 10,500 ¥318 ¥2,500 Statewide Data Systems ............................................................................................................................................ 34,539 70,000 33,500 ¥1,039 ¥36,500 Assessment: 

National Assessment ......................................................................................................................................... 129,000 149,616 129,000 ............................ ¥20,616 
253 

National Assessment Governing Board ............................................................................................................. 8,235 7,827 8,235 ............................ ∂408 

Subtotal, Assessment ................................................................................................................................... 137,235 157,443 137,235 ............................ ¥20,208 Total, IES ....................................................................................................................................................... 573,935 675,883 562,978 ¥10,957 ¥112,905 

DEPARTMENTAL MANAGEMENT 

Program Administration: 

Salaries and Expenses ...................................................................................................................................... 410,000 460,259 390,326 ¥19,674 ¥69,933 Building Modernization ...................................................................................................................................... 1,000 13,830 1,000 ............................ ¥12,830 

Total, Program administration ...................................................................................................................... 411,000 474,089 391,326 ¥19,674 ¥82,763 

Office for Civil Rights ................................................................................................................................................ 100,000 130,691 100,000 ............................ ¥30,691 Office of Inspector General ........................................................................................................................................ 57,791 59,256 57,791 ............................ ¥1,465 

Total, Departmental management ................................................................................................................ 568,791 664,036 549,117 ¥19,674 ¥114,919 Total, Title III, Department of Education ...................................................................................................... 70,470,650 74,138,889 69,164,697 ¥1,305,953 ¥4,974,192 

Current Year ......................................................................................................................................... (47,873,649 ) (51,541,888 ) (46,567,696 ) (¥1,305,953 ) (¥4,974,192 ) Fiscal year 2017 .................................................................................................................................. (22,597,001 ) (22,597,001 ) (22,597,001 ) ............................ ............................

TITLE IV—RELATED AGENCIES 

COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY DISABLED ........................................... 5,362 5,441 5,362 ............................ ¥79 

CORPORATION FOR NATIONAL AND COMMUNITY SERVICE 

Operating Expenses 

Domestic Volunteer Service Programs: 

Volunteers in Service to America [VISTA] ......................................................................................................... 92,364 96,885 90,000 ¥2,364 ¥6,885 National Senior Volunteer Corps: 

Foster Grandparents Program .................................................................................................................. 107,702 107,702 104,781 ¥2,921 ¥2,921 Senior Companion Program ...................................................................................................................... 45,512 45,512 44,278 ¥1,234 ¥1,234 Retired Senior Volunteer Program ............................................................................................................ 48,903 48,903 47,578 ¥1,325 ¥1,325 

Subtotal, Senior Volunteers ................................................................................................................. 202,117 202,117 196,637 ¥5,480 ¥5,480 Subtotal, Domestic Volunteer Service .................................................................................................. 294,481 299,002 286,637 ¥7,844 ¥12,365 
254 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2015 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2016—Continued 

[In thousands of dollars] 

Item 2015 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2015 appropriation Budget estimate 

National and Community Service Programs: 

AmeriCorps State and National Grants ............................................................................................................ 335,430 425,105 270,000 ¥65,430 ¥155,105 Innovation, Assistance, and Other Activities .................................................................................................... 77,400 78,601 7,400 ¥70,000 ¥71,201 Evaluation .......................................................................................................................................................... 5,000 5,000 4,000 ¥1,000 ¥1,000 National Civilian Community Corps [NCCC] ..................................................................................................... 30,000 30,500 30,000 ............................ ¥500 State Commission Support Grants .................................................................................................................... 16,038 17,000 16,038 ............................ ¥962 

Subtotal, National and Community Service ................................................................................................. 463,868 556,206 327,438 ¥136,430 ¥228,768 Total, Operating expenses ............................................................................................................................ 758,349 855,208 614,075 ¥144,274 ¥241,133 

National Service Trust ................................................................................................................................................ 209,618 237,077 145,000 ¥64,618 ¥92,077 Salaries and Expenses ............................................................................................................................................... 81,737 86,176 80,000 ¥1,737 ¥6,176 Office of Inspector General ........................................................................................................................................ 5,250 6,000 5,250 ............................ ¥750 

Total, Corp. for National and Community Service ....................................................................................... 1,054,954 1,184,461 844,325 ¥210,629 ¥340,136 

CORPORATION FOR PUBLIC BROADCASTING: 

Fiscal year 2018 (current) with fiscal year 2016 comparable ........................................................................ 445,000 445,000 445,000 ............................ ............................Fiscal year 2017 advance with fiscal year 2015 comparable (NA) ................................................................. (445,000 ) (445,000 ) (445,000 ) ............................ ............................Fiscal year 2016 advance with fiscal year 2014 comparable (NA) ................................................................. (445,000 ) (445,000 ) (445,000 ) ............................ ............................Public television interconnection system (current) ........................................................................................... ............................ 40,000 ............................ ............................ ¥40,000 

FEDERAL MEDIATION AND CONCILIATION SERVICE .................................................................................................... 45,666 48,748 47,823 ∂2,157 ¥925 FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION ...................................................................................... 16,751 17,085 15,950 ¥801 ¥1,135 INSTITUTE OF MUSEUM AND LIBRARY SERVICES ....................................................................................................... 227,860 237,428 227,860 ............................ ¥9,568 MEDICARE PAYMENT ADVISORY COMMISSION ........................................................................................................... 11,749 12,100 11,100 ¥649 ¥1,000 MEDICAID AND CHIP PAYMENT AND ACCESS COMMISSION ....................................................................................... 7,650 8,700 7,250 ¥400 ¥1,450 NATIONAL COUNCIL ON DISABILITY ............................................................................................................................ 3,250 3,432 3,075 ¥175 ¥357 NATIONAL LABOR RELATIONS BOARD ......................................................................................................................... 274,224 278,000 246,802 ¥27,422 ¥31,198 NATIONAL MEDIATION BOARD ..................................................................................................................................... 13,227 13,230 12,600 ¥627 ¥630 
255 

OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION ..................................................................................... 11,639 13,212 11,100 ¥539 ¥2,112 

RAILROAD RETIREMENT BOARD 

Dual Benefits Payments Account ............................................................................................................................... 34,000 29,000 29,000 ¥5,000 ............................Less Income Tax Receipts on Dual Benefits ............................................................................................................. ¥3,000 ¥2,000 ¥2,000 ∂1,000 ............................

Subtotal, Dual Benefits ................................................................................................................................ 31,000 27,000 27,000 ¥4,000 ............................

Federal Payment to the RR Retirement Accounts ..................................................................................................... 150 150 150 ............................ ............................Limitation on Administration ..................................................................................................................................... 111,225 119,918 111,225 ............................ ¥8,693 Limitation on the Office of Inspector General ........................................................................................................... 8,437 9,450 8,437 ............................ ¥1,013 

SOCIAL SECURITY ADMINISTRATION 

Payments to Social Security Trust Funds .................................................................................................................. 16,400 20,400 20,400 ∂4,000 ............................

Supplemental Security Income Program 

Federal Benefit Payments .......................................................................................................................................... 56,201,000 60,683,000 60,683,000 ∂4,482,000 ............................Beneficiary Services ................................................................................................................................................... 70,000 70,000 70,000 ............................ ............................Research and Demonstration ..................................................................................................................................... 83,000 101,000 101,000 ∂18,000 ............................Afghanistan Special Immigrant Visa ......................................................................................................................... ............................ 3,000 3,000 ∂3,000 ............................Administration ............................................................................................................................................................ 4,578,978 4,765,000 4,453,777 ¥125,201 ¥311,223 

Subtotal, SSI program level .......................................................................................................................... 60,932,978 65,622,000 65,310,777 ∂4,377,799 ¥311,223 

Less funds advanced in prior year ..................................................................................................... ¥19,700,000 ¥19,200,000 ¥19,200,000 ∂500,000 ............................

Subtotal, regular SSI current year ................................................................................................................ 41,232,978 46,422,000 46,110,777 ∂4,877,799 ¥311,223 

New advance, 1st quarter, fiscal year 2017 .................................................................................. 19,200,000 14,500,000 14,500,000 ¥4,700,000 ............................

Total, SSI program ........................................................................................................................................ 60,432,978 60,922,000 60,610,777 ∂177,799 ¥311,223 

Limitation on Administrative Expenses 

OASI/DI Trust Funds ................................................................................................................................................... 4,913,260 5,248,608 4,819,494 ¥93,766 ¥429,114 HI/SMI Trust Funds ..................................................................................................................................................... 1,755,376 1,858,882 1,707,374 ¥48,002 ¥151,508 Social Security Advisory Board ................................................................................................................................... 2,300 2,400 2,300 ............................ ¥100 SSI .............................................................................................................................................................................. 3,614,009 3,827,110 3,515,777 ¥98,232 ¥311,333 

Subtotal, regular LAE .................................................................................................................................... 10,284,945 10,937,000 10,044,945 ¥240,000 ¥892,055 

User Fees: 

SSI User Fee activities ...................................................................................................................................... 124,000 136,000 136,000 ∂12,000 ............................
256 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2015 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2016—Continued 

[In thousands of dollars] 

Item 2015 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2015 appropriation Budget estimate 

SSPA User Fee Activities ................................................................................................................................... 1,000 1,000 1,000 ............................ ............................

Subtotal, User fees ....................................................................................................................................... 125,000 137,000 137,000 ∂12,000 ............................Subtotal, Limitation on administrative expenses ......................................................................................... 10,409,945 11,074,000 10,181,945 ¥228,000 ¥892,055 

Program Integrity: 

OASDI Trust Funds ............................................................................................................................................ 431,031 500,580 500,580 ∂69,549 ............................SSI ..................................................................................................................................................................... 964,969 938,420 938,420 ¥26,549 ............................

Subtotal, Program integrity funding ............................................................................................................. 1,396,000 1,439,000 1,439,000 ∂43,000 ............................Total, Limitation on Administrative Expenses .............................................................................................. 11,805,945 12,513,000 11,620,945 ¥185,000 ¥892,055 

Office of Inspector General 

Federal Funds ............................................................................................................................................................. 28,829 30,000 28,829 ............................ ¥1,171 Trust Funds ................................................................................................................................................................ 74,521 78,795 74,521 ............................ ¥4,274 

Total, Office of Inspector General ................................................................................................................ 103,350 108,795 103,350 ............................ ¥5,445 

Adjustment: Trust fund transfers from general revenues ......................................................................................... ¥4,578,978 ¥4,765,000 ¥4,453,777 ∂125,201 ∂311,223 

Total, Social Security Administration ........................................................................................................... 67,779,695 68,799,195 67,901,695 ∂122,000 ¥897,500 

Federal funds ....................................................................................................................................... 60,603,207 61,109,400 60,797,006 ∂193,799 ¥312,394 

Current year ............................................................................................................................ (41,403,207 ) (46,609,400 ) (46,297,006 ) (∂4,893,799 ) (¥312,394 ) New advances, 1st quarter, fiscal year 2017 ....................................................................... (19,200,000 ) (14,500,000 ) (14,500,000 ) (¥4,700,000 ) ............................

Trust funds .......................................................................................................................................... 7,176,488 7,689,795 7,104,689 ¥71,799 ¥585,106 

Total, Title IV, Related Agencies .................................................................................................................. 70,047,839 71,262,550 69,926,754 ¥121,085 ¥1,335,796 

Federal Funds ...................................................................................................................................... 62,739,940 63,431,287 62,691,303 ¥48,637 ¥739,984 
257 

Current Year ........................................................................................................................... (43,094,940 ) (48,486,287 ) (47,746,303 ) (∂4,651,363 ) (¥739,984 ) Current Year (emergency) ...................................................................................................... ............................ ............................ ............................ ............................ ............................Fiscal year 2017 Advance ...................................................................................................... (19,200,000 ) (14,500,000 ) (14,500,000 ) (¥4,700,000 ) ............................Fiscal year 2018 Advance ...................................................................................................... (445,000 ) (445,000 ) (445,000 ) ............................ ............................

Trust Funds .......................................................................................................................................... 7,307,899 7,831,263 7,235,451 ¥72,448 ¥595,812 

TITLE VI—EBOLA RESPONSE AND PREPAREDNESS (total) .......................................................................... (1,001,000 ) ............................ ............................ (¥1,001,000 ) ............................

Grand Total, current year ................................................................................................................ 845,560,078 892,778,190 879,922,043 ∂34,361,965 ¥12,856,147 

1 Section 4002 of Public Law 111–148. 

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