26–329 

115TH CONGRESS REPORT " ! HOUSE OF REPRESENTATIVES 1st Session 115–244 

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

JULY 24, 2017.—Committed to the Committee of the Whole House on the State of 

the Union and ordered to be printed 

Mr. COLE, from the Committee on Appropriations, 

submitted the following 

R E P O R T 

together with 

MINORITY VIEWS 

[To accompany H.R. 3358] 

The Committee on Appropriations submits the following report in 

explanation of the accompanying bill making appropriations for the 

Departments of Labor, Health and Human Services (except the 

Food and Drug Administration, the Agency for Toxic Substances 

and Disease Registry and the Indian Health Service), Education, 

Committee for Purchase from People Who Are Blind or Severely 

Disabled, Corporation for National and Community Service, Corporation for Public Broadcasting, Federal Mediation and Conciliation Service, Federal Mine Safety and Health Review Commission, 

Institute of Museum and Library Services, Medicaid and CHIP 

Payment and Access Commission, Medicare Payment Advisory 

Commission, National Council on Disability, National Labor Relations Board, National Mediation Board, Occupational Safety and 

Health Review Commission, Railroad Retirement Board, and the 

Social Security Administration for the fiscal year ending September 

30, 2018, and for other purposes. 

INDEX TO BILL AND REPORT 

Page number 

Bill Report 

Summary of Estimates and Appropriation .............................................. ........ 3 

General Summary of the Bill .................................................................... ........ 3 

2 

Page number 

Bill Report 

Title I—Department of Labor: 

Employment and Training Administration ....................................... 2 5 

Employee Benefits Security Administration ..................................... 15 11 

Pension Benefit Guaranty Corporation ............................................. 15 11 

Wage and Hour Division .................................................................... 16 12 

Office of Labor-Management Standards ........................................... 17 12 

Office of Federal Contract Compliance Programs ............................ 17 12 

Office of Workers’ Compensation Programs ..................................... 17 13 

Occupational Safety and Health Administration ............................. 21 14 

Mine Safety and Health Administration ........................................... 24 15 

Bureau of Labor Statistics ................................................................. 26 16 

Office of Disability Employment Policy ............................................. 26 17 

Departmental Management ............................................................... 27 17 

General Provisions .............................................................................. 31 19 

Title II—Department of Health and Human Services: 

Health Resources and Services Administration ............................... 42 20 

Centers for Disease Control and Prevention .................................... 46 33 

National Institutes of Health ............................................................. 52 49 

Substance Abuse and Mental Health Services Administration ...... 60 74 

Centers for Medicare and Medicaid Services .................................... 64 82 

Administration for Children and Families ........................................ 68 88 

Administration on Aging .................................................................... ........ 93 

Office of Secretary ............................................................................... 79 99 

Office of Inspector General ................................................................. 82 103 

Public Health and Social Services Emergency Fund ....................... 83 104 

General Provisions .............................................................................. 85 105 

Title III—Department of Education: 

Education for the Disadvantaged ...................................................... 101 108 

Impact Aid ........................................................................................... 102 110 

School Improvement Programs .......................................................... 103 111 

Indian Education ................................................................................. 104 113 

Innovation and Improvement ............................................................. 105 115 

Safe Schools and Citizenship Education ........................................... 105 117 

English Language Acquisition ........................................................... 105 117 

Special Education ................................................................................ 106 118 

Rehabilitation Services and Disability Research .............................. 109 120 

Special Institutions for Persons with Disabilities ............................ 110 122 

Career, Technical and Adult Education ............................................ 110 123 

Student Financial Assistance ............................................................. 111 124 

Student Aid Administration ............................................................... 111 125 

Higher Education ................................................................................ 111 125 

Howard University .............................................................................. 112 129 

College Housing and Academic Facilities Loans .............................. 113 130 

Historically Black College and University Capital Financing ........ 113 130 

Institute of Education Sciences .......................................................... 114 130 

Departmental Management ............................................................... 114 132 

Office for Civil Rights ......................................................................... 115 134 

Office of the Inspector General .......................................................... 115 134 

General Provisions .............................................................................. 115 134 

Title IV—Related Agencies: 

Committee for the Purchase from People Who Are Blind or Severely Disabled ................................................................................ 118 135 

Corporation for National and Community Service ........................... 119 136 

Federal Mediation and Conciliation Service ..................................... 124 139 

Federal Mine Safety and Health Review Commission ..................... 125 139 

Institute of Museum and Library Services ....................................... 125 139 

Medicaid and CHIP Payment and Access Commission ................... 126 140 

Medicare Payment Advisory Commission ......................................... 126 140 

National Council on Disability ........................................................... 126 140 

3 

Page number 

Bill Report 

National Labor Relations Board ........................................................ 126 141 

National Mediation Board .................................................................. 130 141 

Occupational Safety and Health Review Commission ..................... 130 141 

Railroad Retirement Board ................................................................ 130 141 

Social Security Administration .......................................................... 132 142 

Title V—General Provisions: 

House of Representatives Reporting Requirements ......................... ........ 147 

Minority Views .................................................................................... ........ 260 

SUMMARY OF ESTIMATES AND APPROPRIATIONS

The following table compares on a summary basis the appropriations, including trust funds for fiscal year 2018, the budget request 

for fiscal year 2018, and the Committee recommendation for fiscal 

year 2018 in the accompanying bill. 

2018 LABOR, HHS, EDUCATION BILL 

[Discretionary funding in thousands of dollars] 

Budget Activity 

Fiscal Year— 2018 Committee compared to— 

2017 Enacted 2018 Budget 2018 Committee 2017 Enacted 2018 Budget 

Department of Labor ......................... $12,088,155 $10,641,329 $10,767,464 (1,320,691) 126,135 

Department of Health and Human 

Services ......................................... 78,118,630 63,029,369 77,576,400 (542,230) 14,547,031 

Department of Education .................. 68,239,195 62,889,423 65,823,945 (2,415,250) 2,934,522 

Related Agencies ............................... 14,885,326 13,682,005 14,715,337 (169,989) 1,033,332 

GENERAL SUMMARY OF THE BILL

For fiscal year 2018, the Committee recommends a total of 

$157,938,000,000 in current year discretionary funding, including 

offsets and adjustments. The fiscal year 2018 recommendation is a 

decrease of $5,047,000,000 below the fiscal year 2017 enacted level. 

Within the funds provided, the Committee has focused increases 

on priority areas and reduced funding for programs that are no 

longer authorized, are of limited scope or effectiveness, or do not 

have a clear Federal role. 

First and foremost among these priority areas, the Committee 

continues to build on the investment made last year in biomedical 

research by increasing funding for the National Institutes of 

Health (NIH) by $1,100,000,000. This increase builds on the prior 

$2,000,000,000 increase included in the Consolidated Appropriations Act, 2017 and continues funding from the 21st Century Cures 

Act. Within the total increase, the Committee provides an increase 

of $80,000,000 to the Precision Medicine Initiative, which holds the 

promise of designing personalized, targeted cures and treatment. 

The Committee also includes an increase of $400,000,000 to help 

find a cure for Alzheimer’s disease and an increase of $76,000,000 

for the BRAIN initiative to help better understand how the brain 

functions and learns. 

The Committee has also placed a high priority on combatting 

opioid addiction by including an additional $500,000,000 for grants 

to States, as outlined in the 21st Century Cures Act. The Committee also continues support for programs addressing opioid addiction as authorized in the Comprehensive Addiction and Recovery 

Act. 

4 

To protect public health and the Nation in the event of a bioterrorism or other pandemic crisis, the Committee recommendation 

also includes increases to the Bioshield and the Biomedical Research and Advanced Development Authority (BARDA) programs 

as well as a $178,000,000 increase for detecting and preventing a 

pandemic flu outbreak. The recommendation also increases the 

Strategic National Stockpile by $25,000,000 and includes language 

allowing the Secretary of Health and Human Services greater flexibility to respond to an imminent public health threat within the 

public health and social services emergency fund. 

In the area of education, the Committee has included an increase 

of $200,000,000 to assist local school districts in covering the cost 

of ensuring all children with disabilities have access to a free, appropriate, and public education. The Committee provides a total of 

$500,000,000 for the new Student Support Services program created in the Every Student Succeeds Act. These funds can be used 

flexibly by school districts across the country to meet local challenges, whether those be in the area of counseling, special curriculum services, computer science or physical education needs as 

local demands may dictate. The recommendation also includes an 

increase of $28,000,000 for charter schools. 

The Committee includes robust increases for the TRIO, 

$60,000,000, and GEAR UP, $10,246,000, programs to ensure that 

students from disadvantaged backgrounds have access to a college 

program. The bill also provides sufficient funding to maintain the 

maximum Pell grant award at $5,920 in the 2018–2019 academic 

year. The Head Start program is increased by $21,905,000 and the 

Child Care and Development Block Grant is increased by 

$4,000,000 to continue investments in early childhood education. 

The Committee has also included $250,000,000 within the Department of Health and Human Services for the Preschool Development 

Grants program. 

These increases are offset by eliminating funding for programs 

that do not have a clear or effective Federal role, or that have large 

unobligated balances that are not needed in this fiscal year. 

The Committee believes that public service is a public trust that 

requires Federal employees to place ethical principles above private 

gain. Federal employees are reminded that they shall not advance 

a personal agenda or give preferential treatment to any outside organization or individual within the government programs that they 

administer. Information that is received by the employee, including 

information from other employees, offices, or Congress should be 

handled in a professional and confidential manner in accordance 

with Code of Federal Regulations regarding the basic obligation of 

public service (5 CFR 2635.101). 

The Committee directs each of the agencies funded by this Act 

to continue to report any funds derived by the agency from nonFederal sources, including user charges and fines, that are authorized by law, to be retained and used by the agency or credited as 

an offset in annual budget submissions. 

Paper Reduction Efforts.—The Committee urges each agency 

funded by this Act to work with the Office of Management and 

Budget (OMB) to reduce printing and reproduction costs and directs each agency to inform the Committee on what steps have 

5 

been taken to achieve this goal, including identifying how much 

money each agency expects to save by implementing these measures. 

TITLE I—DEPARTMENT OF LABOR 

EMPLOYMENT AND TRAINING ADMINISTRATION

TRAINING AND EMPLOYMENT SERVICES

The Committee recommends $3,042,720,000 for Training and 

Employment Services (TES). TES provides funding for Federal government job training and employment service programs authorized 

primarily by the Workforce Innovation and Opportunity Act of 2014 

(WIOA). This recommendation is $295,979,000 less than the fiscal 

year 2017 enacted level, and $988,954,000 more than the fiscal 

year 2018 budget request. 

Workforce Training.—The Committee continues to be concerned 

by the skills gap. According to Bureau of Labor Statistics data, employers are currently reporting over six million open positions. Employers are unable to fill many of these positions due to a lack of 

applicants with the required skills. The Committee believes this is 

an enormous missed economic opportunity. In the November 2016 

Top Management and Performance Challenges Facing the U.S. Department of Labor, the Department of Labor Office of Inspector 

General (DOL–OIG) states that the Department has been challenged to assure that participants in its job training programs receive industry-recognized credentials and that participants obtain 

employment in the occupations they have been trained for. The 

Committee urges the Department to consider ways that job-training programs can be better targeted and improved within existing 

authorities in order to train participants for in-demand jobs and reduce the skills gap. 

Governors’ Reserve Fund.—The Committee recommendation 

maintains the Governors’ Reserve Fund at the level authorized by 

WIOA. The Committee supports efforts by the Department of Labor 

to work with States to ensure that funds are used for authorized 

purposes in a timely manner and to minimize the accumulation of 

balances. 

Apprenticeship.—The Committee provides $35,000,000 for the Office of Apprenticeship Services. The Committee urges the Employment and Training Administration (ETA) to continue to expand apprenticeship options through outreach and increased employer engagement in registered apprenticeships. The bill provides no new 

funding for the Apprenticeship Grants program. The Committee 

encourages ETA to work with the authorizing committees of jurisdiction to enact an appropriate apprenticeship program authorization. 

Licensing.—The Committee continues to support the Department’s efforts to address ways in which harmonizing licensing requirements across States can reduce barriers to labor market entry 

and mobility, including for dislocated workers, transitioning service 

members, and veterans. 

Pay for Performance.—The Pay-for-Performance authority provided in WIOA is a promising, innovative approach that leverages 

data, evaluation, and evidence-based performance to improve workVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00005 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
6 

force development outcomes. The Committee urges the Department 

to consider how this authority can be used to improve training and 

employment programs across the workforce development system. 

Formal Partnerships and Job-Placement Services.—The United 

States is experiencing a shortfall of workers with education and 

training beyond a high school education. At the same time, industry surveys show that a lack of qualified workers is a top concern 

for many employers. The Committee urges the Secretary of Labor 

to research and develop strategies for creating formal partnerships 

and job-placement services with industry employers and the Adult 

Employment and Training Activities and Dislocated Worker Employment and Training Activities programs authorized by WIOA. 

Evaluation.—The Committee supports rigorous evaluation of the 

Department’s programs, particularly the workforce training programs authorized by WIOA. The Committee provides $8,040,000 in 

direct appropriations for program evaluations and continues a general provision authorizing the transfer of up to 0.75 percent of appropriations from specific program accounts for purposes of evaluation. 

Evaluations should be targeted in ways that will allow the Department to use the findings to improve program delivery and results. The Committee urges the Department to follow through on 

evaluation findings with evidence-based Congressional justifications. 

Program Integrity.—The Committee continues to be concerned by 

the improper payment rate in the Unemployment Insurance (UI) 

program and urges the Department to use its authority and program integrity resources to help address this issue. 

Information Technology (IT) Consortia.—The Committee remains 

concerned that serious challenges threaten the viability of the UI 

IT modernization projects being carried out by State consortia. The 

Committee directs the Department to continue to provide annual 

reports to the Committees on Appropriations of the House of Representatives and the Senate on the status of all consortia projects 

and to implement appropriate policies and procedures for assessing 

and funding projects by State consortia. In addition, the Committee 

directs the Department to include in the fiscal year 2019 Congressional Justification any necessary recommendations for language or 

direction that would be helpful to ensure the long-term viability of 

the consortia projects and ensure that funds being used for IT modernization projects are achieving the intended results. 

Adult Employment and Training Activities.—For Adult Employment and Training Activities, the Committee recommends 

$776,736,000, which is $38,820,000 less than the fiscal year 2017 

enacted level and $286,366,000 more than the fiscal year 2018 

budget request. 

Youth Employment and Training Activities.—For Youth Employment and Training Activities, the Committee recommends 

$831,842,000, which is $41,574,000 less than the fiscal year 2017 

enacted level and $308,175,000 more than the fiscal year 2018 

budget request. 

Dislocated Worker Employment and Training Activities.—For 

Dislocated Worker Employment and Training Activities, the Committee recommends $1,145,530,000 which is $96,189,000 less than 

7 

the fiscal year 2017 enacted level and $413,045,000 more than the 

fiscal year 2018 budget request. 

Of the total provided for Dislocated Worker Employment and 

Training Activities, $1,015,530,000 is designated for State grants 

that provide core and intensive services, training, and supportive 

services for dislocated workers. In addition, States use these funds 

for rapid response assistance to help workers affected by mass layoffs and plant closures. 

The remaining $130,000,000 is available for the Dislocated Workers National Reserve (DWNR). The DWNR supports national emergency grants, technical assistance and demonstration projects as 

authorized by WIOA. The Committee recommendation eliminates 

advance appropriations for the DWNR by providing $130,000,000 

in current year funds and rescinding the advance provided in fiscal 

year 2017. No advance is provided for fiscal year 2019. The Committee recommendation includes up to $66,000,000 to assist dislocated workers in the Appalachian region as requested in the fiscal year 2018 budget request. The Committee appreciates the Department’s efforts to address severe dislocations of workers in the 

coal industry. 

Native Americans.—For the Indian and Native American programs, the Committee recommends $50,000,000, which is the same 

as the fiscal year 2017 enacted level and $95,000 more than the fiscal year 2018 budget request. 

Migrant and Seasonal Farmworkers.—For the National Farmworker Jobs program, the Committee recommends $72,000,000, 

which is $9,896,000 less than the fiscal year 2017 enacted level. 

The fiscal year 2018 budget request proposed no funding for this 

program. 

The Committee encourages the Department to consider ways 

that the Migrant and Seasonal Farmworkers program can be used 

to help address shortages of workers in the agricultural sector. 

YouthBuild.—For the YouthBuild program, the Committee recommends $84,534,000, which is the same as the fiscal year 2017 

enacted level and $161,000 more than the fiscal year 2018 budget 

request. 

Technical Assistance.—The Committee recommends no direct 

funding for technical assistance, which is $2,500,000 less than the 

fiscal year 2017 and $5,226,000 less than the fiscal year 2018 budget request. WIOA provides the authority to use DWNR funds for 

technical assistance and the Committee maintains a provision allowing the set-aside of up to 10 percent of such funds for technical 

assistance activities. 

Reintegration of Ex-Offenders.—The Committee recommends 

$82,078,000 for ex-offender retraining and reintegration activities, 

which is $6,000,000 less than the fiscal year 2017 enacted level and 

$4,167,000 more than the fiscal year 2018 budget request. 

Workforce Data Quality Initiative.—The Committee recommends 

no funding for the Workforce Data Quality Initiative, which is 

$6,000,000 less than the fiscal year 2017 enacted level and the 

same as the fiscal year 2018 budget request. 

8 

JOB CORPS

(INCLUDING TRANSFER OF FUNDS)

The Committee recommends $1,688,155,000 for Job Corps, which is $16,000,000 less than the fiscal year 2017 enacted level and 

$239,711,000 more than the fiscal year 2018 budget request. 

Operations.—For Job Corps Operations, the Committee rec- ommends $1,572,886,000, which is $14,439,000 less than the fiscal 

year 2017 enacted level and $231,568,000 more than the fiscal year 

2018 budget request. 

Construction, Rehabilitation, and Acquisition.—The Committee 

recommends $83,000,000 for construction, rehabilitation, and acquisition activities of Job Corps centers, which is $1,500,000 less 

than the fiscal year 2017 enacted level and $8,143,000 more than 

the fiscal year 2018 budget request. 

Administration.—The Committee recommends $32,269,000 for 

the administrative expenses of the Job Corps program, which is 

$61,000 less than the fiscal year 2017 enacted level and the same 

as the fiscal year 2018 budget request. 

Job Corps is a residential education and vocational training program that helps young people ages 16 through 24 improve the 

quality of their lives through vocational and academic training. 

On March 31, 2017, the DOL–OIG issued a report entitled Review of Job Corps Center Safety and Security (Report Number 26– 

17–001–03–370). The DOL–OIG found that campuses audited had 

significant physical security weaknesses and that center management continued to underreport or misclassify incidents of student 

misconduct to Job Corps. The Consolidated Appropriations Act, 

2017 and the fiscal year 2018 Committee recommendation includes 

additional funds for Job Corps construction. The Committee directs 

the Department to use these funds to address physical security 

weaknesses at Job Corps centers. The Committee directs the Department to review and make any necessary changes to the collection and processing of misconduct reports. 

The Committee continues to be concerned about the safety and 

security of students in the Job Corps program. The Committee supports the Department’s efforts to improve safety and urges ETA to 

continue to review and implement policies that will enhance safety 

and security on Job Corps campuses throughout the country. 

The Committee is concerned that a backlog in the procurement 

of Job Corps operations contracts has resulted in a number of unnecessary and costly bridge contracts in recent years. The Committee recognizes that fewer bridge contracts were reported in the 

most recent quarter and appreciates the efforts the Department 

has undertaken to reduce the backlog and need for such bridge contracts in the future. 

The Committee is aware of challenges with respect to the recruitment of women participants in the Job Corps program. The Department is directed to submit a report to the Committees on Appropriations of the House of Representatives and the Senate within 

180 days of enactment of this Act providing detail on current outreach and recruitment activities, barriers to women’s participation 

in the program, and ways that Job Corps recruitment policies can 

better target women. As part of the report, the Committee encourages ETA to work with HHS early childhood education programs 

9 

to assess current partnerships and develop recommendations to improve or expand upon successful partnership models at Job Corps 

campuses to facilitate the participation of women with children. 

The Committee encourages the Department to consider establishing a working group of Job Corps administrators, industry leaders and other relevant parties to identify ways in which the program can be better targeted to support the goals of training young 

Americans for in-demand jobs that benefit their communities, the 

economy, and help reduce poverty. 

The Committee continues to support the policy of closing a limited number of chronically underperforming Job Corps centers and 

directs the Department to submit a comprehensive plan to the 

Committees on Appropriations of the House of Representatives and 

the Senate at least 60 days prior to initiating the closure of any 

existing Job Corps centers. The plan should identify the centers 

that will be closed, provide the financial and management rationale 

for closing each center, and include a detailed analysis of the costs 

and anticipated savings that will result from the closure. 

Section 106(b) authorizes the Secretary to transfer up to 0.5 percent of discretionary ETA appropriations to carry out program integrity activities within those programs, the Committee directs the 

Department to notify the Committees on Appropriations of the 

House of Representatives and the Senate at least 15 days in advance of any such transfer with respect to funds appropriated to 

Job Corps. 

COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS

The Committee recommends transferring the Community Service 

Employment for Older Americans program to the Administration 

for Community Living at the Department of Health and Human 

Services. 

FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES

The Committee recommends $790,000,000 for Federal Unemployment Benefits and Allowances, which is $59,000,000 less than the 

fiscal year 2017 enacted level and the same as the fiscal year 2018 

budget request. 

The Trade Adjustment Assistance program (TAA) provides assistance to workers adversely affected by international trade. TAA 

provides training, income support, wage subsidies for older workers, job search and relocation allowances to groups of workers who 

file a petition and are certified as eligible to apply for such benefits 

due to job losses resulting from increases in imports or foreign 

trade. 

STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE

OPERATIONS

The Committee recommends $2,830,903,000 for State Unemployment Insurance and Employment Service Operations. The total includes $2,760,903,000 from the Employment Security Administration Account from the Unemployment Trust Fund and $70,000,000 

from the General Fund of the Treasury. These funds are used to 

support the administration of Federal and State unemployment 

compensation laws. 

10 

Unemployment Insurance Compensation.—For Unemployment Insurance (UI) Compensation, the Committee recommends 

$2,665,775,000, which is $21,825,000 less than the fiscal year 2017 

enacted level and $30,000,000 more than the fiscal year 2018 budget request. The total includes $2,665,775,000 for State Operations 

and $13,000,000 for National Activities. 

The recommendation for State UI Operations includes 

$160,000,000 to conduct in-person reemployment and eligibility assessments (REA), which is $45,000,000 more than the fiscal year 

2017 enacted level and $30,000,000 more than the fiscal year 2018 

budget request. The Committee supports the REA program as a 

means to reduce waste, fraud, abuse, to conduct eligibility assessments, and to refer beneficiaries to appropriate training options. 

As in previous years, the recommendation provides contingency 

funding for increased workloads that States may face in the administration of UI. During fiscal year 2018, for every 100,000 increase 

in the total average weekly insured unemployment above 

2,246,000, an additional $28,600,000 shall be made available from 

the Unemployment Trust Fund. 

Employment Service.—The Committee recommends $19,818,000 

for Employment Service National Activities, which is the same as 

the fiscal year 2017 enacted level and $38,000 more than the fiscal 

year 2018 budget request. 

Foreign Labor Certification.—The Committee recommends 

$62,310,000 for the Foreign Labor Certification (FLC) program, 

which is the same as the fiscal year 2017 enacted level and 

$118,000 more than the fiscal year 2018 budget request. The recommendation includes $48,028,000 for Federal administration activities and $14,282,000 for grants to States. 

The FLC program administers temporary foreign worker programs including the H–2A and the H–2B temporary visa programs. 

These programs are essential to employers in industries that have 

cyclical peaks or that are seasonal in nature, including agriculture, 

tourism, and hospitality. 

The Committee is concerned about previous delays in the processing of labor certifications in the H–2A, H–2B, and PERM programs. The Department is directed to use all appropriate resources 

and authorities to prevent any backlogs of applications in Foreign 

Labor Certification programs in fiscal year 2018. 

The Committee is aware that there continues to be concern regarding the methodology for calculating H–2A wage rates prescribed in the Final Rule published by the Department of Labor on 

February 12, 2010. The Committee encourages the Department to 

review the wage methodology prescribed in the Final Rule and determine whether an alternate methodology could reduce disparate 

impacts on local areas. 

One-Stop Career Centers/Labor Market Information.—The Committee recommends $70,000,000 for One-Stop Career Centers and 

Labor Market Information, which is $2,347,000 more than the fiscal year 2017 enacted level and $2,476,000 more than the fiscal 

year 2018 budget request. The Committee expects the Department 

to use additional funds to ensure claimants have access to timely 

information on job openings and other appropriate labor market information. 

11 

ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS

The Committee recommends such sums as necessary for Advances to the Unemployment Trust Fund and Other Funds. The 

funds are made available to accounts authorized under Federal and 

State unemployment insurance laws and the Black Lung Disability 

Trust Fund when the balances in such accounts are insufficient. 

PROGRAM ADMINISTRATION

The Committee recommends $156,348,000 for Program Adminis- tration, which is $2,308,000 less than the fiscal year 2017 enacted 

level and $2,083,000 more than the fiscal year 2018 budget request. 

The recommendation includes $106,461,000 from the General Fund 

of the Treasury and $49,887,000 from the Employment Security 

Administration Account in the Unemployment Trust Fund. 

EMPLOYEE BENEFITS SECURITY ADMINISTRATION

SALARIES AND EXPENSES

The Committee recommends $175,600,000 for the Employee Benefits Security Administration (EBSA). This recommendation is 

$5,400,000 less than the fiscal year 2017 enacted level and 

$8,326,000 less than the fiscal year 2018 budget request. The 

EBSA assures the security of retirement, health and other workplace-related benefits of working Americans. 

The Committee understands there is concern regarding the 

amount of time it takes to complete audits of Association Health 

Plans and urges the Department to review its audit policies to determine if there are ways to reduce the burdens on plan administrators and complete audits in a timely manner. 

PENSION BENEFIT GUARANTY CORPORATION

The Committee includes an obligation limitation for administra- tive expenses of $424,417,000 for the Pension Benefit Guaranty 

Corporation (PBGC). The limitation is $95,089,000 less than the 

fiscal year 2017 enacted level and $98,500,000 less than the fiscal 

year 2018 budget request. The recommendation includes bill language that defines PBGC’s discretionary authority to incur additional unforeseen and emergency administrative expenses related 

to its multiemployer plan insurance program. Congress established 

the PBGC to insure the defined-benefit pension plans of working 

Americans. 

The Committee recommendation does not include $98,500,000 for 

expenses related to the relocation of headquarters space, which was 

provided in the Consolidated Appropriations Act, 2017. The Committee expects the fiscal year 2019 budget request for PBGC to return to its base funding needs and that the consolidation of headquarters space will result in lower operating costs for PBGC in the 

future. 

The Committee directs PBGC to submit a report to the Committees on Appropriations of the House of Representatives and the 

Senate within 180 days of enactment of this Act that includes an 

evidence-based review and assessment of the Smaller Asset Manager Pilot Program. The report should include performance comparisons of pilot participants and non-pilot PBGC asset managers, 

12 

after fees, relative to their portfolio benchmarks, and should identify best practices and lessons learned that could be applied at 

PBGC and other Federal pension and retirement benefit systems. 

The Committee directs PBGC to submit reports required by the 

Employee Retirement Income Security Act of 1974 and the Pension 

Protection Act of 2006. 

WAGE AND HOUR DIVISION

SALARIES AND EXPENSES

The Committee recommends $217,500,000 for the Wage and Hour Division (WHD), which is $10,000,000 less than the fiscal 

year 2017 enacted level and $12,568,000 less than the fiscal year 

2018 budget request. 

The WHD enforces Federal minimum wage, overtime pay, recordkeeping, and child labor requirements of the Fair Labor Standards 

Act. WHD also has enforcement and other administrative responsibilities related to the Migrant and Seasonal Agricultural Worker 

Protection Act, the Employee Polygraph Protection Act, the Family 

and Medical Leave Act, the Davis Bacon Act and the Service Contract Act. 

The Committee continues to be concerned that the Establishing 

a Minimum Wage for Contractors regulation published by the Department of Labor in the Federal Register on October 7, 2014 (79 

Fed. Reg. 60634 et seq.) disproportionately affects entities operating seasonal recreational services and equipment rental to the 

general public on Federal property or lands. 

OFFICE OF LABOR-MANAGEMENT STANDARDS

SALARIES AND EXPENSES

The Committee recommends $41,129,000 for the Office of LaborManagement Standards (OLMS), which is $2,942,000 more than 

the fiscal year 2017 enacted level and $5,505,000 less than the fiscal year 2018 budget request. The recommendation does not include funding for the proposed Electronic Labor Organization Reporting System (e.LORS) modernization project. 

OLMS administers the Labor-Management Reporting and Disclosure Act, which establishes safeguards for union democracy and 

union financial integrity, and requires public disclosure reporting 

by unions, union officers, employees of unions, labor relations consultants, employers, and surety companies. 

OFFICE OF FEDERAL CONTRACT COMPLIANCE PROGRAMS

SALARIES AND EXPENSES

The Committee recommends $94,500,000 for the Office of Federal 

Contract Compliance Programs (OFCCP), which is $9,976,000 less 

than the fiscal year 2017 enacted level and $6,500,000 more than 

the fiscal year 2018 budget request. The OFCCP ensures equal employment opportunity in the Federal contracting community 

through enforcement, regulatory work, outreach and education to 

workers and their advocates. 

In September 2016, GAO issued a report entitled, ‘‘Equal Employment Opportunity: Strengthening Oversight Could Improve 

13 

Federal Contractor Nondiscrimination Compliance’’ (GAO–16–750). 

In the report GAO found, among other things, that OFCCP does 

not have reasonable assurance that the methods used for selecting 

contractors for compliance reviews effectively target contractors 

that pose the greatest risk of non-compliance, that compliance assistance activities have declined by 30 percent since 2012 ‘‘as the 

agency refocused its activities on enforcement,’’ and that ‘‘many 

contractors told GAO they do not feel comfortable contacting 

OFCCP for assistance and hire third party support to help comply 

with federal nondiscrimination and affirmative action requirements.’’ 

The Committee has raised concerns with these issues in recent 

years and appreciates that the Department agreed with the six recommendations GAO made in its report. The Committee directs 

OFCCP to submit a report to the Committees on Appropriations of 

the House of Representatives and the Senate within 160 days of 

enactment of this Act on its efforts and the status of implementing 

each of the GAO recommendations. 

OFFICE OF WORKERS’ COMPENSATION PROGRAMS

SALARIES AND EXPENSES

The Committee recommends $116,550,000 for the Office of Workers’ Compensation Programs (OWCP), which is $1,051,000 less 

than the fiscal year 2017 enacted level and $1,268,000 more than 

the fiscal year 2018 budget request. The recommendation includes 

$114,377,000 in General Funds from the Treasury and the authority to expend $2,173,000 from the Special Fund established by the 

Longshore and Harbor Workers’ Compensation Act. 

The OWCP administers the Federal Employees’ Compensation 

Act, the Longshore and Harbor Workers’ Compensation Act, the 

Energy Employees Occupational Illness Compensation Program 

Act, and the Black Lung Benefits Act. These programs provide eligible injured and disabled workers and their survivors with compensation, medical benefits, and services including rehabilitation, 

supervision of medical care, and technical and advisory counseling. 

The Committee supports the efforts of OWCP to reduce fraud 

and abuse related to the prescription of compound pharmaceuticals 

and opioids. 

The Committee remains concerned about backlogs of claims in 

OWCP programs. The Committee directs OWCP to implement policies and consider other ways in which processing times can be 

brought more closely into alignment with agency goals. 

SPECIAL BENEFITS

(INCLUDING TRANSFER OF FUNDS)

The Committee recommends $220,000,000 for Special Benefits, 

which is the same as the fiscal year 2017 enacted level and the fiscal year 2018 budget request. These funds provide mandatory benefits under the Federal Employees’ Compensation Act. 

SPECIAL BENEFITS FOR DISABLED COAL MINERS

The Committee recommends $54,319,000 for Special Benefits for 

Disabled Coal Miners. This amount is in addition to the 

14 

$16,000,000 appropriated in fiscal year 2017 as an advance for the 

first quarter of fiscal year 2018. The total program level recommendation is $70,319,000, which is $10,000,000 less than the 

fiscal year 2017 enacted level and the same as the fiscal year 2018 

budget request. 

These funds provide mandatory benefits to coal miners disabled 

by black lung disease, to their survivors and eligible dependents, 

and for necessary administrative costs. The Committee recommendation also provides $15,000,000 as an advance appropriation for the first quarter of fiscal year 2019. These funds ensure 

uninterrupted payments to beneficiaries. 

ADMINISTRATIVE EXPENSES, ENERGY EMPLOYEES OCCUPATIONAL

ILLNESS COMPENSATION FUND

The Committee recommends $59,846,000 for the Energy Employees Occupational Illness Compensation Program, which is the same 

as the fiscal year 2017 enacted level and the fiscal year 2018 budget request. 

These funds provide mandatory benefits to eligible employees or 

survivors of employees of the Department of Energy (DOE); its contractors and subcontractors; companies that provided beryllium to 

DOE; atomic weapons employees who suffer from a radiationrelated cancer, beryllium-related disease, or chronic silicosis as a 

result of their work in producing or testing nuclear weapons; and 

uranium workers covered under the Radiation Exposure Compensation Act. 

BLACK LUNG DISABILITY TRUST FUND

(INCLUDING TRANSFER OF FUNDS)

The Committee recommends such sums as necessary for payment 

of benefits and interest on advances for the Black Lung Disability 

Trust Fund. The Committee recommends $414,806,000 for the 

Black Lung Disability Trust Fund, which is $42,121,000 more than 

the fiscal year 2017 enacted level and the same as the fiscal year 

2018 budget request. 

The Black Lung Disability Trust Fund pays black lung compensation, medical and survivor benefits, and administrative expenses when no mine operator can be assigned liability for such 

benefits, or when mine employment ceased prior to 1970. The 

Black Lung Disability Trust Fund is financed by an excise tax on 

coal, reimbursements from responsible mine operators, and shortterm advances from the Treasury. The Emergency Economic Stabilization Act of 2008 authorized a restructuring of the Black Lung 

Disability Trust Fund debt and required that annual operating surpluses be used to pay down the debt until all remaining obligations 

are retired. 

OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION

SALARIES AND EXPENSES

The Committee recommends $531,470,000 for the Occupational 

Safety and Health Administration (OSHA). This recommendation is 

$21,317,000 less than the fiscal year 2017 enacted level and 

15 

$11,787,000 less than the fiscal year 2018 budget request. OSHA 

enforces the Occupational Safety and Health Act of 1970. 

The Committee strongly supports the mission of OSHA to promote a safe and healthy workplace and protect workers from injury, illness, and death. The Committee supports the efforts of 

OSHA to adopt an approach that more effectively balances enforcement with education, training, and compliance assistance. Unfortunately, overreliance on enforcement in recent years has fostered a 

toxic environment between the agency and employers that is undermining the agency’s goals for workplace safety and is at odds 

with Federal policies that support economic growth and job creation. 

Safety and Health Standards.—The Committee recommends 

$18,000,000 for Safety and Health Standards. 

Federal Enforcement.—The Committee recommends $194,250,000 

for Federal Enforcement. 

Whistleblower Programs.—The Committee recommends 

$17,500,000 for Whistleblower Programs. 

State Programs.—The Committee recommends $100,850,000 for 

State Programs. 

Technical Support.—The Committee recommends $24,469,000 for 

Technical Support. 

Compliance Assistance.—The Committee recommends 

$131,851,000 for Federal and State compliance assistance programs. The total includes $72,351,000 for Federal Assistance and 

$59,500,000 for State Consultation Grants. 

Training Grants.—No funding is provided for Training Grants. 

Voluntary Protection Program/Safety and Health Achievement 

Recognition Program.—The Committee supports the Voluntary Protection Program and the Safety and Health Achievement Recognition Program and urges OSHA to expand these vital programs as 

part of a comprehensive strategy realignment that focuses more on 

cooperative safety efforts and less on punitive enforcement. 

Whistleblower Provisions.—The Committee directs OSHA to issue 

whistleblower citations consistent with and not to exceed the authority provided in section 11(c) of the Occupational Safety and 

Health Act. 

Outreach Training Program.—The Committee directs OSHA to 

conduct a fair and open competition for any new or reissued request for proposals for the Outreach Training Program. 

National/Regional/Local Emphasis Programs.—The explanatory 

statement accompanying the fiscal year 2016 Consolidated Appropriations Act directed OSHA to notify the Committee on Appropriations of the House of Representatives and the Senate 10 days prior 

to the announcement of any new National, Regional or Local Emphasis Program including the circumstances and data used to determine the need for the launch of the new program. The Committee directs OSHA to continue to provide such notices in fiscal 

year 2018. 

MINE SAFETY AND HEALTH ADMINISTRATION

SALARIES AND EXPENSES

The Committee recommends $359,975,000 for the Mine Safety 

and Health Administration (MSHA), which is $13,841,000 less than 

16 

the fiscal year 2017 enacted level and $15,197,000 less than the fiscal year 2018 budget request. 

MSHA enforces the Federal Mine Safety and Health Act in underground and surface coalmines and metal/non-metal mines. 

The Committee continues bill language designating up to $2,000,000 for mine rescue recovery activities, and provides for the 

retention of fees up to $2,499,000 for the testing and certification 

of equipment. The Committee includes $10,537,000 for State assistance training grants and provides the authority to use such funds for the 

purchase and maintenance of equipment required by the ‘‘‘Lowering Miners’ Exposure to Respirable Coal Mine Dust, Including 

Continuous Personal Dust Monitors’’ regulation. 

The Committee supports the efforts of MSHA to reemphasize 

compliance assistance programs that help mine operators to improve safety and comply with regulations without the threat of punitive enforcement. 

The Committee appreciates the significant reductions in mining 

injury and illness rates that have been achieved in recent decades 

and remains a strong proponent for vigilant mine safety oversight. 

The Committee notes significant worker dislocations and mine closures as a result of economic conditions throughout the mining industry, and in coal mining in particular. The Committee continues 

to receive reports of inspectors exceeding necessary and appropriate levels of oversight to the point of significantly impeding mining operations. The Committee questions whether this strategy materially improves safety and if the costs outweigh the benefits of 

such additional oversight. The Committee continues to support the 

efforts MSHA has undertaken to realign its resources and capacity 

to match where mining activity is currently occurring. MSHA has 

made progress in recent years but must accelerate the process, including reductions in force if necessary, in order to ensure sufficient industry oversight that meets and does not exceed statutory 

and regulatory requirements. 

The Committee continues to support advances MSHA has made 

in mine rescue technology and communications. The Committee directs MSHA to assess its current mine rescue deployment capability and strategy and discuss ongoing operational and resource 

needs in the fiscal year 2019 Congressional Justification. 

BUREAU OF LABOR STATISTICS

SALARIES AND EXPENSES

The Committee recommends $609,000,000 for the Bureau of 

Labor Statistics (BLS), which is the same as the fiscal year 2017 

enacted level and $1,158,000 more than the fiscal year 2018 budget 

request. The recommendation includes $544,000,000 from the General Fund of the Treasury and $65,000,000 from the Employment 

Security Administration Account in the Unemployment Trust 

Fund. 

BLS is an independent national statistical agency that collects, 

processes, analyzes, and disseminates essential economic data to 

the Congress, Federal agencies, State and local governments, businesses, and the public. Its principal surveys include the Consumer 

Price Index and the monthly unemployment series. 

17 

Employment and Unemployment Statistics.—The Committee recommends $203,878,000 for Employment and Unemployment Statistics. 

Labor Market Information.—The Committee recommends 

$65,000,000 for Labor Market Information. 

Prices and Cost of Living.—The Committee recommends 

$211,444,000 for Prices and Cost of Living. 

Compensation and Working Conditions.—The Committee recommends $82,880,000 for Compensation and Working Conditions. 

Productivity and Technology.—The Committee recommends 

$10,798,000 for Productivity and Technology. 

Executive Direction and Staff Services.—The Committee recommends $35,000,000 for Executive Direction and Staff Services. 

OFFICE OF DISABILITY EMPLOYMENT POLICY

SALARIES AND EXPENSES

The Committee recommends $36,800,000 for the Office of Disability Employment Policy (ODEP), which is $1,403,000 less than 

the fiscal year 2017 enacted level and $9,597,000 more than the fiscal year 2018 budget request. ODEP provides policy guidance and 

leadership to eliminate employment barriers to people with disabilities. 

DEPARTMENTAL MANAGEMENT

SALARIES AND EXPENSES

(INCLUDING TRANSFER OF FUNDS)

The Committee recommends $272,847,000 for Departmental 

Management, which is $61,997,000 less than the fiscal year 2017 

enacted level and $12,989,000 more than the fiscal year 2017 budget request. The recommendation includes $272,539,000 from the 

General Fund of the Treasury and $308,000 from the Employment 

Security Administration Account in the Unemployment Trust 

Fund. The Departmental Management appropriation provides 

funds for the staff responsible for Departmental operations, management, and policy development. 

Program Direction and Support.—The Committee recommends 

$30,250,000 for Program Direction and Support. 

Departmental Program Evaluation.—The Committee recommends $8,040,000 for Departmental Program Evaluation. 

Legal Services.—The Committee recommends $122,445,000 for 

Legal Services. 

International Labor Affairs.—The Committee recommends 

$26,500,000 for International Labor Affairs (ILAB). The recommendation provides no funding for ILAB grants as requested in 

the fiscal year 2018 budget request and returns ILAB to its original mission of research, advocacy, and technical assistance. 

Administration and Management.—The Committee recommends 

$23,496,000 for Administration and Management. 

Adjudication.—The Committee recommends $33,561,000 for Adjudication. 

Women’s Bureau.—The Committee recommends $11,466,000 for 

the Women’s Bureau. 

18 

Civil Rights Activities.—The Committee recommends $6,867,000 

for Civil Rights Activities. 

Chief Financial Officer.—The Committee recommends $9,914,000 

for the Chief Financial Officer. 

The Committee directs the Department to submit its annual Operating Plan to the Committees on Appropriations of the House of 

Representatives and the Senate within the 45-day statutory deadline. 

VETERANS EMPLOYMENT AND TRAINING

The Committee recommends $284,051,000 for the Veterans Employment and Training (VETS) program, which is $5,010,000 more 

than the fiscal year 2017 enacted level and $4,456,000 more than 

the fiscal year 2018 budget request. The recommendation includes 

$47,537,000 from the General Fund of the Treasury and 

$236,514,000 from the Employment Security Administration Account in the Unemployment Trust Fund. 

The VETS program serves America’s veterans and separating 

service members by preparing them for meaningful careers, providing employment resources and expertise, and protecting their 

employment rights. 

The Committee continues to support the VETS program and encourages the Department to pursue opportunities to cooperation 

with other Federal, State and private enterprises to help the country better serve its veterans. 

The Committee includes funding for the initiation of the HIRE 

Vets Medallion Program authorized by the Honoring Investments 

in Recruiting and Employing American Military Veterans Act of 

2017. 

State Grants.—The Committee recommends $175,000,000 for 

State Grants. 

Transition Assistance Program.—The Committee recommends 

$16,073,000 for the Transition Assistance Program. 

Homeless Veterans’ Reintegration Program.—The Committee recommends $47,537,000 for the Homeless Veterans’ Reintegration 

Program. 

Federal Administration.—The Committee recommends 

$42,027,000 for Federal Administration. 

National Veterans’ Employment and Training Service Institute.— The Committee recommends $3,414,000 for the National Veterans’ 

Employment and Training Institute. 

INFORMATION TECHNOLOGY MODERNIZATION

The Committee recommends $20,769,000 for Information Technology (IT) Modernization, which is $1,991,000 more than the fiscal 

year 2017 enacted level and $8,953,000 less than the fiscal year 

2018 budget request. 

The Committee directs the Department to establish a multi-year 

IT modernization plan consistent with the Department’s capacity to 

oversee effectively projects, within available appropriations, and to 

propose the plan and required funding in the fiscal year 2019 Congressional Justification. 

The Committee directs the Department to assign a qualified 

project manager that is a full-time employee of the Department to 

each modernization project to ensure the all IT modernization 

19 

projects are executed effectively, according to Departmental requirements, on time, and within budget. 

OFFICE OF INSPECTOR GENERAL

The Committee recommends $89,147,000 for the Department of 

Labor Office of Inspector General (DOL–OIG), which is $1,426,000 

more than the fiscal year 2017 enacted level and $3,011,000 more 

than the fiscal year 2018 budget request. The recommendation includes $83,487,000 from the General Fund of the Treasury and 

$5,660,000 from the Employment Security Administration Account 

in the Unemployment Trust Fund. 

The DOL–OIG conducts audits of Department programs and operations in order to determine that they comply with the applicable 

laws and regulations, that they use resources effectively, and that 

they are achieving their intended results. 

The Committee supports the DOL–OIG efforts to reduce improper payments in the UI program, and to reduce fraud and abuse 

in the Workers’ Compensation programs related to the prescription 

of compound pharmaceuticals and opioids. 

GENERAL PROVISIONS

Sec. 101. The Committee continues a provision to prohibit the 

use of Job Corps funds for the salary of an individual at a rate in 

excess of Executive Level II. 

(TRANSFER OF FUNDS)

Sec. 102. The Committee continues a provision providing the Secretary of Labor with the authority to transfer up to one percent of 

discretionary funds between appropriations, provided that no appropriation is increased by more than three percent by any such 

transfer. 

Sec. 103. The Committee continues a prohibition on use of funds 

to purchase goods that are in any part produced by indentured children. 

Sec. 104. The Committee continues a provision related to grants 

made from funds available to the Department under the American 

Competitiveness and Workforce Improvement Act. 

Sec. 105. The Committee continues a provision to prohibit recipients of funds provided to the Employment and Training Administration from using such funds for the compensation of any individual at a rate in excess of Executive Level II. 

(TRANSFER OF FUNDS)

Sec. 106. The Committee continues a provision providing the Secretary of Labor with the authority to transfer funds made available 

to the Employment and Training Administration to Program Administration for technical assistance and program integrity activities. 

(TRANSFER OF FUNDS)

Sec. 107. The Committee continues a provision allowing up to 

0.75 percent of discretionary appropriations provided in this Act for 

specific Department of Labor agencies to be used by the Office of 

20 

the Chief Evaluation Officer for evaluation purposes consistent 

with the terms and conditions in this Act applicable to such office. 

Sec. 108. The Committee continues a provision relating to section 

147 of the WIOA authorizing competitive procurement of certain 

Job Corps Civilian Conservation Centers. 

Sec. 109. The Committee continues a provision relating to the 

Fair Labor Standards Act and certain insurance personnel conducting post-disaster activity. 

(RESCISSION)

Sec. 110. The Committee continues a provision rescinding advance appropriations in the Dislocated Workers’ National Reserve 

account. 

Sec. 111. The Committee continues a provision relating to flexibility of H–2B nonimmigrant crossings. 

Sec. 112. The Committee continues a provision relating to wage 

determinations in the H–2B program. 

Sec. 113. The Committee continues a provision relating to the administration of the H–2B program. 

Sec. 114. The Committee includes a new provision relating to the 

definition of the term ‘‘fiduciary.’’ 

TITLE II—DEPARTMENT OF HEALTH AND HUMAN 

SERVICES 

HEALTH RESOURCES AND SERVICES ADMINISTRATION

The Committee recommends $5,815,727,000 for health resources 

and services programs, which is $397,620,000 below the fiscal year 

2017 enacted level and $276,893,000 above the fiscal year 2018 

budget request. The Health Resources and Services Administration 

(HRSA) supports programs that provide health services to disadvantaged, medically underserved, and special populations; decrease infant mortality rates; assist in the education of health professionals; and provide technical assistance regarding the utilization of health resources and facilities. 

PRIMARY HEALTH CARE

Health Centers 

The Committee recommends $1,491,422,000 for the Health Centers program, which is $900,000 above the fiscal year 2017 enacted 

level and $2,835,000 above the fiscal year 2018 budget request. 

The Committee includes bill language providing up to $99,893,000 for the Federal Tort Claims Act program, which is the 

same as the fiscal year 2017 enacted level and $190,000 above the 

fiscal year 2018 budget request. The program provides medical 

malpractice liability protection to Federally supported health centers. 

The Committee requests HRSA include an update in the fiscal 

year 2019 Congressional justification on the agency’s efforts to implement the recommendations described in GAO Report (GAO–12– 

546) Health Center Program: Improved Oversight Needed to Ensure Grantee Compliance with Requirements. 

In addition, the Committee allocates not less than $15,000,000 

for the establishment of a Health Center Audit, Compliance, and 

21 

Oversight Office within the Bureau of Primary Health Care. The 

Committee expects the office to perform periodic audits and compliance reviews of all health center access points, with a goal of conducting a compliance or audit review for every access point location 

every five years. The office shall oversee Federally Qualified Health 

Centers, Health Center Program Look-Alikes, and Health Centers 

receiving a grant under section 330 of the Public Health Service 

Act. The office should provide uniform guidance to health center 

project officers, monitor project officer adherence to program guidance, and periodically assess whether program guidance is meeting 

program objectives. The office will also conduct independent compliance reviews, ensuring all health center access points have policies, procedures, and training to comply with applicable Federal 

laws. The office shall submit quarterly reports to the Committees 

on Appropriations of the House of Representatives and the Senate 

containing the results of all audits and compliance reviews of 

health center access points and oversight of health center project 

officers. The Committees directs HRSA to provide a briefing within 

45 days of enactment of this Act on efforts to establish this office. 

Tuberculosis.—The Committee supports the coordination between 

health centers and State and local Tuberculosis (TB) control programs to help ensure appropriate identification, treatment, and 

prevention of TB among target populations. The Committee encourages HRSA to continue to implement the recommendations of the 

Tuberculosis Action Plan and recommends that the agency include 

an update of its progress in the fiscal year 2019 Congressional Justification. 

Free Clinics Medical Malpractice 

The Committee recommends $100,000 for carrying out responsibilities under the Federal Tort Claims Act. This amount is 

$900,000 below the fiscal year 2017 enacted level and the same as 

the fiscal year 2018 budget request. The program provides medical 

malpractice coverage to individuals involved in the operation of free 

clinics in order to expand access to health care services to low-income individuals in medically underserved areas. A free clinic must 

apply, consistent with the provisions applicable to community 

health centers, to have those individuals ‘‘deemed’’ an employee of 

the Public Health Service, and therefore eligible for coverage. 

HEALTH WORKFORCE

Health Professions 

The Committee recommends $748,236,000 for the Health Professions programs, which is $90,459,000 below the fiscal year 2017 enacted level and $365,605,000 above the fiscal year 2018 budget request. The Health Professions programs support grants for the development of the health workforce in fields challenged by a high 

need and insufficient supply of health professionals. Given that colleges and universities serve the dual role of training students and 

carrying out a majority of Federally-funded biomedical research, 

the Committee believes that they serve as an ideal setting to expose future clinicians to the evidence base that underlies their intended profession. 

22 

Within the total for Health Professions, the Committee recommends the following amounts: 

Budget Activity FY 2018 Committee 

Health Professions Training for Diversity 

Centers of Excellence ............................................................................................................................ $9,711,000 

Faculty Loan Repayment ....................................................................................................................... 1,190,000 

Scholarships for Disadvantaged Students ............................................................................................ 45,970,000 

Workforce Information and Analysis .............................................................................................................. 4,663,000 

Primary Care Training and Enhancement ...................................................................................................... 38,924,000 

Oral Health Training Programs ...................................................................................................................... 36,673,000 

Interdisciplinary, Community-based Linkages 

Area Health Education Centers ............................................................................................................. 30,250,000 

Geriatric Programs ................................................................................................................................ 34,737,000 

Mental and Behavioral Health .............................................................................................................. 9,916,000 

Behavioral Health Workforce Education and Training .......................................................................... 25,000,000 

NURSE Corps Scholarship and Loan Repayment ........................................................................................... 83,135,000 

Nursing Workforce Development ..................................................................................................................... 128,067,000 

Training for Diversity 

Centers of Excellence.—The Committee directs HRSA to provide 

continuation grants for activities authorized under section 736 of 

the Public Health Service Act. 

Primary Care Training and Enhancement 

Interprofessional Education.—The Committee is aware of the 

growing recognition that interprofessional clinical health programs 

represent the state of the art in health care. The Committee believes interprofessional clinical care teams that include physicians 

and physician assistants and other disciplines (such as nurses, oral 

health practitioners, behavioral health professionals, and allied 

health providers) can achieve better care, better population health, 

and lower costs. Further, the Committee shares HRSA’s belief that 

health organizations and professionals should be trained for a contemporary practice environment focused on new and more efficient 

models of care that include interprofessional and team-based care. 

The Committee also believes that implementation of interprofessional practice requires health students and faculty, as well as staff 

at the clinic site, be prepared effectively to work side-by-side. In 

carrying out the various workforce programs authorized by Title 

VII and VIII of the Public Health Service Act, including the Primary Care Training and Enhancement Program, the Committee 

supports efforts by the Bureau of Health Workforce to include 

interprofessional education as a component in funding announcements, particularly with respect to programs that address student 

and faculty learning as well as clinical site readiness. 

Integration of Primary Care and Oral Health Practice.—The 

Committee is aware that a number of medications (prescription 

drugs, over the counter drugs, and vitamins and minerals) can affect oral health. Many medications used to treat chronic diseases 

have adverse effects on oral health that patients and/or providers 

might not be aware of. The most common side effect is dry mouth, 

which can be brought on by more than 400 different prescription 

medications. Dry mouth raises the risk of tooth decay and gum disease. The Committee encourages HRSA to address the impact of 

medication on oral health as part of its ongoing efforts to promote 

oral health and primary care integration across the patient lifeVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00022 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
23 

span, additional focus would feature diabetic patients as a population of interest for primary care integration. 

Rare Diseases.—The Committee encourages HRSA to examine 

programs to increase primary care physician’s preparedness in the 

diagnosis of rare diseases. 

Oral Health Training 

The Committee recommends $36,673,000 for Oral Health Training programs, which is the same as the fiscal year 2017 enacted 

level and $36,673,000 above the fiscal year 2018 budget request. 

These programs serve to increase the number of medical graduates 

from minority and disadvantaged backgrounds and to encourage 

students and residents to choose primary care fields and practice 

in underserved urban and rural areas. 

Within the funds provided, the Committee includes not less than $10,000,000 for General Dentistry Programs and not less than 

$10,000,000 for Pediatric Dentistry programs. The Committee directs HRSA to provide continuation funding for pre-doctoral and 

postdoctoral training grants initially awarded in fiscal year 2015. 

Within the funds provided, the Committee provides not less than $1,675,000 for the Dental Faculty Loan Repayment program authorized by section 748 of the Public Health Service Act. The Committee directs HRSA to provide continuation funding for grants initially awarded in fiscal years 2016 and 2017. 

Area Health Education Centers 

The Committee strongly supports Area Health Education Centers 

(AHEC) oral health projects that establish primary points of service 

and address the need to help patients find treatment outside of 

hospital emergency rooms. The Committee is aware that some 

State dental associations have already initiated programs to refer 

emergency room patients to dental networks. HRSA is encouraged 

to work with these programs. 

The Committee is pleased with the national work of the AHEC 

program, which has worked to educate primary care health providers on emerging public health needs. The Committee encourages 

HRSA to engage additional Federal partners, external stakeholders, including current and former grantees of the program, to 

determine how the AHEC network can be used to continually educate primary care health professionals, especially concerning infectious diseases. 

Mental and Behavioral Health 

The Committee recommendation includes $8,916,000 for the 

interprofessional Graduate Psychology Education (GPE) Program 

to increase the number of health service psychologists trained to 

provide integrated services to high-need, underserved populations 

in rural and urban communities. Recognizing the growing need for 

highly trained mental and behavioral health professionals to deliver evidence-based services to the rapidly aging population, the 

Committee encourages HRSA to invest in geropsychology training 

programs and to help integrate health service psychology trainees 

at Federally Qualified Health Centers. The GPE program is dedicated to the education and training of doctoral-level psychologists 

to provide supervised behavioral, mental health services to underVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00023 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
24 

served populations, including older adults, children, the chronically 

ill, and veterans. HRSA should build on recent efforts to expand 

training to increase mental, behavioral health services for returning service members, veterans, and their families, with an emphasis on veterans reintegrating into rural civilian communities. 

Behavioral Health Workforce Education and Training 

The Committee recommends $25,000,000 for the Behavioral 

Health Workforce Education and Training Grant Program. Eligible 

entities for this program shall include accredited programs that 

train Master’s level social workers, psychologists, counselors, marriage and family therapists, psychology doctoral interns, as well as 

behavioral health paraprofessionals. The Committee directs HRSA 

to share information concerning pending grant opportunity announcements with State licensing organizations and all the relevant professional associations. 

Nursing Workforce Development 

The Committee recognizes the need for a highly educated nursing workforce to reflect the diversity of the populations it serves. 

The recruitment of culturally and economically diverse individuals 

positively impacts the classroom and professional practice environments. Exposure to other viewpoints and perspectives serves to advance collaboration that will translate into improved care delivery. 

The Title VIII Nursing Workforce Development Programs directly 

bolster this effort by supporting students from diverse and underrepresented backgrounds in the nursing profession through recruitment and retention efforts. For example, in Academic Year 2014– 

2015, the Title VIII Nursing Workforce Diversity (NWD) Grants 

program supported 13,225 students and aspiring students, 

partnering with over 900 clinical training sites. Of these sites, 42 

percent were located in medically-underserved areas. Title VIII 

programs like NWD offer a two-fold benefit: not only are the direct 

recipients provided financial assistance, but they also connect these 

clinicians with communities that vary in socioeconomic, racial/ethnic, and geographic backgrounds some that experience higher rates 

of health disparities. The Committee requests HRSA include in the 

fiscal year 2019 Congressional Justification information on the impact of Title VIII programs on workforce diversity. 

The Committee is aware of provider shortages and recognizes 

that training postgraduate Nurse Practitioners in Federally Qualified Health Centers could address aspects of the primary care provider shortage. The Committee supports efforts to train Nurse 

Practitioners on a model of care consistent with both Institute of 

Medicine principles and the needs of vulnerable populations. The 

Committee believes a focus of the program should be training in 

the integration of primary care and behavioral health, since mental 

health issues and opioid and other illegal drug addiction remain 

healthcare priorities. 

Children’s Hospitals Graduate Medical Education 

The Committee recommends $300,000,000 for the Children’s Hospitals Graduate Medical Education Payment program, which is the 

same as the fiscal year 2017 enacted level and $5,000,000 more 

than the fiscal year 2018 budget request. The Children’s Hospitals 

25 

Graduate Medical Education Payment program helps eligible hospitals maintain graduate medical education programs, which support the training of residents to care for the pediatric population 

and enhance the supply of primary care and pediatric medical and 

surgical subspecialties. 

National Practitioner Data Bank 

The Committee assumes $18,000,000 for the National Practitioner Data Bank, which is $814,000 below the fiscal year 2017 enacted level and the same as the fiscal year 2018 budget request. 

The Committee recommendation and the fiscal year 2018 budget 

request assume that the data bank will be self-supporting. The 

Committee continues to include bill language to ensure that user 

fee collections cover the full costs of data bank operations. 

MATERNAL AND CHILD HEALTH

Maternal and Child Health Block Grant 

The Committee recommends $641,700,000 for the Maternal and 

Child Health (MCH) Block Grant, which is the same as the fiscal 

year 2017 enacted level and $25,287,000 below the fiscal year 2018 

budget request. States use the block grant to improve access to 

care for mothers, children, and their families; reduce infant mortality; provide pre- and post-natal care; support screening and 

health assessments for children; and provide systems of care for 

children with special health care needs. 

Maternal Depression.—The Committee recognizes that over 

400,000 women in the United States suffer from postpartum depression each year. Postpartum depression can affect mother-infant 

bonding and have longer-term effects on the development of children. The Committee supports efforts by HRSA to address the 

needs of mothers and children related to maternal depression. 

Neonatal Abstinence Syndrome Effects on Maternal and Child 

Health.—The Committee is alarmed by the prevalence of Neonatal 

Abstinence Syndrome (NAS) and the resulting health and developmental impacts on children. The Committee requests an update in 

the fiscal year 2019 Congressional Justification on efforts undertaken by HRSA to address NAS. 

Prenatal Screening Working Group.—Patient education materials 

related to non-invasive prenatal screening (NIPS) often lag behind 

fast-moving NIPS technological advancements and fail to reflect 

the most current clinical guidance. To ensure patients and providers are educated about evidence-based practices and their applications, as well as the underlying conditions for which a patient 

may require further diagnostic testing based on screening results, 

the Committee asks the Maternal and Child Health Bureau within 

120 days of enactment of this Act to convene a meeting of Federal 

and public stakeholders representing health care professionals, industry, and patient voices to discuss the purposes and definitions 

of NIPS, the status of research regarding the effectiveness of various practices regarding NIPS, other factors that should be considered in implementing NIPS, provider best practices and guidance, 

and patient and industry needs related to information dissemination and standards for screenings. The goal of such a meeting is for 

stakeholders to establish consensus about next steps for provider 

26 

and patient education. Within 120 days after the meeting, recommended consensus driven activities will be reported from HRSA, 

along with a plan and timeline for implementation of next steps. 

The Committee expects a report outlining consensus recommendations for education of women regarding NIPS, and possible methods/timeline for implementing an education initiative related to 

prenatal screening. In addition, the working group should recommend to the Secretary a process by which materials related to 

specific conditions are created, disseminated, and updated on a routine basis. 

The Committee continues bill language identifying specific 

amounts for Special Projects of Regional and National Significance 

(SPRANS). The Committee provides the following within SPRANS: 

Budget Activity FY 2018 

Committee 

Set-aside for Oral Health ............................................................................................................................... $5,250,000 

Set-aside for Epilepsy .................................................................................................................................... 3,642,000 

Set-aside for Sickle Cell Disease ................................................................................................................... 3,000,000 

Set-aside for Fetal Alcohol Syndrome ............................................................................................................ 477,000 

Set-aside for Oral Health.—The Committee has included 

$250,000 to continue demonstration projects to increase the implementation of integrating oral health and primary care practice. The 

projects should model the core clinical oral health competencies for 

non-dental providers that HRSA published and initially tested in 

its 2014 report, Integration of Oral Health and Primary Care Practice. The Committee expects the Chief Dental Officer to play a key 

role in the design, monitoring, oversight, and implementation of 

these projects. 

Thalassemia.—HRSA has a long history of supporting thalassemia services. The thalassemia program has been instrumental in 

aiding patients with this inherited blood disorder, especially as 

treatments and best practices have evolved over time. The Committee encourages HRSA to reconstitute this program in order to 

ensure the continued improvement of care and treatment options 

for patients with this complex and debilitating blood disorder. 

Maternal and Child Health Programs 

In addition to the Maternal and Child Health Block Grant, the 

Maternal and Child Health Bureau at HRSA supports several programs to improve the health of all mothers, children, and their 

families. These programs support activities that develop systemic 

mechanisms for the prevention and treatment of sickle cell disease; 

provide information and research on and promote screening of autism and other developmental disorders; provide newborn and child 

screening of heritable disorders; provide grants to reduce infant 

mortality and improve perinatal outcomes; fund States to conduct 

newborn hearing screening; and provide grants to improve existing 

emergency medical services. 

Within the total for Maternal and Child Health Programs, the 

Committee recommends the following amounts: 

Budget Activity FY 2018 

Committee 

Sickle Cell Anemia Program ........................................................................................................................... $4,455,000 

Autism and Other Developmental Disorders .................................................................................................. 47,099,000 

27 

Budget Activity FY 2018 

Committee 

Heritable Disorders ......................................................................................................................................... 13,883,000 

Healthy Start .................................................................................................................................................. 103,500,000 

Universal Newborn Hearing ............................................................................................................................ 17,818,000 

Emergency Medical Services for Children ...................................................................................................... 20,162,000 

Birthplace and Seamless Systems for Transfer of Care.—The 

Committee continues to note the rising rates for out of hospital 

births in the United States, and the subsequent importance of collaboration within an integrated maternity care system in order to 

achieve optimal mother-baby outcomes. The Committee believes 

that all women and families planning a home or birth center birth 

have a right to respectful, safe, and seamless consultation, referral, 

transport and transfer of care when necessary. The Committee encourages HRSA to work with its partners, including National organizations representing professionals who attend home, birthing 

center, and hospital births, to develop a strategy for facilitating ongoing inter-professional dialogue and cooperation and universal 

adoption of the Best Practice Guidelines for Transfer from Planned 

Home Birth to Hospital. The goal of this effort should be to achieve 

optimal mother-baby outcomes in all settings and with all providers. The Committee requests HRSA include information on this 

effort in the fiscal year 2019 Congressional Justification. 

Breastfeeding Support and Safe Sleep Promotion.—The Committee is aware that 49 jurisdictions have selected the Title V National Performance Measure 4 on Breastfeeding and encourages 

HRSA to ensure incorporation and coordination of breastfeeding 

support within and among the Title V Maternal and Child Health 

Block Grant, the Healthy Start program, and the Maternal, Infant 

and Early Childhood Home Visiting Program. The Committee further encourages the integration of breastfeeding support and safe 

sleep promotion activities within these programs. 

Vision.—One out of four children in the United States have some 

form of low vision and at least four million schoolchildren start the 

school year not being able to see clearly. Most of these cases of poor 

vision are due to refractive error, a condition that is easily corrected. The Committee supports efforts at HRSA to assist programs 

that identify and provide prescription eyeglasses to children from 

low-income families. 

Autism and Other Developmental Disorders 

The Committee recommends $47,099,000 for Autism and Other 

Developmental Disorders; this funding level is the same as the fiscal year 2017 enacted level and $47,099,000 above the fiscal year 

2018 budget request. These programs seek to improve the health 

and well-being of children and adolescents with autism spectrum 

disorder and other developmental disabilities and to advance best 

practices for the early identification and treatment of autism and 

related developmental disabilities. 

The Committee provides not less than $31,317,485 for the Leadership Education in Neurodevelopmental and Related Disabilities 

(LEND) program to maintain the program’s capacity to train professionals to screen, diagnose, and provide evidence-based interventions to individuals with autism spectrum disorder and other developmental disabilities as authorized by the Autism CARES Act. This 

28 

funding will also enable the LEND network to assist in ongoing developmental monitoring, especially for children exposed to lead and 

other environmental toxins and for infants exposed to the Zika 

virus with its resulting complications. LEND programs provide a 

strong community link to services and support these newest members of the disability community and their families. In addition, the 

funding will allow these programs to develop innovative strategies 

to integrate and enhance existing investments, including translating research findings on interventions, development of guidelines, tools, and systems management approaches for training settings and promotion of life-course considerations, from developmental screening in early childhood, to transition to adulthood 

issues. 

Heritable Disorders 

The Committee provides $13,883,000 for the Heritable Disorders 

program, which is the same as the fiscal year 2017 enacted level 

and $13,883,000 above the fiscal year 2018 budget request. Newborn Screening is a complex public health system that relies on coordinated actions by stakeholders, including clinicians, hospitals, 

parents, labs, and public health professionals. HRSA’s Heritable 

Disorders Program supports a number of activities that strengthen 

this system to ensure infants born in every State receive rapid 

identification, early intervention, and potentially life-saving treatment. 

Pediatric Hospice Care.—The Committee recognizes the importance of pediatric hospice care. The Committee understands the 

unique conditions surrounding pediatric hospice care and grief support for families including the need to support family members, the 

recognition that child death can have more intense and longer 

grieving periods, and the need for development of best practices for 

counseling, support, medication, and other factors impacting the 

end of life experience for children. 

Recommended Uniform Screening Panel.—The Committee encourages HRSA to expand the Heritable Disorders program to support States with the implementation, education, and awareness of 

newborn screening for new conditions recently added to the Recommended Uniform Screening Panel, including Pompe, 

Mucopolysaccharidosis I, and X-linked adrenoleukodystrophy. The 

program will also disseminate National, regional and State education and training resources for parents, families and providers. 

Severe Combined Immune Deficiency.—Within the amount for 

Heritable Disorders, the Committee provides $2,000,000 to continue efforts to support wider implementation, education, and 

awareness of Newborn Screening for Severe Combined Immune Deficiency (SCID). The Committee supports HRSA’s efforts to address 

SCID and encourages the agency to continue the program in its 

current form. 

Healthy Start 

The Committee recommends $103,500,000 for the Healthy Start 

program, which is the same as the fiscal year 2017 enacted level 

and $24,803,000 below the fiscal year 2018 budget request. The 

program provides discretionary grants to communities with high 

29 

rates of infant mortality to support primary and preventive health 

care services for mothers and their infants. 

Within the total for Healthy Start, the Committee directs not less than $1,000,000 for screening and treatment for maternal depression as authorized in section 10005 of the 21st Century Cures 

Act (P.L. 114–255). 

Fetal Infant Mortality Review.—The Fetal Infant Mortality Review (FIMR) program is an important component of many Healthy 

Start and local health department initiatives that provide evidencebased interventions crucial to improving infant health in high-risk 

communities. HRSA is encouraged to continue to support the FIMR 

program with Healthy Start funding while educating Healthy Start 

Programs on the successes of FIMR. 

RYAN WHITE HIV/AIDS PROGRAM

Ryan White HIV/AIDS Program 

The Committee provides $2,318,781,000 for the Ryan White HIV/ 

AIDS program, which is the same as the fiscal year 2017 enacted 

level and $58,773,000 above the fiscal year 2018 budget request. 

The Ryan White HIV/AIDS program funds activities to address 

the care and treatment of persons living with HIV/AIDS who are 

either uninsured or underinsured and need assistance to obtain 

treatment. The program provides grants to States and eligible metropolitan areas to improve the quality, availability, and coordination of health care and support services to include access to HIVrelated medications; grants to service providers for early intervention outpatient services; grants to organizations to provide care to 

HIV infected women, infants, children, and youth; and grants to organizations to support the education and training of health care 

providers. 

Within the total for the Ryan White HIV/AIDS program, the 

Committee provides the following amounts: 

Budget Activity FY 2018 

Committee 

Emergency Assistance .................................................................................................................................... $655,876,000 

Comprehensive Care Programs ...................................................................................................................... 1,315,005,000 

AIDS Drug Assistance Program ...................................................................................................................... 900,313,000 

Early Intervention Program ............................................................................................................................. 201,079,000 

Children, Youth, Women, and Families .......................................................................................................... 75,088,000 

AIDS Dental Services ...................................................................................................................................... 13,122,000 

Education and Training Centers .................................................................................................................... 33,611,000 

Special Projects of National Significance ...................................................................................................... 25,000,000 

HEALTH CARE SYSTEMS

The Committee recommends $100,518,000 for Health Care Sys- tems, which is $3,675,000 below the fiscal year 2017 enacted level 

and $1,167,000 above the fiscal year 2018 budget request. The programs within Health Care Systems support National activities that 

enhance health care delivery in the United States. Activities include maintaining a National system to allocate and distribute 

donor organs to individuals awaiting transplant; building an inventory of cord blood units; maintaining a National system for the recruitment of bone marrow donors; operating the 340B drug discount program; and operating a national toll-free poison control 

hotline. 

30 

Within the total for Health Care Systems, the Committee provides the following amounts: 

Budget Activity FY 2018 

Committee 

Organ Transplantation ................................................................................................................................... $23,549,000 

National Cord Blood Inventory ....................................................................................................................... 12,266,000 

C.W. Bill Young Cell Transplantation Program .............................................................................................. 22,109,000 

Office of Pharmacy Affairs ............................................................................................................................. 10,238,000 

Poison Control Centers ................................................................................................................................... 18,846,000 

National Hansen’s Disease Program .............................................................................................................. 11,653,000 

Hansen’s Payment to Hawaii ......................................................................................................................... 1,857,000 

Organ Transplantation 

Organ Donation Rates.—The Committee remains aware of the insufficient supply of donated organs to meet Nationwide need and 

of the existing variations among local communities in donation 

rates and procurement practices. The Committee directs HRSA to 

develop a comprehensive report with recommendations and initiatives that can be pursued to ensure that local communities adopt 

best practices to increase the supply of donated organs. The recommendations shall place special emphasis on assisting localities 

with low donation and procurement rates. HRSA shall provide this 

report within 120 days of enactment of this Act. 

Organ Distribution Proposal.—The Committee understands that 

the Organ Procurement and Transplantation Network (OPTN) developed the ‘‘Redesigning Liver Distribution’’ proposal and released 

the proposal for public comment in 2016. The Committee recognizes 

that OPTN expects to release for public comment an amended proposal in 2017. The Committee urges HRSA to ensure that any proposals see a robust and transparent public debate on the merits of 

the proposal. Furthermore, the Committee believes that an extended process will allow the transplant community and its stakeholders to assess fully the use of appropriate supply and demand 

metrics and the protection of programs serving rural and underserved communities. The Committee encourages HRSA to ensure 

that liver redistribution proposals go through a transparent process 

and receive support from the transplant community prior to final 

action. 

Costs of Liver Distribution Proposals.—The Committee is aware 

that OPTN is preparing a revised proposal for redesigning the distribution of livers for transplant in the United States. The Committee encourages the proposal to include the scope of financial 

costs associated with the proposal, including estimates of the direct 

and indirect costs imposed on the Federal government, State governments, local governments, and public and private health insurers. 

Positions at Organ Procurement and Transplantation Network.— 

The Committee appreciates the valuable role played by individuals 

in leadership positions and other voting positions at OPTN. The 

Committee expects HRSA to ensure OPTN policymaking committees and subcommittees are selected in a manner that provides 

equal representation with unbiased selection. 

31 

National Cord Blood Inventory 

The Committee recommends $12,266,000 for the National Cord 

Blood Inventory, which is the same as the fiscal year 2017 enacted 

level and $1,021,000 more than the fiscal year 2018 budget request. 

The National Cord Blood Inventory program builds a genetically 

and ethnically diverse inventory of high-quality umbilical cord 

blood for transplantation. 

C.W. Bill Young Cell Transplantation Program 

The Committee recommends $22,109,000 for the C.W. Bill Young 

Cell Transplantation program, which is the same as the fiscal year 

2017 enacted level and $42,000 more than the fiscal year 2018 

budget request. 

The Committee continues to support cell transplantation through 

the use of cord blood, bone marrow, and peripheral blood stem 

cells. The Committee appreciates HRSA’s efforts to increase the diversity of the volunteer registry and the program’s research efforts 

to improve the availability, efficiency, safety, and cost of transplants and the effectiveness of program operations. 

Office of Pharmacy Affairs 

The Committee provides $10,238,000 for the Office of Pharmacy 

Affairs (OPA), which is the same as the fiscal year 2017 enacted 

level and $19,000 above the fiscal year 2018 budget request. The 

Office of Pharmacy Affairs oversees the 340B Drug Pricing Program, which requires drug manufacturers to provide discounts on 

outpatient prescription drugs to certain safety net health care providers. 

The Committee recognizes that the 340B Drug Pricing program 

was designed to help safety net providers maintain, improve, and 

expand patient access to healthcare services generally. Since its enactment in 1992, the 340B program has lowered the cost of outpatient drugs to Government funded health clinics, as well as nonprofit and public hospitals that serve a disproportionate share of 

low-income patients or rural communities. 

The Committee is aware that the 340B statute requires HRSA to 

make 340B ceiling prices available to covered entities through a secure website and continues to be concerned that OPA has failed to 

meet deadlines to complete work on the secure website. The Committee urges OPA to complete the development of a secure website. 

The Committee directs OPA to include an update on the status of 

the secure website in the fiscal year 2019 budget request. 

Poison Control Centers 

The Committee recommends $18,846,000 for Poison Control Centers, which is the same as the fiscal year 2017 enacted level and 

$36,000 above the fiscal year 2018 budget request. The Committee 

recognizes the critical role of this proven National public health 

program and the value of its services to all citizens. In 2015, poison 

control centers managed 2.8 million calls, which is an average of 

approximately 8,000 calls per day. Of these calls, 47 percent related to exposures to children age five and under, and 22 percent 

came from health care facilities. Of the approximate 2.2 million 

poisonings reported in 2015, 67 percent were managed at the site 

of exposure, avoiding unnecessary visits to emergency departments. 

32 

RURAL HEALTH

The Committee recommends $156,060,000 for Rural Health programs, which is the same as the fiscal year 2017 enacted level and 

$81,665,000 more than the fiscal year 2018 budget request. Rural 

Health programs provide funding to improve access, quality, and 

coordination of care in rural communities; for research on rural 

health issues; for technical assistance and recruitment of health 

care providers; for screening activities for individuals affected by 

the mining, transport, and processing of uranium; for the outreach 

and treatment of coal miners and others with occupation-related 

respiratory and pulmonary impairments; and for the expansion of 

telehealth services. 

The Committee requests an update in the fiscal year 2019 Congressional Justification information on the best practices and strategies to attract healthcare practitioners to rural clinics and hospitals in areas with healthcare professional shortages. 

Within the total for Rural Health activities, the Committee provides the following amounts: 

Budget Activity FY 2018 

Committee 

Rural Outreach Programs ............................................................................................................................... $65,500,000 

Rural Health Research ................................................................................................................................... 9,351,000 

Rural Hospital Flexibility Grants .................................................................................................................... 43,609,000 

State Offices of Rural Health ........................................................................................................................ 10,000,000 

Black Lung Clinics ......................................................................................................................................... 7,266,000 

Radiation Exposure Screening and Education ............................................................................................... 1,834,000 

Telehealth ....................................................................................................................................................... 18,500,000 

Radiation Safety.—The Committee supports efforts to ensure information regarding exposure to radiation is up-to-date on all available options to protect surgical/interventional health care personnel 

and patients from radiation exposure. 

Telehealth.—The Committee recognizes the growing importance 

of telehealth in delivering high-quality healthcare to medically underserved communities in both rural and urban areas. The Committee encourages the Secretary to establish a Telehealth Center of 

Excellence to test the efficacy of telehealth services in both urban 

and rural geographic locations. 

FAMILY PLANNING

The Committee does not recommend funding for the Family 

Planning program, which is $286,479,000 below the fiscal year 

2017 enacted level and fiscal year 2018 budget request. The Family 

Planning program administers Title X of the Public Health Service 

Act. 

PROGRAM MANAGEMENT

The Committee recommends $151,993,000 for the cost of Federal 

staff and related activities to coordinate, direct, and manage the 

programs of HRSA, which is $2,007,000 below the fiscal year 2017 

enacted level and the same as the fiscal year 2018 budget request. 

Chief Dental Officer.—The Committee is pleased that HRSA has 

restored the position of Chief Dental Officer (CDO) and looks forward to learning how the agency has ensured that the CDO is 

functioning with executive level authority with resources to oversee 

33 

and lead HRSA oral health programs and initiatives. The Committee would like an update in the fiscal year 2019 Congressional 

Justification on how the CDO is serving as the agency representative on oral health issues to international, National, State, and/or 

local government agencies, universities, and oral health stakeholder organizations. 

VACCINE INJURY COMPENSATION PROGRAM TRUST FUND

The Committee estimates that $268,000,000 will be released 

from the Vaccine Injury Compensation Trust Fund, which is 

$28,000,000 more than the fiscal year 2017 enacted level and the 

same as the fiscal year 2018 budget request. 

The National Vaccine Injury Compensation Program provides a 

system of compensation for individuals with vaccine-associated injuries or deaths. Funds for claims from vaccines administered on 

or after October 1, 1988 are generated by a per-dose excise tax on 

the sale of selected prescribed vaccines. The Vaccine Injury Compensation Trust Fund receives revenues raised by this tax. Trust 

funds made available will support the liability costs of vaccines administered after September 30, 1988. 

The Committee recommends $8,250,000 for administration of the 

program, which is $500,000 more than the fiscal year 2017 enacted 

level and $950,000 less than the fiscal year 2018 budget request. 

CENTERS FOR DISEASE CONTROL AND PREVENTION

The Committee recommends a program level of $7,056,811,000 

for the Centers for Disease Control and Prevention (CDC), which 

is $198,350,000 below the fiscal year 2017 enacted level and 

$1,026,210,000 above the fiscal year 2018 budget request. This 

level includes $6,010,153,000 in discretionary budget authority, 

$55,358,000 in mandatory funds under the terms of the Energy 

Employees Occupational Illness Compensation Program Act 

(EEOICPA), $840,600,000 in transfers from the Prevention and 

Public Health (PPH) Fund, and $150,700,000 in PHS Act section 

241 evaluation set-aside transfers. CDC works with State, local, 

and Tribal health authorities and other non-governmental healthrelated organizations to understand, control, and reduce public 

health problems. 

IMMUNIZATION AND RESPIRATORY DISEASES

The Committee recommends $744,350,000 for Immunization and 

Respiratory Diseases (IRD), which includes $470,700,000 in discretionary budget authority, and $273,650,000 in transfers from the 

PPH Fund. This level is $50,000,000 below the fiscal year 2017 enacted level and $43,522,000 above the fiscal year 2018 budget request level. 

Immunization grants are awarded to States and local agencies 

for planning, developing, and conducting childhood, adolescent, and 

adult immunization programs, including enhancement of the vaccine delivery infrastructure. CDC directly maintains a stockpile of 

vaccines, supports consolidated purchase of vaccines for State and 

local health agencies, and conducts surveillance, investigations, 

and research into the safety and efficacy of new and presently-used 

vaccines. 

34 

Within the total for IRD, the Committee recommends the following amounts: 

Budget Activity FY 2018 

Committee 

Section 317 Immunization Program ............................................................................................................... $556,792,000 

National Immunization Survey .............................................................................................................. 12,864,000 

Influenza Planning and Response ................................................................................................................. 187,558,000 

HIV/AIDS, VIRAL HEPATITIS, SEXUALLY TRANSMITTED DISEASES AND

TUBERCULOSIS PREVENTION

The Committee recommends $1,117,278,000 for HIV/AIDS, Viral 

Hepatitis, Sexually Transmitted Diseases (STD), and Tuberculosis 

(TB) Prevention, which is the same as the fiscal year 2017 enacted 

level and $183,278,000 above the fiscal year 2018 budget request. 

CDC provides National leadership and support for HIV prevention research and the development, implementation, and evaluation 

of evidence-based HIV prevention programs serving persons affected by, or at risk for, HIV infection. Activities include surveillance, epidemiologic and laboratory studies, and prevention activities. CDC provides funds to State, local, and Tribal health departments and community-based organizations to develop and implement integrated community prevention plans. 

Within the total for HIV/AIDS, Viral Hepatitis, STD, and TB 

Prevention, the Committee recommends the following amounts: 

Budget Activity FY 2018 

Committee 

Domestic HIV/AIDS Prevention and Research ................................................................................................ $788,712,000 

HIV Prevention by Health Departments ................................................................................................. 397,161,000 

HIV Surveillance .................................................................................................................................... 119,861,000 

Activities to Improve Program Effectiveness ........................................................................................ 103,208,000 

National, Regional, Local, Community, and Other Organizations ........................................................ 135,401,000 

School Health-HIV .................................................................................................................................. 33,081,000 

Viral Hepatitis ................................................................................................................................................ 34,000,000 

Sexually Transmitted Infections ..................................................................................................................... 152,310,000 

Tuberculosis .................................................................................................................................................... 142,256,000 

Hepatitis B.—The Committee is concerned that even though the 

hepatitis B vaccine is more than 90 percent effective, there are over 

50,000 new hepatitis B virus (HBV) infections each year and more 

than 10 deaths each day due to this disease in the U.S. As a result 

of the opioid epidemic, infection with HBV has spiked in many 

parts of the nation with, for example, acute HBV infections increasing 114 percent from 2006 to 2013 in three states that have suffered from widespread opioid overuse (Kentucky, Tennessee, and 

West Virginia). The Committee notes that the link between HBV 

infection and primary liver cancer is well-established, with up to 60 

percent of global liver cancer cases caused by HBV. Many of these 

liver cancer cases are preventable with early detection of, treatment of, and vaccination for HBV. An innovative public health effort to reduce HBV-related disease burden would move the U.S. 

into a global leadership position likely to benefit U.S. relations 

with countries in Asia, Africa, and other global regions where HBV 

infection and its severe complications are endemic. 

Latent TB Infection.—The Committee notes with concern that 

there are up to 13 million individuals in the U.S. with latent TB 

35 

infection. The diagnosis and treatment of individuals with latent 

TB infection at highest risk of progression to active TB would prevent future cases of this airborne infectious disease. The Committee acknowledges that only by addressing latent TB infection 

can the U.S. achieve TB elimination. The Committee recognizes the 

vital role of CDC’s Division of TB Elimination to address TB and 

urges support to ensure that State and local TB programs have 

adequate resources to effectively identify and treat latent TB infection cases. 

Liver Health.—The Committee commends CDC for its efforts to 

increase national awareness of viral hepatitis B and C, and requests that CDC support liver health and wellness activities in an 

effort to reduce morbidity and mortality for persons infected with 

viral hepatitis who develop liver disease, cirrhosis, liver failure, 

and liver cancer. 

EMERGING AND ZOONOTIC INFECTIOUS DISEASES

The Committee recommends $551,522,000 for Emerging and 

Zoonotic Infectious Diseases (EZID), which includes $499,522,000 

in discretionary appropriations and $52,000,000 in transfers from 

the PPH Fund. This level is $33,400,000 below the fiscal year 2017 

enacted level and $37,522,000 above the fiscal year 2018 budget request. The EZID programs support the prevention and control of 

infectious diseases through surveillance, outbreak investigation 

and response, research, and prevention. 

Within the total for EZID, the Committee recommends the following amounts: 

Budget Activity FY 2018 

Committee 

Core Infectious Diseases ................................................................................................................................ $362,950,000 

Emerging Infectious Diseases ............................................................................................................... 125,000,000 

Lab Safety and Quality ......................................................................................................................... 8,000,000 

Antibiotic Resistance Initiative ............................................................................................................. 163,000,000 

All Other Infectious Diseases ................................................................................................................ 23,840,000 

Vector-borne Diseases ........................................................................................................................... 26,410,000 

Lyme Disease ......................................................................................................................................... 10,700,000 

Prion Disease ......................................................................................................................................... 6,000,000 

Chronic Fatigue Syndrome .................................................................................................................... 0 

Food Safety ..................................................................................................................................................... 54,000,000 

National Health Care Safety Network ............................................................................................................ 21,000,000 

Quarantine ...................................................................................................................................................... 31,572,000 

Advanced Molecular Detection ....................................................................................................................... 30,000,000 

Epidemiology and Laboratory Capacity .......................................................................................................... 40,000,000 

Healthcare-Associated Infections ................................................................................................................... 12,000,000 

Combating Antibiotic-Resistant Bacteria.—The Committee recognizes the importance of addressing antibiotic-resistant bacteria 

through a ‘‘One Health’’ approach, simultaneously combating antibiotic resistance in human, animal, and environmental settings. 

The Committee encourages CDC to develop a national capacity to 

identify and catalog microbial genome sequences, paying attention 

to antibiotic-resistant microbes. CDC is encouraged to continue to 

pursue research opportunities in the area of antimicrobial stewardship in diverse healthcare settings and encourage regional collaborations to study the most effective strategies to improve antibiotic 

prescribing and stewardship. 

36 

Lyme Disease Activities.—Lyme disease can be found in at least 

80 countries around the globe and is endemic in many regions. In 

the U.S., Lyme disease is the most common disease transmitted 

from animals to humans. CDC estimated in 2013 that only 10 percent of Lyme disease cases were being reported annually. The Committee encourages CDC to expand activities related to developing 

sensitive and more accurate diagnostic tools and tests for Lyme disease and evaluating the development of a national reporting system. 

Sepsis.—The Committee encourages CDC to increase its public 

awareness, outreach, and education efforts on sepsis, including 

health provider outreach and other related activities to improve diagnosis and treatment of sepsis. The Committee requests an update in the fiscal year 2019 Congressional Justification on activities 

to improve public awareness of sepsis. 

Tick-Borne Disease Resources and Guide.—The Committee encourages CDC to ensure transparency on its website of its physician education programs regarding Lyme disease, including scientific resources and schedules; to solicit input from the treating 

physician community at large regarding such education programs; 

and to include the broad spectrum of scientific viewpoints. The 

Committee also encourages CDC to provide a written rationale for 

the selection of Lyme and tick-borne disease treatment guidelines 

it displays on its website and to intensify surveillance of Borrelia 

infections in non-endemic/non-high incidence areas. 

Vector-Borne Diseases.—Vector-borne diseases, such as Lyme disease, West Nile Virus, and Zika, have high human consequences 

and are a growing threat to public health. The impacts of these diseases and the effectiveness of programs for surveillance, prevention, and control should be better gauged and understood. Therefore, the Committee directs CDC to include goals and performance 

indicators for each high-priority vector-borne disease in its annual 

Congressional Justification. Additionally, within 90 days of enactment, the Committee directs CDC to submit a report to the Committees on Appropriations of the House of Representatives and the 

Senate, that: (1) Compares funding for high priority vector-borne 

diseases to the burden of disease as defined by Disability Adjusted 

Life Years (DALYs), and (2) Includes estimates for the burden of 

each high-priority vector-borne disease on the U.S. economy, including direct medical costs, indirect medical costs, nonmedical 

costs, and productivity losses. 

Vector Control Guidelines.—The Committee requests that CDC 

maintain an online guide for use by States and local communities 

with a full scope of vector control options, tools, and other factors 

State and local jurisdictions may consider as they develop plans to 

carry out vector control activities to control Zika and other related 

diseases carried by insects. The Committee encourages CDC to update the guidelines annually. 

Zika.—The Committee continues to support CDC’s preparedness 

and response efforts to control outbreaks of Zika virus infection. 

The Committee strongly encourages CDC to invest in innovative 

vector control technologies to enhance current vector-borne disease 

control efforts, including those discussed by the World Health Organization’s Vector Control Advisory Group, which outlines new 

and existing vector control tools for use in response to Zika virus 

37 

outbreaks. The Committee also notes CDC’s report of research from 

Brazil showing that some infants exposed to Zika who were born 

without microcephaly nevertheless did develop it later or developed 

other neurological problems. Therefore, the Committee expects 

CDC to continue to work closely with the vector control unit in 

Puerto Rico and to address not only basic surveillance and research 

but also the use of new approaches to limit the spread of infected 

Aedes Aegypti mosquitoes through innovative vector control technologies which can be effective in environments and locations not 

amenable to traditional pesticides. 

CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION

The Committee recommends $1,041,646,000 for Chronic Disease 

Prevention and Health Promotion (CDPHP), which includes 

$703,696,000 in discretionary appropriations and $337,950,000 in 

transfers from the PPH Fund. This level is $73,950,000 below the 

fiscal year 2017 enacted level and $89,396,000 above the fiscal year 

2018 budget request level. The CDPHP programs provide support 

for State, Tribal, and community programs on surveillance, prevention research, evaluation, and health promotion. 

The Committee recommendation for CDPHP maintains most of 

the existing program line items as they were funded in fiscal year 

2017 and does not provide funding for the America’s Health Block 

Grant proposed in the budget request. Chronic diseases, such as 

Alzheimer’s disease, diabetes, heart disease, and stroke, are the 

leading causes of death and disability in the U.S. and account for 

86 cents of every dollar spent on health care. Many of these conditions are largely preventable through improved nutrition and physical activity. Recent large-scale pilots have shown that as much as 

$2,650 per year per senior can be saved by investing in public 

health programs like the National Diabetes Prevention Program 

and similar studies have shown hospitalizations can be reduced 

and save as much as $945 per year per adult by scaling programs 

that control arthritis pain through evidence-based physical activity 

programs. A robust investment in in the prevention and control of 

chronic diseases is essential to curb health spending and improve 

health and quality of life for millions of Americans, who are at risk 

of, living with, or have survived a chronic condition. 

Within the total provided, the Committee recommends the following amounts: 

Budget Activity FY 2018 Committee 

Tobacco ........................................................................................................................................................... $155,000,000 

Nutrition, Physical Activity, and Obesity ........................................................................................................ 49,920,000 

High Obesity Rate Counties .................................................................................................................. 10,000,000 

School Health ................................................................................................................................................. 15,400,000 

Health Promotion ............................................................................................................................................ 14,025,000 

Glaucoma ............................................................................................................................................... 3,300,000 

Visual Screening Education .................................................................................................................. 525,000 

Alzheimer’s Disease ............................................................................................................................... 3,500,000 

Inflammatory Bowel Disease ................................................................................................................. 750,000 

Interstitial Cystitis ................................................................................................................................. 850,000 

Excessive Alcohol Use ........................................................................................................................... 3,000,000 

Chronic Kidney Disease ......................................................................................................................... 2,100,000 

Prevention Research Centers ......................................................................................................................... 25,461,000 

Heart Disease and Stroke .............................................................................................................................. 136,037,000 

Diabetes .......................................................................................................................................................... 144,129,000 

National Diabetes Prevention Program .......................................................................................................... 25,000,000 

38 

Budget Activity FY 2018 Committee 

Cancer Prevention and Control ...................................................................................................................... 356,674,000 

Breast and Cervical Cancer .................................................................................................................. 210,000,000 

WISEWOMAN .................................................................................................................................. 21,120,000 

Breast Cancer Awareness for Young Women ........................................................................................ 4,960,000 

Cancer Registries .................................................................................................................................. 49,440,000 

Colorectal Cancer .................................................................................................................................. 43,294,00 

Comprehensive Cancer .......................................................................................................................... 19,675,000 

Johanna’s Law ....................................................................................................................................... 5,500,000 

Ovarian Cancer ...................................................................................................................................... 8,000,000 

Prostate Cancer ..................................................................................................................................... 13,205,000 

Skin Cancer ........................................................................................................................................... 2,125,000 

Cancer Survivorship Resource Center ................................................................................................... 475,000 

Oral Health ..................................................................................................................................................... 18,500,000 

Safe Motherhood/Infant Health ...................................................................................................................... 44,000,000 

Preterm Birth ......................................................................................................................................... 2,000,000 

Other Chronic Diseases .................................................................................................................................. 25,500,000 

Arthritis .................................................................................................................................................. 11,000,000 

Epilepsy ................................................................................................................................................. 8,500,000 

National Lupus Patient Registry ........................................................................................................... 6,000,000 

Racial and Ethnic Approaches to Community Health ................................................................................... 0 

Million Hearts ................................................................................................................................................. 4,000,000 

National Early Child Care Collaboratives ...................................................................................................... 4,000,000 

Hospitals Promoting Breastfeeding ................................................................................................................ 8,000,000 

Good Health and Wellness in Indian Country ................................................................................................ 16,000,000 

Chronic Obstructive Pulmonary Disease.—The Committee understands that chronic obstructive pulmonary disease (COPD) is the 

third leading cause of death in the U.S., leading to the death of 

over 145,000 Americans each year. The Committee commends CDC 

for working with the National Heart, Lung, and Blood Institute on 

the development of the National Action Plan for COPD. The Committee expects CDC to implement the public health recommendations identified in the plan. 

Chronic Pain.—According to the Institute of Medicine, 100 million Americans are burdened with chronic pain, which costs the 

U.S. economy more than $560 billion annually in direct healthcare 

costs and lost productivity. Longitudinal comparisons of pain data 

to identify trends, subpopulations at risk, and the health consequences of pain in terms of morbidity, mortality, and disability 

are critical in order to address this issue. The Committee directs 

CDC to collect epidemiological data to clarify the incidence and 

prevalence of various pain syndromes differentiated by patient age, 

comorbidities, socio-economic status, race, and gender. The Committee directs CDC to collect resource utilization data of medical 

and social services; on direct healthcare costs of pain treatment, 

both traditional and alternative; on the effectiveness of evidencebased treatment approaches; and on indirect costs (i.e., missed 

work, public and private disability, reductions in productivity). Finally, the Committee directs CDC to report these pain statistics to 

Congress and publish annually. 

Epilepsy.—Close to three million individuals in the U.S. have 

epilepsy and, while new cases are most common among young children, the onset of epilepsy can occur at any age. The Committee 

encourages CDC to support telehealth and educational training 

programs for rural and under-served areas that reach school 

nurses, childcare personnel, first responders, and care providers for 

seniors, to recognize and respond appropriately to seizures caused 

by epilepsy or result from trauma and other acute chronic illness. 

39 

Good Health and Wellness in Indian Country.—The Committee 

recommendation includes $16,000,000 for awards to Tribes and 

Tribal Organizations to comprehensively address the leading 

causes of death and associated risk factors while incorporating culturally-driven wellness practices under the Good Health and 

Wellness in Indian Country program. The Committee also directs 

CDC to provide funding at not less than the fiscal year 2017 level 

within CDPHP for the Comprehensive Approach to Good Health 

and Wellness in Indian Country cooperative agreement. 

Heart Disease and Stroke Prevention.—Largely preventable, cardiovascular disease, including heart disease and stroke, continues 

to inflict the highest burden on our Nation’s health and economy. 

Yet, effective evidence-based prevention initiatives are not fully implemented and death rates are starting to rise. The Committee increases support for CDC’s heart disease and stroke prevention activities within State, local, and Tribal public health departments, 

and for enhanced surveillance and research to target high-burden 

populations and guide public health strategies. 

Heart Valve Disease.—The Committee understands that heart 

valve disease can be debilitating and if not treated properly can result in heart failure, sudden cardiac arrest, and death. The Committee urges CDC to include information on valve disease on its 

website and to help bring public awareness to this disease. The 

Committee encourages CDC to engage with patient and research 

organizations to explore collaborative ways to integrate information 

about the warning signs, symptoms, and risk factors of valve disease into CDC’s existing programs. 

Inflammatory Bowel Disease.—The Committee commends CDC 

for its commitment to the study of Inflammatory Bowel Disease 

(IBD) epidemiology and is concerned by the results of the recent 

Morbidity and Mortality Weekly Report study ‘‘Prevalence of Inflammatory Bowel Disease Among Adults Aged 18 Years’’, which 

demonstrates that IBD affects 3.3 million Americans, twice as 

many as originally thought. The Committee is particularly concerned that IBD is increasingly recognized in minority and underserved communities, yet there are gaps in our knowledge about 

IBD in these populations. The Committee expects CDC to include 

a focus on these groups in its existing IBD epidemiology study. 

Johanna’s Law.—The Committee strongly encourages CDC to 

take steps to integrate components of the Inside Knowledge Campaign and Know: BRCA, to the extent possible, to ensure coordination of public health messages related to ovarian cancer, leveraging 

of resources, and maximizing economies of scale. 

Million Hearts 2022.—The Committee continues to support Million Hearts 2022 to capitalize on the solid foundation, best practices, evidence, shared tools, and progress made on this public-private initiative to prevent heart attacks and strokes. Funding will 

allow for mobilization of communities and the healthcare sector to 

implement evidence-based interventions to prevent heart disease 

and stroke in areas with the highest burden by implementing the 

ABCS: Aspirin when appropriate, Blood pressure control, Cholesterol management, and Smoking cessation; supporting innovative 

strategies to increase physical activity; using cardiac rehabilitation; 

and developing innovative, scalable approaches to improve cardiovascular health. 

40 

National Early Child Care Collaboratives Program.—The Committee recognizes the importance of the early years and particularly early child care and education settings in promoting healthy 

habits. The Committee is aware that the National Early Child Care 

Collaboratives (NECCC) program has produced statistically significant improvements in adoption of best practices for healthy eating, 

physical activity, reduced screen time, and breastfeeding support. 

The Committee encourages CDC to build on the success of the 

NECCC program to provide training and technical assistance to 

early care and education providers to improve healthy eating and 

physical practices, including testing approaches to strengthen family engagement. Funds support technical assistance to integrate 

healthy eating and physical activity into State and local systems 

initiatives. The Committee encourages the NECCC to service a mix 

of rural, suburban, and urban areas, including areas with high 

childhood obesity rates. 

National Lupus Patient Registry.—The Committee continues to 

support research efforts under the National Lupus Patient Registry 

program and acknowledges that there has been significant progress 

to understand better the epidemiology of lupus. However, the Committee recognizes that challenges still remain and encourages CDC 

to focus on studies related to the natural history and pathogenesis 

of pediatric lupus to understand better the lifetime burden of disease in children and young adults. The Committee also encourages 

the continuing development of lupus self-management programs by 

current lupus registry cohorts and national voluntary health organizations for adults with lupus to improve quality of life and health 

outcomes. 

Oral Health.—The Committee has provided additional funding 

for the Division of Oral Health to continue distributing new waterline safety guidelines to dentist offices and clinics, to conduct follow 

up research where needed, and to work with professional organizations to educate dentists and dental students of such guidelines. 

Outreach to and Study of Obese Populations with Limited 

English Ability.—The Committee is concerned about specific obese 

populations that are overrepresented and medically underserved. 

The Committee encourages CDC to conduct additional outreach to 

and study of these specific populations. CDC is additionally encouraged to work with Hispanic-Serving Institutions and Historically 

Black Colleges and Universities in this effort. 

Ovarian Cancer.—The Committee continues to support the Ovarian Cancer Control Initiative to advance ovarian cancer prevention, 

early detection, risk assessment, and access to care. The Committee 

commends the CDC for its work to evaluate existing risk assessment tools, which can be used to help identify patients with a genetic predisposition to ovarian and other cancers, and identify 

which of these existing tools are valid, reliable, and the most userfriendly for providers and patients. The Committee requests that 

the Secretary of HHS present the findings of this review and provide recommendations with respect to how CDC can support the 

deployment of the tools found to have the greatest value and utility 

in the fiscal year 2019 Congressional Justification. 

Psoriasis and Psoriatic Arthritis.—The Committee recognizes the 

growing body of evidence linking psoriatic disease, which impacts 

more than eight million Americans, to other comorbidities such as 

41 

cardiovascular disease, mental health and substance abuse challenges, kidney disease, and other conditions. The Committee also 

recognizes the low rate of diagnosis of psoriatic arthritis and the 

high percentage of patients with psoriatic disease who do not treat 

or who undertreat their disease. The Committee directs the CDC 

to develop an action plan not later than 180 days after the enactment of this Act as to how it can leverage existing programs and 

resources, including the Prevention Research Centers and projects 

supported by the CDC’s Arthritis program, to build upon the agency’s Public Health Agenda for Psoriasis and Psoriatic Arthritis to 

address diagnosis, treatment and public health self-management 

needs of this patient population. 

Pulmonary Hypertension Program.—The Committee is concerned 

that most Pulmonary Hypertension (PH) patients are not diagnosed until the condition has reached a catastrophic stage, which 

leads to significant disability, greatly increased mortality, and the 

need for costly and dramatic medical interventions, such as heartlung transplantation. Considering the availability of effective 

therapies for early-stage PH, CDC is encouraged to support education, awareness, and epidemiology activities that promote early 

and accurate diagnosis of PH. 

Safe Motherhood and Infant Health.—The Committee continues 

to support activities within this line related to maternal and infant 

health, such as State-Based Perinatal Collaboratives and the Pregnancy Risk Assessment Monitoring System, at the fiscal year 2017 

enacted level. The Committee recommendation does not include 

funding for the teen pregnancy prevention cooperative agreement. 

Type 1 Diabetes and Diabetic Ketoacidosis.—The Committee is 

concerned about the increase in type 1 diabetes and the risk of diabetic ketoacidosis, and encourages the CDC to work with the States 

to educate parents, providers, and schools on this risk. 

BIRTH DEFECTS AND DEVELOPMENTAL DISABILITIES

The Committee recommends $137,560,000 for Birth Defects and 

Developmental Disabilities (NCBDDD), which is the same as the 

fiscal year 2017 enacted level and $37,560,000 above the fiscal year 

2018 budget request. This program supports the prevention of and 

collects, analyzes, and makes available data on the incidence and 

causes of birth defects and developmental disabilities. 

Within the total, the Committee recommends the following 

amounts: 

Budget Activity FY 2018 Committee 

Child Health and Development ...................................................................................................................... $65,800,000 

Birth Defects ................................................................................................................................ 19,000,000 

Fetal Death ................................................................................................................................... 900,000 

Fetal Alcohol Syndrome ................................................................................................................ 11,000,000 

Folic Acid ...................................................................................................................................... 3,150,000 

Infant Health ................................................................................................................................ 8,650,000 

Autism .......................................................................................................................................... 23,100,000 

Health and Development for People with Disabilities ................................................................................... 56,660,000 

Disability & Health incl. Child Development ............................................................................... 24,000,000 

Tourette Syndrome ........................................................................................................................ 2,000,000 

Early Hearing Detection and Intervention .................................................................................... 10,760,000 

Muscular Dystrophy ...................................................................................................................... 6,000,000 

Attention Deficit Hyperactivity Disorder ....................................................................................... 1,900,000 

Fragile X ....................................................................................................................................... 2,000,000 

Spina Bifida ................................................................................................................................. 6,000,000 

42 

Budget Activity FY 2018 Committee 

Congenital Heart Failure .............................................................................................................. 4,000,000 

Blood Disorders .............................................................................................................................................. 15,100,000 

Public Health Approach to Blood Disorders ................................................................................. 4,400,000 

Hemophilia Activities .................................................................................................................... 3,500,000 

Hemophilia Treatment Centers ..................................................................................................... 5,100,000 

Thalassemia Blood Disorders ....................................................................................................... 2,100,000 

Blood Safety Monitoring.—Patients who receive regular blood 

transfusions are at increased risk for transmission of blood-borne 

infectious diseases. Facing an increase in infectious diseases that 

have a known or potential risk of transmission via blood transfusion, patients with thalassemia, anemia, and other diseases that 

impact blood production often face a lack of information about 

transmission modes and rates of infectious diseases, including new 

or emerging viruses like the Zika virus. Given the increased threat 

to patients who are reliant on blood transfusions, and the increased 

prevalence of blood-borne viruses like babesia, the Committee 

urges CDC to provide specific information to assist blood centers in 

responding to emerging infectious diseases that may be transmitted by blood transfusion. 

Congenital Heart Disease.—The Committee commends NCBDDD 

for its leadership in addressing Congenital Heart Disease (CHD) 

and adult CHD surveillance efforts and requests a report in the fiscal year 2019 Congressional Justification on CDC surveillance and 

research efforts regarding CHD across the lifespan, age-specific 

prevalence, and factors associated with those patients who may 

have dropped out of appropriate specialty care. 

Duchenne Muscular Dystrophy.—The Committee expects 

NCBDDD to continue its work to update, evaluate, and disseminate the revised Duchenne care standards; to expand surveillance 

of Duchenne via the MD STARnet, to develop a Duchenne newborn 

screening program; and to support refinement of an International 

Classification of Disease (ICD 10) code for Duchenne and Becker 

Muscular Dystrophy. 

Fragile X and Associated Disorders.—The Committee commends 

CDC’s efforts to identify and define the population impacted by 

Fragile X (FX) and all conditions associated with the gene mutation 

with the goal of understanding the public health impact of these 

conditions. The Committee acknowledges the significant progress 

made by the NCBDDD Fragile X Clinical and Research Consortium 

in growing its FORWARD Database and Patient Registry, and is 

pleased that a new grant was awarded in 2015 to continue and expand upon this important work. The Committee also notes with approval the public-private partnership meeting to set the Public 

Health Research Agenda and the resulting focus on longitudinal 

data to characterize the natural history of Fragile X, to in turn better inform the development of outcome measures and biomarkers 

for new drug treatments under development. The Committee believes even more robust natural history data will lead to improved 

outcome measures and urges increased focus on this effort. Given 

the connections among Fragile X, the FX protein, and autism, the 

prospect of targeted treatments for both conditions, the overlapping 

public health impacts and current budgetary constraints, the Committee urges the NCBDDD to explore cross-divisional funding opVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00042 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
43 

portunities to accelerate data-driven public health research to reduce the public health burdens of both FX and autism. 

Hereditary Hemorrhagic Telangiectasia Pilot.—The Committee 

recommends $100,000 within the Hemophilia Treatment Centers 

line to support the second year of a two-year pilot program that enables up to three existing Federally-funded Hemophilia Treatment 

Centers across the country to serve as specialty centers for the 

evaluation and management of Hereditary Hemorrhagic 

Telangiectasia. 

National Spina Bifida Program.—The Committee recognizes that 

Spina Bifida is the most common permanently disabling birth defect in the U.S. While Spina Bifida and related neural tube defects 

are largely preventable through education and adequate daily folic 

acid consumption, there are an estimated 166,000 individuals living with all forms of this complex birth defect. The Committee commends the work of the National Spina Bifida Program (NSBP) and 

its support of the Spina Bifida Clinical Care Monitoring and Tracking Program, which provides input into research priorities for the 

National Spina Bifida Patient Registry. Further, the Committee 

commends the NSBP for serving as a model for programs assisting 

other individuals living with similar complex conditions and encourages the CDC to continue to work with a National patient advocacy organization that disseminates information to clinicians, 

parents, and families living with Spina Bifida. 

Preterm Birth Perinatal Collaboratives.—Preterm birth affects 

more than 500,000 babies each year in the U.S. and is the leading 

cause of neonatal mortality. The Committee commends CDC for 

funding six State-based Perinatal Collaboratives that focus on improving birth outcomes and improving maternal health and safety 

using known prevention strategies such as reducing early elective 

deliveries. 

Tuberous Sclerosis Complex.—The Committee encourages CDC to 

take into consideration tuberous sclerosis complex (TSC) as a possible cause of autism, epilepsy, and cardiac rhabdomyomas in its 

surveillance network. 

PUBLIC HEALTH SCIENTIFIC SERVICES

The Committee recommends $479,397,000 program level for Public Health Scientific Services (PHSS), which includes funds for the 

National Center for Health Statistics. The total program level includes $328,697,000 in discretionary budget authority and 

$150,700,000 from PHS Act section 241 evaluation set-aside transfers. The Committee recommendation is $10,000,000 below the fiscal year 2017 enacted level and $19,397,000 above the fiscal year 

2018 budget request. 

Within the total, the Committee recommends the following 

amounts: 

Budget Activity FY 2018 Committee 

Health Statistics ............................................................................................................................................. $155,397,000 

Surveillance, Epidemiology, and Informatics ................................................................................................. 279,000,000 

Laboratory Training and Oversight ....................................................................................................... 5,000,000 

Public Health Workforce ................................................................................................................................. 45,000,000 

Hydrocephalus.—The Committee encourages CDC to collect information on the incidence rates and prevalence of hydrocephalus, inVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00043 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
44 

cluding available information on children and adults, and to identify any changes over time with respect to the incidence and prevalence of hydrocephalus. 

ENVIRONMENTAL HEALTH

The Committee recommends $159,750,000 for Environmental 

Health (EH), which includes $142,750,000 in discretionary appropriations and $17,000,000 in transfers from the PPH Fund. This 

level is $56,000,000 below the fiscal year 2017 enacted level and 

$2,750,000 above the fiscal year 2018 budget request. The EH program focuses on preventing disability, disease, and death caused by 

environmental factors through laboratory and field research. 

Within the total, the Committee recommends the following 

amounts: 

Budget Activity FY 2018 Committee 

Environmental Health Laboratory ................................................................................................................... $56,150,000 

Newborn Screening Quality Assurance Program ................................................................................... 8,400,000 

Newborn Screening /Severe Combined Immunodeficiency Diseases .................................................... 1,250,000 

Environmental Health Activities ..................................................................................................................... 32,600,000 

Environmental Health Activities ............................................................................................................ 14,000,000 

Safe Water ............................................................................................................................................. 8,600,000 

Amyotrophic Lateral Sclerosis (ALS) Registry ....................................................................................... 10,000,000 

Climate Change ..................................................................................................................................... 0 

Environmental and Health Outcome Tracking Network ................................................................................. 25,000,000 

Asthma ........................................................................................................................................................... 29,000,000 

Childhood Lead Poisoning .............................................................................................................................. 17,000,000 

Harmful Algal Blooms.—The Committee supports the work that 

CDC is doing to conduct surveillance for and report health concerns 

related to harmful algal blooms. The Committee urges CDC to continue this work and (1) provide more outreach to State and local 

public health officials to use these surveillance and reporting systems, and (2) work with other agencies, including EPA, NOAA, and 

USGS, to integrate disparate sets of data to allow for a broader understanding of the spatial and temporal dynamics of the environmental and health impacts of harmful algal blooms. 

Lead Poisoning Prevention.—The Committee commends CDC for 

funding nearly 60 childhood lead poisoning prevention programs to 

develop, implement, and evaluate lead poisoning prevention activities. The Committee encourages CDC to require that States receiving funding for lead prevention report all blood tests in a standardized format through the National Notifiable Diseases Surveillance 

System. 

National Asthma Control Program.—The Committee continues to 

support the work of the National Asthma Control Program, recognizing that asthma is one of the most common and costly health 

conditions in the U.S. Twenty-five million Americans have asthma, 

including six million children. The Committee understands that 

better coordination of public health and health systems interventions are necessary to reduce the burden caused by asthma, and 

encourages CDC to continue its collaboration with payers and 

health systems. 

Newborn Screening Quality Assurance Program.—The Committee 

is aware that State laboratories need specialized support to begin 

screening for additional newborn conditions and recognizes CDC’s 

expertise in working with laboratories to implement accurate newVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00044 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
45 

born screening tests. The Committee continues to support State 

laboratories through the Newborn Screening Quality Assurance 

Program as they implement screening for new disorders. This program will also support evaluation of testing methods for new conditions, expansion of CDC’s quality assurance materials, and critical 

infrastructure and development of tests for rare conditions. 

INJURY PREVENTION AND CONTROL

The Committee recommends $286,059,000 for Injury Prevention 

and Control, which is the same as the fiscal year 2017 enacted 

level and $69,894,000 above the fiscal year 2018 budget request. 

The program supports intramural research, injury control research 

centers, extramural research grants, and technical assistance to 

State, local, and Tribal health departments to prevent premature 

death and disability and to reduce human suffering and medical 

costs caused by injury and violence. 

Within the total, the Committee recommends the following 

amounts: 

Budget Activity FY 2018 Committee 

Intentional Injury ............................................................................................................................................ $97,730,000 

Domestic Violence and Sexual Violence ................................................................................................ 32,700,000 

Child Maltreatment ...................................................................................................................... 7,250,000 

Youth Violence Prevention ..................................................................................................................... 15,100,000 

Domestic Violence Community Projects ................................................................................................ 5,500,000 

Rape Prevention .................................................................................................................................... 44,430,000 

National Violent Death Reporting System ...................................................................................................... 16,000,000 

Unintentional Injury ........................................................................................................................................ 8,800,000 

Traumatic Brain Injury .......................................................................................................................... 6,750,000 

Elderly Falls ........................................................................................................................................... 2,050,000 

Injury Prevention Activities ............................................................................................................................. 28,950,000 

Prescription Drug Overdose ............................................................................................................................ 112,000,000 

Illicit Opioid Use Risk Factors ....................................................................................................................... 13,579,000 

Injury Control Research Centers .................................................................................................................... 9,000,000 

Childhood Lead Poisoning Prevention.—The Committee encourages CDC to collaborate with the Department of Education to improve awareness of educational intervention strategies for children 

with elevated blood lead levels. The CDC and the Department of 

Education are expected to implement prioritization initiatives and 

provide technical assistance that informs educators, parents, and 

State and local education agencies about the severity and symptoms of lead poisoning and intervention strategies for children with 

elevated blood lead levels. The Committee requests an update on 

the CDC’s strategy and its outcomes on this topic in the fiscal year 

2019 Congressional Justification. 

Gun Research.—The Committee continues a general provision to 

prevent funds from being used to advocate for or promote gun control. 

Rape Prevention.—The Committee directs CDC to allocate at 

least 75 percent of funds appropriated to the Rape Prevention and 

Education program to State and territory health departments 

through formula grants that support State and local rape prevention activities. 

Using Data to Prevent Opioid-Related Overdosing.—The Committee continues to be very concerned about the high rate of opioid 

abuse and overdosing and understands that with data, forecasting 

of overdosing risk by geographic region can be provided. The ComVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00045 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
46 

mittee encourages CDC to begin using data to provide such forecasts that public health officials can use to intervene and prevent 

overdoses. 

NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH

The Committee recommends $325,200,000 for the National Institute for Occupational Safety and Health (NIOSH), which is 

$10,000,000 below the fiscal year 2017 enacted level and 

$125,200,000 above the fiscal year 2018 budget request. NIOSH 

conducts applied research, develops criteria for occupational safety 

and health standards, and provides technical services to government, labor, and industry, including training for the prevention of 

work-related diseases and injuries. This appropriation supports 

surveillance, health hazard evaluations, intramural and extramural research, instrument and methods development, dissemination, and training grants. 

Within the total for NIOSH, the Committee recommends the following amounts: 

Budget Activity FY 2018 

Committee 

National Occupational Research Agenda ....................................................................................................... $116,000,000 

Agricultural, Forestry, and Fishing ........................................................................................................ 25,500,000 

Education and Research Centers ................................................................................................................... 29,000,000 

Personal Protective Technology ...................................................................................................................... 20,000,000 

Mining Research ............................................................................................................................................. 59,500,000 

National Mesothelioma Registry and Tissue Bank ........................................................................................ 1,100,000 

Other Occupational Safety and Health Research .......................................................................................... 99,600,000 

Total Worker Health.—The agreement provides funding in the 

Other Occupational Safety and Health Research line to continue to 

support the Total Worker Health program at no less than the fiscal 

year 2017 level. 

ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION

PROGRAM

The Committee recommends $55,358,000 in mandatory funding 

for CDC to administer the Energy Employees Occupational Illness 

Compensation Program (EEOICPA), which is the same as the fiscal 

year 2017 enacted level and the fiscal year 2018 budget request. 

EEOICPA provides compensation to employees or survivors of employees of Department of Energy facilities and private contractors 

who have been diagnosed with a radiation-related cancer, beryllium-related disease, or chronic silicosis as a result of their work. 

NIOSH estimates occupational radiation exposure for cancer cases, 

considers and issues determinations for adding classes of workers 

to the Special Exposure Cohort, and provides administrative support to the Advisory Board on Radiation and Worker Health. 

GLOBAL HEALTH

The Committee recommends $435,121,000 for Global Health 

(GH), which is the same as the fiscal year 2017 enacted level and 

$85,121,000 above the fiscal year 2018 budget request. Through its 

GH activities, CDC coordinates, cooperates, participates with, and 

provides consultation to other nations, Federal agencies, and international organizations to prevent and contain diseases and enviVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00046 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
47 

ronmental health problems and to develop and apply health promotion activities. In cooperation with ministries of health and 

other appropriate organizations, CDC tracks and assesses evolving 

global health issues and identifies and develops activities to apply 

CDC’s technical expertise to be of maximum public health benefit. 

Within the total, the Committee recommends the following 

amounts: 

Budget Activity FY 2018 

Committee 

Global AIDS Program ...................................................................................................................................... $128,421,000 

Global Immunization Program ........................................................................................................................ 224,000,000 

Polio Eradication ................................................................................................................................... 174,000,000 

Other Global/Measles ............................................................................................................................ 50,000,000 

Parasitic Diseases and Malaria ..................................................................................................................... 24,500,000 

Global Disease Detection and Emergency Response ..................................................................................... 48,400,000 

Global Public Health Capacity Development ................................................................................................. 9,800,000 

Global Health Security and Global Health Research.—The Committee supports CDC’s work to protect American and global health 

security through the Center for Global Health, the National Center 

for Emerging and Zoonotic Infectious Diseases, and other programs 

that detect, prevent, and respond to infectious disease and other 

health threats. As emerging infectious diseases like Ebola and Zika 

represent perpetual challenges for our health system, the Committee supports continued and enhanced work in health research, 

innovation, capacity building for disease research, detection, and 

surveillance, and robust monitoring and evaluation systems at 

home and abroad. 

PUBLIC HEALTH PREPAREDNESS AND RESPONSE

The Committee recommends $1,450,000,000 for Public Health 

Preparedness and Response (PHPR), which is $45,000,000 above 

the fiscal year 2017 enacted level and $184,000,000 above the fiscal 

year 2018 budget request. CDC distributes grants to State, local, 

Tribal, and territorial public health agencies. The PHPR supports 

capabilities and infrastructure upgrades to respond to all potential 

hazards, including acts of terrorism, infectious disease outbreaks, 

or natural disasters. Funds are used for needs assessments, response planning, support training, strengthening epidemiology and 

surveillance, and upgrades for laboratory capacity and communications systems. Activities support the establishment of procedures 

and response systems, and build the infrastructure necessary to respond to a variety of disaster scenarios. 

Within the total, the Committee recommends the following 

amounts: 

Budget Activity FY 2018 

Committee 

State and Local Preparedness and Response Capability .............................................................................. $688,200,000 

Public Health Emergency Preparedness Cooperative Agreement ......................................................... 680,000,000 

Academic Centers for Public Health Preparedness .............................................................................. 8,200,000 

CDC Preparedness and Response .................................................................................................................. 161,800,000 

BioSense ................................................................................................................................................ 23,000,000 

All Other CDC Preparedness and Response ......................................................................................... 138,800,000 

Strategic National Stockpile (SNS) ................................................................................................................ 600,000,000 

48 

Procurement of Medical Countermeasures.—The Committee continues to have concerns over the consistency in acquisition and replenishment of vaccines and medical countermeasures (MCMs) that 

are procured for emergency response under Federal contracts. Because these MCMs, in many cases, have few or no commercial market applications, procurement requires special planning, development, and contract execution so that private industry will continue 

to invest in their development. The Committee strongly encourages 

CDC to take steps to ensure that the procurement process for 

MCMs is efficient, consistent, and aligned with the mission of the 

Strategic National Stockpile. 

BUILDINGS AND FACILITIES

(INCLUDING TRANSFER OF FUNDS)

The Committee recommends $10,000,000 for CDC buildings and 

facilities, which is the same as the fiscal year 2017 enacted level 

and $10,000,000 below the fiscal year 2018 budget request. In addition, the Committee continues the language from fiscal year 2017 

to allow CDC to retain unobligated funds in the Individual Learning Accounts from departed employees to support the replacement 

of the underground and surface coal mine safety and health research facility. 

CDC-WIDE ACTIVITIES AND PROGRAM SUPPORT

The Committee recommends $263,570,000 for CDC-Wide Activities and Program Support, which includes $103,570,000 in discretionary funds and $160,000,000 in transfers from the PPH Fund. 

This level is $10,000,000 below the fiscal year 2017 enacted level 

and $158,570,000 above the fiscal year 2018 budget request. This 

activity supports several crosscutting areas within CDC. Included 

is CDC’s leadership and management function, which funds the 

CDC Office of the Director. 

Within the total, the Committee recommends the following 

amounts: 

Budget Activity FY 2018 

Committee 

Preventive Health and Health Services Block Grant ..................................................................................... $160,000,000 

Public Health Leadership and Support .......................................................................................................... 103,570,000 

Cross-Border Disease Control.—The Committee requests that 

CDC provide a report in the fiscal year 2019 Congressional Justification on how CDC coordinates its various programs with State 

and local public health departments and international partners to 

measure, track, control, and manage cross-border infectious disease 

in high-volume port cities. 

Vector-Borne Disease Centers of Excellence.—The Committee encourages CDC to fund an additional university-based vector-borne 

disease center of excellence in the West. The Committee notes that 

CDC only awarded centers east of the Rocky Mountains, despite 

the fact that the West is home to densely populated areas and is 

at high risk of importation of vectors and vector-borne diseases due 

to high volumes of travel and trade. 

49 

Preventive Health and Health Services Block Grant 

The Committee does not concur with the Administration’s proposed elimination of the Preventive Health and Health Services 

Block Grant and funds this program at the fiscal year 2017 enacted 

level of $160,000,000. The Committee expects CDC to provide these 

flexible funds to State public health agencies to work with local 

and Tribal public health agencies to address the most critical public health needs. 

NATIONAL INSTITUTES OF HEALTH

The Committee recommends $35,184,000,000 for the National Institutes of Health (NIH), which is $1,100,000,000 above the fiscal 

year 2017 enacted level and $8,580,443,000 above the fiscal year 

2018 budget request. This level includes $34,359,557,000 in discretionary appropriations and $824,443,000,000 in PHS Act section 

241 evaluation set-aside transfers. Within the total discretionary 

appropriations, the Committee recommendation includes 

$496,000,000 in budget authority authorized in the 21st Century 

Cures Act. 

The mission of NIH is to seek fundamental knowledge about the 

nature and behavior of living systems and the application of that 

knowledge to enhance health, lengthen life, and reduce illness and 

disability. NIH conducts and supports research to understand the 

basic biology of human health and disease; apply this understanding towards designing new approaches for preventing, diagnosing, and treating disease and disability; and ensure that these 

approaches are widely available. 

The recommendation provides an increase of $400,000,000 for 

Alzheimer’s disease research; an increase of $30,000,000 for combating antibiotic-resistant bacteria; an increase of $80,000,000 for 

the ‘‘All of Us’’ research program (formerly called the Precision 

Medicine Initiative); an increase of $76,000,000 for the Brain Research through Application of Innovative Neurotechnologies 

(BRAIN) Initiative; an increase of $8,000,000 for regenerative medicine; and increases to every Institute and Center (IC) to support 

innovative research to advance fundamental knowledge and speed 

the development of new therapies and diagnostics to improve the 

health of all Americans. The Committee also continues to support 

the Cancer Moonshot Initiative with a total of $300,000,000 in fiscal year 2018. 

The Committee expects the 3.2 percent increase of funds over the 

fiscal year 2017 enacted level to support an increase in the number 

of new and competing Research Project Grants (RPGs), with a 

focus on early-stage investigators and investigators seeking firsttime renewals. The Committee encourages NIH to restore extramural support to at least 90 percent of all NIH funding and to continue to focus on basic research. The Committee expects NIH to 

support an increased number of Ruth L. Kirschstein National Research Service Awards and to provide a stipend level increase to 

training grantees that is consistent with any fiscal year 2018 Federal employee pay raise. The Committee continues to provide in bill 

language specific funding levels for Clinical and Translational 

Science Awards, Institutional Development Awards (IDeA), the 

50 

Cures Acceleration Network, the Common Fund (CF), and the follow-on to the National Children’s Study. 

While the Committee appreciates the Secretary’s efforts to find 

efficiencies in NIH research spending, the Administration’s proposal to drastically reduce and cap reimbursement of facilities and 

administrative (F&A) costs to research institutions is misguided 

and would have a devastating impact on biomedical research across 

the country. To ensure that NIH can continue supporting both direct and F&A costs as is their current practice, the bill includes a 

new general provision directing NIH to continue reimbursing institutions for F&A costs according to the rules and procedures described in 45 CFR 75 (with the exception of existing waivers for 

training grants). This provision also prohibits funds in this Act 

from being used to implement any further caps on F&A cost reimbursements. 

The Committee recognizes that there are opportunities to reduce 

the administrative burden on research institutions through legislative, regulatory, and administrative means, so that NIH can support more researchers who can in turn spend more time on science 

and less time on paperwork. The National Academies of Sciences, 

Engineering, and Medicine 2016 publication ‘‘Optimizing the Nation’s Investment in Academic Research: A New Regulatory Framework for the 21st Century’’ put forth several recommendations for 

reducing burden on institutions and investigators. The Committee 

directs NIH to identify the most appropriate and potentially 

impactful recommendations and submit a plan to the Committees 

on Appropriations of the House of Representatives and the Senate 

within 90 days of enactment of this Act outlining concrete steps to 

achieving these goals. NIH should consult with academic and independent research institutions, investigators who receive NIH 

grants, the HHS Office of Cost Allocation, the Office of Management and Budget, and other relevant stakeholders in developing 

this plan. 

NATIONAL CANCER INSTITUTE (NCI)

Mission.—NCI conducts and supports basic and applied cancer 

research in early detection, diagnosis, prevention, treatment, and 

rehabilitation. NCI provides training support for research scientists, clinicians and educators, and maintains a national network 

of cancer centers, clinical cooperative groups, and community clinical oncology programs, along with cancer prevention and control 

initiatives and outreach programs to translate rapidly basic research findings into clinical practice. 

Cancer Moonshot.—The Committee recommendation directs NIH 

to transfer $300,000,000 from the NIH Innovation Account to NCI 

to support the Cancer Moonshot initiative. These funds were authorized in the 21st Century Cures Act. 

Gastric Cancer.—The Committee continues to be concerned about 

the deadly outcomes of gastric cancer, particularly among young 

adults. The five-year survival rate for stomach cancer is 30 percent. 

The Committee encourages NCI to consider developing a scientific 

framework, as specified by the Recalcitrant Cancer Research Act of 

2012, for advancing stomach cancer research. 

Heavy Ion Cancer Therapy and Research.—The Committee supports NIH’s continued exploration of advanced therapeutic cancer 

51 

research, specifically heavy ion irradiation technology. Heavy ion 

technology will introduce a novel treatment option to cancer patients that is currently not available in the U.S. The Committee 

notes that the U.S. stands to be a world leader in this advanced 

research. The Committee encourages NIH to explore further the development of a state of the art heavy ion research facility in the 

U.S. Furthermore, the Committee encourages NIH to work with 

the Departments of Defense and Energy, and other applicable Federal agencies to equip the first U.S. heavy ion research center. The 

Committee urges NIH to capitalize on the expertise and potential 

of recently awarded heavy ion facility planning grant recipients in 

order to foster a multidisciplinary approach and advance heavy ion 

research that would produce novel, cutting edge treatments for cancer patients. 

Hepatitis B.—The Committee notes that liver cancer is the second deadliest cancer in the U.S., with a five-year survival rate less 

than 18 percent. According to the CDC, unlike other cancers, the 

rates of liver cancer deaths and incidence are rising. To increase 

the five-year survivability of liver cancer, the Committee urges that 

NCI issue targeted calls for proposals and create an ad hoc special 

emphasis panel to review liver cancer applications. The Committee 

also notes that the link between hepatitis B infection and primary 

liver cancer is well-established with up to 60 percent of global liver 

cancer cases caused by the hepatitis B virus (HBV) and, therefore, 

urges close collaboration with NIAID and NIDDK on issues related 

to HBV research. 

Immunotherapy for Childhood Cancers.—Recent NIH studies 

demonstrate that a new cancer immunotherapy method to specifically attack tumor cells that have mutations unique to a patient’s 

cancer could be effective against a wide range of cancers. The Committee encourages NCI to continue to explore further new interventions, such as immunotherapy, as a promising new treatment strategy for children with cancer. 

Glyphosate.—The Committee directs NIH to provide an update 

within 60 days of enactment of this Act on research related to 

whether glyphosate causes cancer in humans. 

Lung Cancer.—The Committee encourages NCI to continue to 

prioritize support for meritorious research for lung cancer generally 

and specifically related to early detection of lung cancer and continued advances in treating lung cancer with personalized medicine, 

immunotherapy, and other innovative treatments. The Committee 

requests an update in the fiscal year 2019 budget request on these 

efforts. 

Melanoma.—Given the significant advances in melanoma research, in biology, molecular profiling, targeted therapies, immunology, vaccines, and other areas, and with added Congressional 

support to achieve Cancer Moonshot goals in five years, the Committee requests that NCI update the Committee on advances in 

melanoma research in the fiscal year 2019 Congressional Justification. 

Pancreatic Cancer Research.—In 2016, pancreatic cancer rose to 

become the third leading cause of cancer-related death in the U.S., 

claiming the lives of nearly 42,000 Americans. Despite progress in 

combating other forms of cancer, pancreatic cancer remains the 

only major cancer with a five-year survival rate in the single digits, 

52 

at nine percent, in large part because there are no reliable early 

detection methods or effective treatment options. To help turn the 

tide against this deadly cancer, Congress in 2012 passed the Recalcitrant Cancer Research Act (P.L. 112–239), calling for the development of a scientific framework for certain recalcitrant cancers. The 

Committee requests an update on pancreatic cancer research in the 

fiscal year 2019 Congressional Justification. 

Pediatric Oncology Research.—The Committee encourages NCI to 

continue its important investments in pediatric oncology research, 

including clinical studies for children with brain tumors, the important pediatric preclinical testing program evaluating new agents 

for treating pediatric malignancies, and development of the novel 

pediatric Molecular Analysis for Therapy Choice (MATCH) study. 

The Committee requests an update in the fiscal year 2019 Congressional Justification on the progress of these important programs. 

Precision Oncology.—The Committee recognizes the potential for 

significant advancements in cancer treatments from the NCI 

MATCH trial. It remains the central pillar of precision medicine research focused on oncology for cancers that are unresponsive to 

standard interventions. The Committee urges NCI to continue to 

expand precision oncology trials. NCI should also continue to focus 

on launching the important pediatric-MATCH trial as pediatric oncology mechanisms are very different from mutations seen in 

adults. NCI shall provide an update on these activities in the fiscal 

year 2019 Congressional Justification. 

Regional Clinical Trial Networks.—The Committee encourages 

NCI to coordinate with other ICs to leverage existing platforms and 

consider new approaches in conjunction with communities to identify clinical research and fosters enhanced participation in clinical 

trials by community members. The Committee encourages that the 

resulting model include robust collaboration with industry partners, the identification of best practices, and methods to efficiently 

implement clinical studies in the regional networks. 

NATIONAL HEART, LUNG, AND BLOOD INSTITUTE (NHLBI)

Mission.—NHLBI provides leadership for a national research 

program in diseases of the heart, blood vessels, lungs, and blood, 

in blood resources, and in sleep disorders through support of basic, 

clinical, and population-based research. 

Lung Disease.—Lung disease is the third leading cause of death 

in the U.S., with a rising morbidity and mortality burden among 

all Americans, including older Americans. The Committee urges 

the institute to collaborate with the National Institute on Aging to 

study the impact of the lungs’ vulnerability to systemic disease and 

aging. 

Lymphangioleiomyomatosis (LAM).—The Committee remains 

very interested in efforts to find a cure for LAM, a progressive and 

often fatal lung disease in women. The Committee supports both 

intramural and extramural research on LAM and urges NHLBI to 

use all available mechanisms as appropriate, including 

Translational Program Project Grants, to stimulate a broad range 

of clinical and basic research. The Committee commends NIH for 

supporting multicenter LAM trials and encourages additional support of such trials. 

53 

Pulmonary Hypertension.—The Committee applauds NHLBI for 

identifying the study of underlying mechanisms of disease of Pulmonary Hypertension as one of its areas of focus within its recent 

strategic vision plan for research. The Committee encourages 

NHLBI to continue its focus in this area, particularly on idiopathic 

pulmonary arterial hypertension, so that additional gains can be 

made that benefit patient outcomes and further improve survivability for affected individuals. 

Sickle Cell Disease Research.—The Committee understands the 

burden sickle cell disease places on more than 100,000 Americans. 

Additionally, Federal research spending on sickle cell disease has 

historically been eclipsed by other medical conditions that affect 

fewer Americans. The Committee encourages NHLBI to consider an 

increased focus on innovation in treatment of sickle cell disease 

and continue support for highly meritorious research on sickle cell 

disease. 

NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH

(NIDCR)

Mission.—The mission of NIDCR is to improve the Nation’s oral, 

dental, and craniofacial health through research and research 

training. NIDCR accomplishes its mission by performing and supporting basic and clinical research; conducting and funding research training and career development programs to ensure that 

there is an adequate number of talented, well prepared, and diverse investigators; and coordinating and assisting relevant research and research-related activities. 

Biomaterials.—The Committee is pleased that NIDCR is exploring approaches to prevent dental caries with probiotic therapy, and 

in the development of biomaterials. The Committee encourages 

NIDCR to increase its investment in the development of new and 

improved biomaterials for use in clinical settings to enhance the 

prevention and treatment of caries. 

NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY

DISEASES (NIDDK)

Mission.—NIDDK supports research in three major disease categories: diabetes, endocrinology, and metabolic diseases; digestive 

diseases and nutrition; and kidney, urologic, and hematologic diseases. NIDDK supports a coordinated program of fundamental and 

clinical research and demonstration projects relating to the causes, 

prevention, diagnosis, and treatment of diseases within these categories. 

Glomerular Diseases.—The Committee encourages continued support for the Cure Glomerulonephropathy (CureGN) initiative, 

which has enrolled over 1,500 clinical research subjects working towards furthering the understanding of rare forms of kidney diseases. 

Inflammatory Bowel Disease.—The Committee is pleased by 

NIDDK’s support of research into inflammatory bowel disease 

(IBD) and urges the Institute to provide support for research on 

the environmental triggers and epigenetics of IBD as well as interventions for the rising prevalence of IBD to both pediatric and 

adult patients. 

54 

Interstitial Cystitis.—The Committee is pleased with the evolving 

research on interstitial cystitis and encourages NIDDK to work 

with stakeholders on a comprehensive state of the science conference to examine mechanisms for scientific opportunity. 

Multidisciplinary Approach to the Study of Chronic Pelvic 

Pain.—The Committee is pleased with the progress of the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research 

Network and encourages collaborations with stakeholders to ensure 

proper dissemination of information. 

Pediatric Kidney Disease.—The Committee is encouraged by the 

current multicenter pediatric kidney disease research funded by 

NIDDK. While important strides have been made, further research 

is critical to the validation of new prognostic indicators, novel diagnostic biomarkers, and therapeutics necessary to better understand 

and treat kidney disease as children mature from newborns and ultimately transition to adulthood. The Committee urges the NIDDK 

to work collaboratively with other NIH institutes, including the 

NICHD, NHLBI, and NIMHD, to advance further multidisciplinary 

research for children and young adults with kidney disease and its 

complex co-morbidities. The Committee requests that NIDDK report back in the fiscal year 2019 Congressional Justification on the 

steps taken to advance this type of collaborative research. 

Study of Overrepresented and Medically Underserved Populations 

with Diabetes.—The Committee is concerned about specific diabetic 

populations that are more likely to be overrepresented and medically underserved. The Committee encourages NIDDK to support 

research on these specific populations. The Committee also encourages NIDDK to work with Hispanic-Serving Institutions and Historically Black Colleges and Universities in this effort. 

NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

(NINDS)

Mission.—NINDS supports and conducts basic, translational, and 

clinical neurological research and research training to increase understanding of the brain and improve the prevention and treatment 

of neurological and neuromuscular disorders. The NINDS mission 

encompasses over 600 disorders, including stroke, head and spinal 

cord injury, epilepsy, multiple sclerosis, and neurodegenerative disorders such as Parkinson’s disease. 

BRAIN Initiative.—The Committee recommendation includes bill 

language transferring $43,000,000 from the NIH Innovation Account to NINDS to support the BRAIN Initiative. These funds were 

authorized in the 21st Century Cures Act. 

Brain Aneurysm Research.—The Committee is concerned that an 

estimated one out of every 50 individuals in the U.S. has a brain 

aneurysm and an estimated 30,000 Americans suffer a brain aneurysm rupture each year, with little to no warning. Ruptured brain 

aneurysms are fatal in about 40 percent of cases. The Committee 

requests a report from NINDS regarding its annual funding level 

for brain aneurysm research funding over the past five years, including the types of grants supported. 

Duchenne Muscular Dystrophy.—The Committee is aware of 

stakeholder efforts to achieve validated and qualified biomarkers 

for Duchenne Muscular Dystrophy. The Committee supports these 

activities and urges NINDS to work with other Institutes and with 

55 

the Food and Drug Administration to provide the necessary guidance and to assemble a workshop of all stakeholders to advance 

this work. The Committee is also concerned about a lack of access 

to Federally-funded data, such as imaging and biomarker data, 

which could support qualification of an MRI imaging biomarker 

and directs NIH to ensure all Federally-funded Duchenne investigators are in full compliance with the data sharing requirements 

included in the 21st Century Cures Act. The Committee also remains optimistic about the potential for additional Duchenne treatments using exon skipping splicing and encourages NIH to work 

with other Federal agencies to convene a workshop on exon skipping in Duchenne and other neuromuscular diseases. 

Dystonia.—The Committee encourages NINDS to continue to expand the dystonia research portfolio. NINDS is encouraged to work 

with stakeholders in support of a comprehensive state of the 

science conference to examine evolving mechanisms for scientific 

opportunities in dystonia research. 

Headache Disorders.—The Committee encourages NIH to 

prioritize fundamental, translational, and clinical research on 

headache disorders over the next decade. The World Health Organization has found that migraines are the third most prevalent 

global disorder and the seventh leading cause of global disability. 

Hydrocephalus Research.—The Committee encourages NIH, 

under the direction of NINDS, to conduct a scientific workshop on 

hydrocephalus research. The Committee requests that a key agenda item of the workshop be a discussion of future needs for hydrocephalus research, and that NIH report back to the Committee in 

the fiscal year 2019 Congressional Justification on this and other 

findings and recommendations of the workshop. 

Myotonic Dystrophy.—The Committee recognized there are significant gaps in our scientific understanding of the causes of 

myotonic dystrophy and there are still no FDA approved treatments for this inherited genetic disorder that can cause multiple 

organ systems to fail or severely disrupt their function that affects 

approximately 100,000 Americans. The Committee encourages the 

NIH to fund efforts to recruit young researchers to this field and 

stimulate more high quality research proposals to advance this critical scientific field. Myotonic dystrophy research holds significant 

promise for major advances across many neurodegenerative diseases, particularly other triplet repeat expansion diseases. 

Peripheral Neuropathies.—The Committee is pleased at the 

progress of ongoing research into Guillain-Barre ́ syndrome (GBS), 

chronic inflammatory demyelinating polyneuropathy, and related 

conditions, and notes the important connection between Zika and 

GBS. The Committee encourages NINDS to continue work to advance emerging research in an organized and meaningful way. 

Stroke.—The Committee is concerned that stroke continues to inflict a massive burden on our Nation’s long-term health and economic stability and encourages NIH to expand its investment commensurate with the impact on public health, the economy, and innovative scientific opportunities. NINDS shall continue to implement top priorities identified in the 2012 planning initiative for 

stroke prevention, treatment and recovery research, particularly 

augmentation of the Stroke Clinical Trials Network, including 

early stroke recovery. The Committee lauds the Institute for its 

56 

leadership in convening a workshop on ‘‘Translational Stroke Research: Vision and Opportunities’’ and directs NINDS to accelerate 

implementation of key recommendations and other findings. 

Traumatic Brain Injury.—The Committee understands regenerative medicine research and the use of adult stem cells may play an 

important role in the treatment of Traumatic Brain Injury (TBI). 

The Committee strongly encourages NINDS to work with the National Institute of Aging to support a robust and coordinated portfolio of TBI research with a focus on how to leverage regenerative 

medicine research and the use of adult stem cells in the treatment 

of TBI. The Committee requests an update in the fiscal year 2019 

Congressional Justification on efforts in these specific areas of TBI 

research. 

NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES (NIAID)

Mission.—NIAID supports and conducts basic, applied, and clinical research, and research training programs in infectious, 

immunologic, and allergic diseases. NIAID-supported research includes research on HIV/AIDS, malaria, tuberculosis, sexually transmitted infections, neglected tropical diseases, emerging and reemerging infectious diseases, asthma, allergic and autoimmune diseases, and transplantation. The goals of NIAID research are to increase the understanding of disease pathogenesis and the immune 

system, to improve disease diagnosis, to develop new and improved 

drugs to treat such diseases, and to develop new and improved vaccines and other approaches to prevent such diseases, many of 

which significantly affect public health. 

Antimicrobial Resistance.—The Committee recommendation includes an increase of $30,000,000 within NIAID for combating antimicrobial resistance. The Committee continues to support research 

on mechanisms of drug resistance, bacterial pathogenesis, and infection control; developing new or repurposing existing 

antimicrobials; and exploring approaches to prevention including 

bacterial vaccines and other strategies. The Committee encourages 

NIH to coordinate with CDC to determine how data in the CDC resistant pathogens database can be leveraged to improve future research. The Committee requests an update in the fiscal year 2019 

Congressional Justification on how NIAID is working with CDC 

and other Federal partners in this field of research. 

Autoimmune Neuropathies.—The Committee is pleased that 

NIAID and NINDS are working on a state of the science of autoimmune neuropathies research into conditions like Guillain-Barre ́

syndrome and chronic inflammatory demyelinating polyneuropathy, 

and encourages them to work with stakeholders on the importance 

of the patient perspective. 

Hepatitis B.—The Committee notes that infection with hepatitis 

B virus (HBV) is a serious public health threat and is associated 

with approximately 887,000 deaths each year worldwide, making it 

a leading cause of death in the world. In the U.S., one in 20 Americans has been infected with HBV and up to 2.2 million are chronically infected. Left undiagnosed and untreated, one in four of those 

with chronic HBV infection will die prematurely from cirrhosis, 

liver failure, and/or liver cancer. With hepatitis C now curable and 

study of the entire HBV lifecycle now possible, NIAID is urged to 

intensify its current efforts to find a cure for HBV. To meet this 

57 

goal, the Committee urges NIAID to issue targeted calls for HBV 

research proposals in fiscal year 2018, focused on therapeutic development and the many critical research opportunities identified 

by the scientific community. 

Malaria.—The Committee urges NIH to continue its efforts to 

understand the biology of the malaria parasite, and to continue its 

role in developing tools needed for effective and sustainable malaria prevention, treatment, and control, including vaccines. 

Microbicides.—The Committee recognizes that with NIH and 

United States Agency for International Development (USAID) leadership, research has shown the potential for antiretroviral (ARV) 

drugs to prevent HIV infection in women. The Committee encourages NIAID to continue coordination with USAID, the State Department, and others to advance ARV-based microbicide development efforts with the goal of enabling regulatory approval of the 

first safe and effective microbicide for women and supporting an active ARV-based microbicide pipeline to produce additional solutions 

to prevent HIV and to help end the epidemic. 

Neglected Tropical Diseases.—One-sixth of the world’s population 

suffers from one or more neglected tropical diseases (NTDs). In the 

U.S., we have seen Chikungunya, Dengue, and Chagas disease 

emerge. Research conducted by NIH is a key component to ensuring there are tools to treat, control, and eventually eradicate many 

neglected diseases. The Committee urges NIH to continue its investment in malaria and NTD research, including work in latestage and translational research for NTDs, and to work with other 

agencies to foster research and ensure that basic discoveries are 

translated into solutions. 

Tick-Borne Diseases.—The Committee encourages NIH to intensify research on Lyme and tick-borne diseases, including research 

that will increase understanding of the full range of Lyme disease 

processes and the physiology of Borrelia burgdorferi and Borrelia 

mayonii, including the mechanisms of persistent infection such as 

persisters and potential treatment protocols for identified mechanisms of persistence. The Committee also encourages NIH to intensify research efforts focused on the development of more sensitive 

and accurate diagnostic tests for Lyme and tick-borne diseases, including next generation polymerase chain reaction and new testing 

methodologies such as proteomics and metabolomics. 

Translational Vaccinology.—The Committee notes a very promising area in the field of vaccine and immunology is translational 

vaccinology, in which researchers are able to translate the science 

of vaccine design and development into the assessment of current 

and novel, experimental vaccines through pre-clinical and clinical 

trials. The Committee strongly encourages NIAID to support a robust portfolio of extramural, highly meritorious translational vaccine research that focus on an interdisciplinary approach to this research. The Committee requests NIAID provide an update in the 

fiscal year 2019 Congressional Justification on expansion opportunities for interdisciplinary translational vaccinology research. 

Tuberculosis.—According to the World Health Organization 

(WHO), Tuberculosis (TB) is the leading global infectious disease 

killer, accounting for the deaths of 1.8 million people annually and 

the continued spread of drug resistant TB is a serious global health 

problem. There is an urgent need to develop faster point-of-care 

58 

diagnostics; shorter, safer, and more tolerable treatments; and effective vaccines for all populations, including for drug resistant TB. 

The Committee urges the Institute to prioritize the development of 

new TB diagnostic, treatment, and prevention tools. 

Zika-Related Conditions.—The Committee encourages NIAID 

along with other Institutes and Centers to establish cross-cutting 

research activities to combat Zika-related conditions, including 

Guillain-Barre ́ Syndrome. 

NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES (NIGMS)

Mission.—NIGMS supports research and research training in the 

basic biomedical sciences. Institute grantees, working in such fields 

as cell biology, biophysics, genetics, developmental biology, pharmacology, physiology, biological chemistry, bioinformatics, and computational biology study normal biological processes to better understand what goes wrong when disease occurs. In this way, 

NIGMS supports the development of new knowledge, theories, and 

technologies that can then be applied to the disease-targeted studies supported by other NIH components. NIGMS-supported basic 

research advances also find applications in the biotechnology and 

pharmaceutical industries. The Institute’s training programs help 

develop scientists needed in industry and academia and increase 

the diversity of the biomedical workforce. 

Institutional Development Awards.—The Committee has provided $373,641,000 for the IDeA program, $40,000,000 above the fiscal 

year 2017 enacted level. IDeA supports high-quality research and 

investigators throughout the country in States in which the success 

rate for NIH grants has been historically low. 

EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH

AND HUMAN DEVELOPMENT (NICHD)

Mission.—The NICHD conducts and supports basic, 

translational, and clinical research on the reproductive, developmental, and behavioral processes that determine and maintain— 

and rehabilitation that restores and improves—the health and 

well-being of children, adults, families, and populations. 

National Breastfeeding Research Consortium.—The Committee is 

aware of the substantial amount of research showing that 

breastfeeding can contribute significantly to health and the prevention of childhood obesity and chronic conditions. The Committee 

supports the Surgeon General’s Call to Action to Support 

Breastfeeding and its recommendations for the development of a 

national consortium on breastfeeding research. The Committee 

urges NICHD to convene the national consortium on breastfeeding 

research called for by the Surgeon General. 

Preterm Birth Research.—The Committee applauds NICHD’s 

work with leading global health organizations to develop a research 

agenda aimed at reducing preterm birth. Public and privately funded research that spans the range of discovery, development, and 

delivery science is needed to identify the causes of premature birth. 

The Committee urges NICHD to enhance investments in biomedical and clinical research related to the prevention of preterm 

birth and the care and treatment of preterm infants. 

Rehabilitation Research.—The Committee recognizes the significant challenges faced by patients with neurological impairments 

59 

who live in rural areas, where access to assistive devices, medical 

advice, and community resources can be limited. Proper rehabilitation, with the help of patient ‘‘navigators,’’ is critical to improving 

patients’ quality of life and preventing further, and more costly, 

health problems. Therefore, the Committee urges the NIH, acting 

through the trans-NIH Rehabilitation Coordinating Committee that 

is chaired by the National Center for Medical Rehabilitation Research at NICHD, to provide greater support for research efforts 

that involve the combination of patient navigators and assistive 

health technology, particularly in underserved rural settings. 

Research on the Long-Term and Developmental Health Effects of 

Zika.—The Committee recognizes the unique nature of NICHD research into how the Zika virus infection affects pregnancy and the 

long-term and developmental health effects on children exposed to 

the Zika virus. The Committee urges NICHD to prioritize investment into long-term and developmental health effects of the Zika 

virus as the fight against the virus continues. 

Task Force on Research in Pregnant Women and Lactating 

Women.—The Committee looks forward to an update on the work 

of the Task Force on Research in Pregnant Women and Lactating 

Women, and continues to encourage and support the important 

work of the Task Force to ensure that consumers and health care 

professionals have up-to-date and accurate information on the safety and efficacy of drugs that women are taking while pregnant or 

breastfeeding. 

NATIONAL EYE INSTITUTE (NEI)

Mission.—NEI conducts and supports basic and clinical research, 

research training, and other programs with respect to blinding eye 

diseases, visual disorders, and mechanisms of visual function, preservation of sight, and the special health problems and needs of individuals who are visually-impaired or blind. 

3-D Retina Organoid Challenge.—The Committee directs NIH to 

provide an update on the 3-D Retina Organoid Challenge authorized in the Consolidated Appropriations Act, 2016. 

Blepharospasm.—The Committee encourages NEI to expand research on blepharospasm, a form of dystonia. 

NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES (NIEHS)

Mission.—The mission of NIEHS is to prevent and reduce the 

burden of human illness and disability by understanding how the 

environment influences the development and progression of human 

disease. In addition, NIEHS is responsible for the research of the 

National Toxicology Program whose mission is to coordinate toxicity testing across the Federal government and to evaluate substances of public health concern. 

NATIONAL INSTITUTE ON AGING (NIA)

Mission.—NIA supports and conducts biomedical, social and behavioral research with respect to the aging process and the diseases and other special problems and needs of older Americans. 

Alzheimer’s Disease.—In recognition that Alzheimer’s disease 

poses a serious threat to the nation’s long-term health and economic stability, the Committee recommends an increase of 

60 

$400,000,000 within NIA to support a total of at least 

$1,791,000,000 on Alzheimer’s disease research. NIA should continue to address the research goals set forth in the National Plan 

to Address Alzheimer’s disease, as well as the recommendations 

from the Alzheimer’s Disease Research Summit in 2015. Additionally, the Committee encourages NIA to continue support for additional Alzheimer’s Disease Centers in States with high patient 

incidences of Alzheimer’s disease. Preference shall be given to centers demonstrating collaborative work among basic scientists and 

clinical scientists to expedite new treatment protocols, particularly 

among underrepresented areas. 

NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN

DISEASES (NIAMS)

Mission.—NIAMS conducts and supports basic and clinical research and on the more than 100 forms of arthritis; osteoporosis 

and other bone diseases; muscle biology and muscle diseases; orthopedic disorders, such as back pain and sports injuries; and numerous skin diseases. 

Alopecia Areata Research.—The Committee recognizes NIAMS 

for leadership on recent research breakthroughs that could potentially lead to effective treatments for alopecia areata and related 

conditions, and encourages NIAMS to continue to support research 

in this area. 

NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION

DISORDERS (NIDCD)

Mission.—NIDCD funds and conducts research in human communication. Included in its program areas are research and research training in the normal and disordered mechanisms of hearing, balance, smell, taste, voice, speech and language. The Institute 

addresses special biomedical and behavioral problems associated 

with people who have communication impairments or disorders. In 

addition, NIDCD is actively involved in health promotion and disease prevention, and supports efforts to create devices that substitute for lost and impaired sensory and communication functions. 

Spasmodic Dysphonia.—The Committee encourages NIDCD to 

expand research on spasmodic dysphonia, a form of dystonia. 

NATIONAL INSTITUTE OF NURSING RESEARCH (NINR)

Mission.—NINR supports and conducts scientific research and 

research training to reduce the burden of illness and disability; improve health-related quality of life; enhance end-of-life and palliative care; and establish better approaches to promote health and 

prevent disease. 

NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM (NIAAA)

Mission.—NIAAA supports research to generate new knowledge 

to answer crucial questions about why people drink; why some individuals are vulnerable to alcohol dependence or alcohol-related 

diseases and others are not; the relationship between genetic and 

environmental factors involved in alcoholism; the mechanisms 

whereby alcohol produces its disabling effects, including organ 

damage; how to prevent alcohol abuse and associated damage, esVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00060 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
61 

pecially in the underage population; and how alcoholism treatment 

can be improved. NIAAA addresses these questions through a program of biomedical, behavioral, and epidemiologic research on alcoholism, alcohol abuse, and related problems. 

NATIONAL INSTITUTE ON DRUG ABUSE (NIDA)

Mission.—NIDA-supported science addresses questions about 

drug abuse and addiction, which range from its causes and consequences to its prevention and treatment. NIDA research explores 

how drugs of abuse affect the brain and behavior and develops effective prevention and treatment strategies. 

Barriers to Research.—The Committee is concerned that restrictions associated with Schedule 1 of the Controlled Substance Act 

effectively limit the amount and type of research that can be conducted on certain schedule 1 drugs, especially marijuana or its 

component chemicals and certain synthetic drugs. At a time when 

we need as much information as possible about these drugs, we 

should be lowering regulatory and other barriers to conducting this 

research. The Committee directs NIDA to provide a short report on 

the barriers to research that result from the classification of drugs 

and compounds as Schedule 1 substances. 

Drug Treatment in the Justice System.—The Committee understands that providing evidence-based treatment for substance use 

disorders offers a valuable opportunity to interrupt the substance 

use/criminal justice system cycle for people struggling with substance use disorders. Untreated substance use disorder renders 

prior criminal offenders particularly vulnerable to recidivism and 

continued health problems, preventing them from being able to find 

stable employment, jeopardizing public health and safety, and taxing justice and health system resources. When combined with therapy, medication assisted treatment (MAT) has consistently been 

shown to be more effective in treating substance use disorder than 

abstinence. The Committee applauds NIDA’s focus on adult and juvenile justice populations in its research around substance use disorder treatment. The Committee supports this important work and 

asks for a progress report on those efforts, including information on 

the use and success of MAT in the juvenile justice system. 

Marijuana Research.—The Committee is concerned that States 

are changing public policies related to marijuana without the benefit of scientific research to help guide those decisions. NIDA is encouraged to continue supporting a full range of research on the effects of marijuana and its components, including research focused 

on policy change and implementation across the country. 

Neonatal Abstinence Syndrome.—The Committee recognizes the 

importance of research on prevention, identification, and treatment 

of prenatal opioid exposure and Neonatal Abstinence Syndrome. 

The Committee encourages NIDA to ensure that the review process 

includes appropriate focus on geographic locations where the problem is particularly acute. The Committee encourages NIH, based 

on appropriate scientific review, to support meritorious research 

opportunities in Appalachia and at institutions that have unique 

opportunities to study innovative care models. 

Opioid Misuse and Addiction.—The Committee continues to be 

extremely concerned about the epidemic of prescription opioids, 

heroin, and synthetic opioid use, addiction, and overdose in the 

62 

U.S. Approximately 144 people die each day in this country from 

opioid overdose, making it one of the most common causes of nondisease-related deaths for adolescents and young adults. This crisis 

has been exacerbated by the availability of fentanyl and its analogs 

into many communities. The Committee appreciates the important 

role that research can and should play in the various Federal initiatives aimed at this crisis. The Committee urges NIDA to (1) continue funding research on medication development to alleviate 

pain, especially the development of medications with reduced abuse 

liability; (2) as appropriate, work with private companies to fund 

innovative research into such medications; and (3) report on what 

is knows regarding the transition from opioid analgesics to heroin 

and synthetic opioid abuse and addiction within affected populations. 

Raising Awareness and Engaging the Medical Community in 

Drug Abuse and Addiction Prevention and Treatment.—Education 

is a critical component of any effort to curb drug use and addiction, 

and it must target every segment of society, including healthcare 

providers (doctors, nurses, dentists, and pharmacists), patients, 

and families. Medical professionals must be in the forefront of efforts to curb the opioid crisis. The Committee continues to be 

pleased with the NIDAMeD initiative, targeting physicians-intraining, including medical students and resident physicians in primary care specialties (e.g., internal medicine, family practice, and 

pediatrics). NIDA should continue its efforts in this space, providing physicians and other medical professionals with the tools 

and skills needed to incorporate drug abuse screening and treatment into their clinical practices. 

NATIONAL INSTITUTE OF MENTAL HEALTH (NIMH)

Mission.—NIMH is responsible for basic and clinical research to 

improve diagnosis, treatments, and overall quality of care for persons with mental illnesses. Disorders of high priority to NIMH include schizophrenia; depression and manic-depressive illness; obsessive-compulsive disorder; anxiety disorders and other mental 

and behavioral disorders that occur across the lifespan, which include childhood mental disorders such as autism and attention-deficit/hyperactivity disorder; eating disorders; and other illnesses. 

NIMH supports and conducts fundamental research in neuroscience, genetics, and behavioral science. In addition to laboratory 

and controlled clinical studies, NIMH supports research on the 

mental health needs of special populations and health services research. 

BRAIN Initiative.—The Committee recommendation includes bill 

language transferring $43,000,000 from the NIH Innovation Account to NIMH to support the BRAIN Initiative. These funds were 

authorized in the 21st Century Cures Act. 

Adolescent and Young Adult Brain Development.—The Committee recognizes and supports the NIH Adolescent Brain and Cognitive Development (ABCD) Study. The Committee recognizes that 

an individual’s brain continues to develop into his or her midtwenties. However, little is known about the dramatic brain development that takes place during adolescence and how the various 

experiences people are exposed to during this time interact with 

each other and their biology to affect brain development and, ultiVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00062 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
63 

mately, social, behavioral, health, and other outcomes. The ABCD 

study addresses this knowledge gap. 

Improving the Treatment of Mental Illness.—The Committee 

shares the concern of the NIMH National Advisory Mental Health 

Council that over the past decade the NIMH research portfolio has 

increasingly become focused on basic neuroscience research at the 

expense of research focused on finding ways to ease the burden of 

those currently suffering from devastating mental conditions. 

Therefore, the Committee urges NIMH to diversify its research 

portfolio to better balance basic neuroscience and applied research 

to increase the development of more effective treatments for people 

suffering from mental conditions now. 

NATIONAL HUMAN GENOME RESEARCH INSTITUTE (NHGRI)

Mission.—NHGRI provides leadership for the development of resources and technology to accelerate genome research and its application to human health. NHGRI-supported activities include basic 

and translational research to understand the sequence and function of both human and non-human genomes, human genetic variation, and the genetic and environmental basis of disease. Also central to NHGRI research goals are training programs and a strong 

focus on the ethical, legal, and social implications of genomic 

science and medicine. 

NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING

(NIBIB)

Mission.—The NIBIB mission is to improve human health by 

leading the development and accelerating the application of biomedical technologies. The Institute is committed to integrating the 

engineering and physical sciences with the life sciences to advance 

basic research and medical care. 

NATIONAL INSTITUTE ON MINORITY HEALTH AND HEALTH DISPARITIES

(NIMHD)

Mission.—NIMHD conducts and supports research, training, and 

other programs aimed at reducing the disproportionately high incidence and prevalence of disease, burden of illness and mortality experienced by certain American populations, including racial and 

ethnic minorities and other groups, such as the urban and rural 

poor, with disparate health status. 

Focal Segmental Glomerulosclerosis (FSGS) Research.—The Committee encourages NIMHD to continue research collaboration with 

NIDDK to address the connection between the APOL1 gene and 

the onset of FSGS. 

Health Disparities and Pediatric Kidney Disease.—The Committee recognizes that health disparities play a significant role in 

kidney disease in children, from the incidence and progression of 

kidney disease in children, to the long-term health outcomes, such 

as access to kidney transplant, access to living donors and disparate transplant survival. Children of minority populations are 

disproportionately impacted by kidney disease, and NIMHD’s work 

in this area is critical to defining the basis for these health disparities and developing mechanisms to address them. The Committee 

requests that NIMHD catalog the research being conducted in this 

64 

area and report back on the research currently underway and research gaps in this area of study in the fiscal year 2019 Congressional Justification. 

NATIONAL CENTER FOR COMPLEMENTARY AND ALTERNATIVE

MEDICINE (NCCAM)

Mission.—NCCAM was established to stimulate, develop, and 

support rigorous and relevant research of high quality and open, 

objective inquiry into the safety and effectiveness of complementary 

and alternative medicine (CAM) practices and to train individuals 

to apply the tools of exacting science to CAM systems and modalities in order to provide health care professionals and the American 

public with reliable information about these practices. 

NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES (NCATS)

Mission.—NCATS was established to advance translational 

sciences, coordinating and developing resources that leverage basic 

research in support of translational science and developing partnerships and working cooperatively to foster synergy in ways that do 

not create duplication, redundancy, and competition with industry 

activities. NCATS also includes the Office of Rare Disease Research 

(ORD) that was established in recognition of the need to provide 

a focal point of attention and coordination at NIH for research on 

rare diseases. ORD works within the authorized mission of NCATS 

to provide an increased focus on rare disease research and orphan 

product development; develop a centralized database on rare diseases research; and stimulate rare disease research by supporting 

scientific workshops and symposia to identify research opportunities. 

Clinical and Translational Science Awards.—The Committee remains deeply concerned over the broad utilization of resources it 

specifically allocated for the Clinical and Translational Science 

Awards (CTSA) hubs and has provided NCATS with direct instructions regarding the number of awards. As investment in the CTSA 

program continues, NCATS is directed to ensure the level of support for CTSA institutions is maintained to appropriately reflect 

the additional resources provided by the Committee. Further, 

NCATS is directed to maintain the number of CTSA hubs at no 

fewer than 64 institutions. 

Hereditary Angioedema.—The Committee applauds the Office of 

Rare Diseases Research for their efforts to facilitate research into 

Hereditary Angioedema (HAE) and encourages continued collaboration with other Institutes and Centers (ICs) to advance our scientific understanding and spur the further development of innovative treatment options for patients. 

Pediatric Rare Diseases.—The Committee is encouraged by the 

work of the Rare Diseases Clinical Research Network (RDCRN) 

across a range of rare diseases. The burden of pediatric rare diseases is especially difficult for families navigating multiple research opportunities and clinical service needs. The Committee encourages NCATS to work with RDCRN members to create a pediatric rare disease center of excellence model. 

65 

JOHN E. FOGARTY INTERNATIONAL CENTER (FIC)

Mission.—FIC was established to improve the health of the people of the U.S. and other nations through international collaborations in the biomedical sciences. In support of this mission, the FIC 

pursues the following four goals: (1) mobilize international research 

efforts against global health threats; (2) advance science through 

international cooperation; (3) develop human resources to meet 

global research challenges; and (4) provide leadership in international science policy and research strategies. 

Recent disease outbreaks such as Ebola, Zika, and Dengue have 

shown the importance of the Center’s essential role in global infectious disease health research training and health system strengthening to help developing countries to eventually advance their own 

research and health solutions and tools. FIC has developed important partnerships in countries, including countries unfriendly to 

the U.S., to not only fight malaria, neglected tropical diseases, and 

other infectious diseases, but also to have the capabilities to help 

the U.S. detect and treat infectious diseases that are not endemic 

to the U.S. before they travel to the U.S., thus protecting Americans here at home. The Committee urges FIC to continue this important work building relationships with scientists abroad to foster 

a stronger and more effective science workforce and health capacity 

on the ground, helping to detect infectious diseases and building 

the capacity to confront those diseases while improving the image 

of the U.S. though health diplomacy in their countries. 

NATIONAL LIBRARY OF MEDICINE (NLM)

Mission.—The NLM collects and organizes information important 

to biomedicine; serves as a national information resource for medical education, research, and health service activities; enhances access to biomedical literature through electronic services; serves the 

public by providing electronic access to reliable health information 

for consumers; supports and directs the national network of libraries of medicine; provides grants for research in biomedical communications, medical library development, and training health information specialists; conducts and supports research in biomedical 

informatics and computational biology; and creates information resources for genomics, molecular biology, toxicology, medical images, 

environmental health, emergency preparedness and response, and 

health services research. 

OFFICE OF THE DIRECTOR (OD)

Mission.—The OD provides leadership to the NIH research enterprise and coordinates and directs initiatives that crosscut NIH. OD 

is responsible for the development and management of intramural 

and extramural research and research training policy, the review 

of program quality and effectiveness, the coordination of selected 

NIH-wide program activities, and the administration of centralized 

support activities essential to the operations of NIH. 

Common Fund.—The Committee recommends $695,580,000 for 

the Commond Fund (CF), including $12,600,000 provided to support the Gabriella Miller Kids First Research Act for the fourth 

year of the ten-year Pediatric Research Initiative. NIH is expected 

to continue the longstanding CF policy for projects to be shortVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00065 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
66 

term, high-impact awards, with no projects receiving funding for 

more than 10 years. 

The Committee urges the Director to use a portion of the $10,000,000 made available to the Director’s Discretionary Fund 

(DDF) to support additional pediatric research. The Committee requests a quarterly report on DDF obligations for each activity supported. The report should include a description of the program, 

which ICs are to provide continuation costs, and how this research 

serves a high priority for pediatric diseases. The quarterly reports 

shall be posted on the NIH website within 30 days after being released to the Committee on Appropriations of the House of Representatives and the Senate. 

Operating Plan.—The Committee continues the understanding 

that the IC mechanism tables serve as the NIH operating plans for 

available resources and requests NIH continue to provide quarterly 

updates of these mechanism operating plans to the Committee on 

Appropriations of the House of Representatives and the Senate. 

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

The mission of DPCPSI is to coordinate and facilitate trans-NIH 

research initiatives and emerging areas of scientific opportunities 

and public health challenges. The Division houses these NIH offices: the Office of Research on Women’s Health; the Office of AIDS 

Research; the Office of Dietary Supplements; the Office of Behavioral and Social Sciences Research; the Office of Disease Prevention; and the Office Research Infrastructure Programs. 

The Committee directs the Director of DPCPSI to develop a 

trans-NIH strategic approach to improve coordination and facilitation of trans-NIH research with measurable objectives. The Director should also take specific steps with the ICs to strengthen to reduce duplication and increase effectiveness and efficiency of research. 

Office of Research on Women’s Health 

The Office of Research on Women’s Health (ORWH) works in collaboration with the ICs to promote and foster efforts to address 

gaps in knowledge related to women’s health through the enhancement and expansion of funded research and/or the initiation of new 

investigative studies. ORWH is responsible for supporting the inclusion of women in clinical research funded by NIH, including the 

development of a computerized tracking system and the implementation of guidelines on such inclusion. ORWH is also involved in 

promoting programs to increase the number of women in biomedical science careers, and in the development of women’s health 

and gender factors as a focus in biology. 

Office of AIDS Research 

The Office of AIDS Research (OAR) is authorized to manage 

trans-NIH AIDS research. The Director of OAR and the Director of 

NIH jointly determine the total for AIDS research within the NIH 

appropriation based on scientific need and meritorious scientific opportunity relative to NIH’s overall plan. The Committee encourages 

the Office to use a strategic focus of resources allocated to AIDS 

towards the highest quality peer reviewed projected aimed at findVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00066 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
67 

ing cures, creating a vaccine, and developing better treatments for 

the disease. 

Office of Dietary Supplements 

The Office of Dietary Supplements (ODS) was established in recognition that dietary supplements can have an important impact 

on prevention and health maintenance. In collaboration with other 

NIH institutes and centers and other Federal agencies, ODS works 

to strengthen knowledge about dietary supplements by supporting 

and coordinating scientific research in the field. 

Office of Behavioral and Social Sciences Research 

The Office of Behavioral and Social Sciences Research (OBSSR) 

provides leadership and direction for the development of a transNIH plan to increase the scope of and support for behavioral and 

social sciences research and in defining an overall strategy for the 

integration of these disciplines across NIH institutes and centers; 

develops initiatives to stimulate research in the behavioral and social sciences arena and to integrate a bio-behavioral perspective 

across the research areas of NIH; and promotes studies to evaluate 

the contributions of behavioral, social and lifestyle determinants in 

the development, course, treatment, and prevention of illness and 

related public health problems. 

Office of Science Education 

The Office of Science Education (OSE) plans, develops, and coordinates a comprehensive science education program to strengthen 

and enhance efforts of the NIH to attract young people to biomedical and behavioral science careers and to improve science literacy in both adults and children. The Office develops curriculum 

supplements and other educational materials; maintains a website 

as a central source of information about NIH science education resources; establishes national model programs in public science education, and promotes science education reform as outlined in the 

National Science Education Standards and related guidelines. 

Office of Disease Prevention 

The Office of Disease Prevention (ODP) assesses, facilitates, 

stimulates research into disease prevention and health promotion 

in collaboration with NIH and other public and private partners, 

and disseminates the results of this research to improve public 

health. ODP produces evidence-based consensus statements addressing controversial medical issues. The Committee expects ODP 

to disseminate consensus statements and disease prevention and 

health promotion information through appropriate HHS outreach 

programs. 

Office of Research Infrastructure Programs 

The Office of Research Infrastructure Programs (ORIP) provides 

support for research and a variety of research infrastructure needs, 

including animal models and facilities; research models, biological 

materials, and human biospecimens; training and career development for veterinarians engaged in research; the acquisition of 

state-of-the-art instrumentation through the Shared and High-End 

Instrumentation Programs; research resources grants to expand, 

68 

re-model, renovate, or alter existing research facilities or to construct new research facilities; and coordinates science education activities. 

Multi-institute Research Issues 

Addressing Hispanic Research Issues.—The Committee is encouraged by NIH’s efforts seeking to address health disparity research 

issues impacting the U.S. Hispanic population across various ICs. 

The Committee recognizes that the longitudinal Study of Latino 

Health research program being conducted by NHLBI, as well as 

the collaborative research efforts at NIMHD, are providing important progress in measuring more precisely the risk factors and outcomes and determining effective interventions among U.S. Hispanics. The Committee urges NIH to fill out key gaps in its 

translational research portfolio to include children and youth and 

reproductive-age young women, as well as older populations, in 

high-density areas to allow for broader research cohorts. 

Adolescents and Medication-Assisted Treatment.—The Committee 

applauds the ongoing coordinated efforts at NIH to understand and 

address substance use and substance use disorders among adolescents and young adults as a specific population. As part of those 

efforts, the Committee also encourages NIH to examine the effectiveness of medication assisted treatment in adolescents struggling 

with substance use disorder, and identify any barriers to treatment 

as well as potential unintended consequences. 

Adolescents and Young Adults.—The Committee encourages an 

NIH-wide emphasis on understanding and addressing substance 

use and substance use disorders among adolescents and young 

adults as a specific population. The Committee encourages NIH to 

identify and coordinate its efforts in this area and provide an update in the fiscal year 2019 Congressional Justification on these actions. 

Amyloidosis.—The Committee recommends that NIH continue to 

expand its research efforts into amyloidosis, a group of rare diseases characterized by abnormally folded protein deposits in tissues. Amyloidosis is often fatal and there is no known cure. Current methods of treatment are risky and unsuitable for many patients. The Committee directs NIH to keep the Committee informed 

on the steps taken to increase the understanding of the causes of 

amyloidosis and the measures taken to improve the diagnosis and 

treatment of this devastating group of diseases. 

Angelman Syndrome.—The Committee recognizes the promising 

scientific gains made in the pursuit of treatments for Angelman 

Syndrome. The Committee applauds the significant contributions of 

the Angelman Syndrome Natural History Study, funded by NIH, 

and the private partners working diligently to advance the growing 

body of Angelman Syndrome research towards practical treatments. Because Angelman Syndrome is a single-gene disorder, specifically caused by a deleted UBE3A gene, the Committee believes 

that with recent advances in medical therapeutics and technology, 

the disorder is curable today. Further research in this area holds 

great promise for both Angelman Syndrome and forms of autism 

also linked to misexpression of the UBE3A gene. With two innovative new treatments poised for clinical trials, the Committee urges 

NIH to dedicate available resources to Angelman Syndrome reVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00068 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
69 

search, and specifically to advance research in the roles of the 

UBE3A gene in brain functions. In this challenging budget environment, the Committee also believes public-private partnerships 

should be further encouraged as translational research progresses 

in the areas of Angelman Syndrome, autism, and UBE3A related 

disorders. 

Basic Biomedical Research.—The purpose of basic research is to 

discover the nature and mechanics of disease and identify potential 

therapeutic avenues likely to lead to the prevention and treatment 

of human disease. Without this early scientific investigation, future 

development of treatments and cures would be impossible. Basic 

biomedical research must remain a key component of both the intramural and extramural research portfolio at the NIH. The Committee encourages NIH to take actions to ensure the percentage of 

funding in the extramural research program on basic research does 

not fall below 55 percent of NIH resources. 

Bilateral Renal Agenesis.—The Committee requests NIH conduct 

a state of the science report on bilateral renal agenesis research, 

possible treatments, and related dialysis for preemies and 

newborns, and provide an update in the fiscal year 2019 Congressional Justification. 

Cerebral Cavernous Angioma Research.—The Committee urges 

NIH to expand and strengthen NINDS programs regarding research and related activities for cavernous angioma by including 

basic, clinical, and translational research as well as promoting 

training programs for medical and allied health clinicians and scientists, increasing outreach and awareness, and sharing clinical 

and other surveillance information. The Committee also encourages 

NIH and FDA to work with patient advocacy organizations to research and promote effective treatments. The Committee is aware 

of patient advocacy groups asking NIH to conduct clinical trials. 

The Committee urges NIH to continue to work with these organizations on this request. 

Children in NIH Research.—The inclusion of children in clinical 

research is essential to ensure that children benefit from important 

scientific advances. The Committee appreciates provisions of the 

21st Century Cures Act that will now require NIH to track systematically enrollment data to determine if children are actually being 

enrolled appropriately in clinical research. The Committee recognizes that without better data collection, the Committee is unable 

to fully exercise its oversight role and researchers are unable to determine whether children as a whole, or particular pediatric subpopulations, are underrepresented in Federally-funded biomedical 

research. The Committee directs NIH to implement these new requirements expeditiously. 

Chimpanzee Sanctuary Support.—The Committee commends 

NIH for their decision to relocate all Federally-owned chimpanzees 

to the federal sanctuary system. The Committee supports NIH’s 

careful consideration for their welfare, including their health and 

social grouping. The Committee is pleased to see that NIH intends 

to continue transferring chimpanzees to the federal sanctuary system in fiscal year 2017 and strongly encourages further progress 

towards finding both cost-effective and humane care for all Federally-owned and -supported chimpanzees in their retirement. The 

Committee is aware of the suggestion that a change in transporVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00069 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
70 

tation methods or a system expansion could facilitate earlier completion of the retirement effort. Therefore, the Committee directs 

NIH to develop a plan that addresses impediments in the rate of 

transportation of chimpanzees to the sanctuary system and explores the need for expansion, taking into account age and health 

of chimpanzees as well any expansion and facility costs. This plan 

should also include details on how NIH plans to meet the goal of 

retiring all the NIH-owned chimpanzees to the Federal sanctuary 

system as rapidly as possible, but no later than within five years. 

The NIH shall report back to the Committee with this plan within 

120 days of enactment of this act. 

Chronic Fatigue Syndrome.—The Committee is pleased that NIH 

has begun to expedite research into Myalgic Encephalomyelitis/ 

Chronic Fatigue Syndrome, including its intramural study and the 

request for applications (RFAs) for the collaborative research centers. However, the Committee is concerned that the level of funding 

is still very low considering the burden of disease and the current 

plan to expand research will take too long to produce Food and 

Drug Administration approved treatments and diagnostic tests. 

The Committee urges NIH to collaborate with disease experts and 

the patient community to identify additional opportunities to expedite progress on this understudied disease. Specifically, the Committee recommends that NIH significantly increase research funding to be commensurate with disease burden and use that funding 

to further accelerate the research field through a set of intramural 

and extramural investments such as (a) RFAs for biomarkers and 

treatment trials, (b) additional funding for investigator initiated 

studies and early stage investigator awards, (c) an initiative to 

reach consensus on the case definition, and (d) mechanisms to 

incentivize researchers to enter the field. 

Coordination with the Department of Energy (DOE) and National 

Laboratories to Implement 21st Century Cures Act.—NIH is encouraged enter into collaborative research programs, as appropriate, 

with DOE, the National Laboratories, and others determined to be 

appropriate, to utilize the broader scientific and technological capabilities of DOE and the National Laboratories relevant to the successful implementation of the 21st Century Cures Act (P.L. 114– 

255). 

Dietary Reference Intake for Carbohydrates.—The Committee 

notes keen public interest in various dietary guidance proposals 

and food labeling initiatives regarding consumption of carbohydrates. Yet, the last Dietary Reference Intake (DRI) review conducted regarding carbohydrates was completed in 2002. The Committee encourages NIH to consider arranging for a DRI review for 

carbohydrates. 

Fragile X.—The Committee commends NIH for the NICHD-led 

effort that has resulted in significant progress in mapping the molecular, physiological, biological and genetic connections among 

Fragile X (FX), the FX protein, and autism. Increased focus on 

basic science is needed to identify additional targetable mechanisms of the disease. The Committee acknowledges that recently 

concluded drug trials were unable to demonstrate and measure 

positive clinical outcomes when compared to a placebo. The Committee urges the Director to support expanded natural history studies to supplement the CDC’s efforts, and to focus on validating outVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00070 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
71 

come measures and biomarkers that bridge the mouse model and 

humans with the disease across the full spectrum of CGG repeat 

expansion in males and females. The Committee endorses the creation of a Clinical Trial Network that builds upon the already established consortium of FX clinics to accelerate the development of 

specialized outcome measures. This will ensure that, as additional 

targetable mechanisms of the disease are identified, clinical trials 

can promptly follow. Given the inextricable connection between the 

FX protein and autism, the Committee urges the Director and his 

counterparts at each institute with Fragile X and autism portfolios 

to explore ways to create greater efficiency and synergy among 

these two research tracks to accelerate translational research toward a better understanding of both conditions and to shorten the 

time to bring effective treatments for both conditions to market. 

The Committee commends the NIH for its previous work to create 

and update the NIH Research Plan on Fragile X Syndrome and Associated Disorders. 

Gut Microbiome.—The Committee commends the Office of the Director’s partnership with NIDDK on the Human Microbiome 

project and urges expanded investigation into the manipulation of 

the microbiome to improve scientific understanding of functional 

gastrointestinal disorders, including Irritable Bowel Syndrome. 

National Children’s Study (NSC) Follow-On.—The Committee 

continues to recognize the importance of investigating the effects of 

environmental exposures on child health and development. The National Children’s Study (NCS)/Environmental Influences on Child 

Health Outcomes (ECHO) Project has the potential to increase 

greatly understanding of this critical determinate of health across 

the lifespan. The Committee is pleased that NIH has established 

an External Scientific Board for NCS/ECHO that reports directly 

to the NIH Director, and encourages greater communication about 

to the program’s progress toward goals, milestones, and projected 

funding estimates with both external stakeholders and Congress. 

The Committee directs NIH to provide an update in the fiscal year 

2019 Congressional Justification including a summary of progress 

made to date, an analysis of the composition of the funded cohort 

studies, and the short- and long-term goals of the study. 

Neurofibromatosis.—The Committee supports efforts to increase 

funding and resources for Neurofibromatosis (NF) research and 

treatment at multiple NIH Institutes, including NCI, NINDS, 

NIDCD, NHLBI, NICHD, NIMH, NCATS, and NEI. Children and 

adults with NF are at significant risk for the development of many 

forms of cancer; the Committee encourages NCI to increase its NF 

research portfolio in fundamental basic science, translational research and clinical trials focused on NF. The Committee also encourages the NCI to support NF centers, NF clinical trials consortia, NF preclinical mouse models consortia and NF-associated 

tumor sequencing efforts. Because NF causes brain and nerve tumors and is associated with cognitive and behavioral problems, the 

Committee urges NINDS to continue to aggressively fund fundamental basic science research on NF relevant to nerve damage and 

repair. Based on emerging findings from numerous researchers 

worldwide demonstrating that children with NF are at significant 

risk for autism, learning disabilities, motor delays, and attention 

deficits, the Committee encourages NINDS, NIMH and NICHD to 

72 

expand their investments in laboratory-based and clinical investigations in these areas. Since NF2 accounts for approximately 5 

percent of genetic forms of deafness, the Committee encourages 

NIDCD to expand its investment in NF2 basic and clinical research. Since NF1 can cause vision loss due to optic gliomas, the 

Committee encourages NEI to expand its investment in NF1 basic 

and clinical research. The Committee requests an update on efforts 

to address these research efforts in the FY19 Congressional Justification. 

Neurogenic Bladder and Kidney Disease.—The Committee encourages NIA, NIDDK, NICHD, and NINDS to study the causes 

and care of the neurogenic bladder and kidney disease in order to 

improve the quality of life of children and adults with Spina Bifida; 

to support research to address issues related to the treatment and 

management of Spina Bifida and associated secondary conditions, 

such as hydrocephalus; and to invest in understanding the myriad 

co-morbid conditions experienced by individuals with Spina Bifida, 

including those associated with both paralysis and developmental 

delay. 

Pediatric Precision Medicine.—The Committee is encouraged by 

the enormous potential of precision medicine for all populations, including children, since much of adult health is rooted in the earliest years. The Committee is aware that, at an All of Us Research 

Program stakeholder briefing, NIH announced plans to develop a 

working group to address inclusion of the pediatric population and 

has also indicated plans to host a pediatric stakeholder convening. 

The Committee requests an update within 30 days of enactment of 

this Act on the status and timeline for the working group to release 

recommendations regarding pediatric enrollment in the All of Us 

Research Program and the expected timeline for beginning enrollment of children in the program. The Committee expects NIH to 

ensure that the research cohort includes a sufficient number of 

children to make meaningful studies possible. 

Pregnancy-Related Research.—Each year, approximately four 

million women give birth in the U.S. Pregnancy research is essential to learning more about the health and development of both 

mother and baby, yet this research lags behind disease or organspecific research. The U.S. is ranked 47th globally for its maternal 

mortality rate, and unlike any other industrialized country, its 

rates are on the rise. As maternal mortality and maternal morbidity increases, health care costs rise, and pregnancy presents a 

greater need for improved research and clinical guidance, the need 

to understand how to manage pregnancy better to prevent poor 

outcomes and to have evidence-based guidelines for management of 

high-risk pregnancies is imperative. The Committee requests that 

NIH conduct a state of the science report on pregnancy research 

and provide an update in the fiscal year 2019 Congressional Justification. The Committee requests the following additional information from the NIH as it relates to research in pregnancy, for 

each of the last three years: the number of clinical research 

awards, including all Institutes and Centers, addressing questions 

related to pregnancy; within NICHD, what is the proportion of the 

total NICHD budget spent on clinical research involving pregnancy; 

and how might NIH better address questions related to pregnancy 

across the ICs. 

73 

Teacher Stress.—The Committee is aware that high levels of 

stress are adversely affecting the health of teachers. Elementary 

school teachers who have greater stress and show more symptoms 

of depression create classroom environments that are less conducive to learning. Stress is contributing to the high turnover rate 

among teachers. The Committee encourages NIH to support research on reducing teacher stress and promoting wellbeing by implementing and analyzing evidence-based stress management programs that will help reduce the stress of teachers. 

Trisomy 21.—The Committee continues to recognize that the 

presence of a third copy of human chromosome 21, which causes 

Down syndrome, predisposes individuals to significant immune system dysregulation. This dysregulation is associated with the occurrence of Alzheimer’s disease as individuals with Down syndrome 

age and the high incidence of autoimmune disease as well as protections against most solid tumor cancers and cardiovascular disease. These findings present a rich research opportunity and, based 

on the NIH’s recently released report on the Feasibility of a MultiYear Study on Trisomy 21 in Humans, the Committee encourages 

NIH to pursue a multi-year, trans-NIH research initiative examining immune system dysregulation and trisomy 21, with the aim 

of yielding scientific learnings that could significantly improve the 

health of individuals with Down syndrome as well as millions of 

typical individuals. 

Undiagnosed Illnesses.—The Committee urges the Undiagnosed 

Disease Network (UDN) to continue efforts to enhance access to patients, caregivers, and other stakeholders as well as make information obtained through the UDN available to Federal agencies and 

health-related agencies. 

Usher Syndrome.—The Committee continues to urge the NIH to 

prioritize Usher syndrome research at NEI and NIDCD. The Committee requests an update in the fiscal year 2019 Congressional 

Justification. The update should include efforts to stimulate the 

field and to accelerate viable human treatment options for those 

with Usher syndrome. 

Valley Fever.—The Committee commends NIH and CDC on 

launching a Randomized Control Trial (RCT) to identify an effective treatment for Valley Fever. The Committee requests an update 

on the status of the RCT, and continues to support efforts to develop early diagnostic tests, increase awareness of this disease 

among medical professionals and the public, and develop a vaccine. 

Young Investigators.—The Committee expects NIH to report on 

actions it has taken to lower the median age at which investigators 

receive their first R01 awards annually in the fiscal year 2019 Congressional Justification. In addition, the NIH shall provide an update on the concrete steps it is taking to lower the median age at 

which individuals receive their first R01 award within 60 days of 

enactment of this Act. 

BUILDINGS AND FACILITIES

Mission.—The Buildings and Facilities appropriation provides for 

the design, construction, improvement, and major repair of clinical, 

laboratory, and office buildings and supporting facilities essential 

to the mission of the National Institutes of Health. The funds in 

this appropriation support the buildings on the main NIH campus 

74 

in Bethesda, Maryland; the Animal Center in Poolesville, Maryland; the National Institute of Environmental Health Sciences facility in Research Triangle Park, North Carolina; and other smaller 

facilities throughout the U.S. 

The Committee notes NIH has a significant backlog of maintenance and repairs. The Committee requests NIH and HHS develop 

a coordinated plan to address the backlog with the Office of Management and Budget in the fiscal year 2019 Congressional Justification. 

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

The Committee recommends $3,458,934,000 for the Substance 

Abuse and Mental Health Services Administration (SAMHSA), 

which is $306,086,000 below the fiscal year 2017 enacted program 

level and $68,101,000 above than the fiscal year 2018 budget request program level. 

The Committee includes bill language directing the Secretary to 

exempt the Mental Health Block Grant and the Substance Abuse 

Prevention and Treatment Block Grant as a source for the Public 

Health Service Act section 241 evaluation set-aside in fiscal year 

2018. 

The Committee does not include the requested bill language allowing the Assistant Secretary for Mental Health and Substance 

Use to transfer three percent or less of funds between any of the 

SAMHSA accounts. 

American Indians and Alaska Natives continue to face significant 

behavioral health problems, and have significantly limited access to 

behavioral health services. The Committee is aware that State authorities must have meaningful and timely Tribal consultation as 

they undertake their block grant planning process. The Committee 

strongly encourages SAMHSA to ensure States engage meaningfully with their Tribal populations. The Committee would also support information from States on how block grant funds have been 

used to support Indian Tribes and/or Tribal organizations within 

their borders and to what extent States have consulted with Tribes 

on the disbursement of block grant funds. 

The Committee directs SAMHSA, where statute allows, when 

issuing new funding opportunity announcements, to include as eligible applicants, States, political subdivisions of States such as 

local government or communities, Indian Tribes or tribal organizations, health facilities, or programs operated by or in accordance 

with a contract or grant with the Indian Health Service, or other 

public or nonprofit private entities. It is important to the Committee that all of these entities have the opportunity to compete for 

funding. While States play a critical role, in many cases Tribal governments, nonprofit organizations, or local communities are better 

positioned to target resources to those most in need. The Committee encourages SAMHSA to provide outreach and technical assistance to these entities to ensure they are able to compete for 

new grant announcements. 

MENTAL HEALTH

The Committee provides $949,707,000 for Mental Health, which is $231,330,000 below the fiscal year 2017 enacted program level 

75 

and $37,360,000 above the fiscal year 2018 budget request program 

level. 

The Committee requests an update in the fiscal year 2019 Congressional Justification information on the costs to law enforcement, first responders, judicial systems, and health systems that 

accrue due to recidivist clients, including potential options for more 

cost-effective solutions to providing care for such clients. 

Within the total provided for Mental Health Programs of Regional and National Significance, the Committee provides the following amounts: 

Budget Activity FY 2018 

Committee 

Capacity: 

Seclusion and Restraint ........................................................................................................................ $1,147,000 

Mental Health First Aid ......................................................................................................................... 14,963,000 

National Child Traumatic Stress Network ............................................................................................. 48,887,000 

Children and Family Programs ............................................................................................................. 7,229,000 

Consumer and Family Network Grants ................................................................................................. 4,954,000 

Mental Health System Transformation and Health Reform .................................................................. 3,779,000 

Project LAUNCH ..................................................................................................................................... 23,605,000 

Primary and Behavioral Health Care Integration ................................................................................. 49,877,000 

Suicide Prevention: 

National Strategy for Suicide Prevention .............................................................................................. 11,000,000 

Zero Suicide .................................................................................................................................. 9,000,000 

American Indian and Alaska Native Set-Aside .......................................................... 2,000,000 

Suicide Lifeline ...................................................................................................................................... 7,198,000 

Garrett Lee Smith-Youth Suicide Prevention: 

State Grants .......................................................................................................................................... 35,427,000 

Campus Grants ..................................................................................................................................... 6,488,000 

American Indian and Alaska Native Suicide Prevention ...................................................................... 2,931,000 

Tribal Behavioral Health Grants ........................................................................................................... 15,000,000 

Homeless Prevention Programs ............................................................................................................. 30,696,000 

Minority AIDS ......................................................................................................................................... 4,206,000 

Criminal and Juvenile Justice Programs ............................................................................................... 4,269,000 

Assisted Outpatient Treatment ............................................................................................................. 15,000,000 

Science and Service: 

Garrett Lee Smith-Suicide Prevention Resource Center ....................................................................... 5,988,000 

Consumer and Consumer Support Technical Assistance Centers ........................................................ 1,918,000 

Primary and Behavioral Health Care Integration Technical Assistance .............................................. 1,991,000 

Minority Fellowship Program ................................................................................................................. 8,059,000 

Disaster Response ................................................................................................................................. 1,953,000 

Homelessness ........................................................................................................................................ 2,296,000 

Mental Health First Aid.—The Committee is pleased with the 

progress of the Mental Health First Aid program including training 

more than 740,000 Americans to recognize the signs and symptoms 

of common mental disorders. In continuing competitive funding opportunities, SAMHSA is directed to include as eligible grantees 

local law enforcement agencies, fire departments, and emergency 

medical units with a special emphasis on training for crisis de-escalation techniques. SAMHSA is also encouraged to allow training for 

veterans, armed services personnel and their family members. Any 

qualified community mental health education program should be 

considered as eligible for funding under the Mental Health First 

Aid program. 

Mental Health Block Grant 

The Committee recommends a total of $421,039,000 for the Mental Health Block Grant, which is $141,532,000 below the fiscal year 

2017 enacted program level and $5,500,000 above the fiscal year 

2018 budget request program level. The block grant provides funds 

76 

to States to support mental illness prevention, treatment, and rehabilitation services. Funds are allocated according to a statutory 

formula among the States that have submitted approved annual 

plans. 

The Committee continues the ten percent set-aside within the 

Mental Health Block Grant for evidence-based programs that address the needs of individuals with early serious mental illness, including psychotic disorders. The Committee expects SAMHSA to 

continue its collaboration with the National Institute of Mental 

Health to encourage States to use this block grant funding to support programs that demonstrate strong evidence of effectiveness. 

Children’s Mental Health 

The Committee recommends $119,026,000 for the Children’s 

Mental Health program, which is the same as the fiscal year 2017 

enacted level and $226,000 above the fiscal year 2018 budget request. Funding for this program supports grants and technical assistance for community-based services for children and adolescents 

with serious emotional, behavioral, or mental disorders. The program assists States and local jurisdictions in developing integrated 

systems of community care. 

Pediatric Psychiatric Beds.—The Committee understands there is 

a shortage of psychiatric beds, particularly pediatric psychiatric 

beds, which help treat children with mental health and substance 

abuse issues. The Committee recommends SAMHSA review the 

best practices of pediatric psychiatric programs and provide an update in the fiscal year 2019 Congressional Justification on this 

topic. 

Projects for Assistance in Transition from Homelessness 

The Committee recommends $64,635,000 for the Projects for Assistance in Transition from Homelessness (PATH) program, which 

is the same as the fiscal year 2017 enacted level and $123,000 

above the fiscal year 2018 budget request. The PATH program supports grants to States and territories for assistance to individuals 

suffering from severe mental illness and/or substance abuse disorders and who are homeless or at imminent risk of becoming 

homeless. Grants may be used for outreach, screening and diagnostic treatment services, rehabilitation services, community mental health services, alcohol or drug treatment services, training, 

case management services, supportive and supervisory services in 

residential settings, and a limited set of housing services. 

Protection and Advocacy for Individuals with Mental Illness 

The Committee recommends $36,146,000 for the Protection and 

Advocacy for Individuals with Mental Illness program, which is the 

same as the fiscal year 2017 enacted level and $69,000 above the 

fiscal year 2018 budget request. This program serves to ensure that 

the rights of mentally ill individuals are protected while they are 

patients in all public and private facilities or while they are living 

in the community. Funds are allocated to States according to a formula based on population and relative per capita incomes. 

77 

SUBSTANCE ABUSE TREATMENT

The Committee recommends $2,211,506,000 for Substance Abuse 

Treatment programs, which is $1,000,000 less than the fiscal year 

2017 enacted program level and $15,071,000 more than the fiscal 

year 2018 budget request program level. 

State Targeted Response to the Opioid Crisis.—The Committee 

includes $500,000,000 for the second year of continuation funding 

as authorized under section 1003 of the 21st Century Cures Act. 

Consistent with the authorization, the Committee recommends 

States be given flexibility within the existing grant to direct resources in accordance with local needs. SAMHSA should permit 

States to allocate funds for prevention, training, treatment, recovery, and other public health related activities at levels based on the 

conditions of each State. 

The Committee is aware of the significant challenge presented by 

opioid abuse, and believes that addressing the opioid crisis requires 

that states coordinate efforts among myriad agencies and organizations. Regional collaborations involving hospital systems, institutions of higher education, local government, and the judiciary can 

drive best practices and have shown success in identifying solutions 

for opioid abuse. Therefore, the Committee encourages SAMHSA to 

utilize such regional collaborative stakeholder teams. 

Within the total provided for Programs of Regional and National 

Significance, the Committee recommends the following amounts: 

Budget Activity FY 2018 

Committee 

Capacity: 

Opioid Treatment Programs and Regulatory Activities ......................................................................... $8,724,000 

Screening, Brief Intervention and Referral to Treatment ..................................................................... 30,000,000 

PHS Evaluation Funds .................................................................................................................. 2,000,000 

Targeted Capacity Expansion-General .................................................................................................. 67,192,000 

Medication-Assisted Treatment for Prescription Drug and Opioid Addiction .............................. 56,000,000 

Pregnant and Postpartum Women ........................................................................................................ 19,931,000 

Recovery Community Services Program ................................................................................................ 2,434,000 

Children and Families ........................................................................................................................... 29,605,000 

Treatment Systems for Homeless .......................................................................................................... 36,386,000 

Minority AIDS ......................................................................................................................................... 65,570,000 

Criminal Justice Activities ..................................................................................................................... 78,000,000 

Building Communities of Recovery ....................................................................................................... 3,000,000 

Science and Service: 

Addiction Technology Transfer Centers ................................................................................................. 9,046,000 

Minority Fellowship Program ................................................................................................................. 3,539,000 

Screening, Brief Intervention and Referral to Treatment 

The Committee provides $30,000,000 for Screening, Brief Intervention and Referral to Treatment, which is the same as the fiscal 

year 2017 enacted program level, and $16,804,000 below the fiscal 

year 2018 budget request program level. Within this amount, the 

Committee provides $1,000,000 for grants to pediatric health care 

providers in accordance section 9016 of the 21st Century Cures Act 

(P.L. 114–255). Grants should focus on screening for underage 

drinking, opioid use, and other drug use. The Committee understands that substance use disorders, including opioid use, typically 

begin in adolescence, and that preventing underage drinking and 

other early substance use is a cost-effective strategy in preventing 

costly problems later in life. 

78 

Targeted Capacity Expansion 

The Committee recommends $67,192,000 for Targeted Capacity Expansion activities. Of this amount, $56,000,000 is for services 

that address prescription drug abuse and heroin use in high-risk 

communities. SAMHSA should target States with the highest rates 

of admissions and that have demonstrated a dramatic increase in 

admissions for the treatment of opioid use disorders. The Center 

for Substance Abuse Treatment is directed to include as an allowable use medication-assisted treatment and other clinically appropriate services to achieve and maintain abstinence from all opioids 

and heroin and prioritize treatment regimens that are less susceptible to diversion for illicit purposes. 

Pregnant and Postpartum Women 

The Committee provides $19,931,000 for Pregnant and 

Postpartum Women, which is the same as the fiscal year 2017 enacted level and the same as the fiscal year 2018 budget request. 

Addiction to opioids has risen dramatically over the past few years. 

Especially important are pregnant women at risk for opioid dependence and opioid exposure during pregnancy, and infants born 

with neonatal abstinence syndrome. The Government Accountability Office conducted a review of programs and stated in a 2015 

report ‘‘the program gap most frequently cited was the lack of 

available treatment programs for pregnant women.’’ Substance 

abuse treatment that supports the family as a unit has proven effective for maintaining maternal sobriety and child well-being. 

There is a need for increased availability of outpatient treatment 

options that are responsive to women’s complex responsibilities, 

often as the primary or sole caregivers for their families. Reauthorized as part of the Comprehensive Addiction and Recovery Act (P.L. 

114–198), the Pregnant and Postpartum Women program supports 

residential treatment programs for pregnant and postpartum 

women with substance use disorders, including opioids. These programs provide substance use disorder treatment to women in residential facilities, and allow women to bring their minor children. 

Congress authorized the program to use funds for pilot programs 

to address service delivery gaps for pregnant and postpartum 

women, including services in non-residential settings, and to encourage new approaches and models of service delivery across the 

continuum of care. 

Criminal Justice Activities 

The Committee provides $78,000,000 for the Criminal Justice Ac- tivities program and expects that no less than $60,000,000 will be 

used exclusively for Drug Court activities. 

Drug Courts.—The Committee continues to direct SAMHSA to 

ensure that all funding appropriated for Drug Treatment Courts is 

allocated to serve people diagnosed with a substance use disorder 

as their primary condition. The Committee directs SAMHSA to ensure that all drug treatment court grant recipients work directly 

with the corresponding State substance abuse agency in the planning, implementation, and evaluation of the grant. The Committee 

further directs SAMHSA to expand training and technical assistance to drug treatment court grant recipients to ensure evidencebased practices are fully implemented. 

79 

Minority AIDS 

Viral Hepatitis Screening.—The Committee commends SAMHSA 

for encouraging grantees to screen for viral hepatitis including the 

use of innovative strategies like rapid testing. The Committee notes 

the disproportionate impact of viral hepatitis among minority populations and the co-infection rate among individuals with HIV/AIDS. 

The Committee encourages SAMHSA to continue its work with 

grantees to incorporate hepatitis screening into programmatic activities and requests a report on the implementation of hepatitis 

screening activities in the fiscal year 2019 Congressional Justification. 

Substance Abuse Prevention and Treatment Block Grant 

The Committee recommends a program level of $1,858,079,000 

for the Substance Abuse Prevention and Treatment Block Grant, 

which is the same as the fiscal year 2017 enacted program level 

and $3,382,000 above the fiscal year 2018 budget request program 

level. The Substance Abuse Prevention and Treatment Block Grant 

provides funds to States to support alcohol and drug abuse prevention, treatment, and rehabilitation services. The Committee recognizes the critical role the block grant plays in State systems across 

the country. 

Handheld Analyzers.—The Committee understands the role 

played by handheld drug analyzers, particularly for police officers 

and other first responders. These instruments can identify various 

drugs and assist first responders in treatment referral. They also 

keep officers safe by minimizing the exposure to toxic drugs, while 

reducing the overall cost and backlog of cases at crime labs. The 

Committee encourages SAMHSA to work with the relevant stakeholders to clarify the policy of block grant funds and handheld analyzers. 

Peer Recovery Support Services.—The Committee values the role 

of peer recovery support services to individuals and families impacted by substance use disorder treatment. The Committee requests information in the fiscal year 2019 Congressional Justification on the amount of funds from the Substance Abuse Prevention 

and Treatment Block Grant used for peer recovery support services. 

Pregnant Women.—The Committee remains concerned about the 

lack of treatment options for pregnant women and women with dependent children. States are required to allocate a portion of their 

block grant funds to support treatment for this population. The 

Committee requests information in the fiscal year 2019 Congressional Justification on the amount of funds from the Substance 

Abuse Prevention and Treatment Block Grant used for pregnant 

women and women with dependent children, including information 

on how States are implementing these requirements, funding level 

by State, and information on availability of treatment, and barriers 

to treatment. 

SUBSTANCE ABUSE PREVENTION

The Committee recommends $165,373,000 for the Substance 

Abuse Prevention programs, which is $57,846,000 below the fiscal 

80 

year 2017 enacted level and $15,670,000 above the fiscal year 2018 

budget request. 

Within the total provided for Programs of Regional and National 

Significance, the Committee provides the following amounts: 

Budget Activity FY 2018 

Committee 

Capacity: 

Strategic Prevention Framework ..................................................................................................................... $74,000,000 

Strategic Prevention Framework Rx ...................................................................................................... 10,000,000 

Grants to Prevent Prescription Drug and Opioid Overdose Related Deaths ................................................. 12,000,000 

First Responder Training ................................................................................................................................ 12,000,000 

Rural Focus ........................................................................................................................................... 6,000,000 

Minority AIDS .................................................................................................................................................. 28,843,000 

Federal Drug-Free Workplace ......................................................................................................................... 4,894,000 

Sober Truth on Preventing Underage Drinking 

National Adult-Oriented Media Public Service Campaign .................................................................... 1,000,000 

Community Based Coalition Enhancement Grants ............................................................................... 5,000,000 

Interagency Coordinating Committee to Prevent Underage Drinking ................................................... 1,000,000 

Tribal Behavioral Health Grants .................................................................................................................... 15,000,000 

Science and Service: 

Center for the Application of Prevention Technologies ........................................................................ 7,493,000 

Science and Service Program Coordination .......................................................................................... 4,072,000 

Minority Fellowship Program ................................................................................................................. 71,000 

Federal Drug Free Workplace.—The Committee is concerned that 

the Secretary of Health and Human Services has yet to release 

technical guidelines for the use of hair testing as a Federally accepted drug testing method, in accordance with section 5402 of the 

Fixing America’s Surface Transportation Act (P.L.114–94). The 

Committee believes these guidelines pose tremendous safety implications due to hair testing’s many advantages over currently recognized testing methods, including providing employers with a longer 

detection window than the standard urinalysis, as well as being 

easier to collect and harder to adulterate. Therefore, the Committee 

strongly encourages the Secretary to expeditiously produce the 

technical guidelines for the use of hair testing as a Federally accepted drug testing method. The Committee requests an update on 

this effort in the fiscal year 2019 Congressional Justification. 

Overdose Fatality Prevention.—The agreement reflects strong 

concerns about the increasing number of unintentional overdose 

deaths attributable to prescription and nonprescription opioids. 

SAMHSA is urged to take steps to encourage and support the use 

of Substance Abuse and Prevention Block Grant funds for opioid 

safety education and training, including initiatives that improve access for licensed healthcare professionals, including paramedics, to 

emergency devices used to rapidly reverse the effects of opioid 

overdoses. Such initiatives should incorporate robust evidence 

based intervention training, and must facilitate linkage to treatment and recovery services. 

Strategic Prevention Framework.—The Committee directs 

SAMHSA to provide continuation grants for Strategic Prevention 

Framework activities in fiscal year 2018. 

HEALTH SURVEILLANCE AND PROGRAM SUPPORT

The Committee provides $132,348,000 for Health Surveillance 

and Program Support, which is $15,910,000 below the fiscal year 

2017 enacted program level and the same as the fiscal year 2018 

budget request program level. 

81 

The Committee provides the following amounts for Health Surveillance and Program Support: 

Budget Activity FY 2018 

Committee 

Health Surveillance ........................................................................................................................................ $33,842,000 

PHS Evaluation Funds ........................................................................................................................... 22,428,000 

Program Support ............................................................................................................................................ 73,043,000 

Public Awareness and Support ...................................................................................................................... 11,572,000 

Performance and Quality Information Systems ............................................................................................. 12,893,000 

Agency-Wide Initiatives.

PHS Evaluation Funds ........................................................................................................................... 998,000 

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

Health. 

AGENCY FOR HEALTHCARE RESEARCH AND QUALITY

HEALTHCARE RESEARCH AND QUALITY

The Committee recommends $300,000,000 in discretionary funds 

for the Agency for Healthcare Research and Quality (AHRQ), which 

is $24,000,000 below the fiscal year 2017 enacted level and 

$300,000,000 above the fiscal year 2018 budget request. Within the 

total for AHRQ, the agreement includes the following amounts: 

Budget Activity FY 2018 

Committee 

Patient-Centered Health Research ................................................................................................................. $0 

Prevention/Care Management ........................................................................................................................ 11,649,000 

Health Information Technology (IT) ....................................................................................................... 16,500,000 

Health IT to Improve Quality ................................................................................................................. 14,500,000 

Patient Safety Research ................................................................................................................................. 70,276,000 

Healthcare-Associated Infections (HAI) Prevention ............................................................................... 36,000,000 

Combating Antibiotic-Resistant Bacteria (non-add within HAI) .......................................................... 10,000,000 

Section 933 Grants ............................................................................................................................... 10,000,000 

Patient Safety and Medical Errors ........................................................................................................ 19,000,000 

Patient Safety Organizations ................................................................................................................. 5,276,000 

Crosscutting Activities Related to Quality, Effectiveness and Efficiency Research ..................................... 68,731,000 

Health Services Contract/IAA Research ................................................................................................ 12,000,000 

Investigator-Initiated Research Grants ................................................................................................. 25,731,000 

Medical Expenditure Panel Survey ................................................................................................................. 66,000,000 

Program Management .................................................................................................................................... 66,844,000 

The Committee notes that the findings from research conducted 

and supported by AHRQ provide evidence to improve the quality, 

safety, accessibility, and affordability of health care. It is in the Nation’s interest to ensure this work is being supported and managed 

effectively and efficiently, and in a way that avoids unnecessary 

duplication with other Federal agencies and/or the private sector. 

The Committee directs AHRQ to enter into an agreement with the 

National Academy of Public Administration to conduct a study and 

make recommendations for how the Federal government should 

best manage this important research, including the optimal organizational location and means of avoiding unnecessary overlap with 

other stakeholders. 

DRI for Sodium.—The Committee notes that the systematic review for updating the DRI for sodium for healthy populations is already underway. The Committee is concerned that the key questions being asked in the AHRQ systematic review ignore the imVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00081 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
82 

pact of sodium intake on healthy populations within the normal (as 

defined by medical literature) versus low sodium ranges. This question must be answered in order for the DRI committee to be able 

to determine optimal sodium intakes for healthy populations, including whether the impact to health at normal vs. low intakes is 

linear or non-linear. The Committee requests that AHRQ answer 

this question and report back to the Committee before finalizing 

the systematic review and sending it to the DRI committee. 

Investigator-Initiated Research.—The Committee provides support for investigator-initiated research. Investigator-initiated research should not be targeted to any specific area of health services 

research and should be merit based from the best unsolicited ideas 

from the research community within the AHRQ patient safety and 

medical error mission. The Committee is aware that enhanced utilization of independent academic medical centers (non-universityowned centers that retain significant graduate medical education 

positions) could lead to innovative and pragmatic solutions that improve clinical practices. 

Patient-Reported Outcomes in Children.—Patient-reported outcomes play a major role in assessing the type and quality of care 

being received by patients. While patient-reported outcome measures are being advanced as an important component of clinical decision-making, there is little evidence to guide pediatric providers 

with respect to implementation and application of these measures, 

particularly as children move from early childhood through adolescence and to adulthood. The Committee requests that AHRQ report 

back on the state of patient reported outcomes in children with kidney disease and how the agency intends to advance the scientific 

application of these measures toward improving health outcomes in 

kidney patients as they mature from newborns to young adults in 

the fiscal year 2019 Congressional Justification. 

Bibliography of Peer-Reviewed Tick-Borne Diseases Literature.— The Committee encourages AHRQ to assemble a bibliography of 

peer-reviewed tick-borne diseases literature, appropriately organized for use by the scientific community, treating physicians, and 

the public. The bibliography should include literature relating to 

possible mechanisms of persistent infection with Borrelia 

burgdorferi or other types of Borrelia. 

CENTERS FOR MEDICARE AND MEDICAID SERVICES

GRANTS TO STATES FOR MEDICAID

The Committee recommends $284,798,384,000 for the Federal 

share of Medicaid costs, which is $22,794,417,000 above the fiscal 

year 2017 enacted level and the same as the fiscal year 2018 budget request. This amount does not include $125,219,452,000, which 

was provided as advance funding for the first quarter of fiscal year 

2018. In addition, the Committee recommends an advance appropriation of $134,847,759,000 for program costs in the first quarter 

of fiscal year 2019. 

The Committee continues bill language providing indefinite 

budget authority for unanticipated costs in fiscal year 2018. Federal Medicaid grants reimburse States for a portion of their expenditures in providing health care for individuals whose income 

and resources fall below specified levels. Subject to certain minVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00082 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
83 

imum requirements, States are provided certain limited authority 

within the law to set eligibility, coverage, and payment levels. 

PAYMENTS TO THE HEALTH CARE TRUST FUNDS

The Committee recommends $323,497,300,000 for the Payments 

to the Health Care Trust Funds account. This amount is 

$24,309,600,000 above the fiscal year 2017 enacted level and equal 

to the fiscal year 2018 budget request. 

This account includes the general fund subsidy to the Federal 

Supplementary Medical Insurance Trust Fund for Medicare Part B 

benefits, and Medicare drug benefits and administration, as well as 

other reimbursements to the Federal Hospital Insurance Trust 

Fund for benefits and related to administrative costs, which have 

not been financed by payroll taxes or premium contributions. The 

Committee continues bill language providing indefinite authority to 

pay the general revenue portion of the Medicare Part B premium 

match and providing resources for the Medicare Part D drug benefit program in the event that the annual appropriation is insufficient. 

PROGRAM MANAGEMENT

The Committee makes available $3,451,141,000 in trust funds for 

Federal administration of the Medicare and Medicaid programs, 

which is $218,603,000 below the fiscal year 2017 enacted level and 

$136,855,000 below the fiscal year 2018 budget request. 

Program Operations 

The Committee recommends $2,341,274,000 for Program Operations to support activities used to administer the Medicare program, fund beneficiary outreach and education, maintain information technology (IT) infrastructure needed to support various claims 

processing systems, and continue programmatic improvements. 

Adult Immunization Quality Measures.—The Committee is aware 

that the Centers for Medicare & Medicaid Servies (CMS) is working to close gaps in quality measures to improve care delivery and 

patient outcomes, including reducing racial and ethnic health disparities. Adult immunization quality measures are one area where 

more work is needed, as noted in a 2014 National Quality Forum 

(NQF) report entitled Priority Setting for Healthcare Performance 

Measurement: Addressing Performance Measure Gaps for Adult 

Immunization. The Committee recommends CMS work with relevant partners, such as NQF, to address the current gaps in adult 

immunization quality measures and ensure the quality measures 

reflect current immunization practice standards as well as the Advisory Committee on Immunization Practice recommendations for 

adult immunization. The Committee requests a report from CMS 

no later than 12 months following enactment of this Act on the 

steps the agency has taken to improve quality measures applicable 

to adult immunization under Medicare and Medicaid, including an 

action plan to enable widespread adoption across healthcare settings. 

Agents Used for Cosmetic Purposes or Hair Growth.—The Committee recognizes that recently passed legislation eliminated Federal Medicaid matching funds for prescription drugs used for cosmetic purposes or hair growth unless they are determined to be 

84 

medically necessary. The Committee encourages CMS to include 

autoimmune conditions that cause hair loss, such as alopecia 

areata and thyroid disease, within these medically necessary coverage criteria. 

Ambulatory Surgical Centers.—CMS is directed to submit a report to the Committees on Appropriations of the House of Representatives and Senate, and the authorizing committees of jurisdiction, on any increased cost to the Medicare program and its 

beneficiaries due to the migration of procedures from ambulatory 

surgical centers (ASCs) to higher cost settings. The report will 

evaluate volume changes over the past ten years to identify procedures that are migrating from ASCs to higher cost settings and 

make specific recommendations that CMS can implement to reverse this trend. 

Chronic Obstructive Pulmonary Disease.—Chronic Obstructive 

Pulmonary Disease (COPD) is the third leading cause of death and 

fourth most costly condition with respect to hospital readmissions. 

Respiratory therapists are educated and trained in all aspects of 

pulmonary medicine and play a critical role in the treatment of 

COPD patients. The Committee encourages CMS to conduct an 

analysis of the most recent claims data of services provided to 

Medicare beneficiaries with COPD in the emergency department, 

inpatient and physician office settings, and long-term care facilities 

to determine the role of respiratory therapists in improved health 

outcomes, reduced readmissions, and potential cost savings. The 

Committee requests an update on this effort in the fiscal year 2019 

Congressional Justification. 

Colorectal Cancer Screening.—The Committee recognizes the inequity in beneficiary cost sharing for screening colonoscopies. The 

Committee urges CMS to align its interpretation of the colorectal 

cancer screening cost-sharing requirements for Medicare beneficiaries with the policy of colorectal cancer cost-sharing requirements for other Federally funded health programs. The Committee 

encourages CMS to conduct an analysis of recent scientific literature on the efficacy of colorectal cancer screening. The Committee requests an update on this topic in the fiscal year 2019 Congressional Justification. 

Critical Access Hospitals.—The Committee continues to note concerns about the proposal to eliminate Critical Access Hospitals 

(CAH) status from facilities located less than 10 miles from another 

hospital and reducing the reimbursement rate from 101 to 100 percent. Changes to the reimbursement for CAH can affect their ability to provide proper care to local residents. The Committee supports efforts by CMS to address concerns from CAH. 

Diabetic Retinal Exams.—According to the CDC, diabetes-related 

blindness costs the nation about $500 million annually. The Committee recognizes that as more Medicare beneficiaries are diagnosed with diabetes, diabetic retinopathy remains a concern. Experts recommend that all individuals diagnosed with diabetes 

should be examined for eye health yet failure to receive annual diabetic retinal exams (DREs) is prevalent due to a variety of reasons. 

The Committee urges CMS to update its policy to make DREs more 

accessible to diabetic patients in primary care settings. 

Electrodiagnostic (EDX) Patient Care.—The Committee thanks 

CMS for providing additional guidance on actions taken in reVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00084 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
85 

sponse to the recommendations in the 2014 OIG Report: Questionable Billing for Medicare Electrodiagnostic Tests. The Committee 

notes that utilization of the codes for EDX testing continue to increase and that identified efforts to curb rampant fraud and abuse 

are exclusively focused on physicians with high utilization rates, 

and do not capture the full scope of the problem. The Committee 

remains interested in comprehensive solutions from CMS that advance quality care and cost savings by ensuring patients do not receive inadequate or unnecessary EDX tests. 

Evaluation and Management Codes.—Over 90 percent of the care 

provided by infectious disease (ID) physicians is considered evaluation and management (E&M). These face-to-face encounters continue to be undervalued by current payment systems that much 

more generously reward procedures. This has created a significant 

compensation disparity between ID physicians and specialists who 

provide more procedure-based care, as well as primary care physicians who provide similar or identical E&M services but who have 

received payment increases simply because their specialty enrollment designations as ‘‘primary care physicians.’’ The Committee requests CMS, as part of its ongoing effort to improve valuation and 

payment accuracy, research the necessary documentation that 

would more precisely describe the cognitive work in the office visits 

of ID physicians. The Committee requests an update on this topic 

in the fiscal year 2019 Congressional Justification. 

Home Health Care.—The Committee is aware that the current 

requirement that home health plans be certified solely by a physician has resulted in problems with access to home health care. The 

Committee acknowledges CMS’ efforts to limit the requirements 

placed on the certifying physician. The Committee requests an update in the fiscal year 2019 Congressional Justification on the faceto-face encounter performed by an allowed non-physician practitioner (working in collaboration with/under the supervision of the 

certifying physician or the acute/post-acute-care physician). 

Hospital Rating System.—The Committee is concerned with the 

implementation of CMS’s Hospital Star Rating System. While the 

Committee supports the goals of transparency for patients, it is 

concerned with how CMS measures factors in determining these 

ratings. The Committee requests CMS provide details on the methodology used to determine the ratings in the fiscal year 2019 budget request. The Committee encourages CMS to solicit feedback from 

the stakeholder community regarding the methodology and factors 

used to determine ratings. 

Long Term Care Hospitals.—The Committee recognizes the challenges faced by Long Term Care Hospitals (LTCHs). The Committee encourages continued discussion and analysis on payment 

methodologies that permit flexibility for LTCHs to meet the needs 

of their patients and community. 

Medication Diversion.—The Committee understands the important role of medication-assisted treatment for beneficiaries with 

opioid use disorder. At the same time, there are reports from several authorities of rising rates of diversion of these Food and Drug 

Administration-approved medications. The Committee directs CMS 

to evaluate diversion data from the Drug Enforcement Administration and State sources to determine the scope of this problem and 

86 

to include in the fiscal year 2019 Congressional Justification options to reduce diversion. 

National Health Expenditures.—The Committee requests CMS 

include information in its fiscal year 2019 Congressional Justification explaining the methodology for including data in the National 

Health Expenditure (NHE) database. In addition, the Committee 

requests an analysis of how CMS-published data compares to other 

comparable information on health expenditures, such as industry 

surveys. 

Out of Network Emergency Care.—The Committee is concerned 

the Center for Consumer Information and Insurance Oversight 

(CCIIO) has not provided sufficient clarity on how to determine the 

‘‘Usual, Customary & Reasonable’’ (UCR) amount in its final rule 

for patient protections (80 Fed. Reg. 72191). Therefore, the Committee requests CCIIO publish guidance, which may come in the 

form of Frequently Asked Questions, clarifying what constitutes 

the UCR amount using a transparent and fair standard, such as 

an independent unbiased charge database. 

Patient Matching.—The Committee recognizes that a lack of a 

patient matching system for Medicare beneficiaries results in duplicate procedures and poses a significant patient safety risk. The 

Committee is aware that a number of patient matching systems 

are currently being used in the commercial sector, but one has yet 

to be adopted in Medicare. The Committee requests a report not 

less than 12 months after the date of enactment of this Act on the 

impact on care improvement, reduction in costs, estimated saved 

lives or reduction in errors, and improvements in patient safety if 

hospitals were required to use a patient matching system as a requirement for participation in the Medicare program. 

Readmission Rates.—The Committee continues to support CMS 

efforts to reduce readmission rates among high-risk seniors living 

in communities challenged by poverty, poor health literacy, health 

disparities or non-compliance with treatment regimens. In particular, flexible, community-based multi-payer arrangements have 

encouraged health and social service providers to combine efforts in 

tailoring services to these at-risk populations. The Committee continues to encourage CMS to work with community-based organizations to help identify best practices and transition them to Medicare’s value-based purchasing initiatives. 

Recovery Audit Contractors.—The Committee values the role 

played by Recovery Audit Contractors (RACs) in the identification 

and prevention of improper Medicare payments. However, some 

audit processes have resulted in prolonged delays in payment to 

providers. The Committee encourages efforts by CMS to provide 

oversight to ensure RACs are operating consistent with CMS 

issued guidance. 

Risk Corridors.—The Committee continues bill language prohibiting use of the Program Management appropriation from being 

available for risk corridor payments. 

Rural Health Clinics.—The Committee encourages CMS to engage States and other stakeholders on outstanding issues of payment recoupment, as it relates to CMS-designated Rural Health 

Clinics. The Committee also requests an update in the fiscal year 

2019 Congressional Justification on the study requested in House 

Report 114–699 under this heading. 

87 

Therapeutic Foster Care Services.—The Committee remains concerned about the lack of a uniform definition within the Medicaid 

program for therapeutic foster care (TFC) services. A uniform definition would improve the ability for more consistent care and treatment. The Committee requests an update in the fiscal year 2019 

Congressional Justification on the study requested in House Report 

114–699 under this heading. 

Transparency in Hospital Reimbursement.—The Committee requests CMS provide information in the fiscal year 2019 Congressional Justification identifying all pass-through payments reimbursed from the Hospital Insurance Trust Fund. The Committee 

expects CMS to address pass-through payments for hospital-based 

nursing programs, as well as the oversight function CMS performs 

to ensure such programs are fully accredited. 

Federal Administration 

The Committee recommends $712,533,000 for Federal Administration activities related to the Medicare and Medicaid programs, 

which is $20,000,000 below the fiscal year 2017 enacted level and 

$10,000,000 below the fiscal year 2018 budget request. The Federal 

Administration funding supports CMS staff, along with operating 

and administrative expenses for planning, developing, managing, 

and evaluating healthcare financing programs and policies. 

Health Insurance Exchange Transparency.—The Committee continues to include bill language requiring CMS to provide cost information for the following categories: Federal Payroll and Other Administrative Costs; Exchange related Information Technology (IT); 

Non IT Program Costs, including Health Plan Bid Review, Management and Oversight; Payment and Financial Management; Eligibility and Enrollment; Consumer Information and Outreach, including the Call Center, Navigator Grants, and Consumer Education and Outreach; Exchange Quality Review; Small Business 

Health Options Program and Employer Activities; and Other Marketplace Activities. Cost information should be provided for each 

fiscal year since the enactment of the Patient Protection and Affordable Care Act (Public Law 111–148). CMS is also required to 

include the estimated costs for fiscal year 2019. 

HEALTH CARE FRAUD AND ABUSE CONTROL ACCOUNT

The Committee provides $745,000,000 to the Health Care Fraud 

and Abuse Control Account (HCFAC). This includes a base amount 

of $311,000,000 and an additional $434,000,000 through a discretionary budget cap adjustment authorized under section 251(b) of 

the Balanced Budget and Emergency Deficit Control Act of 1985. 

The HCFAC funds support activities conducted by CMS, the HHS 

Office of Inspector General, and the Department of Justice. This 

level is $20,000,000 above the fiscal year 2017 enacted level and 

$6,000,000 below the fiscal year 2018 budget request. 

This funding is in addition to other mandatory funding provided 

through authorizing legislation. The funding will provide resources 

to continue efforts for Medicaid program integrity activities, for 

safeguarding the Medicare prescription drug benefit and the Medicare Advantage program, and for program integrity efforts carried 

out by the Department of Justice. 

88 

The Committee continues to include bill language to ensure the 

Secretary funds the Senior Medicare Patrol Program administered 

by the Administration for Community Living from funds provided 

to this account. 

The Committee expects all recipients of funds from the Health 

Care Fraud and Abuse Control Account, the Centers for Medicare 

& Medicaid Services, the Department of Health and Human Services Office of Inspector General, and the Department of Justice, to 

use funds for efforts to address fraud and abuse as described in 

section 1128C of the Social Security Act. 

ADMINISTRATION FOR CHILDREN AND FAMILIES

PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND

FAMILY SUPPORT PROGRAMS

The Committee recommends $2,995,400,000 for the Child Support Enforcement and Family Support programs, which is 

$15,231,000 below the fiscal year 2017 enacted level and the same 

as the fiscal year 2018 budget request. The Committee also recommends $1,400,000,000 in advance funding, as requested, for the 

first quarter of fiscal year 2019 to ensure timely payments for 

Child Support Enforcement programs. These programs support 

State-administered programs of financial assistance and services 

for low-income families to promote their economic security and selfsufficiency. 

LOW INCOME HOME ENERGY ASSISTANCE

The Committee recommends $3,390,304,000 for the Low Income 

Home Energy Assistance Program, which is the same as the fiscal 

year 2017 enacted level and $3,390,304,000 above the fiscal year 

2018 budget request. Within the amount available for formula 

grants, the Committee recommends up to $2,988,000 for technical 

assistance, training, and monitoring of program activities. 

REFUGEE AND ENTRANT ASSISTANCE

The Committee recommends $1,022,811,000 for Refugee and En- trant Assistance programs, which is $651,880,000 below the fiscal 

year 2017 enacted level and $433,944,000 below the fiscal year 

2018 budget request. 

The Office of Refugee Resettlement (ORR) programs are designed 

to help refugees, asylees, Cuban and Haitian entrants, and trafficking victims become employed and self-sufficient. These programs also provide for care of unaccompanied immigrant children 

in Federal custody and victims of torture. 

The Committee recognizes the responsibilities of the Federal government for the care of unaccompanied children while in Federal 

custody. The Committee supports policies that are in the best interest of the child while in the custody of the U.S. Department of 

Homeland Security and when subsequently transferred to the Department of Health and Human Service’s Office of Refugee Resettlement (ORR). The Committee expects ORR to coordinate closely 

with U.S. Immigration and Customs Enforcement (ICE) on the 

transfer to ICE of unaccompanied children who turn 18 while in 

ORR custody. 

Within the total, the Committee recommends the following: 

89 

Budget Activity FY 2018 

Committee 

Transitional and Medical Services ................................................................................................................. $320,000,000 

Victims of Trafficking ..................................................................................................................................... 18,755,000 

Refugee Support Services .............................................................................................................................. 175,321,000 

Unaccompanied Children ............................................................................................................................... 498,000,000 

Victims of Torture ........................................................................................................................................... 10,735,000 

Healthcare Costs Related to Illegal Immigration.—The Committee requests an update to the report submitted to Congress by 

the Department of Health and Human Services pursuant to this 

heading as it appeared in the explanatory statement accompanying 

division H of the Consolidated Appropriations Act, 2016 (P.L. 114– 

113). 

National Human Trafficking Training and Assistance Center.— 

The Committee directs the Administration for Children and Families to increase funding for the National Human Trafficking Hotline. 

PAYMENTS TO STATES FOR THE CHILD CARE AND DEVELOPMENT

BLOCK GRANT

The Committee recommends $2,860,000,000 for the discretionary 

portion of the Child Care and Development Fund, the Child Care 

and Development Block Grant, which is $4,000,000 above the fiscal 

year 2017 enacted level and $99,000,000 above the fiscal year 2018 

budget request. The Child Care and Development Block Grant provides funds according to a formula to States, territories, and Tribes 

to provide financial assistance to help low-income working families 

and families engaged in training or education activities access child 

care and to improve the quality of child care for all children. 

SOCIAL SERVICES BLOCK GRANT

The Committee recommends $1,700,000,000 for the Social Services Block Grant, which is the same as the fiscal year 2017 enacted 

level and $1,700,000,000 above the fiscal year 2018 budget request. 

States receive grants by formula. States have the flexibility to determine what services and activities are supported, provided they 

are targeted at a broad set of goals, including reducing or eliminating poverty, achieving or maintaining self-sufficiency, and preventing neglect, abuse, or exploitation of children and adults. 

CHILDREN AND FAMILIES SERVICES PROGRAMS

The Committee recommends $11,181,500,000 for Children and 

Families Services programs, which is $112,868,000 below the fiscal 

year 2017 enacted level and $977,207,000 above the fiscal year 

2018 budget request. The Children and Families Services programs 

fund activities serving children, youth, families, the developmentally disabled, Native Americans, victims of child abuse and 

neglect and domestic violence, and other vulnerable populations. 

The Committee recommends the following amounts: 

Budget Activity FY 2018 

Committee 

Programs for Children, Youth, and Families: 

Head Start ...................................................................................................................................................... $9,275,000,000 

Preschool Development Grants ....................................................................................................................... 250,000,000 

90 

Budget Activity FY 2018 

Committee 

Runaway/Homeless Youth .............................................................................................................................. 101,980,000 

Abuse of Runaway Youth Prevention ............................................................................................................. 17,141,000 

State Child Abuse Prevention ........................................................................................................................ 25,310,000 

Discretionary Child Abuse Prevention ............................................................................................................ 33,000,000 

Community-based Child Abuse Prevention .................................................................................................... 39,764,000 

Child Welfare Services ................................................................................................................................... 268,735,000 

Child Welfare Training ................................................................................................................................... 17,984,000 

Adoption Opportunities ................................................................................................................................... 39,100,000 

Adoption Incentives ........................................................................................................................................ 37,943,000 

Social Services/Income Maintenance Research ............................................................................................. 6,512,000 

Native American Programs ............................................................................................................................. 52,050,000 

Community Services: 

Community Services Block Grant .......................................................................................................... 600,000,000 

Community Economic Development ...................................................................................................... 10,000,000 

Rural Community Facilities ................................................................................................................... 7,500,000 

Domestic Violence Hotline .............................................................................................................................. 8,750,000 

Family Violence/Battered Women’s Shelters .................................................................................................. 151,000,000 

Independent Living Training Vouchers ........................................................................................................... 43,257,000 

Disaster Human Services Case Management ................................................................................................ 1,864,000 

Program Direction ........................................................................................................................................... 194,610,000 

Head Start 

The Committee recommends $9,275,000,000 for the Head Start 

program, which is $21,905,000 above the fiscal year 2017 enacted 

level and $106,905,000 above the fiscal year 2018 budget request. 

Within the total for Head Start, the Committee recommends a costof-living adjustment and includes $25,000,000 for the Designation 

Renewal System. Within the total for Head Start, the Committee 

recommends $640,000,000 for Early Head Start-Child Care Partnership grants, which is the same as the fiscal year 2017 enacted 

level and $5,000,000 above the fiscal year 2018 budget request. 

The Committee is concerned about closures and consolidations of 

Head Start centers that have resulted from a number of re-competitions across the country in recent years. The Committee strongly encourages HHS to consider the consequences of Head Start program closures, reductions, and consolidations have on the ability of 

children and families to access Head Start services, particularly in 

rural areas. Transportation barriers can lead to increased absenteeism and missed work for families. In the event of a Head Start 

center closure, reduction, or consolidation, the Committee encourages the Office of Head Start to work with the local grantees to 

consider the impact on children, and encourage grantees to provide 

transportation for children who are displaced to a new Head Start 

center that is more than 15 miles from the center in which they 

were enrolled during the previous school year. 

Preschool Development Grants 

The Committee recommends $250,000,000 for Preschool Development Grants, which is the same as the fiscal year 2017 enacted 

level and $250,000,000 above the fiscal year 2018 budget request. 

This program provides grants to States to build State and local capacity to provide preschool for 4-year-olds from low-and moderateincome families. Research confirms that high-quality preschool improves school readiness and long-term academic success of children 

by supporting their academic and social-emotional skills. Support 

for this grant is an important step to building a globally competitive 21st century workforce. 

91 

Child Abuse Discretionary Activities 

Infant-Toddler Court Teams.—The Committee continues funding 

to for a National resource center to preserve, disseminate, and amplify the work of the Quality Improvement Center (QIC) for Research-based Infant-Toddler Court Teams by providing training 

and technical assistance in support of such court teams’ efforts 

across the country. This funding should help to build upon and continue the work of sites established through the QIC initiative, 

which have brought together the court system, child welfare agencies, health professionals, and community leaders to improve current practices in the child welfare system and make better-informed decisions on behalf of the child. 

Native American Programs 

The Committee recommends $52,050,000 for Native American 

Programs, which is the same as the fiscal year 2017 enacted level 

and $2,145,000 above the fiscal year 2018 budget request. 

Within the total, the Committee recommendation includes 

$12,000,000 for Native American language preservation activities, 

including the requested $3,000,000 for Generation Indigenous, 

which focuses on improving Native American language instruction 

across the educational continuum. The Committee provides not less 

than $4,000,000 for language immersion programs as authorized by 

section 803C(b)(7)(A)–(C) of the Native American Programs Act, as 

amended by the Esther Martinez Native American Language Preservation Act of2006. The Committee strongly encourages the Administration for Children and Families (ACF) to give priority to 

grantees with rigorous immersion programs. 

Community Services Programs 

Community Services Block Grant.—The Committee recommends 

$600,000,000 for the Community Services Block Grant, which is 

$115,000,000 below the fiscal year 2017 enacted level and 

$600,000,000 more than the fiscal year 2018 budget request. 

Community Economic Development.—The Committee provides 

$10,000,000 for Community Economic Development grants, which 

is $9,883,000 below the fiscal year 2017 enacted level and 

$10,000,000 above the fiscal year 2018 budget request. Community 

Economic Development is a Federal grant program funding Community Development Corporations that address the economic needs 

of individuals and families with low income through the creation of 

sustainable business development and employment opportunities. 

CED awards funds to private, non-profit organizations that are 

community development corporations, including faith-based organizations, and Tribal and Alaskan Native organizations. The Committee directs the Administration for Children and Families to 

issue a funding opportunity announcement prioritizing applications 

from rural areas with high rates of poverty, unemployment, and 

substance abuse. 

Rural Community Facilities.—The Committee recommends 

$7,500,000 for the Rural Community Facilities program, which is 

the same as the fiscal year 2017 enacted level, and $7,500,000 

more than the fiscal year 2017 budget request. Grantees work with 

small communities on drinking water and wastewater issues. 

92 

Family Violence Prevention and Battered Women’s Shelters 

The Committee recommends $151,000,000 for the Family Violence Prevention and Battered Women’s Shelters programs, which 

is the same as the fiscal year 2017 enacted level and the fiscal year 

2018 budget request. The Family Violence Prevention and Services 

Act programs provide funding to support the prevention of incidents of family violence, domestic violence, and dating violence, 

and provide the immediate shelter and supportive services for 

adult and youth victims (and their dependents). 

PROMOTING SAFE AND STABLE FAMILIES

The Committee recommends $325,000,000 in mandatory funds 

for the Promoting Safe and Stable Families program, which is the 

same as the fiscal year 2017 enacted level and $20,000,000 below 

the fiscal year 2018 budget request. The Committee also recommends $59,765,000 in discretionary funds for this program, 

which is the same as the fiscal year 2017 enacted level and the fiscal year 2018 budget request. This program enables each State to 

operate a coordinated program of family preservation services, community-based family support services, time-limited reunification 

services, and adoption promotion and support services. States receive funds based on their share of children in all States receiving 

food stamp benefits. 

PAYMENTS FOR FOSTER CARE AND PERMANENCY

The Committee recommends $6,225,000,000 for payments to 

States for foster care and adoption assistance, which is 

$461,000,000 more than the fiscal year 2017 enacted level and the 

same as the fiscal year 2018 budget request. The Committee also 

recommends an advance appropriation of $2,700,000,000 for the 

first quarter of fiscal year 2018 to ensure timely completion of first 

quarter grant awards. 

Within the total, the Committee recommends $5,537,000,000 for 

the Foster Care program, which is $545,000,000 above the fiscal 

year 2017 enacted level and the same as the fiscal year 2018 budget request. This program provides funds to States for foster care 

maintenance payments for children living in foster care. These 

funds also reimburse States for administrative costs to manage the 

program and training for staff and parents. 

Within the total, the Committee recommends $2,867,000,000 for 

Adoption Assistance, which is $87,000,000 more than the fiscal 

year 2017 enacted level and the same as the fiscal year 2018 budget request. This program provides funds to States to subsidize families who adopt children with special needs, such as older children, 

a member of a minority or sibling group, or children with physical, 

mental, and emotional disabilities. In addition, the program provides training for adoptive parents and State administrative staff. 

This annually appropriated entitlement provides alternatives to 

long, inappropriate stays in foster care by developing permanent 

placements with families. 

Within the total, the Committee recommends $181,000,000 for 

the Kinship Guardianship Assistance program, which is 

$29,000,000 more than the fiscal year 2017 enacted level and the 

same as the fiscal year 2018 budget request. This program provides 

93 

subsidies to a relative taking legal guardianship of a child for 

whom being returned home or adoption are not appropriate permanency options. 

Finally, within the total, the Committee recommends 

$140,000,000 for the Independent Living program, which is the 

same as the fiscal year 2017 enacted level and the fiscal year 2018 

budget request. This program assists foster children age 16 or older 

make successful transitions to independence. Funds support a variety of services, including educational assistance, career exploration, 

vocational training, job placement, life skills training, home management, health services, substance abuse prevention, preventive 

health activities, and room and board. Each State receives funds 

based on the number of children on whose behalf the State receives 

Federal Foster Care Payments. 

ADMINISTRATION FOR COMMUNITY LIVING

AGING AND DISABILITY SERVICES PROGRAMS

The Committee recommends a total program level of 

$2,237,224,000 for the Administration for Community Living 

(ACL), which is $243,409,000 above the fiscal year 2017 enacted 

program level and $385,774,000 above the fiscal year 2018 budget 

request. The Committee recommends funding for the Senior Medicare Patrol Program, and provides this funding under the Health 

Care Fraud and Control Abuse Account. 

Home and Community-Based Supportive Services 

The Committee recommends $350,224,000 for Home and Community-Based Supportive Services, which is the same as the fiscal 

year 2017 enacted level and $3,161,000 above the fiscal year 2018 

budget request. This program provides formula grants to States 

and territories to fund a wide range of social services that enable 

seniors to remain independent in their homes for as long as possible. 

Preventive Health Services 

The Committee recommends $19,848,000 for Preventive Health 

Services, which is the same as the fiscal year 2017 enacted level 

and $38,000 above the fiscal year 2018 budget request. This program funds activities that help seniors remain healthy and avoid 

chronic diseases. 

Protection of Vulnerable Older Americans 

The Committee recommends $20,658,000 for activities to protect 

vulnerable older Americans, which is the same as the fiscal year 

2017 enacted level and $39,000 above the fiscal year 2018 budget 

request. These programs provide grants to States for protection of 

vulnerable older Americans through the Long-Term Care Ombudsman and Prevention of Elder Abuse and Neglect programs. 

Family Caregiver Support Services 

The Committee recommends $150,586,000 for the National Caregiver Support program, which is the same as the fiscal year 2017 

enacted level and $286,000 above the fiscal year 2018 budget reVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00093 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
94 

quest. This program supports a multifaceted support system in 

each State for family caregivers. 

Native American Caregiver Support Services 

The Committee recommends $7,556,000 for the Native American 

Caregiver Support program, which is the same as the fiscal year 

2017 enacted level and $39,000 above the fiscal year 2018 budget 

request. This program provides grants to tribes for the support of 

American Indian, Alaskan Native, and Native Hawaiian families 

caring for older relatives with chronic illness or disabilities. 

Congregate and Home-Delivered Nutrition Services 

The Committee recommends a total of $837,753,000 for senior 

nutrition. The Committee recommends $450,342,000 for Congregate Nutrition Services, which is the same as the fiscal year 

2017 enacted level and $2,852,000 above the fiscal year 2018 budget request. The Committee recommends $227,342,000 for Home-Delivered Meal Services, which is the same as the fiscal year 2017 enacted level and $1,430,000 above the fiscal year 2018 budget request. The Committee recommends $160,069,000 for the Nutrition 

Services Incentives program, which is the same as the fiscal year 

2017 enacted level and $304,000 above the fiscal year 2018 budget 

request. These programs help older Americans remain healthy and 

independent in their communities by providing meals and related 

services in a variety of settings (including congregate facilities such 

as senior centers) and via home-delivery to older adults who are 

homebound due to illness, disability, or geographic isolation. 

Native American Nutrition and Supportive Services 

The Committee recommends $31,208,000 for Native American 

Nutrition and Supportive Services, which is the same as the fiscal 

year 2017 enacted level and $109,000 above the fiscal year 2018 

budget request. This program provides grants to Tribes to promote 

the delivery of nutrition and home and community-based supportive services to Native American, Alaskan Native, and Native 

Hawaiian elders. 

Aging Network Support Activities 

The Committee recommends $9,961,000 for the Aging Network 

Support Activities, which is the same as the fiscal year 2017 enacted level and $19,000 above the fiscal year 2018 budget request. 

This program supports activities that expand public understanding 

of aging and the aging process. 

Holocaust Survivor’s Assistance.—Within funding for the Aging 

Network Support Activities, the Committee provides not less than 

$3,000,000 for Holocaust Survivor’s Assistance. This program provides supportive services for aging Holocaust survivors living in the 

United States. 

Alzheimer’s Disease Services 

The Committee recommends $19,500,000 for the Alzheimer’s Disease Services programs, which is the same as the 2016 enacted program level and $10,000 above the fiscal year 2018 budget request. 

These programs provide competitive matching grants to a limited 

number of States to encourage program innovation and coordinaVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00094 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
95 

tion of public and private services for people with Alzheimer’s disease and their families. 

The Committee accepts the Administration’s proposal to consolidate funding for Alzheimer’s disease programs into one more flexible program authorized under Title IV of the Older Americans Act. 

Lifespan Respite Care 

The Committee recommends $3,360,000 for Lifespan Respite 

Care, which is the same as the fiscal year 2017 enacted level and 

$6,000 above the fiscal year 2018 budget request. The program focuses on easing the burdens of caregiving by providing grants to eligible State organizations to improve the quality of, and access to, 

respite care for family caregivers. 

Elder Falls 

The Committee recommends $5,000,000 for the Elder Falls program, which is the same as the fiscal year 2017 enacted level and 

the fiscal year 2018 budget request. Fall prevention grants support 

the promotion and dissemination of prevention tools delivered in 

community settings. 

Chronic Disease Self-Management Program 

The Committee recommends $5,000,000 for Chronic Disease SelfManagement program, which is $3,000 below the fiscal year 2017 

enacted level and the same as the fiscal year 2018 budget request. 

This program supports grants to States for low-cost, evidence-based 

prevention models that use state-of-the-art techniques to help those 

with chronic conditions address issues related to the management 

of their disease. 

Elder Rights Support Activities 

The Committee recommends $11,874,000 for Elder Rights Support Activities, which is $2,000,000 below the fiscal year 2017 enacted level and $23,000 above the fiscal year 2018 budget request. 

This program supports efforts that provide information, training, 

and technical assistance to legal and aging services organizations 

towards the end of preventing and detecting elder abuse and neglect. 

Aging and Disability Resource Centers 

The Committee recommends $6,119,000 for Aging and Disability 

Resource Centers, which is the same as the fiscal year 2017 enacted level and $12,000 above the fiscal year 2018 budget request. 

These centers provide information, counseling and access for individuals to learn about the services and support options available to 

seniors and the disabled so they may retain their independence. 

Senior Community Service Employment Program 

The Committee transfers the Senior Community Service Employment Program (SCSEP) from the Department of Labor to the Administration for Community Living. The Committee recommends 

$300,000,000 for the administrative and operational costs of 

SCSEP, which is $100,000,000 below the fiscal year 2017 enacted 

level and $300,000,000 above the fiscal year 2018 budget request. 

96 

This program supports low-income seniors in community service 

positions. 

State Health Insurance Program 

Due to funding constraints, the Committee recommends no funding for the State Health Insurance program, which is $47,115,000 

below the fiscal year 2017 enacted level and the same as the fiscal 

year 2018 budget request. Other Federal programs provide similar 

services. 

Paralysis Resource Center 

The Committee recommends $6,700,000 for the Paralysis Resource Center, which is the same as the fiscal year 2017 enacted 

level and $6,700,000 above the fiscal year 2018 budget request. The 

Paralysis Resource Center offers activities and services aimed at 

increasing independent living for people with paralysis and related 

mobility impairments, and supporting integration into the physical 

and cultural communities in which they live. 

Limb Loss Resource Center 

The Committee recommends $2,500,000 for the Limb Loss Resource Center, which is the same as the fiscal year 2017 enacted 

level and $2,500,000 above the fiscal year 2018 budget request. The 

Limb Loss Resource Center supports a variety of programs and 

services for those living with limb loss, including a national peer 

support program, educational events, training for consumers and 

healthcare professionals, and information and referral services. 

Traumatic Brain Injury 

The Committee recommends $9,321,000 for the Traumatic Brain 

Injury program, which is the same as the fiscal year 2017 enacted 

level and $6,159,000 above the fiscal year 2017 budget request. The 

program provides grants to States for the development of a comprehensive, coordinated family and person-centered service system 

at the state and community level for individuals who sustain a 

traumatic brain injury. 

Developmental Disabilities State Councils 

The Committee recommends $73,000,000 for State Councils on 

Developmental Disabilities, which is the same as the fiscal year 

2017 enacted level and $73,000,000 above the fiscal year 2018 

budget request. The State Councils work to develop, improve and 

expand the system of services and supports for people with developmental disabilities. 

Partnerships for Innovation, Inclusion, and Independence 

The Committee does not consolidate the State Councils on Developmental Disabilities, State Independent Living Councils, and 

State Advisory Boards on Traumatic Brain Injury. The Committee 

recognizes the unique role played by each program and believes 

consolidation into one program will not serve the needs of people 

living with a disability. 

97 

Developmental Disabilities Protection and Advocacy 

The Committee recommends $38,734,000 for Developmental Disabilities Protection and Advocacy, which is the same as the 2017 

enacted level and $74,000 above the fiscal year 2018 budget request. This formula grant program provides funding to States to establish and maintain protection and advocacy systems to protect 

the legal rights of persons with developmental disabilities. 

The Committee recognizes that the Americans with Disabilities 

Act (ADA) encourages states to administer services for people with 

intellectual/developmental disabilities (I/DD) ‘‘in the most integrated setting appropriate to the needs of qualified individuals 

with disabilities.’’ As a result of enactment of the ADA and the Supreme Court decision in Olmstead v. L.C. (1999), there has been a 

National trend towards deinstitutionalization, whereby individuals 

have been encouraged to move out of State-run and other Federally-funded, certified facilities and into residential settings in their 

respective communities. However, the Committee is aware that 

many family members and legal guardians of individuals residing 

in these facilities have been pressured to move their loved ones into 

the community against their wishes. The Committee is concerned 

about the adequacy of community-based housing and the lack of 

specialized care and support services available in them, the pace of 

transfer, higher rates of abuse and mortality in community settings, and the adequacy of opportunities for residents to express 

views and preferences throughout the process. 

The Committee fully supports the ADA’s goal of enabling people 

with I/DD to receive services ‘‘in the most integrated setting appropriate to the[ir] needs.’’ However, the Committee also notes that 

Olmstead held that the ADA does not condone or require removing 

individuals from institutional settings when they are unable to 

handle or benefit from a community-based setting and that the 

ADA does not require the imposition of community-based treatment on patients who do not desire it. Congress endorsed the same 

principle in the Developmental Disabilities (DD) Act of 2000. The 

Committee strongly urges the DD Act programs (state developmental disabilities councils, protection and advocacy systems and 

university centers for excellence in developmental disabilities) to 

continually consult with parents and guardians of those individuals 

within these facilities. The Committee urges the Administration on 

Community Living to monitor this matter and to include an update 

on the efforts to ensure compliance with bill language requiring notification in the fiscal year 2019 Congressional Justification. 

The Committee strongly urges the Department to ensure that 

DD Act programs properly account for the needs and desires of patients, their families, and caregivers, and the importance of affording patients the proper setting for their care, into their enforcement of the ADA. 

Voting Access for Individuals with Disabilities 

The Committee recommends $4,963,000 for Voting Access for Individuals with Disabilities program, which is the same as the fiscal 

year 2017 enacted level and $9,000 above the fiscal year 2018 

budget request. 

The Voting Access for Individuals with Disabilities program authorized by the Help America Vote Act provides formula grants to 

98 

ensure full participation in the electoral process for individuals 

with disabilities, including registering to vote, casting a vote, and 

accessing polling places. 

Developmental Disabilities Projects of National Significance 

The Committee recommends $7,600,000 for Developmental Dis- abilities Projects of National Significance, which is $2,400,000 

below the fiscal year 2017 enacted level and the same as the fiscal 

year 2018 budget request. This program funds grants and contracts 

that develop new technologies and demonstrate innovative methods 

to support the independence, productivity, and integration of the 

disabled into the community. 

University Centers for Excellence in Developmental Disabilities 

The Committee recommends $38,619,000 for University Centers 

for Excellence in Developmental Disabilities, which is the same as 

the fiscal year 2017 enacted level and $73,000 above the fiscal year 

2018 budget request. 

Independent Living 

The Committee recommends $101,183,000 for the Independent Living program, of which $22,878,000 is for the Independent Living 

State Grants program and $78,305,000 is for the Centers for Independent Living program. This funding level is the same as the fiscal year 2017 enacted level and $23,027,000 above the fiscal year 

2018 budget request. Independent Living programs maximize the 

leadership, empowerment, independence and productivity of individuals with disabilities. 

National Institute on Disability, Independent Living, and Rehabilitation Research 

The Committee recommends $103,970,000 for the National Institute on Disability, Independent Living, and Rehabilitation Research, which is the same as the fiscal year 2017 enacted level and 

$8,843,000 above the fiscal year 2018 budget request. The National 

Institute on Disability, Independent Living, and Rehabilitation Research serves to generate knowledge and promote its effective use 

to enhance the abilities of people with disabilities to perform activities of their choice in the community and to expand society’s capacity to provide full opportunities for its citizens with disabilities. 

Assistive Technology 

The Committee recommends $34,000,000 for Assistive Technology, which is the same as the fiscal year 2017 enacted level and 

$2,061,000 above the fiscal year 2018 budget request. Of this 

amount, the Committee provides $2,000,000 for competitive grants 

to support existing and new alternative financing programs that 

provide for the purchase of assistive technology (AT) devices. The 

Committee intends for this funding to support the expansion of existing programs and the creation of new programs that allow greater access to affordable financing to help people with disabilities 

purchase the specialized technologies required to live independently, to succeed at school and work and to live active and productive lives. Programs that have previously received funding are eligible to compete but must report on how the prior funding has been 

99 

used, including the number of loans extended and individuals 

served, funding leveraged, and asset development programs created. The Committee intends for applicants to incorporate creditbuilding activities into their programs, including financial education and information about other possible funding sources. Successful applicants must emphasize consumer choice and control and 

build programs that will provide financing for the full array of AT 

devices and services and ensure that all people, regardless of type 

of disability or health condition, age, level of income, and residence 

have access to the program. Assistive Technology programs maximize the ability of individuals with disabilities of all ages and their 

family members, guardians, advocates, and authorized representatives to obtain AT devices and AT services. 

Program Administration 

The Committee recommends $37,987,000 for Program Administration, which is $2,076,000 below the fiscal year 2017 enacted 

level and the same as the fiscal year 2018 budget request. This 

funding supports Federal administrative costs associated with administering ACL programs. 

OFFICE OF THE SECRETARY

GENERAL DEPARTMENTAL MANAGEMENT

The Committee recommends a program level total of 

$350,346,000 for General Departmental Management, which is 

$175,111,000 below the fiscal year 2017 enacted level and 

$11,620,000 below the fiscal year 2018 budget request. Of the 

funds provided, $57,465,000 shall be derived from evaluation setaside funds available under section 241 of the Public Health Service Act, which is $7,363,000 below the fiscal year 2017 enacted 

level and the same as the fiscal year 2018 budget request. 

This appropriation supports activities that are associated with 

the Secretary’s roles as policy officer and general manager of the 

Department of Health and Human Services. The Office of the Secretary also implements administration and Congressional directives, and provides assistance, direction and coordination to the 

headquarters, regions, and field organizations of the department. 

In addition, this funding supports the Office of the Surgeon General and several other health promotion and disease prevention activities that are centrally administered. 

Office of the Assistant Secretary for Health 

Breastfeeding.—The Committee recognizes the importance of 

breast milk in improving health outcomes for babies and mothers 

and requests HHS to report to the Committee on the impact of recommended breastfeeding rates on health outcomes and healthcare 

costs. The report should examine the impact of clinically recommended breastfeeding rates on associated Medicaid expenditures, urgent care costs, and direct and indirect medical costs, including workplace productivity and employee retention. The Committee also directs the Secretary to ensure that pregnant women 

have access to guidance on nutritional advice based on the latest 

scientific research on the health and cost benefits of human milk. 

100 

Chronic Fatigue Syndrome (CFS).—The Committee supports the 

CFS Advisory Committee and encourages HHS agencies to partner 

with the medical community and other stakeholders to ensure access to clinical care and expert medical providers and Food and 

Drug Administration approved treatments to better address the 

needs of over one million Americans suffering from CFS. 

Embryo Adoption Awareness Campaign.—The Committee recommends $1,000,000 for the Embryo Adoption Awareness Campaign, the same as the fiscal year 2017 enacted level and the budget request. These funds will be used to educate Americans about 

the existence of frozen human embryos (resulting from in-vitro fertilization), which may be available for donation/adoption to help 

other couples build their families. The Committee includes bill language permitting these funds also to be used to provide medical 

and administrative services to individuals adopting embryos, 

deemed necessary for such adoptions, consistent with the Code of 

Federal Regulations. 

Evidence-Based Programming.—The Committee is concerned 

about the uneven capacity of HHS operating divisions to apply and 

to build evidence that will improve program effectiveness. The 

Committee believes that ASPE can play a central role in improving 

evaluation and evidence-based policymaking across the Department 

by helping all HHS components develop capacity to meet the standards set forth in the Administration on Children and Families’ 

Evaluation Policy. The Committee encourages ASPE to help operating divisions adopt cost-effective approaches to building evidence 

through use of innovative grant designs that support partnerships 

between service delivery projects and researchers; by leveraging 

emerging opportunities to use linked data to measure performance 

and conduct comprehensive, rigorous evaluations at a reasonable 

cost; and by partnering with philanthropic organizations that focus 

on improving the use of rigorous research to inform policy. 

Global Health.—The Committee requests an update on how the 

CDC, Food and Drug Administration (FDA), Biomedical Advanced 

Research and Development Authority (BARDA), and NIH—including the National Center for Advancing Translational Science— 

jointly coordinate global health research activities with specific 

measurable metrics used to track progress and collaboration toward shared health goals. 

Indian Hospital Facilities.—The Committee continues to be concerned by the poor quality of facilities operated by HHS in Indian 

country. The Committee is aware that funding from the Nonrecurring Expenses Fund has been planned for facility upgrades in 

these hospitals, and strongly supports this effort. The Committee 

directs the Secretary to prioritize obligations for these facilities and 

expects obligation of such funds as quickly as possible in order to 

continue progress on improving these structures. The Committee 

requests an update within 45 days of enactment of this Act on all 

obligations from the Nonrecurring Expenses Fund. 

Opioid Response.—The Committee believes that the Federal response to the opioid epidemic will be most effective if resources 

made available through the Comprehensive Addiction and Recovery 

Act and related programs are directed to strategies that are backed 

by strong evidence or to innovative and promising approaches that 

will be rigorously evaluated to learn their impact. In implementing 

101 

new and existing programs that address the opioid epidemic, HHS 

is urged to utilize evidence-based policymaking principles, tools, 

and program designs such as those disseminated by the EvidenceBased Policymaking Collaborative. The Committee encourages 

HHS to collaborate with outside researchers and philanthropic organizations that focus on improving the use of rigorous research to 

inform policy. 

Pulmonary Hypertension (PH).—The Committee remains concerned that most PH patients are not diagnosed for many years 

until the condition has reached a catastrophic stage, which leads 

to greatly increased mortality and the need for costly and dramatic 

medical interventions. There are many effective therapies for earlystage PH and HHS is encouraged to work collaboratively with the 

patient and professional community to prepare recommendations to 

improve early diagnosis and treatment of PH. 

Sexual Risk Avoidance.—The Committee provides $20,000,000 in 

budget authority for sexual risk avoidance programs, which is 

$5,000,00 above the fiscal year 2017 level and the fiscal year 2018 

budget request. 

In implementing these funds, it is the intent of the Committee 

that HHS provide substantive and practical technical assistance to 

grantees so they place meaningful emphasis on Sexual Risk Avoidance (SRA) in all educational messaging to teens. The Committee 

notes that such technical assistance should be provided in the following venues: during National and regional conferences, webinars 

and one-on-one conversations with funded projects. The Committee 

further intends that SRA-credentialed experts consult with grantees and HHS staff with oversight of these programs on methodologies and best practices in SRA for teens. The Committee also encourages all operating divisions at HHS that implement or inform 

youth programs to implement consistently a public health model 

that stresses risk avoidance or works to return individuals to a lifestyle without risk, particularly as it relates to sexual risk. 

Vector-Borne Disease Research.—A number of agencies across the 

Federal government are engaged in various facets of vector-borne 

disease research and control. In an effort to foster greater coordination, collaboration and transparency across agency lines, the Committee encourages the Secretary to establish a coordinating office 

to facilitate and expedite the government’s response to vector-borne 

disease threats, including combating the spread of disease through 

innovative vector control technologies. 

Office of Minority Health 

The Committee provides $45,250,000 for the Office of Minority 

Health (OMH), which is $11,420,000 below the fiscal year 2017 enacted level and $11,312,000 below the budget request. The OMH 

works with U.S. Public Health Service agencies and other agencies 

of the Department to address the health status and quality of life 

for racial and ethnic minority populations in the United States. 

OMH develops and implements new policies; partners with States, 

Tribes, and communities through cooperative agreements; supports 

research, demonstration, and evaluation projects; and disseminates 

information. 

Hepatitis.—The Committee continues to be concerned about the 

HIV/AIDS epidemic in the African American and Hispanic commuVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00101 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
102 

nities, and is aware of the concurrent high co-infection rate for hepatitis C. The Committee commends OMH for their advancements 

in the treatment and management of hepatitis. The Committee 

asks that the agency provide the Committee with a report that outlines the progress in continuing encouragement of community partnerships that promote awareness and outreach to improve testing, 

diagnosis, and treatment no later than 60 days after enactment of 

this Act. 

Lupus.—The agreement continues to provide $2,000,000 for 

Lupus activities at OMH. The Committee continues to support the 

OMH National Health Education Lupus Program. The action plan 

will focus on fostering public-private and community partnerships, 

evaluating current minority clinical trial education and participation programs, and creating a research plan for new clinical trial 

education models in lupus. The Committee is encouraged by the research conducted by the OMH National Health Education Lupus 

Program and encourages OMH to optimize that research and utilize other resources in development to further support populations 

at highest risk; more specifically Hispanics, Native Americans, 

Asians and African Americans. The Committee recommends collaborating with the lupus community to expand the development of 

linguistically and culturally appropriate tools, resources and materials for these adults and children with lupus, their caregivers and 

health care providers. 

Office of Women’s Health 

The Committee includes $25,712,000 for the Office of Women’s 

Health, which is $6,428,000 below the fiscal year 2017 enacted 

level and the 2018 budget request. 

Faith Based Center 

The Committee includes $1,299,000 for the Faith Based Center, 

the same as fiscal year 2017 enacted level and the fiscal year 2018 

budget request. 

OFFICE OF MEDICARE HEARINGS AND APPEALS

The Committee provides $112,381,000 for the Office of Medicare 

Hearings and Appeals, which is $5,000,000 above the fiscal year 

2017 enacted level and $4,796,000 below the fiscal year 2018 budget request. This Office supports hearings at the administrative law 

judge level, the third level of Medicare claims appeals. 

Medicare Appeals Backlog.—The Committee is concerned with 

the size of the Medicare Appeals Backlog. The Committee supports 

the Office of Medicare Hearings and Appeals to take administrative 

actions that will reduce the number of cases awaiting a hearing 

with an Administrative Law Judge. 

OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION

TECHNOLOGY

The Committee provides $38,381,000 for the Office of the National Coordinator for Health Information Technology (ONC), 

which is $21,986,000 below the fiscal year 2017 enacted level and 

the same as the fiscal year 2018 budget request. ONC is the principal Federal entity charged with coordination of Nationwide efVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00102 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
103 

forts to implement and use the most advanced health information 

technology and the electronic exchange of health information. 

Patient Data Matching.—The Committee is aware that a challenge inhibiting the safe and secure electronic exchange of health 

information is the lack of a consistent approach to matching patient data. The Committee encourages ONC to engage with stakeholders on private-sector led initiatives to develop a coordinated 

strategy that will promote patient safety by accurately identifying 

patients to their health information. 

Prescription Drug Monitoring.—The Committee understands that 

the spread of the prescription drug epidemic throughout the Nation 

has made the creation, implementation, and use of State prescription drug monitoring programs (PDMPs) and their ability to operate in concert with electronic health record (EHR) and electronic 

prescribing (e-prescribing) systems more important than ever. The 

Committee encourages ONC to continue its support for pilot programs to find usability challenges among PDMP, EHR, and e-prescribing systems; develop and award challenge awards to private 

entities for health information technology innovation; and offer targeted technical assistance to help medical professionals use PDMP, 

EHR, and e-prescribing systems. The Committee further encourages ONC to collaborate and coordinate its efforts with partner 

agencies such as the Centers for Disease Control and Prevention 

and the Bureau of Justice Assistance in the Department of Justice. 

OFFICE OF INSPECTOR GENERAL

The Committee recommends $80,000,000 for the Office of Inspector General (OIG), which is the same as the fiscal year 2017 enacted level and $11,915,000 above the fiscal year 2018 budget request. In addition, within the Health Care Fraud and Abuse Control (HCFAC) program discretionary appropriations for fiscal year 

2018, the Committee provides the OIG with $82,132,000. Mandatory appropriations for this office also are contained in the HCFAC 

program and the Health Insurance Portability and Accountability 

Act of 1996. 

Within the total provided, the Committee provides sufficient 

funding for the OIG to monitor HHS compliance with the provision 

that prohibits the use of Federal funding for lobbying campaigns. 

The Committee remains concerned that certain HHS operating divisions have skirted the prohibition on using taxpayer funding to 

lobby State and or local governments. As such, the Committee requests that the OIG monitor grantee activities to ensure that no 

taxpayer resources are used for lobbying. 

OFFICE FOR CIVIL RIGHTS

The Committee provides $38,798,000 for the Office for Civil 

Rights (OCR), which is the same as the fiscal year 2017 enacted 

level and $6,268,000 above the 2018 budget request. The OCR is 

responsible for enforcing civil rights statutes that prohibit discrimination in health and human services programs. OCR implements 

the civil rights laws through a compliance program designed to 

generate voluntary compliance among all HHS recipients. 

The Committee is concerned about reports of continued discrimination against persons with disabilities in organ transplant programs. Despite the Americans with Disabilities Act (ADA) and SecVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00103 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
104 

tion 504 of the Rehabilitation Act prohibiting discrimination on the 

basis of disability in organ transplantation, a number of States 

have found it necessary to enact laws to address continued barriers 

to receiving this lifesaving care. These barriers are reported to include medical professionals and transplant centers refusing to approve organ transplants for people with disabilities who may need 

help in order to follow complicated post-transplant treatment plans, 

or deciding that people with disabilities should be given a lower 

priority on waiting lists to receive an organ transplant. In coordination with HRSA, the Committee urges the Office for Civil Rights 

(OCR) to develop and issue guidance that clarifies the obligations 

of ADA- and Section 504-covered entities participating in the transplant process to provide equal access to their programs to individuals with disabilities. In developing such guidance, the Committee 

encourages OCR to consider prohibiting such covered entities from, 

among other things, denying medical services related to organ 

transplantation, refusing to refer an individual to a transplant center or other related specialist for the purpose of evaluation or receipt of an organ transplant, and refusing to place an individual on 

an organ transplant waiting list, or placement of the individual at 

a lower-priority position on the list than the position at which he 

or she would have been placed if not for his or her disability. 

RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED

OFFICERS

The Committee provides for retirement pay and medical benefits 

of Public Health Service Commissioned Officers, for payments 

under the Retired Serviceman’s Family Protection Plan, and for 

medical care of dependents and retired personnel. Total costs are 

estimated to be $618,689,000 for fiscal year 2018, which is 

$11,719,000 below the fiscal year 2017 enacted level and the same 

as the fiscal year 2018 budget request. 

PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND

The Committee provides $1,739,258,000 for the Public Health 

and Social Services Emergency Fund to support a comprehensive 

program to prepare for and respond to the health and medical consequences of all public health emergencies, including bioterrorism, 

and support the cybersecurity efforts of the Department of Health 

and Human Services. This amount is $221,300,000 above the fiscal 

year 2017 enacted level and $76,642,000 above the 2018 budget request. 

The Committee does not include the authority requested in the 

budget to create a Federal Emergency Response Fund. However, 

the Committee recognizes the benefit of allowing some flexibility to 

allow HHS to move more quickly in the event of a public health 

emergency. To address this issue, the Committee provides enhanced transfer authority to make it easier for HHS to direct resources where they are needed in the case of a public health emergency, such as an influenza pandemic. 

National Ebola Training and Education Center.—The Committee 

supports the continued efforts of the National Ebola Training and 

Education Center (NETEC). Supplemental funds to support 

NETEC were provided in P.L. 113–235. 

105 

Office of the Assistant Secretary for Preparedness and Response 

The Committee provides $1,424,928,000 for activities administered by the Office of the Assistant Secretary for Preparedness and 

Response (ASPR). This amount is $28,300,000 above the fiscal year 

2017 enacted level and $55,883,000 above the fiscal year 2018 

budget request. ASPR is responsible for coordinating national policies and plans for medical and public health preparedness and for 

administering a variety of public health preparedness programs, including the National Disaster Medical System, the Hospital Preparedness Cooperative Agreement Grants Program, Project BioShield, and the Office of Biomedical Advanced Research and Development Authority. 

Biomedical Advanced Research and Development Authority 

(BARDA) 

The Committee provides $520,000,000 for BARDA, which is $8,300,000 above fiscal year 2017 enacted level and the fiscal year 

2018 budget request. In addition, the Committee provides 

$530,000,000 for Project BioShield, which is $20,000,000 above the 

fiscal year 2017 enacted level and the fiscal year 2018 budget request. The funds support acquisitions of medical countermeasures 

(MCMs) to address Chemical, Biological, Radiological, and Nuclear 

(CBRN) threats. 

The Committee remains committed to ensuring the nation is adequately prepared against CBRN attacks. Public-private partnerships to develop MCMs are required to successfully prepare and defend the nation against these threats. The Committee supports the 

goal of market development where there is little or no commercial 

market. The funds allow for sustained management and funding of 

critical priorities, facilitate flexible and rapid response to emerging 

threats, and prevent the loss of resources from year to year, especially when the country is facing such tight budget constraints 

while threats persist. 

Pathogen Reduction Technology.—The Committee commends 

BARDA for taking the critical steps of supporting FDA-approved 

pathogen reduction technology in U.S. blood centers to ensure the 

safety of blood products being provided to patients and specifically 

for patients at risk for exposure to emerging pathogens. The Committee urges BARDA to continue funding the development of 

pathogen reduction technology. The Committee recommends $250,000,000 for the ASPR’s pan- demic influenza program, which is $178,000,000 above the fiscal 

year 2017 enacted level and $43,137,000 above the fiscal year 2018 

budget request. This funding supports research and development of 

next-generation influenza MCMs, preparedness testing and evaluation, and stockpiling. 

GENERAL PROVISIONS

PREVENTION AND PUBLIC HEALTH FUND

The Committee continues a provision that directs the transfer of 

the Prevention and Public Health (PPH) Fund. In fiscal year 2018, 

the level appropriated for the fund is $840,600,000 after accounting 

for sequestration. The agreement includes bill language in section 

225 of this Act that requires that funds be transferred within 45 

106 

days of enactment of this Act to the following accounts, for the following activities, and in the following amounts: 

Agency Budget Activity FY 2018 

Agreement 

CDC ........................... Breast Feeding Grants (Hospitals Promoting Breastfeeding) ................................ $8,000,000 

CDC ........................... Diabetes .................................................................................................................. 72,000,000 

CDC ........................... Epidemiology and Laboratory Capacity Grants ...................................................... 40,000,000 

CDC ........................... Healthcare Associated Infections ........................................................................... 12,000,000 

CDC ........................... Heart Disease and Stroke Prevention Program ...................................................... 107,950,000 

CDC ........................... Good Health and Wellness in Indian Country ........................................................ 16,000,000 

CDC ........................... Million Hearts Program .......................................................................................... 4,000,000 

CDC ........................... Preventive Health and Health Services Block Grant ............................................. 160,000,000 

CDC ........................... Tobacco ................................................................................................................... 126,000,000 

CDC ........................... Section 317 Immunization Grants ......................................................................... 273,650,000 

CDC ........................... Lead Poisoning Prevention ..................................................................................... 17,000,000 

CDC ........................... Early Care Collaboratives ....................................................................................... 4,000,000 

Sec. 201. The Committee continues a provision to limit the 

amount available for official reception and representation expenses. 

Sec. 202. The Committee continues a provision to limit the salary 

of an individual through an HHS grant or other extramural mechanism to not more than the rate of Executive Level II. 

Sec. 203. The Committee continues a provision to prohibit the 

Secretary from using evaluation set-aside funds until the Committees on Appropriations of the House of Representatives and the 

Senate receive a report detailing the planned use of such funds. 

Sec. 204. The Committee modifies a provision regarding the enacted level for the PHS evaluation set-aside, reducing it to 2.4 percent. 

(TRANSFER OF FUNDS)

Sec. 205. The Committee continues a provision permitting the 

Secretary of HHS to transfer up to one percent of any discretionary 

funds between appropriations, provided that no appropriation is increased by more than three percent by any such transfer to meet 

emergency needs. Notification must be provided to the Committees 

on Appropriations at the program, project, and activity level in advance of any such transfer. 

Sec. 206. The Committee continues the 60 day flexibility for National Health Service Corps contract terminations. 

Sec. 207. The Committee continues a provision to prohibit the 

use of Title X funds unless the applicant for the award certifies to 

the Secretary that it encourages family participation in the decision of minors to seek family planning services and that it provides 

counseling to minors on how to resist attempts to coerce minors 

into engaging in sexual activities. 

Sec. 208. The Committee continues a provision stating that no 

provider of services under Title X shall be exempt from any state 

law requiring notification or the reporting of child abuse, child molestation, sexual abuse, rape, or incest. 

Sec. 209. The Committee continues a provision related to the 

Medicare Advantage program. 

Sec. 210. The Committee continues a provision prohibiting funds 

from being used to advocate or promote gun control. 

Sec. 211. The Committee continues a provision to allow funding 

for HHS international HIV/AIDS and other infectious disease, 

chronic and environmental disease, and other health activities 

107 

abroad to be spent under the State Department Basic Authorities 

Act of 1956. 

Sec. 212. The Committee continues a provision authorizing certain international health activities. 

(TRANSFER OF FUNDS)

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

(TRANSFER OF FUNDS)

Sec. 214. The Committee continues a provision that makes NIH 

funds for human immunodeficiency virus research available to the 

Office of AIDS Research. 

Sec. 215. The Committee continues a provision granting authority to the Office of the Director of the NIH to enter directly into 

transactions in order to implement the NIH Common Fund for 

medical research and permitting the Director to utilize peer review 

procedures, as appropriate, to obtain assessments of scientific and 

technical merit. 

Sec. 216. The Committee continues a provision clarifying that 

funds appropriated to NIH institutes and centers may be used for 

minor repairs or improvements to their buildings, up to $3,500,000 

per project with a total limit for NIH of $45,000,000. 

(TRANSFER OF FUNDS)

Sec. 217. The Committee continues a provision transferring one 

percent of the funding made available for National Institutes of 

Health National Research Service Awards to the Health Resources 

and Services Administration. 

Sec. 218. The Committee continues the Biomedical Advanced Research and Development Authority ten year contract authority. 

Sec. 219. The Committee continues a provision relating to publicly accessible information regarding uses of funds under section 

4002 of Public Law 111–148. 

Sec. 220. The Committee continues language requiring HHS to 

include certain information concerning the number of full-time Federal employees and contractors working on the Affordable Care Act 

in the fiscal year 2018 budget request. 

Sec. 221. The Committee continues specific report requirements 

for CMS’s marketplaces activities in the fiscal year 2018 budget request. 

Sec. 222. The Committee continues certain Congressional notification requirements. 

Sec. 223. The Committee continues a provision prohibiting CMS 

Program Management account from being used to support risk corridor payments. 

Sec. 224. The Committee continues a provision requiring HHS to 

submit an analysis of the impact of section 2713 of the PHS Act 

on discretionary programs. 

Sec. 225. The Committee continues language directing the spending of the Prevention and Public Health fund. 

108 

Sec. 226. The Committee includes a new provision prohibiting 

funds from being used for Title X family planning activities. 

Sec. 227. The Committee continues a provision relating to breast 

cancer screening. 

Sec. 228. The Committee includes a new provision relating to indirect cost negotiated rates. 

Sec. 229. The Committee includes a new provision prohibiting 

funds from being used for the Navigators program. 

TITLE III—DEPARTMENT OF EDUCATION 

EDUCATION FOR THE DISADVANTAGED

The Committee recommends $15,953,790,000 for the Education 

for the Disadvantaged programs, which is $190,000,000 below the 

fiscal year 2017 enacted level and $393,768,000 below the fiscal 

year 2018 budget request. Of the total amount available, 

$5,035,990,000 is appropriated for fiscal year 2018 for obligation on 

or after July 1, 2018 and $10,841,177,000 is appropriated for fiscal 

year 2018 for obligation on or after October 1, 2018. This appropriation account includes compensatory education programs authorized under title I and subpart 2 of part B of title II of the Elementary and Secondary Education Act of 1965 (ESEA) and section 

418A of the Higher Education Act. 

Grants to Local Educational Agencies 

For fiscal year 2018, the Committee recommends $15,459,802,000 

for Title I grants to Local Educational Agencies (LEAs, or school 

districts), which is the same as the fiscal year 2017 enacted level 

and $421,656,000 below the fiscal year 2018 budget request. Title 

I grants provide supplemental education funding for activities that 

offer extra academic support to help students from low-income families and in high-poverty schools to meet State academic standards. Of the amounts provided for Title I programs, $6,459,401,000 is 

available for Basic Grants to LEAs, which is the same as the fiscal 

year 2017 enacted level and $28,344,000 above the fiscal year 2018 

budget request. Basic grants are awarded to school districts with 

at least 10 low-income children who make up more than two percent of the school-age population. 

Within the amount for Title I Basic Grants, up to $5,000,000 is 

made available to the Secretary of Education on October 1, 2017, 

to obtain annually-updated LEA-level poverty data from the Bureau of the Census. 

The Committee recommends $1,362,301,000 for Title I Concentration Grants, which is the same as the fiscal year 2017 enacted level and the fiscal year 2018 budget request. Concentration 

Grants target funds to school districts in which the number of lowincome children exceeds 6,500 or 15 percent of the total school-age 

population. 

The Committee recommends $3,819,050,000 for Title I Targeted 

Grants, which is the same as the fiscal year 2017 enacted level and 

$275,000,000 above the fiscal year 2018 budget request. Targeted 

Grants provide higher payments to school districts with high numbers or percentages of low-income students. 

The Committee recommends $3,819,050,000 for Title I Education 

Finance Incentive Grants (EFIGs), which is the same as the fiscal 

109 

year 2017 enacted level and $275,000,000 above the fiscal year 

2018 budget request. EFIGs provide payments to States and school 

districts that incorporate ‘‘equity’’ and ‘‘effort’’ factors to improve 

the equity of State funding systems. 

The Committee is aware of the budget request proposal to in- clude up to $1,000,000,000 for grants to local educational agencies 

to implement weighted per-pupil funding systems, including open 

enrollment systems that allow students to enroll in a public school 

selected by their parents. However, the Committee notes that such 

a program has not been authorized. Accordingly, the Committee 

has not provided funding for such a program within this bill. Funding for this approach will be considered should it be authorized in 

law. 

Comprehensive Literacy Development Grants 

The Committee recommends no funding for Comprehensive Lit- eracy Development Grants, which is $190,000,000 below the fiscal 

year 2017 enacted level and the same as the fiscal year 2018 budget request. The Committee notes that the current cohort of grantees will complete projects in fiscal year 2017, so program termination will not impact funding for any existing grantees. 

Innovative Approaches to Literacy 

The Committee recommends $27,000,000 for Innovative Approaches to Literacy, the same as the 2017 enacted level and 

$27,000,000 above the fiscal year 2018 budget request. This program provides competitive grants to support school libraries. 

State Agency Programs: Migrant 

The Committee recommends $374,751,000 for the State Agency 

Program for Migrant Education, which is the same as the fiscal 

year 2017 enacted level and $712,000 above the fiscal year 2018 

budget request. This program supports special educational and related services for children of migrant agricultural workers and fishermen, including: (1) supplementary academic education; (2) remedial or compensatory instruction; (3) English for limited English 

proficient students; (4) testing; (5) guidance counseling; and (6) 

other activities to promote coordination of services across States for 

migrant children whose education is interrupted by frequent 

moves. 

State Agency Programs: Neglected and Delinquent 

For the State Agency Program for Neglected and Delinquent 

Children, the Committee recommends $47,614,000, which is the 

same as the fiscal year 2017 enacted level and $91,000 above the 

fiscal year 2018 budget request. This formula grant program supports educational services for children and youth under age 21 in 

State-run institutions, attending community day programs, and in 

correctional facilities. A portion of these funds is provided for 

projects that support the successful re-entry of youth offenders into 

postsecondary and vocational programs. 

Special Programs for Migrant Students 

The Committee recommends $44,623,000 for the Special Programs for Migrant Students, which is the same as the fiscal year 

110 

2017 enacted level and $85,000 above the fiscal year 2018 budget 

request. These programs make grants to colleges, universities, and 

nonprofit organizations to support educational programs designed 

for students who are engaged in migrant and other seasonal farm 

work. The High School Equivalency Program (HEP) recruits migrant students age 16 and over and provides academic and support 

services to help those students obtain a high school equivalency 

certificate and subsequently to gain employment or admission to a 

postsecondary institution or training program. The College Assistance Migrant Program (CAMP) provides tutoring and counseling 

services to first-year, undergraduate migrant students and assists 

those students in obtaining student financial aid for their remaining undergraduate years. The Committee recommendation assumes 

the allocation of funds between HEP and CAMP as proposed by the 

Administration. 

IMPACT AID

The Committee recommends $1,333,603,000 for Federal Impact Aid programs, which is $5,000,000 above the fiscal year 2017 enacted level and $97,168,000 above the fiscal year 2018 budget request. This account supports payments to school districts affected 

by Federal activities, such as those that educate children whose 

families are connected with the military or who live on Indian land. 

Basic Support Payments 

The Committee recommends $1,194,233,000 for Basic Support Payments to LEAs, which is $5,000,000 above the fiscal year 2017 

enacted level and $28,221,000 above the fiscal year 2018 budget request. Basic Support Payments compensate school districts for lost 

tax revenue and are made on behalf of Federally-connected children, such as children of members of the uniformed services who 

live on Federal property. 

Payments for Children with Disabilities 

The Committee recommends $48,316,000 for Payments for Children with Disabilities, which is the same as the fiscal year 2017 

enacted level and $92,000 above the fiscal year 2018 budget request. These payments compensate school districts for the increased costs of serving Federally-connected children with disabilities. 

Facilities Maintenance 

The Committee recommends $4,835,000 for Facilities Maintenance, which is the same as the fiscal year 2017 enacted level and 

$9,000 above the fiscal year 2018 budget request. These capital 

payments are authorized for maintenance of certain facilities 

owned by the Department. 

Construction 

The Committee recommends $17,406,000 for the Construction 

program, which is the same as the fiscal year 2017 enacted level 

and $33,000 above the fiscal year 2018 budget request. This program provides competitive grants for building and renovating 

school facilities to school districts that educate Federally-connected 

students or have Federally-owned land. 

111 

Payments for Federal Property 

The Committee recommends $66,813,000 for Payments for Federal Property, which is the same as the fiscal year 2017 enacted 

level and $66,813,000 above the fiscal year 2018 budget request. 

Funds are awarded to school districts to compensate for lost tax 

revenue as the result of Federal acquisition of real property since 

1938. 

SCHOOL IMPROVEMENT PROGRAMS

The Committee recommends $2,261,064,000 for School Improvement Programs, which is $2,147,503,000 below the fiscal year 2017 

enacted level and $1,563,833,000 above the fiscal year 2018 budget 

request. The School Improvement account includes programs authorized under Titles I, II, IV, VI, and VII of the ESEA; the McKinney-Vento Homeless Assistance Act; Title IV–A of the Civil Rights 

Act; section 203 of the Educational Technical Assistance Act of 

2002; and section 105 of the Compact of Free Association Amendments Act of 2003. 

Supporting Effective Instruction State Grants 

The Committee recommends no funding for Supporting Effective 

Instruction State Grants, which is $2,055,830,000 below the fiscal 

year 2017 enacted level and the same as the fiscal year 2018 budget request. This program duplicates activities that may be supported with other funds, has not demonstrated success in contributing to improved teacher quality and makes formula-based allocations to school districts that often are too small to have a meaningful impact on student outcomes. 

Supplemental Education Grants 

The Committee recommends $16,699,000 for Supplemental Education Grants to the Federated States of Micronesia and the Republic of the Marshall Islands, which is the same as the fiscal year 

2017 enacted level and $32,000 above the fiscal year 2018 budget 

request. The Compact of Free Association Amendments Act of 2003 

(P.L. 108–188) authorizes these entities to receive funding for general education assistance. The Committee recommendation includes 

a consolidated amount for Supplemental Education Grants because 

the underlying statute determines the allocation between Micronesia and the Marshall Islands. 

21st Century Community Learning Centers 

The Committee recommends $1,000,000,000 for 21st Century 

Community Learning Centers, which is $191,673,000 below the fiscal year 2017 enacted level and $1,000,000,000 above the fiscal 

year 2018 budget request. This program awards formula grants to 

States, which in turn distribute funds on a competitive basis to 

local school districts, nonprofit organizations, and other public entities. Funds may be used to provide activities that complement and 

reinforce the regular school-day program for participating students 

and may also fund local activities that are included as part of an 

expanded learning time program. The Committee notes that 

$1,000,000,000 is the level authorized for this program by the 

ESSA. 

112 

State Assessments 

The Committee recommends $369,100,000 for State Assessments, 

which is the same as the fiscal year 2017 enacted level and 

$8,181,000 below the fiscal year 2018 budget request. Funds are 

available to develop and implement academic standards and assessments. The program includes a set-aside for audits to identify 

and eliminate low-quality or duplicative assessments. 

Education for Homeless Children and Youth 

The Committee recommends $77,000,000 for the Education for 

Homeless Children and Youth program, which is the same as the 

fiscal year 2017 enacted level and $7,133,000 above the fiscal year 

2018 budget request. The Committee recognizes that without an 

education, these at-risk children and youth are unlikely to obtain 

the skills they need to become productive adults contributing to the 

economy and their communities. Grants are allocated to States in 

proportion to the total each State receives under the Title I program. 

Training and Advisory Services 

The Committee recommends $6,575,000 for Training and Advisory Services authorized by Title IV–A of the Civil Rights Act, 

which is the same as the fiscal year 2017 enacted level and $12,000 

above the fiscal year 2018 budget request. Title IV–A authorizes 

technical assistance and training services for school districts to address problems associated with desegregation on the basis of race, 

sex, or national origin. The Department awards three-year grants 

to regional Equity Assistance Centers (EACs) located in each of the 

10 Department of Education regions. The EACs provide services to 

school districts upon request. Typical activities include disseminating information on successful education practices and legal requirements related to nondiscrimination on the basis of race, sex, 

and national origin in educational programs. 

Education for Native Hawaiians 

The Committee recommends $33,397,000 for the Education for 

Native Hawaiian program, which is the same as the fiscal year 

2017 level and $33,397,000 above the fiscal year 2018 budget request. Funds are used to provide competitive awards for supplemental education services to the Native Hawaiian population. The 

Committee does not include bill language allowing these funds to 

be used for construction. 

Alaska Native Education Equity 

The Committee recommends $32,453,000 for the Alaska Native 

Education Equity program, which is the same as the fiscal year 

2017 level and $32,453,000 above the fiscal year 2018 budget request. Funds are used to provide competitive awards for supplemental education services to the Alaska Native population. The 

Committee does not include bill language allowing these funds to 

be used for construction. 

Rural Education 

The Committee recommends $175,840,000 for Rural Education 

programs, which is the same as the fiscal year 2017 enacted level 

113 

and $334,000 above the fiscal year 2018 budget request. There are 

two programs to assist rural school districts with improving teaching and learning in their schools: the Small, Rural Schools Achievement program, which provides funds to rural districts that serve a 

small number of students; and the Rural and Low-Income Schools 

program that provides funds to rural districts that serve concentrations of poor students, regardless of the number of students served 

by the district. Funds appropriated for Rural Education shall be divided equally between these two programs. 

Comprehensive Centers 

The Committee recommends $50,000,000 for Comprehensive 

Centers, which is the same as the fiscal year 2017 enacted level 

and $1,347,000 above the fiscal year 2018 budget request. This 

grant program currently supports 22 comprehensive centers, including 15 regional centers that provide training, technical assistance, and professional development to build State capacity to provide high-quality education to all students. The remaining seven 

centers specialize in particular content areas. The Committee includes bill language directing the Secretary to ensure that the Bureau of Indian Education (BIE) has access to services provided 

under this section. 

Student Support and Academic Enrichment State Grants 

The Committee recommends $500,000,000 for Student Support 

and Academic Enrichment (SSAE) State Grants, which is 

$100,000,000 above the fiscal year 2017 enacted level and 

$500,000,000 above the fiscal year 2018 budget request. The ESSA 

eliminated several narrowly-focused competitive grant programs 

and replaced them with this new formula grant program. States 

and school districts have flexibility to focus these resources on locally-determined priorities to provide students with access to a 

well-rounded education, including rigorous coursework, and to improve school conditions and the use of technology. 

STEM and Computer Science Education.—The Committee notes 

that funds available under this program may be used by States and 

school districts to provide or strengthen instruction in STEM fields, 

including computer science. The Committee recognizes the importance of funding Pre K–12 computer science education to address 

national security, and ensure American competitiveness. Supporting education in the science, technology, engineering, arts, and 

mathematics fields, particularly computer science, is critical to ensure that our nation continues to lead in innovation. As computer 

science is a basic skill in the 21st century global economy, the 

Committee encourages the Department to support Pre K–12 computer science education to schools across the country. 

Non-Cognitive Factors.—The Committee notes that programs designed to support non-cognitive factors such as critical thinking 

skills, social skills, work ethic, problem solving, and community responsibility are an eligible use of funds under SSAE grants supporting a well-rounded education. 

INDIAN EDUCATION

The Committee recommends $164,939,000 for Indian Education, 

which is the same as the fiscal year 2017 enacted level and 

114 

$21,274,000 above the fiscal year 2018 budget request. This account supports programs authorized by part A of title VI of the 

ESEA. 

Grants to Local Educational Agencies 

The Committee recommends $100,381,000 for Grants to Local 

Educational Agencies, which is the same as the fiscal year 2017 enacted level and $191,000 above the fiscal year 2018 budget request. 

This program provides assistance through formula grants to school 

districts and schools supported or operated by the Bureau of Indian 

Education. The purpose of this program is to improve elementary 

and secondary school programs that serve Indian students, including preschool children. Grantees must develop a comprehensive 

plan and ensure that the programs they carry out will help Indian 

students reach the same challenging standards that apply to all 

students. This program supplements the regular school program to 

help Indian children sharpen their academic skills, bolster their 

self-confidence, and participate in enrichment activities that would 

otherwise be unavailable. 

Special Programs for Indian Children 

The Committee recommends $57,993,000 for Special Programs 

for Indian Children, which the same as the fiscal year 2017 enacted 

level and $20,072,000 above the fiscal year 2018 budget request. 

These programs make competitive awards to improve the quality of 

education for American Indian students. The program also funds 

the American Indian Teacher Corps and the American Indian Administrator Corps to recruit and support American Indians as 

teachers and school administrators. 

National Activities 

The Committee recommends $6,565,000 for National Activities, 

which is the same as the fiscal year 2017 enacted level and 

$1,011,000 above the fiscal year 2018 budget request. Funds under 

this authority support (1) research, evaluation and data collection 

to provide information about the educational status of Indian students and the effectiveness of Indian education programs; (2) 

grants to support Native language immersion schools and programs; and (3) grants to tribes for education administrative planning, development, and coordination. 

State-Tribal Education Partnership.—The Committee recommends continued funding for the State-Tribal Education Partnership (STEP) program. This program makes grants to tribes to 

build capacity to assume certain State responsibilities for the administration of ESEA programs. Indian educators have long called 

for Tribal-State-Federal partnerships to involve Indian Tribes in 

educating their students and to improve American Indian education outcomes. STEP programs have, and will continue to, assist 

State and Tribal governments to continue delivering the highest 

quality education for Indian students. 

Language Immersion Program.—Within the total for National 

Activities, the Committee continues funding for a Native American 

and Alaska Native Language Immersion Program, the same as the 

fiscal year 2018 budget request. This program, which was authorized in ESSA, will make grants to maintain and promote the use 

115 

of Native languages, support Native language education and development, and provide professional development to teachers. 

INNOVATION AND IMPROVEMENT

The Committee recommends $747,904,000 for Innovation and Improvement programs, which is $139,671,000 below the fiscal year 

2017 enacted level and $460,122,000 below the fiscal year 2018 

budget request. This appropriation account includes programs authorized under portions of Titles II and IV of the ESEA. 

Education Innovation and Research 

The Committee recommends no funding for the Education Inno- vation and Research program. This amount is $100,000,000 below 

the fiscal year 2017 enacted level and $370,000,000 below the fiscal 

year 2018 budget request. This program makes competitive grants 

to support the replication and scaling-up of evidence-based education innovations. Given budget constraints, the Committee has 

chosen instead to focus resources on core formula grant programs. 

The Committee is aware of the budget request proposal to in- clude up to $250,000,000 for grants to local educational agencies to 

implement a program of awarding scholarships to students from 

low-income families to attend a private school selected by their parents. However, the Committee notes that such a program has not 

been authorized. Accordingly, the Committee has not provided 

funding for such a program within this bill. Funding for this approach will be considered should a program be authorized. 

Teacher and School Leader Incentive Grants 

The Committee recommends $200,000,000 for the Teacher and 

School Leader Incentive Grants program, which is the same as the 

fiscal year 2017 enacted level and $437,000 above the fiscal year 

2018 budget request. This program provides grants to States, 

school districts, and partnerships to develop, implement, improve, 

or expand human capital management systems or performancebased compensation systems in schools. 

American History and Civics Academies 

The Committee recommends no funding for American History and Civics Academies, $1,815,000 below the fiscal year 2017 enacted level and the same as the fiscal year 2018 budget request. 

This program reaches only a very limited number of teachers and 

students since an academy may select no more than 300 teachers 

or students for participation. 

American History and Civics National Activities 

The Committee recommends $1,700,000 for American History 

and Civics National Activities, the same as the fiscal year 2017 enacted level and $1,700,000 above the fiscal year 2018 budget request. The Committee recognizes the importance of improving the 

quality of instruction in American history, civics, and geography, 

particularly for schools in underserved rural and urban communities. In recognition of the fact that no one size fits all in effective 

education, and that a variety of approaches are required to meet 

the range of student and community needs, these competitive 

grants will support multiple grantees in making available a menu 

116 

of innovative, effective approaches to teaching American history, 

civics and government, and geography. These validated approaches 

will be available to schools and school districts for their consideration and voluntary use, based on the approach that best meets the 

needs of the students and community. 

Supporting Effective Educator Development 

The Committee recommends $42,000,000 for the Supporting Ef- fective Educator Development (SEED) grant program, $23,000,000 

below the fiscal year 2017 level and the same as the fiscal year 

2018 budget request. SEED provides competitive grants to Institutions of Higher Education (IHEs), national nonprofit organizations, 

BIE, and partnerships to support alternative certification and other 

professional development and enrichment activities for teachers, 

principals, and other school leaders. Funds are included to support 

fully continuation costs for grants made in prior years. 

School Leader Recruitment and Support 

The Committee recommends no funding for School Leader Re- cruitment and Support, which is $14,500,000 below the fiscal year 

2017 level and the same as the budget request. This program supports a small number of grantees and has minimal national impact. 

While school leadership is important, other Federal funds are 

available to support improved leadership in high-need schools. 

Charter Schools Grants 

The Committee recommends $370,000,000 for Charter Schools 

Grants, which is $27,828,000 above the fiscal year 2017 enacted 

level and $130,000,000 below the fiscal year 2018 budget request. 

In exchange for a commitment to increase student achievement, 

charter schools are exempt from many statutory and regulatory requirements. The Charter Schools Grants program awards grants to 

State Educational Agencies (SEAs) or, if a State’s SEA chooses not 

to participate, to charter school developers to support the development and initial implementation of public charter schools. State 

Facilities Incentive Grants and Credit Enhancement for Charter 

School Facilities awards help charter schools obtain adequate 

school facilities. These programs work in tandem to support the development and operation of charter schools. 

The Committee recommends an allocation of funds within this 

program that aligns with ESSA. 

Magnet Schools Assistance 

The Committee recommends $96,463,000 for the Magnet Schools 

Assistance program, which is $1,184,000 below the fiscal year 2017 

enacted level and the same as the fiscal year 2018 budget request. 

This program makes competitive grants to support the establishment and operation of magnet schools that are a part of a courtordered or Federally-approved voluntary desegregation plan. 

Ready to Learn Programming 

The Committee recommends $25,741,000 for Ready to Learn Programming, which is the same as the fiscal year 2017 enacted level 

and $25,741,000 above the fiscal year 2018 budget request. This 

program supports the development and distribution of educational 

117 

video programming for preschool and elementary school children 

and their parents, caregivers, and teachers. 

Arts in Education 

The Committee recommends no funding for Arts in Education, $27,000,000 below the fiscal year 2017 level and the same as the 

fiscal year 2018 budget request. This program provides competitive 

grants to support professional development and the development of 

instructional materials and programming that integrate the arts 

into the curricula. States and school districts may use funds from 

the SSAE grants to support arts education. 

Javits Gifted and Talented Education 

The Committee recommends $12,000,000 for the Javits Gifted 

and Talented Education Program, which is the same as the fiscal 

year 2017 enacted level and $12,000,000 above the fiscal year 2018 

budget request. This program has limited impact, and the Department can support research on gifted and talented education 

through other Institute of Education Science programs. 

SAFE SCHOOLS AND CITIZENSHIP EDUCATION

The Committee recommends $138,000,000 for Safe Schools and 

Citizenship Education programs, which is $13,254,000 below the 

fiscal year 2017 enacted level and $3,143,000 above the fiscal year 

2018 budget request. This appropriation account includes programs 

authorized under parts of Title IV of the ESEA. 

Promise Neighborhoods 

The Committee recommends $60,000,000 for Promise Neighbor- hoods, which is $13,254,000 below the fiscal year 2017 enacted 

level and the same as the fiscal year 2018 budget request. Promise 

Neighborhoods supports grants to nonprofit, community-based organizations for the development of comprehensive neighborhood 

programs designed to combat the effects of poverty and improve 

educational outcomes for children and youth, from birth through 

college. 

School Safety National Activities 

The Committee recommends $68,000,000 for School Safety National Activities, which is the same as the fiscal year 2017 enacted 

level and $6,857,000 below the fiscal year 2018 budget request. 

This program includes a variety of competitive grants that aim to 

increase students’ safety and well-being. 

Full-Service Community Schools 

The Committee recommends $10,000,000 for Full-Service Community Schools, which is the same as the fiscal year 2017 level and 

$10,000,000 above the fiscal year 2018 budget request. This program makes competitive grants to support school-based comprehensive services for students, families, and communities. 

ENGLISH LANGUAGE ACQUISITION

The Committee recommends $737,400,000 for the English Language Acquisition program, which is the same as the fiscal year 

2017 enacted level and $1,402,000 above the fiscal year 2018 budgVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00117 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
118 

et request. Of this amount provided for the 2018–2019 academic 

year, funds are appropriated for obligation on or after July 1, 2018 

and available through September 30, 2018. 

This program provides formula grants to States to serve Limited 

English Proficient (LEP) students. Grants are based on each State’s 

share of the National LEP and recent immigrant student population. Funds under this account also support professional development to increase the pool of teachers prepared to serve LEP students as well as evaluation activities. The bill continues language 

to calculate all State awards based on a three-year average of data 

from the American Community Survey. 

The Committee is interested in information on the effectiveness 

of English Learner (EL) programs in delivering adequate services 

and accommodations to qualified students and requests the Department to include information on outcomes in English language acquisition and proficiency levels in math and reading nationwide, 

disaggregated, to the extent possible, by the major race and ethnicity categories in the Decennial Census, in the fiscal year 2019 

Congressional Justification. 

SPECIAL EDUCATION

The Committee recommends $13,251,691,000 for programs authorized under the Individuals with Disabilities Education Act 

(IDEA) for children with disabilities. This is $187,333,000 above 

the fiscal year 2017 enacted level and $309,565,000 above the fiscal 

year 2018 budget request. Of the total amount available, 

$1,864,818,000 is available for obligation on July 1, 2018, and 

$11,164,824,000 is available for obligation on October 1, 2018. 

These grants help States and localities pay for a free appropriate 

education for 6.7 million students with disabilities aged 3 through 

21 years. 

Grants to States 

The Committee recommends $12,202,848,000 for Part B Grants 

to States, which is $200,000,000 above the fiscal year 2017 enacted 

level and $312,646,000 above the fiscal year 2018 budget request. 

This program provides formula grants to assist States in meeting 

the costs of providing special education and related services to children with disabilities. States generally transfer most of the funds 

to LEAs; however, they can reserve some funds for program monitoring, technical assistance, and other related activities. In order to 

be eligible for funds, States must make free appropriate public education available to all children with disabilities. 

The Committee continues to include bill language excluding any 

amount by which a State’s allocation is reduced for failure to meet 

the maintenance of effort threshold from being used to calculate 

the State’s allocation under section 611(d) of the IDEA in subsequent years. The Committee also continues to include bill language 

directing the Secretary to distribute any reduction in a State’s allocation under said section to all other States based on the formula 

established under section 611(d), excluding those States that are 

penalized. 

119 

Preschool Grants 

The Committee recommends $368,238,000 for Preschool Grants, 

which is the same as the fiscal year 2017 enacted level and 

$700,000 above the fiscal year 2018 budget request. These funds 

provide additional assistance to States to help them make free, appropriate public education available to children with disabilities 

ages three through five. 

Grants for Infants and Families 

The Committee recommends $458,556,000 for Grants for Infants 

and Families, which is the same as the fiscal year 2017 enacted 

level and $872,000 above the fiscal year 2018 budget request. 

These funds provide additional assistance to States to help them 

make free, appropriate public education available to children with 

disabilities from birth through age two. 

IDEA National Activities 

The Committee recommends $222,049,000 for the IDEA National 

Activities program, which is $12,667,000 below the fiscal year 2017 

enacted level and $4,653,000 below the fiscal year 2018 budget request. The IDEA National Activities programs support State efforts 

to improve early intervention and education results for children 

with disabilities. 

State Personnel Development.—The Committee recommends 

$38,630,000 for State Personnel Development, which is the same as 

the fiscal year 2017 enacted level and $2,921,000 below the fiscal 

year 2018 budget request. This program supports grants to States 

to assist with improving personnel preparation and professional development related to early intervention and educational and transition services that improve outcomes for students with disabilities. 

Funds are included to fully support continuation costs for grants 

made in prior years. 

Technical Assistance and Dissemination.—The Committee recommends $44,261,000 for Technical Assistance and Dissemination, 

which is $12,667,000 below the fiscal year 2017 enacted level and 

the same as the fiscal year 2018 budget request. This program provides funding for technical assistance, demonstration projects, and 

information dissemination. These funds support efforts by State 

and local educational agencies, IHEs, and other entities to build 

State and local capacity to make systemic changes and improve results for children with disabilities. Funds are included to fully support continuation costs for grants made in prior years. 

Personnel Preparation.—The Committee recommends 

$83,700,000 for Personnel Preparation, which is the same as the 

fiscal year 2017 enacted level and $159,000 above the fiscal year 

2018 budget request. This program supports competitive awards to 

help address State-identified needs for qualified personnel to work 

with children with disabilities, and to ensure that those personnel 

have the necessary skills and knowledge to serve children with special needs. Awards focus on addressing the need for leadership and 

personnel to serve low-incidence populations. Funds are included to 

fully support continuation costs for grants made in prior years. 

Parent Information Centers.—The Committee recommends 

$27,411,000 for Parent Information Centers, which is the same as 

the fiscal year 2017 enacted level and $52,000 above the fiscal year 

120 

2018 budget request. This program makes awards to parent organizations to support Parent Training and Information Centers, including community parent resource centers. These centers provide 

training and information to meet the needs of parents of children 

with disabilities living in the areas served by the centers, particularly underserved parents and parents of children who may be inappropriately identified. Technical assistance is also provided 

under this program for developing, assisting, and coordinating centers receiving assistance under this program. 

Educational Technology, Media, and Materials.—The Committee 

recommends $28,047,000 for Educational Technology, Media, and 

Materials, which is the same as the fiscal year 2017 enacted level 

and $1,943,000 below the fiscal year 2018 budget request. This program makes competitive awards to support the development, demonstration, and use of technology and educational media activities 

of educational value to children with disabilities. The Committee 

recognizes the ongoing progress made with the tools and services 

provided under this program that have allowed more than 440,000 

students with disabilities free access to more than 515,000 books 

in digitally accessible formats. The Committee strongly encourages 

continued effort to expand this program’s reach to K–12 students 

in underserved areas. 

REHABILITATION SERVICES

The Committee recommends $3,562,582,000 for Rehabilitation 

Services, which is $26,993,000 above the fiscal year 2017 enacted 

level and $426,000 below the fiscal year 2018 budget request. The 

programs in this account are authorized by the Rehabilitation Act 

of 1973 and the Helen Keller National Center Act. 

Vocational Rehabilitation State Grants 

The Committee recommends $3,452,931,000 for Vocational Rehabilitation (VR) State Grants, which is $54,377,000 above the fiscal 

year 2017 enacted level and the same as the fiscal year 2018 budget request. 

This program supports basic vocational rehabilitation services 

through formula grants to the States. These grants support a wide 

range of services designed to help persons with physical and mental disabilities prepare for and engage in gainful employment to the 

extent of their capabilities. Emphasis is placed on providing vocational rehabilitation services to persons with the most significant 

disabilities. The Committee’s recommendation provides the cost-ofliving adjustment for Vocational Rehabilitation Grants to States, as 

authorized. 

Client Assistance State Grants 

The Committee recommends $13,000,000 for Client Assistance 

State Grants, which is the same as the fiscal year 2017 enacted 

level and $25,000 above the fiscal year 2018 budget request. Client 

Assistance State Grants support services for eligible individuals 

and applicants of the VR State Grants program, and other programs, projects, and services funded under the Rehabilitation Act. 

These formula grants are used to help persons with disabilities 

overcome problems with the service delivery system and improve 

121 

their understanding of services available to them under the Rehabilitation Act. 

Training 

The Committee recommends $29,388,000 for the Training program, which is the same as the fiscal year 2017 enacted level and 

$743,000 below the fiscal year 2018 budget request. The program 

supports long-term and short-term training, in-service personnel 

training, and training of interpreters for deaf persons. Projects in 

a broad array of disciplines are funded to ensure that skilled personnel are available to serve the vocational needs of persons with 

disabilities. Funds are included to fully support continuation costs 

for grants made in prior years. 

Demonstration and Training Programs 

The Committee recommends $5,796,000 for Demonstration and 

Training Programs, which is the same as the fiscal year 2017 enacted level and $11,000 above the fiscal year 2018 budget request. 

These programs authorize competitive grants to public and private 

organizations to support demonstrations, direct services, and related activities for persons with disabilities. 

Protection and Advocacy of Individual Rights 

The Committee recommends $17,650,000 for Protection and Advocacy of Individual Rights, which is the same as the fiscal year 

2017 enacted level and $34,000 above the fiscal year 2018 budget 

request. Grants are awarded to entities that have the authority to 

pursue legal, administrative, and other appropriate remedies to 

protect and advocate for the rights of persons with disabilities. 

Supported Employment State Grants 

The Committee recommends no funding for Supported Employment State Grants, which is $27,548,000 below the fiscal year 2017 

enacted level and the same as the fiscal year 2018 budget request. 

These formula grants assist States in developing collaborative programs with public agencies and nonprofit agencies for training and 

post-employment services leading to supported employment. Because supported employment is now an integral part of the vocational rehabilitation State grants program, there is no longer a 

need for a separate funding stream to ensure the provision of these 

services. This elimination will therefore reduce unnecessary administrative burden. The Committee expects State vocational rehabilitation agencies to continue to provide supported employment services in fiscal year 2018 to approximately the same number of individuals as they did previously. 

Independent Living Services for Older Individuals Who Are Blind 

The Committee recommends $33,317,000 for Independent Living 

Services for Older Individuals Who Are Blind, which is the same 

as the fiscal year 2017 enacted level and $63,000 above the fiscal 

year 2018 budget request. Funds are distributed to States according to a formula based on the population of individuals who are 55 

or older, and provide support for services to persons 55 years old 

or over whose severe visual impairment makes gainful employment 

122 

extremely difficult to obtain, but for whom independent living goals 

are feasible. 

Helen Keller National Center 

The Committee recommends $10,500,000 for the Helen Keller 

National Center for Deaf-Blind Youth and Adults, which is 

$164,000 above the fiscal year 2017 enacted level and $184,000 

above the fiscal year 2018 budget request. These funds are used for 

the operation of a National center that provides intensive services 

for deaf-blind individuals and their families at Sands Point, New 

York, and a network of ten regional offices that provide referral, 

counseling, transition services, and technical assistance to service 

providers. 

SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES

The Committee recommends $224,447,000 for Special Institutions for Persons with Disabilities, which is $7,725,000 above as 

the fiscal year 2017 enacted level and $8,137,000 above the fiscal 

year 2018 budget request. 

AMERICAN PRINTING HOUSE FOR THE BLIND

The Committee recommends $26,431,000 for the American Printing House for the Blind, which is $1,000,000 above the fiscal year 

2017 enacted level and $1,048,000 above the fiscal year 2018 budget request. This funding subsidizes the production of educational 

materials for legally blind persons enrolled in pre-college programs. 

The Printing House, which is chartered by the Commonwealth of 

Kentucky, manufactures and maintains an inventory of educational 

materials in accessible formats that are distributed free of charge 

to schools and States based on the number of blind students in 

each State. The Printing House also conducts research and field activities to inform educators about the availability of materials and 

how to use them. 

NATIONAL TECHNICAL INSTITUTE FOR THE DEAF

The Committee recommends $70,016,000 for the National Technical Institute for the Deaf, which is the same as the fiscal year 

2017 enacted level and $133,000 above the fiscal year 2018 budget 

request. Congress established the National Technical Institute for 

the Deaf in 1965 to provide a residential facility for postsecondary 

technical training and education for deaf persons with the purpose 

of promoting the employment of these individuals. The Institute 

also conducts applied research and provides training in various aspects of deafness. The Secretary of Education administers these activities through a contract with the Rochester Institute of Technology in Rochester, New York. 

GALLAUDET UNIVERSITY

The Committee recommends $128,000,000 for Gallaudet University, which is $6,725,000 above the fiscal year 2017 enacted level 

and $6,956,000 above the fiscal year 2018 budget request. 

Gallaudet is a private, non-profit educational institution Federally chartered in 1864 providing elementary, secondary, undergraduate, and continuing education for deaf persons. In addition, 

123 

the University offers graduate programs in fields related to deafness for deaf and hearing students, conducts research on deafness, 

and provides public service programs for deaf persons. 

CAREER, TECHNICAL, AND ADULT EDUCATION

The Committee recommends $1,720,686,000 for Career, Technical, and Adult Education programs, which is the same as the fiscal year 2017 enacted level and $244,245,000 above the fiscal year 

2018 budget request. This account includes vocational education 

programs authorized by the Carl D. Perkins Career and Technical 

Education Act of 2006 and the Adult Education and Family Literacy Act (AEFLA). 

Career and Technical Education: State Grants 

The Committee recommends $1,117,598,000 for Career and Technical Education: State Grants, which is the same as the fiscal year 

2017 enacted level and $168,099,000 above the fiscal year 2018 

budget request. Funds are made available for obligation on October 

1, 2018. 

State Grants support a variety of career and technical education 

programs developed in accordance with the State plan. The Act focuses Federal resources on institutions with high concentrations of 

low-income students. The populations assisted by State Grants 

range from secondary students in pre-vocational courses to adults 

who need retraining to adapt to changing technological and labor 

markets. Funding for State Grants will continue support for stateof-the art career and technical training to approximately 6 million 

students in secondary schools and more than 4 million students in 

community and technical colleges. 

Maker Education.—The Committee recogmzes the need for increased maker education in career and technical education in addition to K–12 curriculum in response to the increasing reliance on 

tools such as 3D printers, laser cutters, desktop machines, and programs for digital design becoming more affordable. Maker education exposes students to hands on project based learning approaches that build critical skills needed to increase economic 

growth and encourages students to imagine, create, innovate, and 

collaborate through the process of manufacturing, testing and demonstrating their ideas. The Committee encourages the expansion of 

maker-spaces in schools, which are community spaces that provide 

access to tools, technology and knowledge for learners and entrepreneurs and result in the prototyping or creation of physical 

goods, and support the development of educational opportunities 

for personal growth, workforce training, and early stage business 

ventures. 

National Programs 

The Committee recommends $7,421,000 for National Programs, 

which is the same as the fiscal year 2017 enacted level and 

$19,986,000 below the fiscal year 2018 budget request. This authority supports the conduct and dissemination of research in career 

and technical education. It also includes support for the National 

Centers for Research and Dissemination in Career and Technical 

Education and other discretionary research. 

124 

Adult Basic and Literacy Education State Grants 

The Committee recommends $581,955,000 for Adult Basic and 

Literacy Education State Grants, which is the same as the fiscal 

year 2017 enacted level and $96,106,000 above the fiscal year 2018 

budget request. State formula grants, authorized under the 

AEFLA, support programs to enable all adults to acquire basic literacy skills, to enable those who so desire to complete secondary 

education, and to make available to adults the means to become 

more employable, productive, and responsible citizens. 

Adult Education National Leadership Activities 

The Committee recommends $13,712,000 for National Leadership 

Activities, which is the same as the fiscal year 2017 enacted level 

and $26,000 above the fiscal year 2018 budget request. This program supports applied research, development, dissemination, evaluation, and program improvement efforts to strengthen the quality 

of adult education services. 

STUDENT FINANCIAL ASSISTANCE

The Committee recommends $24,198,210,000 for Student Financial Assistance programs, which is the same as the fiscal year 2017 

enacted level and $1,265,584,000 above the fiscal year 2018 budget 

request. 

Pell Grants 

The Committee recommends $22,475,352,000 for the Pell Grant 

program, which is the same as the fiscal year 2017 enacted level 

and $42,726,000 above the fiscal year 2018 budget request. These 

funds will support Pell grants to students for the 2018–2019 academic year. 

The Pell Grant program costs have come in below estimates for 

the past few years, resulting in a surplus of funding for the program. Because of this surplus, the Congressional Budget Office estimates that the budget authority provided in this bill is sufficient 

to maintain the discretionary portion of the maximum Pell Grant 

award at $4,860. Combined with mandatory funding streams, the 

maximum Pell Grant in 2018–2019 will be maintained at $5,920. 

Pell Grants help to ensure access to higher educational opportunities for low-and middle-income students by providing need-based 

financial assistance. Grants are determined according to a statutory formula, which considers income, assets, household size, and 

the number of family members in college, among other factors. Pell 

Grants are the foundation of Federal postsecondary student aid 

programs. 

Federal Supplemental Educational Opportunity Grants 

The Committee recommends $733,130,000 for this program, 

which is the same as the fiscal year 2017 enacted level and 

$733,130,000 above the fiscal year 2018 budget request. Supplemental Educational Opportunity Grants (SEOG) provide funds to 

postsecondary institutions for need-based grants of up to $4,000 to 

undergraduate students, with priority given to students who are 

Pell-eligible. Approximately 71 percent of dependent recipients 

have annual family incomes under $30,000 and nearly 76 percent 

125 

of independent SEOG recipients have annual family incomes under 

$20,000. Institutions must contribute a 25 percent match toward 

their SEOG allocation. 

Federal Work-Study 

The Committee recommends $989,728,000 for the Federal WorkStudy program, which is the same as the fiscal year 2017 enacted 

level and $489,728,000 above the fiscal year 2018 budget request. 

Federal Work-Study funds are provided through institutions to students who work part-time. The funds assist with paying for the 

cost of education. Approximately 3,300 colleges and universities receive funding, according to a statutory formula, and may allocate 

it for job location and job development centers. Work-study jobs 

must pay at least the Federal minimum wage and institutions 

must provide 25 percent of student earnings. 

Within the total funding level for the Federal Work-Study program, the Committee recommends $8,390,000 for the Work Colleges program, which is the same as the fiscal year 2017 enacted 

level. The Work Colleges program is authorized under section 448 

of the HEA and supports institutions that require all resident students to participate in a work-learning program. 

STUDENT AID ADMINISTRATION

The Committee recommends $1,697,711,000 for the Student Aid 

Administration (SAA), which is $120,857,000 above the fiscal year 

2017 enacted level and the same as the fiscal year 2018 budget request. Programs administered under this account include Pell 

Grants, campus-based programs, Teacher Education Assistance for 

College and Higher Education grants, and Federal student loan 

programs. 

Salaries and Expenses.—Within the total provided for Student 

Aid Administration, the Committee recommends $680,711,000 for 

salaries and expenses, which $15,932,000 below the fiscal year 

2017 enacted level and the same as the fiscal year 2018 budget request. 

Loan Servicing Activities.—Within the total provided for SAA, 

the Committee recommends $1,017,000,000 for Loan Servicing Activities, which is $136,789,000 above the fiscal year 2017 enacted 

level and the same as the fiscal year 2018 budget request. 

HIGHER EDUCATION

The Committee recommends $2,038,126,000 for Higher Education programs, which is $17,313,000 below the fiscal year 2017 

enacted level and $492,821,000 above the fiscal year 2018 budget 

request. 

Strengthening Institutions 

The Committee recommends $86,534,000 for the Part A, 

Strengthening Institutions program, which is the same as the fiscal 

year 2017 enacted level and 86,534,000 above the fiscal year 2018 

budget request. This program provides competitive grants for general operating subsidies to institutions with low average educational and general expenditures per student and significant percentages of low-income students. Funds may be used for faculty 

126 

and academic program development, management, joint use of libraries and laboratories, acquisition of equipment, and student 

services. 

Strengthening Hispanic-Serving Institutions 

The Committee recommends $107,795,000 for the Hispanic-Serving Institutions program, which is the same as the fiscal year 2017 

enacted level and $205,000 above the fiscal year 2018 budget request. The Hispanic-Serving Institutions program provides operating subsidies to schools that serve at least 25 percent Hispanic 

students. Funds may be used for faculty and academic program development, management, joint use of libraries and laboratories, acquisition of equipment, and student services. 

Promoting Postbaccalaureate Opportunities for Hispanic Americans 

The Committee recommends $9,671,000 for the Promoting 

Postbaccalaureate Opportunities for Hispanic Americans program, 

which is the same as the fiscal year 2017 enacted level and $18,000 

above the fiscal year 2018 budget request. This program provides 

expanded post baccalaureate educational opportunities for the academic attainment of Hispanic and low-income students. In addition, it expands academic offerings and enhances program quality 

at IHEs educating the majority of Hispanic college students. 

Strengthening Historically Black Colleges and Universities 

The Committee recommends $244,694,000 for Strengthening Historically Black Colleges and Universities (HBCUs), which is the 

same as the fiscal year 2017 enacted level and $465,000 above the 

fiscal year 2018 budget request. This program provides operating 

subsidies to accredited, historically black colleges and universities 

that were established prior to 1964, with the principal mission of 

educating black Americans. Funds are distributed through a formula grant based on the enrollment of Pell Grant recipients, number of graduates, and the number of graduates entering graduate 

or professional schools in which blacks are underrepresented. 

Strengthening Historically Black Graduate Institutions 

The Committee recommends $63,281,000 for the Strengthening 

Historically Black Graduate Institutions program, which is the 

same as the fiscal year 2017 enacted level and $120,000 above the 

fiscal year 2018 budget request. The program provides five-year 

grants to 18 postsecondary institutions that are specified in section 

326(e)(1) of the Higher Education Act. Institutions may use funds 

to build endowments, provide scholarships and fellowships, and to 

assist students with the enrollment and completion of post baccalaureate and professional degrees. 

Strengthening Predominantly Black Institutions 

The Committee recommends $9,942,000 for the Strengthening 

Predominantly Black Institutions (PBIs) program, which is the 

same as the fiscal year 2017 enacted level and $19,000 above the 

fiscal year 2018 budget request. This program provides grants to 

PBIs to increase their capacity to serve the academic needs of students. 

127 

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

The Committee recommends $3,348,000 for the Asian American 

Pacific Islander program, which is the same as the fiscal year 2017 

enacted level and $6,000 above the fiscal year 2018 budget request. 

This program provides grants to undergraduate institutions that 

have an undergraduate student enrollment of at least 10 percent 

Asian American or Native American Pacific Islander. 

Strengthening Alaska Native and Native Hawaiian-Serving Institutions 

The Committee recommends $13,802,000 for the Strengthening 

Alaska Native and Native Hawaiian-Serving Institutions program, 

which is the same as the fiscal year 2017 enacted level and $26,000 

above the fiscal year 2018 budget request, to provide competitive 

grants to improve capacity to serve Alaska Native and Native Hawaiian students. 

Native American Serving Non-Tribal Institutions 

The Committee recommends $3,348,000 for the Native American 

Serving Non-Tribal Institutions program, which is the same as the 

fiscal year 2017 enacted level and $6,000 above the fiscal year 2018 

budget request. This program makes grants to IHEs at which enrollment is at least 10 percent Native American students and that 

are not Tribally-Controlled Colleges or Universities. 

Strengthening Tribally Controlled Colleges and Universities 

The Committee recommends $27,599,000 for the Strengthening 

Tribally Controlled Colleges and Universities (TCCUs) program, 

which is the same as the fiscal year 2017 enacted level and $52,000 

above the fiscal year 2018 budget request. This program makes 

grants to TCCUs to increase their capacity to serve the academic 

needs of students. 

International Education and Foreign Language Studies 

Domestic Programs.—The Committee recommends $65,103,000 

for the Domestic Programs of the International Education and Foreign Languages Studies program, which is the same as the fiscal 

year 2017 enacted level and $65,103,000 above the fiscal year 2018 

budget request. Authorized by title VI of the Higher Education Act, 

these programs include National resource centers, foreign language 

and area studies fellowships, undergraduate international studies 

and foreign language programs, international research and studies 

projects, business and international education projects, international business education centers, language resource centers, 

American overseas research centers, and technological innovation 

and cooperation for foreign information access. 

Overseas Programs.—The Committee recommends no funding for 

the Overseas Programs, which is $7,061,000 below the fiscal year 

2017 enacted level and the same as the fiscal year 2018 budget request. Funding for these programs support group projects, faculty 

research, special bilateral research, and doctoral dissertation research conducted abroad. The U.S. Department of State funds similar programs that can continue to support these activities. 

128 

Postsecondary Programs for Students with Intellectual Disabilities 

The Committee recommends $11,800,000 for Postsecondary Programs for Students with Intellectual Disabilities, which is the same 

as the fiscal year 2017 level and $22,000 above the fiscal year 2018 

budget request. This program supports grants to create model transition programs into higher education for students with intellectual 

disabilities. 

Minority Science and Engineering Improvement 

The Committee recommends $9,648,000 for the Minority Science 

and Engineering Improvement Program, which is the same as the 

fiscal year 2017 enacted level and $18,000 above the fiscal year 

2018 budget request. This program awards grants to improve 

mathematics, science, and engineering programs at institutions 

serving primarily minority students and to increase the number of 

minority students who pursue advanced degrees and careers in 

those fields. 

Tribally Controlled Postsecondary Career and Technical Institutions 

The Committee recommends $8,286,000 for this program, which is the same as the fiscal year 2017 enacted level and $16,000 above 

the fiscal year 2018 budget request. This program provides competitive grants to Tribally controlled postsecondary career and technical institutions to provide career and technical education to Native American students. 

Federal TRIO Programs 

The Committee recommends $1,010,000,000 for TRIO programs, which is $60,000,000 above the fiscal year 2017 enacted level and 

$201,711,000 above the fiscal year 2018 budget request. The TRIO 

programs provide a variety of outreach and support services to encourage low-income, often first-generation college students to enter 

and complete college. Discretionary grants of up to four or five 

years are awarded competitively to IHEs and other nonprofit organizations. At least two thirds of the eligible participants in TRIO 

must be low-income, first-generation college students. 

The Committee intends that funds be allocated in the same ratio 

as they were allocated during fiscal year 2017. 

Gaining Early Awareness and Readiness for Undergraduate Programs 

The Committee recommends $350,000,000 for Gaining Early 

Awareness and Readiness for Undergraduate Programs (GEAR 

UP), which is $10,246,000 above the fiscal year 2017 enacted level 

and $131,000,000 above the fiscal year 2018 budget request. GEAR 

UP provides grants to States and partnerships of low-income middle and high schools, IHEs, and community organizations to target 

entire grades of students and give them the skills, encouragement, 

and scholarships to pursue successfully postsecondary education. 

In addition to making continuation awards to existing grantees, 

the Committee directs the Department to conduct a new grant competition for this program in fiscal year 2018. The Department is 

strongly encouraged to publish the notice inviting applications as 

soon as possible. 

129 

The Committee continues bill language allowing the Department 

to maintain the GEAR UP evaluation set-aside at 1.5 percent to 

work with the GEAR UP community and grantees to standardize 

data collection, including through the use of third-party data systems. 

Graduate Assistance in Areas of National Need 

The Committee recommends $5,775,000 for the Graduate Assistance in Areas of National Need program, which is $22,272,000 

below the fiscal year 2017 enacted level and the same as the fiscal 

year 2018 budget request. This program duplicates the efforts of 

other Federally-funded programs that support fellowships in these 

disciplines within the Department and other agencies. The Committee recommendation will enable the Department to fund fully 

the continuation costs of current awards. This program operates at 

a high per student cost, $50,000 per student, and as a result, the 

program supports only a limited number of graduate students. 

Teacher Quality Partnership Grants 

The Committee recommends no funding for Teacher Quality 

Partnerships, which is $43,092,000 below the fiscal year 2017 enacted level and the same as the fiscal year 2018 budget request. 

The Department has determined that the authority for this program is overly restrictive and does not provide States, school districts and institutions of higher education the flexibilities needed to 

make meaningful design changes to teacher preparation, recruitment and induction to meet their needs. Other Federal and State 

programs may provide funding for these activities. Existing authority will enable grantees to close out existing projects and draw 

down grant funds already awarded in prior years. 

Child Care Access Means Parents in School 

The Committee recommends no funding for the Child Care Access Means Parents in School program, which is $15,134,000 below 

the fiscal year 2017 enacted level and the same as the fiscal year 

2018 budget request. This program makes competitive grants to 

colleges and universities to support or establish a campus-based 

childcare program primarily serving the needs of low-income students enrolled at the institution. Given budget constraints, the 

Committee chose to reduce investment in narrowly focused grant 

programs such as this one. 

HOWARD UNIVERSITY

The Committee recommends $221,821,000 for Howard University, which is the same as the fiscal year 2017 enacted level and 

$422,000 above the fiscal year 2018 budget request. Howard University is a ‘‘Research I’’ university located in the District of Columbia. Howard University provides undergraduate liberal arts, graduate and professional instruction to over 10,000 students from all 

50 States. 

Within the amount provided, the Committee recommends 

$27,325,000 for the Howard University Hospital, which is the same 

as the fiscal year 2017 enacted level and $52,000 above the fiscal 

year 2018 budget request. The hospital serves as a major acute and 

130 

ambulatory care center for the District of Columbia, and functions 

as a major teaching facility. 

COLLEGE HOUSING AND ACADEMIC FACILITIES LOANS PROGRAM

The Committee recommends $434,000 for the Federal administration of the College Housing and Academic Facilities Loan program, the Higher Educational Facilities Loans program, and the 

College Housing Loans program, which is the $1,000 below the fiscal year 2017 enacted level and the same as the fiscal year 2018 

budget request. Previously, these programs helped to ensure that 

postsecondary institutions were able to make necessary capital improvements to maintain and increase their ability to provide a 

high-quality education. Since 1994, no new loans have been made, 

and the Department’s role has been to manage the outstanding 

loans. 

HISTORICALLY BLACK COLLEGE AND UNIVERSITY CAPITAL FINANCING

PROGRAM ACCOUNT

The Committee recommends $20,445,000 for the HBCU Capital 

Financing program, which $39,000 below the fiscal year 2017 enacted level and the same as the fiscal year 2018 budget request. 

Funds are available through September 30, 2018. This program is 

authorized under part D of Title III of the HEA and makes capital 

available for repair and renovation of facilities at historically black 

colleges and universities. In exceptional circumstances, capital provided under the program can be used for construction or acquisition of facilities. 

Within the total provided for this program, the Committee recommendation includes $333,000 for the administrative expenses to 

carry out the program and $20,112,000 for loan subsidy costs that 

will be sufficient to guarantee up to $313,513,000 in new loans in 

fiscal year 2018. Funds will also be used to continue technical assistance services to help HBCUs improve their financial stability 

and access to capital markets. 

INSTITUTE OF EDUCATION SCIENCES

The Committee recommends $605,267,000 for the Institute of 

Education Sciences, which is the same as the fiscal year 2017 enacted level and $11,572,000 below the fiscal year 2018 budget request. This account supports education research, statistics, dissemination, evaluation, and assessment activities. 

The Committee recognizes the lack of publicly available research 

indicating the specific educational needs of students with elevated 

blood lead levels. The Committee encourages the Department to 

collaborate with the CDC to improve awareness of educational 

intervention strategies for children with elevated blood lead levels. 

The Department and the CDC are expected to implement 

prioritization initiatives and provide technical assistance that informs educators, parents, and State and local education agencies 

about the severity and symptoms of lead poisoning and intervention strategies for children with elevated blood lead levels. The 

Committee requests an update on the Department’s strategy and 

its outcomes on this topic. 

131 

Research, Development, and Dissemination 

The Committee recommends $187,500,000 for Research, Development, and Dissemination, which is the same as the fiscal year 2017 

enacted level and $7,129,000 below the fiscal year 2018 budget request. This budget account supports research, development, and 

National dissemination activities that are aimed at expanding fundamental knowledge of education and promoting the use of research and development findings in the design of efforts to improve 

education. 

Statistics 

The Committee recommends $109,500,000 for the activities of the 

National Center for Education Statistics (NCES), which is the 

same as fiscal year 2017 enacted level and $2,287,000 below the 

fiscal year 2018 budget request. Statistics activities are authorized 

under title I of the Education Sciences Reform Act of 2002. The 

Center collects, analyzes, and reports statistics on all levels of education in the United States. Activities are carried out directly and 

through grants and contracts and include projections of enrollments, teacher supply and demand, and educational expenditures. 

NCES also provides technical assistance to State and local educational agencies and postsecondary institutions. 

Regional Educational Laboratories 

The Committee recommends $54,423,000 for Regional Educational Laboratories, which is the same as the fiscal year 2017 enacted level and $103,000 above the fiscal year 2018 budget request. 

This program support a network of ten laboratories that promote 

the use and development of knowledge and evidence to increase 

student learning and further school improvement efforts. Funds are 

included to support fully continuation costs for grants made in 

prior years. 

Research in Special Education 

The Committee recommends $54,000,000 for Research in Special 

Education, which is the same as the fiscal year 2017 enacted level 

and $103,000 above the fiscal year 2018 budget request. This program supports competitive awards to produce and advance the use 

of knowledge to improve services and results for children with disabilities. The program focuses on producing new knowledge, integrating research and practice, and improving the use of knowledge. 

Special Education Studies and Evaluations 

The Committee recommends $10,818,000 for Special Education 

Studies and Evaluations, which is the same as the fiscal year 2017 

enacted level and $21,000 above the fiscal year 2018 budget request. This program awards competitive grants, contracts and cooperative agreements to assess the implementation of the IDEA and 

the effectiveness of State and local efforts to provide special education and early intervention programs and services to infants, toddlers, and children with disabilities. 

Statewide Data Systems 

The Committee recommends $32,281,000 for Statewide Data Systems, which is the same as the fiscal year 2017 enacted level and 

132 

$2,192,000 below the fiscal year 2018 budget request. Competitive 

grants under this authority are made to SEAs to help them manage, analyze, disaggregate and use student data consistent with the 

ESEA. 

Assessment 

The Committee recommends $156,745,000 for Assessment, which 

is the same as the fiscal year 2017 enacted level and $191,000 

below the fiscal year 2018 budget request. This amount includes 

$7,745,000 for the National Assessment Governing Board (NAGB), 

which is the same as the fiscal year 2017 enacted level and 

$474,000 below the fiscal year 2018 budget request. 

The National Assessment of Educational Progress (NAEP) is the 

only nationally representative and continuing survey of educational 

ability and achievement of American students. The primary goal of 

the Assessment is to determine and report the status and trends 

of the knowledge and skills of students, subject by subject. Subject 

areas assessed in the past have included reading, writing, mathematics, science, and history, as well as citizenship, literature, art, 

and music. The NAEP is operated by contractors through competitive awards made by the NCES. The NAGB formulates the policy 

guidelines for the program. 

DEPARTMENTAL MANAGEMENT

The Committee recommends $598,756,000 for Departmental Management, which is $1,000,000 below the fiscal year 2017 enacted level and $7,184,000 below the fiscal year 2018 budget request. These activities are authorized by the Department of Education Organization Act (P.L. 96–88) and include costs associated 

with the management and operation of the Department as well as 

separate costs associated with the Office for Civil Rights and the 

Office of Inspector General. 

Program Administration 

The Committee recommends $431,000,000 for Program Administration, which is $1,000,000 below the fiscal year 2017 enacted 

level and $7,000,000 below the fiscal year 2018 budget request. 

These funds support the staff and other costs of administering programs and activities at the Department. Items include personnel 

compensation, health, retirement, and other benefits as well as 

travel, rent, telephones, utilities, postage fees, data processing, 

printing, equipment, supplies, technology training, consultants, and 

other contractual services. 

Absenteeism.—The Committee notes the need to support evidence-based strategies to address chronic absenteeism, and the 

need to expand the reach of attendance-focused activities that have 

been found to be more likely to decrease the percentage of students 

who miss twenty or more days of school each year. Students who 

are chronically absent, on average, score lower than students with 

better attendance on the National Assessment for Educational 

Progress, regardless of race or socioeconomic status. Students who 

are chronically absent in preschool, kindergarten, and 1st grade are 

much less likely to read at grade level by the 3rd grade. Additional 

studies demonstrate the connection between chronic absenteeism, 

low academic achievement and high dropout rates and suggest that 

133 

attendance may predict a student’s academic progress as effectively 

as test scores. The Committee notes that chronic absenteeism programs that use school, family, and community partnership practices can significantly decrease chronic absenteeism. 

Education Costs Related to Illegal Immigration.—The Committee 

requests an update to the report submitted to Congress by the Department of Education on this topic as it appeared in the explanatory statement accompanying division H of the Consolidated Appropriations Act, 2016 (P.L. 114–113). 

Physical Education.—The Committee believes that physical education is a foundation for healthy, active lifestyles and an important part of a well-rounded public education. The Department is 

encouraged to provide guidance to States and school districts on all 

available funding for physical education under ESSA. 

Physician Assistant (PA) Education Access.—The Committee encourages the Secretary of Education to investigate the impact that 

lower Federal Direct Unsubsidized Stafford Loan borrowing limits 

for PA students has on access to physician assistant education, 

overall student loan debt upon graduation, and impact on PA graduate employment in underserved and rural communities. 

Puerto Rico.—The Committee understands that Puerto Rico is 

facing additional technical assistance needs as it works to restructure its education system, and encourages the Department to work 

closely with Puerto Rico to identify and address those needs. 

Science, Technology, Engineering, and Math (STEM).—The Committee recognizes the benefits and advantages of a diverse workforce and encourages the Department of Education to increase diversity in the STEM workforce and pipeline by working to assist 

small and disadvantaged businesses, minority serving institutions, 

and underserved communities in developing greater diversity. The 

Committee supports robust investments in STEM training for 

teachers, internship opportunities in STEM industries such as biotechnology, and creating clear education pathways in STEM between K–12, community colleges, and four-year institutions. 

The Committee encourages the Secretary of Education to study 

the feasibility of creating a database for schools, which would document employees of educational institutions who have been convicted of sexual assault and make such information available to the 

public. 

Youth Deradicalization.—As defense, security, law enforcement 

and diplomatic efforts work together to combat extremism and terror at home and abroad, the effectiveness of our counter-terrorism 

policy and prevention efforts also need to continuously evolve. Domestically, the public education system may be a key point for 

intervention within the United States, but there is a gap in research or guidance from Federal agencies on the most effective 

methods, practices, programs, curriculum, modules, methodologies 

and holistic approaches to combating radicalization and extremist 

ideology influence on youth and students. In order to inform instruction, teachers, administrators and communities, such research 

could help assess and implement preventative measures to combat 

the growing impact of extremist and radical organizations on 

youth, school climate, safety and quality. The Committee believes 

the National Academy of Education may be well suited to conduct 

exploratory research to identify the best practices and most effecVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00133 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
134 

tive intervention models to combat the influence of extremist organizations and radicalization of youth in schools. 

OFFICE FOR CIVIL RIGHTS

The Committee recommends $108,500,000 for the Office for Civil 

Rights, which is the same as the fiscal year 2017 enacted level and 

$1,703,000 below the fiscal year 2018 budget request. The Office for 

Civil Rights is responsible for enforcing laws that prohibit discrimination on the basis of race, color, national origin, sex, disability, 

and age in all programs and institutions that receive funds from 

the Department. These laws extend to 50 State educational agencies, 18,200 LEAs, and nearly 7,200 IHEs, including proprietary 

schools. They also extend to 80 State rehabilitation agencies, libraries, museums, and other institutions receiving Federal funds. 

OFFICE OF INSPECTOR GENERAL

The Committee recommends $59,256,000 for the Office of Inspector General, which is the same as the fiscal year 2017 enacted level 

and $1,887,000 below the fiscal year 2018 budget request. This Office has authority to inquire into all program and administrative 

activities of the Department as well as into related activities of 

grant and contract recipients. It conducts audits and investigations 

to determine compliance with applicable laws and regulations, to 

check alleged fraud and abuse, efficiency of operations, and effectiveness of results. 

GENERAL PROVISIONS

Sec. 301. The Committee continues a provision that prohibits 

funds in this Act from being used for the transportation of students 

or teachers in order to overcome racial imbalances or to carry out 

a plan of racial desegregation. 

Sec. 302. The Committee continues a provision that prohibits 

funds in this Act from being used to require the transportation of 

any student to a school other than the school, which is nearest the 

student’s home in order to comply with Title VI of the Civil Rights 

Act of 1964. 

Sec. 303. The Committee continues a provision that prohibits 

funds in this Act from being used to prevent the implementation 

of programs of voluntary prayer and meditation in public schools. 

(TRANSFER OF FUNDS)

Sec. 304. The Committee continues a provision providing the Secretary of Education with the authority to transfer up to one percent 

of discretionary funds between appropriations, provided that no appropriation is increased by more than three percent by any such 

transfer. This transfer authority is available only to meet emergency needs, and may not be used to create any new program or 

fund a project or activity that is not otherwise funded in this Act. 

All transfers are subject to notification to the Committees on Appropriations of the House of Representatives and the Senate. 

Sec. 305. The Committee continues to include a provision that 

permits Palau to continue participating in Department of Education and other programs pending formal ratification of a new 

compact agreement. 

135 

Sec. 306. The Committee amends a provision allowing ESEA 

funds consolidated for evaluation purposes to be available from 

July 1, 2018 through September 30, 2018. 

Sec. 307. The Committee includes a provision allowing certain institutions to continue to use endowment income for student scholarships. 

Sec. 308. The Committee continues to include a provision extending the authorization of the National Advisory Committee on Institutional Quality and Integrity. 

Sec. 309. The Committee continues to include a provision extending the authority to provide account maintenance fees to guaranty 

agencies for Federal student loans. 

Sec. 310. The Committee modifies a provision to rescind 

$3,270,844,000 from the Pell Grant program surplus. 

TITLE IV—RELATED AGENCIES 

COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR

SEVERELY DISABLED

SALARIES AND EXPENSES

The Committee recommends $8,000,000 for the Committee for 

Purchase From People Who Are Blind or Severely Disabled (referred to as the AbilityOne Commission), which is the same as the 

fiscal year 2017 enacted level and $1,883,000 above the fiscal year 

2018 budget request. The Committee believes oversight is necessary to ensure the program is operating in accordance with statutory requirements that blind or other severely disabled individuals 

provide at least 75 percent of hours or direct labor required for the 

production or provision of the products or services to Federal government agencies. To ensure the AbilityOne Commission maintains 

its oversight capacity, the Committee continues bill language requiring the AbilityOne Commission to establish written agreements 

with any central nonprofit agencies (CNA). The written agreements 

ensure the AbilityOne Commission can conduct appropriate audit, 

oversight, and reporting functions in accordance with standard 

Federal procurement policies. 

Committee For Purchase From People Who Are Blind or Severely 

Disabled—Requested Reports.—The Committee for Purchase From 

People Who Are Blind or Severely Disabled shall submit in an electronic format quarterly reports, due at the end of each calendar 

month after the end of the fiscal year quarter, to the Committees 

on Oversight and Government Reform and Education and the 

Workforce of the House of Representatives, Committees on Homeland Security and Governmental Affairs and Health, Education, 

Labor, and Pensions of the Senate, and Committees on Appropriations of the House of Representatives and the Senate. The first report (Report 1) will include information on fees charged by a CNA. 

The report shall include the following: 

1. Each fee charged pursuant to section 51–3.5 of title 41, 

Code of Federal Regulations 

2. Each organization charged a fee pursuant to section 51– 

3.5 of title 41, Code of Federal Regulations 

3. For each fee charged, for each Government order, please 

include the following information: 

136 

a. name of the nonprofit agency, 

b. description of product or service ordered, 

c. ordering government agency, 

d. order price (total), and 

e. contract award ID associated with any order, where 

applicable. 

The second report (Report 2) will include information on CNA 

Expenditures. Each CNA designated pursuant to section 8503(c) of 

title 41, United States Code shall submit, in an electronic format, 

a report on expenditures, due at the end of each calendar month 

after the end of the fiscal year quarter, to the Committees on Oversight and Government Reform and Education and the Workforce of 

the House of Representatives, Committees on Homeland Security 

and Governmental Affairs and Health, Education, Labor, and Pensions of the Senate, and Committees on Appropriations of the 

House of Representatives and the Senate. The report shall include 

the total amount obligated by the CNA in the previous quarter for 

each of the following: 

1. Employee salaries (total), including executive salaries, 

2. Employee benefits, including executive benefits, 

3. Executive salaries, 

4. Executive benefits, 

5. Total travel expenses, 

6. Executive travel, 

7. Lobbying, 

8. Advertising and promotion, 

9. CNA reserve level, and 

10. Funds spent to support the efforts of the Committee For 

Purchase From People Who Are Blind or Severely Disabled, including a description of the activities, services, and products 

supplied to the Committee For Purchase From People Who Are 

Blind or Severely Disabled. 

Office of Inspector General.—The Committee recommends not 

less than $1,250,000 for the Office of Inspector General. 

CORPORATION FOR NATIONAL AND COMMUNITY SERVICE

OPERATING EXPENSES

The Committee recommends $1,030,358,000 to the Corporation 

for National and Community Service (Corporation) to carry out activities authorized under the Domestic Volunteer Service Act of 

1973 and the National and Community Service Act of 1990. This 

funding level is the same as the fiscal year 2017 enacted level and 

$895,366,000 above the fiscal year 2018 budget request. 

Volunteers in Service to America (VISTA) 

The Committee recommends $92,364,000 for VISTA, which is the 

same as the fiscal year 2017 enacted level and $87,454,000 above 

the fiscal year 2018 budget request. This program provides capacity 

building for small, community-based organizations with a mission 

of combating poverty. VISTA members raise resources, recruit and 

organize volunteers, and establish and expand programs in housing, employment, health, and economic development activities. 

137 

National Senior Volunteer Corps 

The Committee recommends $202,117,000 for the National Senior Volunteer Corps programs, which is the same as the fiscal year 

2017 enacted level and $201,766,000 above the fiscal year 2018 

budget request. Senior Corps is a collection of programs that connect Americans older than the age of 55 with opportunities to contribute their job skills and expertise to community projects and organizations. The breakout of funding by program is as follows: 

National Senior Volunteer Corps FY 2018 

Committee 

Foster Grandparents Program ........................................................................................................................ $107,702,000 

Senior Companion Program ............................................................................................................................ 45,512,000 

Retired Senior Volunteer Program .................................................................................................................. 48,903,000 

AmeriCorps State and National Grants 

The Committee recommends $386,010,000 for AmeriCorps State 

and National Grants, which is the same as the fiscal year 2017 enacted level and $383,669,000 above the fiscal year 2018 budget request. This program provides funds to local and national organizations and agencies to address community needs in education, public 

safety, health, and the environment. 

Innovation, Assistance, and Other Activities 

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

above the fiscal year 2018 budget request. 

Evaluation 

The Committee recommends $4,000,000 for this program, which is the same as the fiscal year 2017 enacted level and $4,000,000 

above the fiscal year 2018 budget request. These funds support research on program effectiveness. 

National Civilian Community Corps 

The Committee recommends $30,000,000 for this program, which 

is the same as the fiscal year 2017 enacted level and $5,913,000 

above the fiscal year 2018 budget request. This program supports 

residential, team-based service opportunities for individuals aged 

18–24. 

State Commission Administrative Grants 

The Committee recommends $16,538,000 for this program, which 

is the same as the fiscal year 2017 enacted level and $16,538,000 

above the fiscal year 2018 budget request. Funds are used for formula grants to support State oversight of service programs. 

PAYMENT TO THE NATIONAL SERVICE TRUST

The Committee recommends $206,842,000 for payments to the 

National Service Trust, which is the same as the fiscal year 2017 

enacted level and $206,842,000 above the fiscal year 2018 budget 

request. The National Service Trust makes payments for Segal 

education awards, pays interest that accrues on qualified student 

loans for AmeriCorps participants during terms of service in apVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00137 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
138 

proved national service positions, and makes other payments entitled to members who serve in the programs of the Corporation. 

SALARIES AND EXPENSES

The Committee recommends $81,737,000 for Salaries and Expenses, which is the same as the fiscal year 2017 enacted level and 

$17,998,000 below the fiscal year 2018 budget request. 

OFFICE OF INSPECTOR GENERAL

The Committee recommends $5,750,000 for the Office of Inspector General, which is the same as the fiscal year 2017 enacted level 

and $2,182,000 above the fiscal year 2018 budget request. 

ADMINISTRATIVE PROVISIONS 

Sec. 401. The Committee continues bill language that combines 

separate matching requirements for AmeriCorps grants. 

Sec. 402. The Committee continues bill language related to National Service Trust minimum share requirements. 

Sec. 403. The Committee continues bill language related to donations. 

Sec. 404. The Committee continues bill language related to veterans. 

Sec. 405. The Committee continues bill language related to criminal history background checks. 

CORPORATION FOR PUBLIC BROADCASTING

The Committee recommends $445,000,000 for the Corporation for 

Public Broadcasting for fiscal year 2020. This appropriation will 

fund content development, community services, and other local station and system needs for the Corporation for Public Broadcasting 

(CPB). The Committee does not provide funding for the public 

broadcasting interconnection system. The Committee recommendation is $50,000,000 below the fiscal year 2017 enacted level and 

$445,000,000 more than the fiscal year 2018 budget request. 

The Committee values the contributions of public television and 

radio stations in serving the needs of their local communities. National organizations should continue to invest in high quality, national, diverse programming to be made available to locally-owned 

and operated stations. In fulfilling the mission of the Public Broadcasting Act, CPB should encourage Federally funded content distributed through National organizations to focus on rural America, 

civic discourse and engagement, and life-long learning. This content should reflect America’s increasing diversity, including age, 

ethnicity, race, gender, socio-economic background, geography, and 

points of view. Local television and radio stations, in the interest 

of best serving their communities, should continue to have discretion on what content to broadcast from the National organizations. 

National Minority Consortia.—According to the Public Broadcasting Act, one of the greatest priorities of public broadcasting is 

to address the needs of unserved and underserved audiences, particularly children and minorities. Programming that reflects the 

histories and perspectives of diverse racial and ethnic communities 

is a core value and responsibility of public broadcasting, therefore 

139 

the Committee supports continued investment in the National Minority Consortia to help accomplish this goal. 

FEDERAL MEDIATION AND CONCILIATION SERVICE

SALARIES AND EXPENSES

The Committee recommends $46,650,000 for the Federal Mediation and Conciliation Service, which is the same as the fiscal year 

2017 enacted level and $2,005,000 less than the fiscal year 2018 

budget request. 

FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION

SALARIES AND EXPENSES

The Committee recommends $17,134,000 for the Federal Mine 

Safety and Health Review Commission, which is $50,000 less than 

the fiscal year 2017 enacted level and $81,000 more than the fiscal 

year 2018 budget request. 

INSTITUTE OF MUSEUM AND LIBRARY SERVICES

OFFICE OF MUSEUM AND LIBRARY SERVICES: GRANTS AND

ADMINISTRATION

The Committee recommends $231,000,000 for the Institute of 

Museum and Library Services (IMLS), which is the same as the fiscal year 2017 enacted level and $208,000,000 above the fiscal year 

2018 budget request. Within the total for IMLS, the Committee 

recommends the following amounts: 

Budget Activity This Bill 

Library Services Technology Act: 

Grants to States .................................................................................................................................... $156,103,000 

Native American Library Services ......................................................................................................... 4,063,000 

National Leadership: Libraries .............................................................................................................. 13,406,000 

Laura Bush 21st Century Librarian ...................................................................................................... 10,000,000 

Museum Services Act: 

Museums for America ........................................................................................................................... 21,149,000 

21st Century Museum Professionals ..................................................................................................... 0 

Conservation Project Support ................................................................................................................ 0 

Native American/Hawaiian Museum Services ....................................................................................... 972,000 

National Leadership: Museums ............................................................................................................. 8,113,000 

African American History and Culture Act: 

Museum Grants for African American History and Culture .................................................................. 1,481,000 

Museum and Library Services Act General Provisions: 

Research, Analysis and Data Collection ............................................................................................... 1,713,000 

Program Administration ................................................................................................................................. 14,000,000 

Library Services and Technology 

The Grants to State Library Agencies program provides funds to 

State Library Administrative Agencies using a population-based 

formula. 

Program Administration 

The Committee recommends $14,000,000 for Program Administration, which is the same as the fiscal year 2017 enacted level. 

These funds provide administrative and management support for 

all programs administered by IMLS. The Committee also includes 

$1,713,000 for IMLS’ activities in policy, research, and data collecVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00139 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
140 

tion, including functions formerly conducted by the National Commission on Libraries and Information Science. 

MEDICARE PAYMENT ADVISORY COMMISSION

SALARIES AND EXPENSES

The Committee recommends $12,175,000 for the Medicare Payment Advisory Commission, which is $250,000 more than the fiscal 

year 2017 enacted level and $120,000 less than the fiscal year 2018 

budget request. 

The Medicare Payment Advisory Commission (MedPAC) is an 

independent agency tasked with advising the U.S. Congress on 

issues affecting the Medicare program. In addition to advising the 

Congress on payments to private health plans participating in 

Medicare and providers in Medicare’s traditional fee-for-service 

program, MedPAC is also responsible for providing analysis on access to care, quality of care, and other issues affecting Medicare. 

MEDICAID AND CHIP PAYMENT AND ACCESS COMMISSION

SALARIES AND EXPENSES

The Committee provides $7,500,000 for the Medicaid & CHIP 

Payment and Access Commission, which is $265,000 less than the 

fiscal year 2017 enacted level and $1,200,000 below the fiscal year 

2018 budget request. 

The Committee supports the unique role played by the Medicaid 

and CHIP Payment and Access Commission (MACPAC) in providing nonpartisan policy and data analysis on a wide array of 

issues affecting Medicaid and the State Children’s Health Insurance Program. In addition to the analysis, MACPAC is also responsible for making recommendations to ensure the programs continue 

to serve low-income and other vulnerable populations, including an 

examination of the budget consequences. The Committee encourages MACPAC to include in their policy recommendations additional specific recommended policy changes to the program that can 

results in savings to accompany any policy changes that may entail 

additional costs. Recognizing the wide array of State practices and 

States’ unique partnership role in running the Medicaid program, 

the Committee also encourages MACAPAC to consider how it may 

serve as a resource in highlighting State innovations in delivery 

system reforms, cost-containment strategies, care coordination best 

practices, and other efforts to run an efficient and effective State 

Medicaid program. 

NATIONAL COUNCIL ON DISABILITY

SALARIES AND EXPENSES

The Committee recommends $3,200,000 for the National Council 

on Disability, which is $50,000 below the fiscal year 2017 enacted 

level and $11,000 below the fiscal year 2018 budget request. 

141 

NATIONAL LABOR RELATIONS BOARD

SALARIES AND EXPENSES

The Committee recommends $249,000,000 for the National Labor 

Relations Board, which is $25,224,000 less than the fiscal year 

2017 enacted level and $9,000,000 less than the fiscal year 2018 

budget request. 

ADMINISTRATIVE PROVISIONS

Sec. 406. The Committee continues a provision relating to electronic voting for purposes of collective bargaining. 

Sec. 407. The Committee includes a new provision relating to jurisdiction over Indian tribes. 

Sec. 408. The Committee includes a new provision relating to 

joint-employer standards. 

Sec. 409. The Committee includes a new provision relating to collective bargaining units. 

NATIONAL MEDIATION BOARD

SALARIES AND EXPENSES

The Committee recommends $13,500,000 for the National Mediation Board, which is $300,000 above the fiscal year 2017 enacted 

level and $295,000 below the fiscal year 2018 budget request. 

OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION

SALARIES AND EXPENSES

The Committee recommends $12,875,000 for the Occupational 

Safety and Health Review Commission, which is $350,000 below 

the fiscal year 2017 enacted level and $260,000 above the fiscal 

year 2018 budget request. 

RAILROAD RETIREMENT BOARD

DUAL BENEFITS PAYMENTS ACCOUNT

The Committee recommends $22,000,000 for dual benefits, which 

is $3,000,000 below the fiscal year 2017 enacted level and the same 

as the fiscal year 2018 budget request. This appropriation is authorized by the Railroad Retirement Act of 1974 to fund vested 

dual benefits received by railroad retirees who, under prior law, 

would have become covered by both the railroad retirement system 

and the Social Security system because railroad retirement was not 

fully coordinated with social security from 1937 to 1974. The Committee includes a provision permitting a portion of these funds to 

be derived from income tax receipts on dual benefits as authorized 

by law. The Railroad Retirement Board estimates that approximately $1,000,000 may be derived in this manner. 

FEDERAL PAYMENT TO THE RAILROAD RETIREMENT ACCOUNTS

The Committee recommends $150,000 for the interest earned on 

unnegotiated checks, which is the same as the fiscal year 2017 enacted level and the fiscal year 2018 budget request. 

142 

LIMITATION ON ADMINISTRATION

The Committee recommends a consolidated limitation of 

$113,500,000 on the expenditure of Railroad Retirement and Railroad Unemployment Trust Funds for administrative expenses of 

the Railroad Retirement Board (RRB), which is the same as the fiscal year 2017 enacted level and $2,275,000 above the fiscal year 

2018 budget request. 

The Committee maintains its position that the financial statements and audit of the National Railroad Retirement Investment 

Trust should remain separate from the financial statements and 

audit of the RRB. The Committee notes that the Railroad Retirement and Survivors’ Improvement Act of 2001 mandates that the 

Trust function independently from the RRB. Further, the Act specifically requires a separate audit of the Trust by a nongovernmental auditor and requires that the results of this audit be included in the Trust’s Annual Management Report to Congress. The 

Committee expects that the Trust shall be administered and audited solely in conformance with the Railroad Retirement and Survivors’ Improvement Act of 2001. 

LIMITATION ON THE OFFICE OF INSPECTOR GENERAL

The Committee recommends authority to expend $10,000,000 

from the Railroad Retirement and Railroad Unemployment Insurance Trust Funds for the Office of Inspector General, which is 

equal to the fiscal year 2017 enacted level and $1,563,000 above 

the fiscal year 2018 budget request. 

SOCIAL SECURITY ADMINISTRATION

PAYMENTS TO SOCIAL SECURITY TRUST FUNDS

The Committee recommends $11,400,000 for mandatory payments necessary to compensate the Old Age and Survivors Insurance (OASI) Trust Fund and the Disability Insurance (DI) Trust 

Fund, which is the same as the fiscal year 2017 enacted level and 

the fiscal year 2018 budget request. This appropriation provides reimbursement to the Social Security trust funds for non-trust fund 

activities. 

SUPPLEMENTAL SECURITY INCOME PROGRAM

The Committee recommends $38,591,635,000 for the Supplemental Security Income (SSI) program, which is $5,026,528,000 

below the fiscal year 2017 enacted level and $35,109,000 above the 

fiscal year 2018 budget request. The Committee recommends 

$19,500,000,000 in advance funding for the first quarter of fiscal 

year 2019, as requested. 

Research and Demonstration 

Within the appropriation for SSI, the Committee recommends 

$101,000,000 for research and demonstration activities, which is 

$43,000,000 more than the fiscal year 2017 enacted level and the 

same as the fiscal year 2018 budget request. 

The Committee does not include bill language extending the period of availability for research and demonstrations. The Committee requests, as part of the fiscal year 2019 Congressional JusVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00142 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
143 

tification, for each research or demonstration project the total cost 

obligated to date. 

Administration 

Within the appropriation for SSI, the Committee recommends $5,095,635,000, which is $66,208,000 above the fiscal year 2017 enacted level and $35,109,000 above the fiscal year 2018 budget request level for payment to the Social Security trust funds for SSI’s 

share of the base administrative expenses of the Social Security 

Administration (SSA). 

LIMITATION ON ADMINISTRATIVE EXPENSES

The Committee recommends $10,538,945,000 for the Limitation 

on Administrative Expenses (LAE) account to be funded from the 

Social Security and Medicare trust funds, which is the same as the 

fiscal year 2017 enacted level and $64,055,000 below the fiscal year 

2018 budget request. The LAE funds support SSA operational costs 

to administer the Old Age and Survivors Insurance (OASI), Disability Insurance (DI), and Supplemental Security Income programs, and to support the Centers for Medicare and Medicaid Services in administering their programs. 

Pilot Program Metrics.—Pilot programs are valuable opportunities to evaluate the effects of programmatic changes, but require a 

well thought out design that includes appropriate measures to 

evaluate the pilot’s effectiveness. For instance, the Social Security 

Advisory Board found, despite beginning the Single Decision Maker 

pilot in 1999, the Social Security Administration (SSA) is unable to 

determine if it was effective due to a lack of quality data. The Committee is concerned with the SSA’s consistent struggle to capture 

useful metrics to evaluate the performance of its pilot programs 

and expects that, prior to undertaking any new pilots, the SSA will 

ensure that it has developed a research design that includes adequate metrics to determine the pilot’s effectiveness. For any new 

pilot launched in the prior fiscal year, or proposed in the current 

or budget year, the Committee directs the SSA to include in the fiscal year 2019 Congressional Justification a description of the pilot 

and what measures SSA will use to determine its effectiveness. 

Information Technology.—The Committee continues to request 

the plan referenced under this heading in House Report 114–699. 

Reducing Social Security Number Use.—Social Security numbers 

(SSNs) are valuable targets for identity theft because of their regular use by both the Federal government and the private sector as 

a unique identifier. Despite this, the Social Security Administration 

(SSA) still mails full SSNs on approximately 233 million notices or 

forms of correspondence each year. While the SSA has committed 

to removing SSNs from its mailings whenever possible, it has not 

provided a timeframe to do so. The Committee appreciates the 

SSA’s stated commitment to reducing the use of SSNs on mailed 

documents and requires additional information to monitor progress. 

The Committee directs the SSA to provide a report within 60 days 

of enactment of this Act to the House of Representatives Committee on Appropriations Subcommittee on Labor, Health and 

Human Services, and Education, and Related Agencies and to the 

Committee on Ways and Means Subcommittee on Social Security, 

that includes the title and identification number of each document 

144 

used by the SSA containing a full SSN, the most recent date this 

document was updated, and either a justification for why the use 

of a full SSN is necessary for inclusion on that document or the 

projected date on which the full SSN will be removed from the document. 

Report on Medical Listings.—SSA employs medical listings to 

make disability determinations, many of which have not been updated. The Committee continues direction for SSA to provide a report within 60 days of enactment to the House of Representatives 

Committee on Appropriations Subcommittee on Labor, Health and 

Human Services, and Education, and Related Agencies and the 

Committee on Ways and Means Subcommittee on Social Security 

regarding the number of years since the last update and when the 

agency expects to conduct all of the updates for all medical listings. 

Report on LAE Expenditures.—The Committee continues to request the report referenced under this heading in House Report 

114–699 as part of the fiscal year 2019 Congressional Justification. 

Social Security Advisory Board 

The Committee recommends that not less than $2,300,000 of the 

LAE funding be available for the Social Security Advisory Board, 

which is the same as the fiscal year 2017 enacted level and the fiscal year 2018 budget request. 

The Committee requests the Social Security Advisory Board include additional information regarding the work of the Social Security Advisory Board in developing recommendations to improve 

SSA’s quality of service to the public in the fiscal year 2019 Congressional Justification. The Committee does not include bill language providing the Social Security Advisory Board reception and 

representation authority. 

User Fees 

In addition to the other amounts provided, the Committee recommends $119,000,000 for administrative activities funded from 

user fees. Of this amount, $118,000,000 is derived from fees collected from States that request SSA to administer State SSI supplementary payments. 

Continuing Disability Reviews and Redeterminations 

The Committee recommends $1,735,000,000 for program integrity activities. In the wake of multiple large-scale disability fraud 

cases, the Committee believes that successful program integrity activities are vital to maintaining the public’s support for benefit payments to recipients deserving of assistance. 

OFFICE OF THE INSPECTOR GENERAL

(INCLUDING TRANSFER OF FUNDS)

The Committee recommends $105,500,000 for the Office of Inspector General, of which the bill provides authority to expend 

$75,500,000 from the OASI and DI trust funds. This funding level 

is the same as the fiscal year 2017 enacted level and the fiscal year 

2018 budget request. 

145 

TITLE V—GENERAL PROVISIONS 

(TRANSFER OF FUNDS)

Sec. 501. The Committee continues a provision allowing the Secretaries of Labor, Health and Human Services, and Education to 

transfer unexpended balances of prior appropriations to accounts 

corresponding to current appropriations to be used for the same 

purposes and for the same periods of time for which they were 

originally appropriated. 

Sec. 502. The Committee continues a provision prohibiting the 

obligation of funds beyond the current fiscal year unless expressly 

so provided. 

Sec. 503. The Committee continues a provision prohibiting funds 

from being used to support or defeat legislation. 

Sec. 504. The Committee continues a provision limiting the 

amount available for official reception and representation expenses 

for the Secretaries of Labor and Education, the Director of the Federal Mediation and Conciliation Service, and the Chairman of the 

National Mediation Board. 

Sec. 505. The Committee continues a provision requiring grantees receiving Federal funds to clearly state the percentage of the 

total cost of the program or project that will be financed with Federal money. 

Sec. 506. The Committee continues a provision prohibiting the 

use of funds for any abortion. 

Sec. 507. The Committee continues a provision providing exceptions to section 506 and a provision prohibiting funds from being 

made available to a Federal agency or program, or to a State or 

local government, if such agency, program or government discriminates against institutional or individual health care entities because they do not provide, pay for, provide coverage of, or refer for 

abortions. 

Sec. 508. The Committee continues a provision prohibiting use of 

funds for certain research involving human embryos. 

Sec. 509. The Committee continues a provision prohibiting use of 

funds for any activity that promotes the legalization of any drug or 

substance included in schedule I of the schedules of controlled substances. 

Sec. 510. The Committee continues a provision prohibiting use of 

funds to promulgate or adopt any final standard providing for a 

unique health identifier until legislation is enacted specifically approving the standard. 

Sec. 511. The Committee continues a provision related to annual 

reports to the Secretary of Labor. 

Sec. 512. The Committee continues a provision prohibiting transfer of funds made available in this Act except by authority provided 

in this Act or another appropriations Act. 

Sec. 513. The Committee continues a provision to limit funds in 

the bill for public libraries to those that comply with the requirements of the Children’s Internet Protection Act. 

Sec. 514. The Committee continues a provision regarding procedures for reprogramming of funds. 

Sec. 515. The Committee continues a provision pertaining to appointments to scientific advisory committees. 

146 

Sec. 516. The Committee continues a provision requiring each department and related agency funded through this Act to submit an 

operating plan within 45 days of enactment, detailing any funding 

allocations that are different than those specified in this Act, the 

accompanying detailed table, or budget request. 

Sec. 517. The Committee continues a provision requiring the Secretaries of Labor, Health and Human Services, and Education to 

submit a quarterly report to the Committees on Appropriations of 

the House of Representatives and the Senate containing certain information on noncompetitive contracts, grants, and cooperative 

agreements exceeding $500,000 in value. 

Sec. 518. The Committee continues a provision prohibiting the 

use of funds to process claims for credit for quarters of coverage 

based on work performed under a Social Security number that was 

not the claimant’s number, where the performance of such work 

under such number has formed the basis for a conviction of the 

claimant of a violation of section 208(a)(6) or (7) of the Social Security Act. 

Sec. 519. The Committee continues a provision prohibiting the 

use of funds to implement a Social Security totalization agreement 

with Mexico. 

Sec. 520. The Committee continues a provision related to needle 

exchange. 

Sec. 521. The Committee continues a provision prohibiting the 

use of funds for the downloading or exchanging of pornography. 

Sec. 522. The Committee continues a provision that prohibits 

funding from going to the Association of Community Organizations 

for Reform Now (ACORN), or any of its affiliates, subsidiaries, allied organizations, or successors. 

Sec. 523. The Committee continues a provision relating to reporting requirements for conference expenditures. 

Sec. 524. The Committee continues a provision relating to disclosure of U.S. taxpayer funding for programs used in advertising. 

Sec. 525. The Committee continues a provision relating to performance partnership pilots. 

Sec. 526. The Committee continues provision requesting quarterly reports on the status of balances of appropriations from the 

Departments of Labor, Health and Human Services and Education 

and the Social Security Administration. 

Sec. 527. The Committee includes a new provision prohibiting 

use of funds to implement, administer, enforce or further the provisions of Public Law 111–148 and portions of public Law 111–152 

with certain exceptions. 

Sec. 528. The Committee includes a new provision prohibiting 

use of funds for research on fetal tissue obtained from an induced 

abortion. 

Sec. 529. The Committee includes a new provision restricting 

funding to certain health care entities. 

(RESCISSION)

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

147 

(RESCISSION)

Sec. 531. The Committee rescinds $15,000,000 provided under 

section 3403 [Independent Payment Advisory Board] of Public Law 

111–148. 

Sec. 532. The Committee modifies a provision relating to the 

Child Enrollment Contingency Fund. 

(RESCISSION)

Sec. 533. The Committee rescinds $323,000,000 in unused funds 

provided under section 1101(g) [Pre-Existing Condition Insurance 

Program] of Public Law 111–148. 

(RESCISSION)

Sec. 534. The Committee rescinds $88,613,000 in unused funds 

provided under section 2105(a)(3) [Children’s Health Insurance 

Program Performance Bonus Payment] of the Social Security Act. 

(RESCISSION)

Sec. 535. The Committee rescinds $3,945,905,000 in unused 

funds provided under section 301(b)(3) [Children’s Health Insurance Program allotments] of Public Law 114–10. 

Sec. 536. The Committee includes a new provision relating to 

conscience protection with respect to health care entities that 

refuse to participate in abortions. 

Sec. 537. The Committee includes a new provision relating to 

minimum wage on Federal lands. 

SPENDING REDUCTION ACCOUNT

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

HOUSE OF REPRESENTATIVES REPORTING REQUIREMENTS

The following materials are submitted in accordance with various 

requirements of the Rules of the House of Representatives: 

STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES

Pursuant to clause 3(c)(4) of rule XIII of the Rules of the House 

of Representatives, the following is a statement of general performance goals and objectives for which this measure authorizes funding: The Committee on Appropriations considers program performance, including a program’s success in developing and attaining 

outcome-related goals and objectives, in developing funding recommendations. 

RESCISSION OF FUNDS

Pursuant to clause 3(f)(2) of rule XIII of the Rules of the House 

of Representatives, the following lists the rescissions of unexpended 

balances included in the accompanying bill: 

RESCISSIONS RECOMMENDED IN THE BILL

Account Amount 

Department of Labor 

Dislocated Workers National Reserve .................................................................................................... $200,000,000 

148 

Account Amount 

Department of Health and Human Services 

Nonrecurring Expenses Fund ................................................................................................................. 560,000,000 

Independent Payment Advisory Board ................................................................................................... 15,000,000 

Preexisting Condition Insurance Program ............................................................................................. 323,000,000 

Children’s Health Insurance Program ................................................................................................... 3,945,905,000 

Performance Bonus Payments ............................................................................................................... 88,046,000 

Department of Education 

Pell Grants ............................................................................................................................................. 3,270,844,000 

TRANSFER OF FUNDS

Pursuant to clause 3(f)(2) of rule XIII of the Rules of the House 

of Representatives, the following lists the transfers of unexpended 

balances included in the accompanying bill: 

TITLE I 

Language is included under ‘‘Job Corps’’ permitting the transfer 

of funds for Job Corps Center construction, rehabilitation and acquisition to meet the operational needs of Job Corps Centers or to 

achieve administrative efficiencies. 

Language is included under ‘‘Special Benefits’ ’’ which provides 

for the transfer of such sums as necessary from the ‘‘Postal Service’’ account. 

Language is included under ‘‘Black Lung Disability Trust Fund’’ 

which provides for the transfer of funds to the ‘‘Department of 

Labor, Office of Workers’ Compensation Program, Salaries and Expenses.’’ 

Language is included under ‘‘Black Lung Disability Trust Fund’’ 

which provides for the transfer of funds to the ‘‘Department of 

Labor, Departmental Management, Salaries and Expenses.’’ 

Language is included under ‘‘Black Lung Disability Trust Fund’’ 

which provides for the transfer of funds to the ‘‘Department of 

Labor, Departmental Management, Office of Inspector General.’’ 

Language is included under ‘‘Black Lung Disability Trust Fund’’ 

which provides for the transfer of funds to the ‘‘Department of the 

Treasury.’’ 

Language is included under ‘‘Departmental Management, Salaries and Expenses’ ’’ authorizing the transfer of funds available for 

program evaluation to any other account within the Department to 

carry out evaluation activities. 

A general provision is included that allows not to exceed one percent of any discretionary appropriations to be transferred between 

an appropriation of the Department of Labor, provided that no 

such appropriation is increased by more than three percent by such 

transfer. 

A general provision is included that authorizes the transfer of 

funds from the ‘‘Employment and Training Administration’’ for 

technical assistance services to grantees to ‘‘Program Administration.’’ 

A general provision is included that provides for the transfer of 

up to 0.75 percent of funds from each appropriation to carry out 

evaluations of any of the programs or activities from ‘‘Training and 

Employment Services’’, ‘‘ Job Corps’’, ‘‘Community Service Employment for Older Americans,’’ ‘‘State Unemployment Insurance and 

Employment Service Operations’’, ‘‘Employee Benefits Security AdVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00148 Fmt 6659 Sfmt 6602 E:\HR\OC\HR244.XXX HR244
149 

ministration’’, ‘‘Office of Workers’ Compensation Programs’’, ‘‘Wage 

and Hour Division’’, ‘‘Office of Federal Contract Compliance Programs’’, ‘‘Office of Labor-Management Standards’’, ‘‘Occupational 

Safety and Health Administration’’, ‘‘Mine Safety and Health Administration’’, Office of Disability Employment Policy, ‘‘Bureau of 

International Affairs’’ and Women’s Bureau’’ within the Departmental Management, Salaries and Expenses’’ account, and ‘‘Veterans Employment and Training’’ for use by the Office of the Chief 

Evaluation Officer. 

TITLE II 

Language is included under ‘‘Centers for Disease Control and 

Prevention, Buildings and Facilities’’ to allow the transfer of prior 

year unobligated Individual Learning Account funds to be transferred to this account to carry out the purpose of this account. 

Language is included under ‘‘Administration for Children and 

Families—Refugee and Entrant Assistance’’ permitting transfers 

pursuant to a general provision to increase an appropriation under 

this heading by ten percent. 

Language is included under ‘‘Administration for Community Living, Aging and Disability Services Programs’’ for transfer to the 

Secretary of Agriculture to carryout section 311 of the Older Americans Act of 1965. 

Language is included under ‘‘Public Health and Social Services 

Emergency Fund’’ to provide enhanced transfer authority to this 

account to address public health emergencies. 

A general provision is included that allows not to exceed one percent of any discretionary funds to be transferred between appropriation accounts of the ‘‘Department of Health and Human Services’’, provided that no appropriation account is increased by more 

than three percent by such transfer. 

A general provision is included that allows the transfer of up to 

three percent among the institutes and centers of the ‘‘National Institutes of Health’’ from amounts identified as pertaining to the 

human immunodeficiency virus. 

A general provision is included that allows the transfer of funding determined to be related to the human immunodeficiency virus 

to the ‘‘Office of AIDS Research’’. 

A general provision is included that transfers one percent of the 

amount made available for ‘‘National Research Service Awards’’ at 

the ‘‘National Institutes of Health’’ to the ‘‘Health Resources and 

Services Administration’’. 

A general provision is included to direct the transfer of the ‘‘Prevention and Public Health Fund’’ as specified in the committee report accompanying this Act. 

TITLE III 

A general provision is included that allows not to exceed one percent of any discretionary funds to be transferred between appropriation accounts of the Department of Education, provided that no 

appropriation account is increased by more than three percent by 

such transfer. 

150 

TITLE IV 

Language is included under Payment to the National Service 

Trust authorizing the transfer of funds from the ‘‘Corporation for 

National and Community Service, Operating Expenses’’ to support 

the activities of national service participants. 

Language is included under ‘‘Social Security Administration’’ authorizing the transfer of up to three percent of the Social Security 

Administration’s ‘‘Limitation on Administration Expenses’ ’’ account 

to be available for purposes of the Office of Inspector General. 

TITLE V 

A general provision is included that allows the Secretaries of 

Labor, Health and Human Services, and Education to transfer balances of prior appropriation to accounts corresponding to current 

appropriations. 

DISCLOSURE OF EARMARKS AND CONGRESSIONALLY DIRECTED

SPENDING ITEMS

Neither the bill nor the report contains any Congressional earmarks, limited tax benefits, or limited tariff benefits as defined in 

clause 9 of rule XXI. 

COMPLIANCE WITH RULE XIII, CL. 3(E) (RAMSEYER RULE) 

In compliance with clause 3(e) of rule XIII of the Rules of the 

House of Representatives, changes in existing law made by the bill, 

as reported, are shown as follows (existing law proposed to be omitted is enclosed in black brackets, new matter is printed in italic, 

existing law in which no change is proposed is shown in roman): 

HIGHER EDUCATION ACT OF 1965 

* * * * * * * 

TITLE I—GENERAL PROVISIONS 

* * * * * * * 

PART B—ADDITIONAL GENERAL PROVISIONS 

* * * * * * * 

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

(a) ESTABLISHMENT.—There is established in the Department a 

National Advisory Committee on Institutional Quality and Integrity (in this section referred to as the ‘‘Committee’’) to assess the 

process of accreditation and the institutional eligibility and certification of institutions of higher education (as defined in section 102) 

under title IV. 

(b) MEMBERSHIP.— 

(1) IN GENERAL.—The Committee shall have 18 members, of 

which— 

(A) six members shall be appointed by the Secretary; 

151 

(B) six members shall be appointed by the Speaker of 

the House of Representatives, three of whom shall be appointed on the recommendation of the majority leader of 

the House of Representatives, and three of whom shall be 

appointed on the recommendation of the minority leader of 

the House of Representatives; and 

(C) six members shall be appointed by the President pro 

tempore of the Senate, three of whom shall be appointed 

on the recommendation of the majority leader of the Senate, and three of whom shall be appointed on the recommendation of the minority leader of the Senate. 

(2) QUALIFICATIONS.—Individuals shall be appointed as 

members of the Committee— 

(A) on the basis of the individuals’ experience, integrity, 

impartiality, and good judgment; 

(B) from among individuals who are representatives of, 

or knowledgeable concerning, education and training beyond secondary education, representing all sectors and 

types of institutions of higher education (as defined in section 102); and 

(C) on the basis of the individuals’ technical qualifications, professional standing, and demonstrated knowledge 

in the fields of accreditation and administration in higher 

education. 

(3) TERMS OF MEMBERS.—Except as provided in paragraph 

(5), the term of office of each member of the Committee shall 

be for six years, except that any member appointed to fill a vacancy occurring prior to the expiration of the term for which 

the member’s predecessor was appointed shall be appointed for 

the remainder of such term. 

(4) VACANCY.—A vacancy on the Committee shall be filled in 

the same manner as the original appointment was made not 

later than 90 days after the vacancy occurs. If a vacancy occurs 

in a position to be filled by the Secretary, the Secretary shall 

publish a Federal Register notice soliciting nominations for the 

position not later than 30 days after being notified of the vacancy. 

(5) INITIAL TERMS.—The terms of office for the initial members of the Committee shall be— 

(A) three years for members appointed under paragraph 

(1)(A); 

(B) four years for members appointed under paragraph 

(1)(B); and 

(C) six years for members appointed under paragraph 

(1)(C). 

(6) CHAIRPERSON.—The members of the Committee shall select a chairperson from among the members. 

(c) FUNCTIONS.—The Committee shall— 

(1) advise the Secretary with respect to establishment and 

enforcement of the standards of accrediting agencies or associations under subpart 2 of part H of title IV; 

(2) advise the Secretary with respect to the recognition of a 

specific accrediting agency or association; 

152 

(3) advise the Secretary with respect to the preparation and 

publication of the list of nationally recognized accrediting agencies and associations; 

(4) advise the Secretary with respect to the eligibility and 

certification process for institutions of higher education under 

title IV, together with recommendations for improvements in 

such process; 

(5) advise the Secretary with respect to the relationship between— 

(A) accreditation of institutions of higher education and 

the certification and eligibility of such institutions; and 

(B) State licensing responsibilities with respect to such 

institutions; and 

(6) carry out such other advisory functions relating to accreditation and institutional eligibility as the Secretary may prescribe by regulation. 

(d) MEETING PROCEDURES.— 

(1) SCHEDULE.— 

(A) BIANNUAL MEETINGS.—The Committee shall meet not 

less often than twice each year, at the call of the Chairperson. 

(B) PUBLICATION OF DATE.—The Committee shall submit 

the date and location of each meeting in advance to the 

Secretary, and the Secretary shall publish such information in the Federal Register not later than 30 days before 

the meeting. 

(2) AGENDA.— 

(A) ESTABLISHMENT.—The agenda for a meeting of the 

Committee shall be established by the Chairperson and 

shall be submitted to the members of the Committee upon 

notification of the meeting. 

(B) OPPORTUNITY FOR PUBLIC COMMENT.—The agenda 

shall include, at a minimum, opportunity for public comment during the Committee’s deliberations. 

(3) SECRETARY’S DESIGNEE.—The Secretary shall designate 

an employee of the Department to serve as the Secretary’s designee to the Committee, and the Chairperson shall invite the 

Secretary’s designee to attend all meetings of the Committee. 

(4) FEDERAL ADVISORY COMMITTEE ACT.—The Federal Advisory Committee Act (5 U.S.C. App.) shall apply to the Committee, except that section 14 of such Act shall not apply. 

(e) REPORT AND NOTICE.— 

(1) NOTICE.—The Secretary shall annually publish in the 

Federal Register— 

(A) a list containing, for each member of the Committee— 

(i) the member’s name; 

(ii) the date of the expiration of the member’s term 

of office; and 

(iii) the name of the individual described in subsection (b)(1) who appointed the member; and 

(B) a solicitation of nominations for each expiring term 

of office on the Committee of a member appointed by the 

Secretary. 

153 

(2) REPORT.—Not later than the last day of each fiscal year, 

the Committee shall make available an annual report to the 

Secretary, the authorizing committees, and the public. The annual report shall contain— 

(A) a detailed summary of the agenda and activities of, 

and the findings and recommendations made by, the Committee during the fiscal year preceding the fiscal year in 

which the report is made; 

(B) a list of the date and location of each meeting during 

the fiscal year preceding the fiscal year in which the report 

is made; 

(C) a list of the members of the Committee; and 

(D) a list of the functions of the Committee, including 

any additional functions established by the Secretary 

through regulation. 

(f) TERMINATION.—The Committee shall terminate on September 

30, ø2017¿ 2018. 

* * * * * * * 

TITLE IV—STUDENT ASSISTANCE 

* * * * * * * 

PART D—WILLIAM D. FORD FEDERAL DIRECT 

LOAN PROGRAM 

* * * * * * * 

SEC. 458. FUNDS FOR ADMINISTRATIVE EXPENSES. 

(a) ADMINISTRATIVE EXPENSES.— 

(1) MANDATORY FUNDS FOR FISCAL YEAR 2006.—For fiscal year 

2006, there shall be available to the Secretary, from funds not 

otherwise appropriated, funds to be obligated for— 

(A) administrative costs under this part and part B, including the costs of the direct student loan programs under 

this part; and 

(B) account maintenance fees payable to guaranty agencies under part B and calculated in accordance with subsections (b) and (c), 

not to exceed (from such funds not otherwise appropriated) 

$820,000,000 in fiscal year 2006. 

(2) 

(3) AUTHORIZATION FOR ADMINISTRATIVE COSTS BEGINNING IN

FISCAL YEARS 2007 THROUGH 2014.—For each of the fiscal years 

2007 through 2014, there are authorized to be appropriated 

such sums as may be necessary for administrative costs under 

this part and part B, including the costs of the direct student 

loan programs under this part. 

(4) CONTINUING MANDATORY FUNDS FOR ACCOUNT MAINTENANCE FEES.—For each of the fiscal years 2007 through ø2017¿ 

2018, there shall be available to the Secretary, from funds not 

otherwise appropriated, funds to be obligated for account maintenance fees payable to guaranty agencies under part B and 

calculated in accordance with subsection (b). 

154 

(5) ACCOUNT MAINTENANCE FEES.—Account maintenance fees 

under paragraph (3) shall be paid quarterly and deposited in 

the Agency Operating Fund established under section 422B. 

(6) TECHNICAL ASSISTANCE TO INSTITUTIONS OF HIGHER EDU- CATION.— 

(A) PROVISION OF ASSISTANCE.—The Secretary shall provide institutions of higher education participating, or seeking to participate, in the loan programs under this part 

with technical assistance in establishing and administering such programs. 

(B) FUNDS.—There are authorized to be appropriated, 

and there are appropriated, to carry out this paragraph (in 

addition to any other amounts appropriated to carry out 

this paragraph and out of any money in the Treasury not 

otherwise appropriated), $50,000,000 for fiscal year 2010. 

(C) DEFINITION.—In this paragraph, the term ‘‘assistance’’ means the provision of technical support, training, 

materials, technical assistance, and financial assistance. 

(7) ADDITIONAL PAYMENTS.— 

(A) PROVISION OF ASSISTANCE.—The Secretary shall provide payments to loan servicers for retaining jobs at locations in the United States where such servicers were operating under part B on January 1, 2010. 

(B) FUNDS.—There are authorized to be appropriated, 

and there are appropriated, to carry out this paragraph (in 

addition to any other amounts appropriated to carry out 

this paragraph and out of any money in the Treasury not 

otherwise appropriated), $25,000,000 for each of the fiscal 

years 2010 and 2011. 

(8) CARRYOVER.—The Secretary may carry over funds made 

available under this section to a subsequent fiscal year. 

(b) CALCULATION BASIS.—Account maintenance fees payable to 

guaranty agencies under subsection (a)(4) shall be calculated on 

the basis of 0.06 percent of the original principal amount of outstanding loans on which insurance was issued under part B. 

(c) BUDGET JUSTIFICATION.—No funds may be expended under 

this section unless the Secretary includes in the Department of 

Education’s annual budget justification to Congress a detailed description of the specific activities for which the funds made available by this section have been used in the prior and current years 

(if applicable), the activities and costs planned for the budget year, 

and the projection of activities and costs for each remaining year 

for which administrative expenses under this section are made 

available. 

* * * * * * * 

PUBLIC HEALTH SERVICE ACT 

* * * * * * * 

TITLE II—ADMINISTRATION AND MISCELLANEOUS 

PROVISIONS 

* * * * * * * 

155 

PART B—MISCELLANEOUS PROVISIONS

* * * * * * * 

SEC. 245A. PROHIBITING GOVERNMENTAL DISCRIMINATION AGAINST 

PROVIDERS OF HEALTH SERVICES THAT ARE NOT INVOLVED IN ABORTION. 

(a) IN GENERAL.—Notwithstanding any other law, the Federal 

Government, and any State or local government that receives Federal financial assistance, may not penalize, retaliate against, or otherwise discriminate against a health care provider on the basis that 

the provider does not— 

(1) perform, refer for, pay for, or otherwise participate in 

abortion; 

(2) provide or sponsor abortion coverage; or 

(3) facilitate or make arrangements for any of the activities 

specified in this subsection. 

(b) RULE OF CONSTRUCTION.—Nothing in this section shall be 

construed— 

(1) to prevent any health care provider from voluntarily electing to participate in abortions or abortion referrals; 

(2) to prevent any health care provider from voluntarily electing to provide or sponsor abortion coverage or health benefits 

coverage that includes abortion; 

(3) to prevent an accrediting agency, the Federal Government, 

or a State or local government from establishing standards of 

medical competency applicable only to those who have knowingly, voluntarily, and specifically elected to perform abortions, 

or from enforcing contractual obligations applicable only to 

those who, as part of such contract, knowingly, voluntarily, and 

specifically elect to provide abortions; 

(4) to affect, or be affected by, section 1867 of the Social Security Act (42 U.S.C. 1395dd, commonly referred to as the ‘‘Emergency Medical Treatment and Active Labor Act’’); or 

(5) to supersede any law enacted by any State for the purpose 

of regulating insurance, except as specified in subsection (a). 

(c) ADMINISTRATION.—The Secretary shall designate the Director 

of the Office for Civil Rights of the Department of Health and 

Human Services— 

(1) to receive complaints alleging a violation of this section, 

section 245 of this Act, or any of subsections (b) through (e) of 

section 401 of the Health Programs Extension Act of 1973; and 

(2) to pursue the investigation of such complaints in coordination with the Attorney General. 

(d) DEFINITIONS.—For purposes of this section: 

(1) FEDERAL FINANCIAL ASSISTANCE.—The term ‘‘Federal financial assistance’’ means Federal payments to cover the cost of 

health care services or benefits, or other Federal payments, 

grants, or loans to promote or otherwise facilitate health-related 

activities. 

(2) HEALTH CARE PROVIDER.—The term ‘‘health care provider’’ 

means— 

(A) an individual physician, nurse, or other health care 

professional; 

(B) a hospital, health system, or other health care facility 

or organization (including a party to a proposed merger or 

156 

other collaborative arrangement relating to health services, 

and an entity resulting therefrom); 

(C) a provider-sponsored organization, an accountable 

care organization, or a health maintenance organization; 

(D) a social services provider that provides or authorizes 

referrals for health care services; 

(E) a program of training in the health professions or an 

applicant to or participant in such a program; 

(F) an issuer of health insurance coverage; or 

(G) a group health plan or student health plan, or a 

sponsor or administrator thereof. 

(3) STATE OR LOCAL GOVERNMENT THAT RECEIVES FEDERAL

FINANCIAL ASSISTANCE.—The term ‘‘State or local government 

that receives Federal financial assistance’’ includes every agency 

and other governmental unit and subdivision of a State or local 

government, if such State or local government, or any agency or 

governmental unit or subdivision thereof, receives Federal financial assistance. 

SEC. 245B. CIVIL ACTION FOR CERTAIN VIOLATIONS. 

(a) IN GENERAL.—A qualified party may, in a civil action, obtain 

appropriate relief with regard to a designated violation. 

(b) DEFINITIONS.—For purposes of this section: 

(1) QUALIFIED PARTY.—The term ‘‘qualified party’’ means— 

(A) the Attorney General of the United States; or 

(B) any person or entity adversely affected by the designated violation. 

(2) DESIGNATED VIOLATION.—The term ‘‘designated violation’’ 

means an actual or threatened violation of— 

(A) section 245 or 245A of this Act; or 

(B) any of subsections (b) through (e) of section 401 of the 

Health Programs Extension Act of 1973 regarding an objection to abortion. 

(c) ADMINISTRATIVE REMEDIES NOT REQUIRED.—An action under 

this section may be commenced, and relief may be granted, without 

regard to whether the party commencing the action has sought or 

exhausted available administrative remedies. 

(d) DEFENDANTS IN ACTIONS UNDER THIS SECTION MAY INCLUDE

GOVERNMENTAL ENTITIES AS WELL AS OTHERS.— 

(1) IN GENERAL.—An action under this section may be maintained against, among others, a party that is a Federal or State 

governmental entity. Relief in an action under this section may 

include money damages even if the defendant is such a governmental entity. 

(2) DEFINITION.—For the purposes of this subsection, the term 

‘‘State governmental entity’’ means a State, a local government 

within a State, and any agency or other governmental unit or 

subdivision of a State or of such a local government. 

(e) NATURE OF RELIEF.—In an action under this section, the court 

shall grant— 

(1) all necessary equitable and legal relief, including, where 

appropriate, declaratory relief and compensatory damages, to 

prevent the occurrence, continuance, or repetition of the designated violation and to compensate for losses resulting from 

the designated violation; and 

157 

(2) to a prevailing plaintiff, reasonable attorneys’ fees and 

litigation expenses as part of the costs. 

* * * * * * * 

CHANGES IN THE APPLICATION OF EXISTING LAW

Pursuant to clause 3(f)(1)(A) of rule XIII of the Rules of the 

House of Representatives, the following statements are submitted 

describing the effect of provisions in the accompanying bill that directly or indirectly change the application of existing law. 

TITLE I—DEPARTMENT OF LABOR 

Language is included under ‘‘Employment and Training Administration’’ providing that allotments to outlying areas are not required to be made through the Pacific Region Educational Laboratory as provided by section 127 of the Workforce Innovation and 

Opportunity Act (WIOA). 

Language is included under ‘‘Employment and Training Administration’’ providing amounts made available for dislocated workers 

may be used for State activities or across multiple local areas 

where workers remain dislocated. 

Language is included under ‘‘Employment and Training Administration’’ providing that technical assistance projects may provide 

assistance to new entrants in the workforce and incumbent workers. 

Language is included under ‘‘Employment and Training Administration’’ providing that the Secretary of Labor may reserve not 

more than 10 of funds to provide technical assistance activities related to the transition to WIOA. 

Language is included under ‘‘Employment and Training Administration’’ providing that the Department of Labor may take no action to limit the number or proportion of eligible applicants receiving related assistance services in the migrant and seasonal farmworkers programs. 

Language is included under ‘‘Job Corps’’ providing that amounts 

made available for construction and rehabilitation may include acquisition and maintenance of major items of equipment. 

Language is included under ‘‘Job Corps’’ providing authority to 

transfer up to 15 percent of construction and rehabilitation funds 

for operational needs with prior written notice to the Committee 

and that any such transfers are available for obligation through 

June 30, 2019. 

Language is included under ‘‘Job Corps’’ providing that no funds 

from any other appropriation may be used for meal services at Job 

Corps. 

Language in included under ‘‘Federal Unemployment Benefits 

and Allowances’’ providing that funding may be available beyond 

the current year in accordance with section 245(c) of the Trade Act 

of 1974. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing for reemployment services and referrals to training for all claimants of unemployment insurance for ex-service members, for improper payment reviews, and 

for unemployment claimants most likely to exhaust their benefits. 

158 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing for additional administrative funds from the Unemployment Trust Fund if unemployment 

claims exceed certain levels. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing authority for States to 

use funds to assist other States to carry out authorized activities 

in cases of a major disaster declared by the President under the 

Robert T. Stafford Disaster Relief and Emergency Assistance Act. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing that the Department of 

Labor may make payments on behalf of States for the use of the 

National Directory of New Hires. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing that the Department of 

Labor may make payments from funds appropriated for States’ 

grants on behalf of States to the entity operating the State Information Data Exchange System. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing that the Department of 

Labor may make payments from funds appropriated for States’ 

grants on behalf of States to the entity operating the Unemployment Insurance Integrity Center of Excellence. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing that appropriations for 

establishing a national one-stop career system may be obligated in 

contracts, grants or agreements with States or non-State entities. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing that States awarded 

grants to support national activities of the Federal-State unemployment insurance system may award subgrants to other States. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing that funds available for 

integrated Unemployment Insurance and Employment Service automation may be used by States notwithstanding cost allocation 

principles prescribed under the Office of Management and Budget 

‘‘Uniform Administrative Requirements, Cost Principles, and Audit 

Requirements for Federal Awards.’’ 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing that the Department of 

Labor may reallot funds among States participating in a consortium. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ allowing the Secretary to collect 

fees, to remain available until September 30, 2019, for the costs associated with additional data collection, analyses, and reporting 

services related to the National Agricultural Workers Survey. 

Language is included under ‘‘Pension Benefit Guarantee Corporation’’ providing for additional administrative funds if participants with plans terminated during the period exceed a certain 

level. 

Language is included under ‘‘Pension Benefit Guarantee Corporation’’ providing that obligations may exceed amounts provided 

for unforeseen and extraordinary pretermination expenses or unVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00158 Fmt 6659 Sfmt 6601 E:\HR\OC\HR244.XXX HR244
159 

foreseen and extraordinary multiemployer program expenses if approved by the Office of Management and Budget. 

Language is included under ‘‘Special Benefits’’ providing that the 

Department of Labor may use authority to reimburse an employer 

who is not the employer at the time of injury for portions of the 

salary of a re-employed, disabled beneficiary. 

Language is included under ‘‘Special Benefits’’ providing that balances of reimbursements unobligated on September 30, 2017 shall 

remain available until expended. 

Language is included under ‘‘Special Benefits’’ providing that 

funds shall be transferred to the appropriation from entities required under 5 U.S.C. 8147(c) as determined by the Department of 

Labor. 

Language is included under ‘‘Special Benefits’’ providing that 

funds transferred from entities under 5 U.S.C 8147(c), specified 

amounts may be used by the Department of Labor for maintenance 

and data and communications systems, workload processing, roll 

disability management and medical review, and program integrity 

with remaining amounts paid into the Treasury. 

Language is included under ‘‘Special Benefits’’ providing that the 

Secretary may prescribe regulations requiring identification for the 

filing benefit claims. 

Language is included under ‘‘Administrative Expenses, Energy 

Employees Occupational Illness Compensation Fund’’ providing 

that the Secretary may prescribe regulations for requiring identification for the filing benefit claims. 

Language is included under ‘‘Occupational Safety and Health Administration’’ providing that up to a certain amount of fees collected from the training institute may be retained and used for related training and education. 

Language is included under ‘‘Occupational Safety and Health Administration’’ providing that fees collected from Nationally Recognized Testing Laboratories may be used to administer laboratory 

recognition programs that insure safety of equipment used in the 

workplace. 

Language is included under ‘‘Occupational Safety and Health Administration’’ that prohibits enforcement on farming operations of 

10 or fewer employees or of an employer with 10 or fewer employees that is below the national average in specific injury categories 

except under specific exclusions. 

Language is included under ‘‘Mine Safety and Health Administration’’ providing that funds made available for State assistance 

grants may be used for the purchase and maintenance of equipment required by the Coal Mine Dust rule. 

Language is included under ‘‘Mine Safety and Health Administration’’ providing that a specific amount may be collected by the 

National Mine Health and Safety Academy and made available for 

mine safety and health education and training. 

Language is included under ‘‘Mine Safety and Health Administration’’ providing that a specific amount may be collected from the 

approval and certification of equipment and materials and made 

available for other such activities. 

Language is included under ‘‘Mine Safety and Health Administration’’ providing that the Department of Labor may accept lands, 

160 

buildings, equipment, and other contributions from public and private sources for cooperative projects. 

Language is included under ‘‘Mine Safety and Health Administration’’ providing that the Department of Labor may promote 

health and safety education and training through cooperative 

agreements with States, industry and safety associations. 

Language is included under ‘‘Mine Safety and Health Administration’’ providing that the Department of Labor may recognize the 

Joseph A. Holmes Safety Association as the principal safety association and may provide funds or personnel as officers in local 

chapters or the national organization. 

Language is included under ‘‘Mine Safety and Health Administration’’ providing that the Department of Labor may use appropriated funds to provide for costs associated with mine rescue and 

survival operations in the event of a major disaster. 

Language is included under ‘‘Departmental Management—Salaries and Expenses’’ providing that the Bureau of International 

Labor Affairs may operating international labor activities through 

grants, subgrants or other arrangements. 

Language is included under ‘‘Departmental Management—Salaries and Expenses’’ providing that funds available for program 

evaluation may be used to administer grants for evaluation purposes under certain conditions. 

Language is included under ‘‘Departmental Management—Salaries and Expenses’’ providing that funds available to the Women’s 

Bureau may be used for grants to service and promote the interests 

of women in the workplace. 

Language is included under ‘‘Departmental Management—Salaries and Expenses’’ providing that certain amounts made available 

to the Women’s Bureau shall be used for grants authorized by the 

Women in Apprenticeship and Nontraditional Occupations Act. 

Language is included under ‘‘Veterans Employment and Training’’ providing that up to three percent of States’ grants may be 

used for federal expenditures for data systems and contract support. 

Language is included under ‘‘Veterans Employment and Training’’ providing that funds may be used for support specialists providing intensive services to wounded servicemembers. 

Language is included under ‘‘Veterans Employment and Training’’ providing that Department of Labor may reallocate up to three 

percent of funds provided among appropriated accounts. 

Language is included under ‘‘Veterans Employment and Training’’ providing that the HIRE Vets Medallion Award Fund shall be 

available to the Secretary for expenses of the HIRE Vets Medallion 

Award Program. 

Language is included under ‘‘Veterans Employment and Training’’ providing that funds made available to assist homeless veterans may be awarded through September 30, 2018. 

Language is included under ‘‘Veterans Employment and Training’’ providing that authorized services to veterans may also be provided to veterans recently released from incarceration. 

Language is included under ‘‘General Provisions’’ prohibiting the 

use of Job Corps funds to pay the salaries and bonuses at a rate 

in excess of Executive Level II. 

161 

Language is included under ‘‘General Provisions’’ authorizing the 

transfer of up to one percent of discretionary funds between programs, projects, or activities as long as the transfer does not increase any program, project, or activity by more than three percent 

and no new program, project, or activity is created by such transfer. 

Language is included under ‘‘General Provisions’’ prohibiting the 

use funds for procurement of goods or services rendered by forced 

or indentured child labor. 

Language is included under ‘‘General Provisions’’ prohibiting the 

use of any funds appropriated for grants solicited after January 15, 

2014, under section 414(c) of the American Competitiveness and 

Workforce Improvement Act of 1998, for purposes other than competitive grants for training individuals over the age of 16 who are 

not currently enrolled in school in the occupations and industries 

for which employers are using H–1B visa to hire foreign workers. 

Language is included under ‘‘General Provisions’’ prohibiting the 

use of any funds appropriated for Employment and Training Administration programs to be used to pay the salaries and bonuses 

at a rate in excess of Executive Level II except under specific exclusions. 

Language is included under ‘‘General Provisions’’ providing that 

the Department of Labor may transfer funds from the Employment 

and Training Administration to Program Administration when it is 

determined that services will be more efficiently performed and 

that the Department may transfer certain amounts to Program Administration to conduct program integrity activities. 

Language is included under ‘‘General Provisions’’ providing that 

the Department of Labor may transfer funds from specified accounts to the ‘‘Office of the Chief Evaluation Officer’’ for program 

evaluations. 

Language is included under ‘‘General Provisions’’ providing that 

the Department of Labor may use the performance accountability 

system in effect prior to July 1, 2016 for purposes of implementing 

section 147 of the WIOA. 

Language is included under ‘‘General Provisions’’ regarding the 

application of certain Fair Labor Standards Act requirements pertaining to the evaluation of claims following a major disaster. 

Language is included under ‘‘General Provisions’’ rescinding advance appropriations for the Dislocated Workers National Reserve. 

Language is included under ‘‘General Provisions’’ providing flexibility of crossing for H–2B nonimmigrant workers in the seafood industry. 

Language is included under ‘‘General Provisions’’ providing requirements for the determination of prevailing wages in the H–2B 

nonimmigrant workers program. 

Language is included under ‘‘General Provisions’’ prohibiting the 

use of any funds to enforce certain administrative requirements 

under the H–2B nonimmigrant workers program. 

Language is included under ‘‘General Provisions’’ providing that 

the regulation regarding the definition of the term fiduciary has no 

effect. 

162 

TITLE II—DEPARTMENT OF HEALTH AND HUMAN 

SERVICES 

Language is included under ‘‘Health Resources and Services Administration—Health Workforce’’ overriding the proportional funding requirements in the Public Health Service Act for sections 736, 

747, 751, and 762. 

Language is included under ‘‘Health Resources and Services Administration—Health Workforce’’ providing that fees collected for 

the disclosure of information under the information reporting requirement program authorized by section 1921 of the Social Security Act shall be sufficient to recover the full costs of the operation 

program and shall remain available until expended to carry out 

that Act. 

Language is included under ‘‘Center for Disease Control and Prevention—Public Health Preparedness and Response’’ permitting 

CDC to operate and maintain an aircraft. 

Language is included under ‘‘Center for Disease Control and Prevention—Buildings and Facilities’’ providing the use of funds to 

support acquisition, renovation, or replacement, of the National Institute Occupational Safety and Health’s underground and surface 

coal mining research capacity. 

Language is included under ‘‘Center for Disease Control and Prevention—Buildings and Facilities’’ providing funds from former employees with existing Individual Learning Accounts unobligated to 

be available to support acquisition, renovation, or replacement, of 

the National Institute for Occupational Safety and Health’s underground and surface coal mining research capacity. 

Language is included under ‘‘Substance Abuse and Mental 

Health Services Administration—Mental Health’’ that allows 

SAMHSA to provide technical assistance to communities that do 

not receive grants but want to implement systems of care model 

programs. 

Language is included under ‘‘Substance Abuse and Mental 

Health Services Administration—Mental Health’’ requiring states 

to spend 10 percent of the Mental Health Block Grant for programs 

for individuals with early serious mental illness. 

Language is included under ‘‘Substance Abuse and Mental 

Health Services Administration—Mental Health’’ exempting the 

Mental Health Block Grant from the evaluation set-aside in section 

241 of the Public Health Service Act. 

Language is included under ‘‘Substance Abuse and Mental 

Health Services Administration Substance Abuse Treatment’’ exempting the Substance Abuse Prevention and Treatment Block 

Grant from the evaluation set-aside in section 241 of the Public 

Health Service Act. 

Language is included under ‘‘Centers for Medicare and Medicaid 

Services—Program Management’’ prohibiting the collection of fees 

from qualified health plans offered through an Exchange established under Public Law 111–148. 

Language is included under ‘‘Centers for Medicare and Medicaid 

Services—Health Care Fraud and Abuse Control Account’’ providing funds to support the cost of the Senior Medicare Patrol program. 

163 

Language is included under ‘‘Administration for Children and 

Families Refugee and Entrant Assistance’’ permitting a 10 percent 

transfer. 

Language is included under Administration for Community Living establishing an assistive technology alternative financing program. 

Language is included under Administration for Community Living prohibiting the use of the funds provided in the bill to pursue 

legal action on behalf of a protection and advocacy system described in section 103 of the Protection and Advocacy for Individuals with Mental Illness Act unless public notice has been provided 

within 90 of instituting action to the named person or their legal 

guardian. 

Language is included under Administration for Community Living waiving the public notice requirement for individuals without 

a guardian, who are not competent to consent, who are wards of 

the State or subject to public guardianship. 

Language is included under ‘‘General Departmental Management’’ for competitive grants that implement education in sexual 

risk avoidance using medically accurate information, evidencebased approaches and teach benefits of healthy relationships, goal 

setting and resisting sexual coercion and other youth risk behaviors. 

Language is included under ‘‘Public Health and Social Services 

Emergency Fund’’ to provide enhanced transfer authority to this 

account to address public health emergencies. 

Section 201 limits the amount available for official reception and 

representation expenses. 

Section 202 limits the salary of an individual through an HHS 

grant or other extramural mechanism to not more than the rate of 

Executive Level II. 

Section 203 prohibits the Secretary from using evaluation setaside funds until the Committees on Appropriations of the House 

of Representatives and the Senate receive a report detailing the 

planned use of such funds. 

Section 204 reduces the PHS evaluation set-aside to 2.4 percent. 

Section 205 permits the Secretary of HHS to transfer up to one 

percent of any discretionary funds between appropriations, provided that no appropriation is increased by more than three percent by any such transfer to meet emergency needs. Notification 

must be provided to the Committees on Appropriations at the program, project, and activity level in advance of any transfer. 

Section 206 continues the 60 day flexibility for National Health 

Service Corps contract terminations. 

Section 207 prohibits the use of Title X funds unless the applicant for the award certifies to the Secretary that it encourages family participation in the decision of minors to seek family planning 

services and that it provides counseling to minors on how to resist 

attempts to coerce minors into engaging in sexual activities. 

Section 208 states that no provider of services under Title X shall 

be exempt from any state law requiring notification or the reporting of child abuse, child molestation, sexual abuse, rape, or incest. 

Section 209 provides conscience protections to participants in the 

Medicare Advantage program who chose not to provide, pay for, 

provide coverage of, or provide referrals for abortions. 

164 

Section 210 prohibits funds from being used to advocate or promote gun control. 

Section 211 permits funding for HHS international HIV/AIDS 

and other infectious disease, chronic and environmental disease, 

and other health activities abroad to be spent under the State Department Basic Authorities Act of 1956. 

Section 212 relates to certain international health activities. 

Section 213 provides the Director of NIH, jointly with the Director of the Office of AIDS Research, the authority to transfer up to 

three percent of human immunodeficiency virus funds. 

Section 214 makes NIH funds available for human immunodeficiency virus research available to the Office of AIDS Research. 

Section 215 grants authority to the Office of the Director of the 

NIH to enter directly into transactions in order to implement the 

NIH Common Fund for medical research and permitting the Director to utilize peer review procedures, as appropriate, to obtain assessments of scientific and technical merit. 

Section 216 clarifies that funds appropriated to NIH institutes 

and centers may be used for minor repairs or improvements to 

their buildings, up to $3,500,000 per project with a total limit for 

NIH of $45,000,000. 

Section 217 transfers one percent of the funding made available 

for National Institutes of Health National Research Service Awards 

to the Health Resources and Services Administration and Agency 

for Healthcare Research and Quality. 

Section 218 continues the Biomedical Advanced Research and 

Development Authority ten year contract authority. 

Section 219 requires HHS to provide details on its public website 

related to how the Prevention and Public Health Funds are used. 

Section 220 requires HHS to include certain information concerning the number of full-time federal employees and contractors 

working on the ACA in the fiscal year 2019 budget request. 

Section 221 includes specific report requirements for CMS’s marketplaces activities in the fiscal year 2019 budget request. 

Section 222 continues certain Congressional notification requirements. 

Section 223 prohibits CMS Program Account from being used to 

support risk corridor payments. 

Section 224 requires HHS to submit an analysis of the impact of 

section 2713 of the PHS Act on discretionary programs. 

Section 225 directs the spending of the Prevention and Public 

Health fund. 

Section 226 prohibits funds from being used for Title X family 

planning activities. 

Section 227 continues a provision relating to breast cancer 

screening. 

Section 228 requires the NIH to continue to use existing indirect 

cost negotiated rates. 

Section 229 prevents funding of the Navigator program. 

TITLE III—DEPARTMENT OF EDUCATION 

Language is included under ‘‘General Provisions’’ allowing ESEA 

funds consolidated for evaluation purposes to be available from 

July 1, 2018 through September 30, 2019. 

165 

Language is included under ‘‘General Provisions’’ allowing certain institutions to continue to use endowment income for student 

scholarships. 

Language is included under ‘‘General Provisions’’ extending the 

authorization of the National Advisory Committee on Institutional 

Quality and Integrity. 

Language is included under ‘‘General Provisions’’ extending the 

authority to provide account maintenance fees to guaranty agencies 

for Federal student loans. 

TITLE IV—RELATED AGENCIES 

Language is included under ‘‘Federal Mediation and Conciliation 

Service—Salaries and Expenses’’ providing that fees charged for 

special training and other services and be retained and used for authorized purposes, that fees for arbitration services may only be 

used for training agency personnel, and that the Director may accept gifts and services in aid of any projects under the Director’s 

jurisdiction. 

Language is included under ‘‘National Labor Relations Board— 

Salaries and Expenses’’ prohibiting the use of funds for organizing 

or assisting in the organization of agricultural workers or for investigations, hearings, directives, or orders related to bargaining units 

of agricultural workers including employees involved in the maintenance and operations of ditches, canals, reservoirs and waterways 

for agricultural purposes. 

Language is included under ‘‘National Labor Relations Board— 

Administrative Provisions’’ prohibiting the use of electronic voting 

in representation elections. 

Language is included under ‘‘National Labor Relations Board— 

Administrative Provisions’’ prohibiting the exertion of jurisdiction 

related to Indian Tribes. 

Language is included under ‘‘National Labor Relations Board— 

Administrative Provisions’’ prohibiting the application of a new 

‘‘joint-employer’’ standard. 

Language is included under ‘‘National Labor Relations Board— 

Administrative Provisions’’ prohibiting the application of a certain 

bargaining unit standard. 

Language is included under ‘‘The Committee for Purchase from 

People Who are Blind or Severely Disabled’’ requiring that written 

agreements, with certain oversight provisions, be in place in order 

for authorized fees to be charged by certified nonprofit agencies. 

TITLE V—GENERAL PROVISIONS 

Section 501 permits the Secretaries of Labor, Health and Human 

Services, and Education to transfer unexpended balances of prior 

appropriations to accounts corresponding to current appropriations 

to be used for the same purpose and for the same periods of time 

for which they were originally appropriated. 

Section 502 prohibits the obligation of funds beyond the current 

fiscal year unless expressly so provided. 

Section 503 prohibits funds from being used to support or defeat 

legislation. 

Section 504 limits the amount available for official reception and 

representation expenses for the Secretaries of Labor and EduVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00165 Fmt 6659 Sfmt 6601 E:\HR\OC\HR244.XXX HR244
166 

cation, the Director of the Federal Mediation and Conciliation Service, and the Chairman of the National Mediation Board. 

Section 505 requires grantees receiving Federal funds to clearly 

state the percentage of the total cost of the program or project that 

will be financed with Federal money. 

Section 506 prohibits the use of funds for any abortion. 

Section 507 provides exceptions to section 506 and a provision 

prohibiting funds from being made available to a Federal agency or 

program, or to a State or local government, if such agency, program 

or government discriminates against institutional or individual 

health care entities because they do not provide, pay for, provide 

coverage of, or refer for abortions. 

Section 508 prohibits use of funds for certain research involving 

human embryos. 

Section 509 prohibits use of funds for any activity that promotes 

the legalization of any drug or substance included in schedule I of 

the schedules of controlled substances. 

Section 510 prohibits use of funds to promulgate or adopt any 

final standard providing for a unique health identifier until legislation is enacted specifically approving the standard. 

Section 511 prohibits funds to be obligated or expended on a contract with an entity that has not submitted a report on qualified 

veteran employees as required under 38 U.S.C. 4212(d). 

Section 512 prohibits any transfer of funds made available in 

this Act except by the authority provided in this Act or another appropriations Act. 

Section 513 limits funds in the bill for public libraries to those 

that comply with the requirements of the Children’s Internet Protection Act. 

Section 514 dictates the procedures for the reprogramming of any 

funds provided in the bill. 

Section 515 continues a provision pertaining to appointments to 

federal scientific advisory committees to prevent the disclosure of 

information like political affiliation of candidates for appointment. 

Section 516 requires each department and related agency funded 

through this Act to submit an operating plan within 45 days of enactment, detailing any funding allocations that are different than 

those specified in this Act, the accompanying detailed table, or 

budget request. 

Section 517 requires the Secretaries of Labor, Health and 

Human Services, and Education to submit a quarterly report to the 

Committees on Appropriations of the House of Representatives and 

the Senate containing certain information on noncompetitive contracts, grants, and cooperative agreements exceeding $500,000 in 

value. 

Section 518 prohibits use of funds to process claims for credit for 

quarters of coverage based on work performed under a Social Security number that was not the claimant’s number, where the performance of such work under such number has formed the basis for 

a conviction of the claimant of a violation of section 208(a)(6) or (7) 

of the Social Security Act. 

Section 519 prohibits use of funds to implement a Social Security 

totalization agreement with Mexico. 

Section 520 prohibits federal funds for the purchase of syringes 

or sterile needles, but allows communities with rapid increases in 

167 

cases of HIV and Hepatitis to access federal funds for other activities, including substance use counseling and treatment referrals. 

Section 521 prohibits the use of funds for the downloading or exchanging of pornography. 

Section 522 prohibits funding from going to the Association of 

Community Organizations for Reform Now (ACORN), or any of its 

affiliates, subsidiaries, allied organizations, or successors. 

Section 523 directs certain reporting requirements for conference 

expenditures. 

Section 524 requires disclosure of U.S. taxpayer funding for programs used in advertising. 

Section 525 authorizes performance partnership pilots. 

Section 526 requires quarterly reports on the status of balances 

of appropriations from the Departments of Labor, Health and 

Human Services and Education and the Social Security Administration. 

Section 527 prohibits the use of funds to implement, administer, 

enforce or further the provisions of Public Law 111–148 and portions of Public Law 111–152 with certain exceptions. 

Section 528 prohibits funds for research on fetal tissue obtained 

from an induced abortion. 

Section 529 restricts funding to certain health care entities. 

Section 532 delays obligations in the Child Enrollment Contingency Fund. 

Section 537 prohibits application of certain minimum wage requirements on Federal lands. 

APPROPRIATIONS NOT AUTHORIZED BY LAW

Pursuant to clause 3(f)(1)(B) of rule XIII of the Rules of the 

House of Representatives, the following table lists the appropriations in the accompanying bill which are not authorized by law for 

the period concerned: 

Agency Program Last Year of Authorization Authorization Level 

Appropriations in 

Last Year of Authorization 

Appropriations in 

this Bill 

DEPARTMENT OF LABOR ETA: 

Reintegration of Ex-Offenders (transition 

activities authorized by Second 

Chance Act, 2007).

FY 2010 ............... $20,000,000 ........ $15,000,000 $82,078,000 

VETERANS’ EMPLOYMENT AND TRAINING SERVICE: 

Homeless Veterans Program .................... FY 2015 ............... 50,000,000 .......... 38,109,000 47,537,000 

DEPARTMENT OF HEALTH AND HUMAN SERVICES: 

HRSA: 

Nursing Education Loan Repayment FY 2007 ............... Such Sums .......... 31,055,000 83,135,000 

Faculty Loan Repayment ................. FY 2014 ............... 5,000,000 ............ 1,187,000 1,190,000 

Scholarships for Disadvantaged 

Students.

FY 2014 ............... Such Sums .......... 44,857,000 45,970,000 

National Center for Workforce Analysis.FY 2014 ............... 7,500,000 ............ 4,651,000 4,663,000 

Primary Care Training and Enhancement.FY 2014 ............... Such Sums .......... 36,831,000 38,924,000 

Oral Health Training Programs ....... FY 2012 ............... 25,000,000 .......... 31,928,000 36,673,000 

Area Health Education Centers ....... FY 2014 ............... 125,000,000 ........ 30,250,000 30,250,000 

Education & Training—Geriatrics.

(Workforce Development) ........ FY 2014 ............... 10,800,000 .......... 33,237,000 34,737,000 

(Career Incentive Awards) ...... FY 2013 ............... 10,000,000 .......... ........................ ........................

Mental & Behavioral Health Education.FY 2013 ............... 35,000,000 .......... 7,896,000 9,916,000 

168 

Agency Program Last Year of Authorization Authorization Level 

Appropriations in 

Last Year of Authorization 

Appropriations in 

this Bill 

Nursing Workforce Development.

(Nurse Education, Practice, 

Retention, and Quality 

Grants).

FY 2014 ............... Such Sums .......... 37,913,000 128,067,000 

(Nurse Faculty Loan Program) ........ FY 2014 ............... Such Sums .......... 24,500,000 ........................

Sickle Cell ....................................... FY 2009 ............... 10,000,000 .......... 4,455,000 4,455,000 

Healthy Start ................................... FY 2013 ............... Formula ................ 100,746,000 103,500,000 

Emergency Relief—Part A .............. FY 2013 ............... 789,471,000 ........ 649,373,000 655,876,000 

Comprehensive Care—Part B ......... FY 2013 ............... 1,562,169,000 ..... 1,314,446,000 1,315,005,000 

Early Intervention—Part C ............. FY 2013 ............... 285,766,000 ........ 205,544,000 201,079,000 

Coordinated Services and Access to 

Research for Women, Infants, 

Children and Youth—Part D.

FY 2013 ............... 87,273,000 .......... 75,088,000 75,088,000 

Special Projects of National Significance—Part F.FY 2013 ............... 25,000,000 .......... 25,000,000 25,000,000 

Education and Training Centers— 

Part F.

FY 2013 ............... 42,178,000 .......... 33,275,000 33,611,000 

Dental Reimbursement—Part F ..... FY 2013 ............... 15,802,000 .......... 12,991,000 13,122,000 

Organ Transplantation .................... FY 1993 ............... Such Sums .......... 2,767,000 23,549,000 

Rural Health Outreach Grants ........ FY 2012 ............... 45,000,000 .......... 55,553,000 65,500,000 

Rural Hospital Flexibility Grants ..... FY 2012 ............... Such Sums .......... 41,040,000 43,609,000 

State Offices of Rural Health ......... FY 2002 ............... Such Sums .......... 4,000,000 10,000,000 

Telehealth ........................................ FY 2006 ............... Such Sums .......... 6,814,000 18,500,000 

CDC: 

Sexually Transmitted Diseases 

Grants.

FY 1998 ............... Such Sums .......... 113,671,000 152,310,000 

National Cancer Registries ............. FY 2003 ............... Such Sums .......... N/A 49,440,000 

National Center for Health Statistics.FY 2003 ............... Such Sums .......... 125,899,000 155,397,000 

WISEWOMEN .................................... FY 2003 ............... Such Sums .......... 12,419,000 21,120,000 

Asthma (Environmental) ................. FY 2005 ............... Such Sums .......... 32,422,000 29,000,000 

Folic Acid ......................................... FY 2005 ............... Such Sums .......... 2,188,000 3,150,000 

Injury Prevention and Control ......... FY 2005 ............... Such Sums .......... 138,237,000 286,059,000 

Oral Health Promotion ..................... FY 2005 ............... Such Sums .......... 11,204,000 18,500,000 

Safe Motherhood/Infant Health Promotion.FY 2005 ............... Such Sums .......... 44,738,000 44,000,000 

Birth Defects, Developmental Disability, Disability and Health.FY 2007 ............... Such Sums .......... 122,242,000 137,560,000 

Developmental Disabilities Surveillance and Research Program 

(Autism).

FY 2011 ............... 21,000,000 .......... 21,380,000 23,100,000 

Breast and Cervical Cancer ............ FY 2012 ............... 275,000,000 ........ 204,779,000 210,000,000 

Johanna’s Law ................................. FY 2012 ............... 18,000,000 .......... 4,972,000 5,500,000 

Epidemiology Laboratory Capacity 

Grants.

FY 2013 ............... 190,000,000 ........ 32,424,000 40,000,000 

National TB Strategy/Grants ........... FY 2013 ............... 243,101,000 ........ 132,997,000 142,256,000 

Public Health Workforce and Career 

Development.

FY 2013 ............... 39,500,000 .......... 64,000,000 45,000,000 

National Diabetes Prevention Program.FY 2014 ............... Such Sums .......... 10,000,000 25,000,000 

Section 317 Immunization .............. FY 2014 ............... Such Sums .......... 610,847,000 556,792,000 

Young Women’s Breast Health 

Awareness.

FY 2014 ............... 9,000,000 ............ 4,951,000 4,960,000 

Congenital Heart Disease Programs FY 2015 ............... Such Sums .......... 4,000,000 4,000,000 

SAMHSA: 

Treatment Systems for Homeless 

Individuals.

FY 2003 ............... 50,000,000 .......... 16,700,000 36,386,000 

AHRQ: 

Research on Health Costs, Quality, 

and Outcomes.

FY 2005 ............... Such Sums .......... 324,000,000 300,000,000 

ACF: 

Low Income Home Energy Assistance Program.FY 2007 ............... 5,100,000,000 ..... 2,161,170,000 3,390,304,000 

Children and Families Services Programs 

Adoption Awareness Programs FY 2005 ............... Such Sums .......... 12,453,000 39,100,000 

169 

Agency Program Last Year of Authorization Authorization Level 

Appropriations in 

Last Year of Authorization 

Appropriations in 

this Bill 

Adoption and Legal Guardianship Incentive Payments.FY 2016 ............... Such Sums .......... 37,943,000 37,943,000 

Native American Programs .... FY 2002 ............... Such Sums .......... 45,826,000 52,050,000 

Community Services Block 

Grant.

FY 2003 ............... Such Sums .......... 645,762,000 600,000,000 

Head Start .............................. FY 2012 ............... Such Sums .......... 7,968,544,000 9,275,000,000 

Runaway and Homeless Youth 

Programs.

FY 2013 ............... Such Sums .......... 107,852,000 119,121,000 

CAPTA programs ..................... FY 2015 ............... Such Sums .......... 143,981,000 137,174,000 

Family Violence Programs ...... FY 2015 ............... 178,500,000 ........ 139,500,000 159,750,000 

Disaster Human Services 

Case Management.

N/A ....................... N/A ....................... N/A 1,864,000 

Refugee and Entrant Assistance 

Transitional and Medical Services .. FY 2002 ............... Such Sums .......... 227,243,000 320,000,000 

Victims of Torture .................. FY 2007 ............... 25,000,000 .......... 9,817,000 10,735,000 

ACL: 

Alzheimer’s Diseases Demonstration FY 2002 ............... Such Sums .......... 11,483,000 19,500,000 

Lifespan Respite Care ..................... FY 2011 ............... 94,810,000 .......... 2,495,000 3,360,000 

Developmental Disabilities .............. FY 2007 ............... Such Sums .......... 155,115,000 162,916,000 

Voting Access for People with Disabilities.FY 2005 ............... 17,410,000 .......... 13,879,000 4,963,000 

Elder Justice/Adult Protective Services.FY 2014 ............... 129,000,000 ........ 0 11,874,000 

Assistive Technology ....................... FY 2010 ............... Such Sums .......... 25,000,000 34,000,000 

DEPARTMENT OF EDUCATION: 

Adult Education ........................................ FY 2004 ............... Such Sums .......... 590,233,000 579,195,000 

Howard University—Endowment Program FY 1985 ............... Such Sums .......... 2,000,000 3,405,000 

Institute of Education Sciences ............... FY 2009 ............... Such Sums .......... 617,175,000 459,903,000 

RELATED AGENCIES: 

Corporation for Public Broadcasting ....... FY 1996 ............... 425,000,000 ........ 275,000,000 445,000,000 

Institute of Museum and Library Services FY 2009 ............... Such Sums .......... 274,840,000 231,000,000 

National Council on Disability ................. FY 2003 ............... Such Sums .......... 3,144,000 3,200,000 

PROGRAM DUPLICATION

Pursuant to section 3(j)(2) of H. Res. 5 (115th Congress), no provision of this bill establishes or reauthorizes a program of the Federal Government known to be duplicative of another Federal program, a program that was included in any report from the Government Accountability Office to Congress pursuant to section 21 of 

Public Law 111–139, or a program related to a program identified 

in the most recent Catalog of Federal Domestic Assistance. 

DIRECTED RULE MAKING

The bill does not direct any rule making. 

COMPARISON WITH THE BUDGET RESOLUTION

Pursuant to clause 3(c)(2) of rule XIII of the Rules of the House 

of Representatives and Section 308(a)(1)(A) of the Congressional 

Budget Act of 1974, the following table compares the levels of new 

budget authority provided in the bill with the appropriate allocations under section 302(b) of the Budget Act: 

[In millions of dollars] 

302(b) Allocation This Bill 

Budget 

Authority Outlays Budget Authority Outlays 

Discretionary .................................................................................. $157,938 $170,231 $157,938 1 $168,476 

170 

[In millions of dollars] 

302(b) Allocation This Bill 

Budget 

Authority Outlays Budget Authority Outlays 

Mandatory ...................................................................................... 778,472 778,222 778,472 1 778,222 

1 Includes outlays from prior-year budget authority. 

FIVE-YEAR OUTLAY PROJECTIONS

Pursuant to section 308(a)(1)(B) of the Congressional Budget Act 

of 1974, the following table contains five-year projections prepared 

by the Congressional Budget Office of outlays associated with the 

budget authority provided in the accompanying bill: 

[In millions of dollars] 

Projection of outlays associated with the recommendation: 

2018 ................................................................................................................... 1 $847,411 

2019 ................................................................................................................... 71,432 

2020 ................................................................................................................... 18,776 

2021 ................................................................................................................... 2,909 

2022 and future years ....................................................................................... 628 

1 Excludes outlays from prior-year budget authority. 

ASSISTANCE TO STATE AND LOCAL GOVERNMENTS

Pursuant to section 308(a)(1)(C) of the Congressional Budget Act 

of 1974, the amounts of financial assistance to State and local governments is as follows: 

[In millions of dollars] 

New Budget Authority ................................................................................................. $428,675 

Fiscal year 2018 outlays resulting therefrom ............................................................ 1 425,239 

1 Excludes outlays from prior-year budget authority. 

171 


Insert offset folio 190 here HR244.001

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. I 

Date: July 19,2017 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2018 

Motion by: Ms. DeLauro 

Description of Motion: Restore ftmding for the Apprenticeship program; no offset. 

Results: Defeated 22 yeas to 29 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms. DeLauro 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms.Meng 

Ms. Pingree 

Mr. Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. W asserrnan Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr.Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Dent 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs.Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Siq~pson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
172 


Insert offset folio 191 here HR244.002

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule Xlll of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. 2 

Date: July 19,2017 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2018 

Motion by: Ms. Roybal-Allard 

Description of Motion: Restore funding for various health professions l!lld nurse training programs; no offset. 

Results: Defeated 22 yeas to 30 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms.DeLauro 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms.Meng 

Ms. Pingree 

Mr.Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. ViscloskY 

Ms. Wasserman Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr.Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Dent 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenldns 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs.Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
173 


Insert offset folio 192 here HR244.003

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. 3 

Date: July 19, 2017 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2018 

Motion by: Mr. Price 

Description of Motion: Restore funding for various teacher education programs; no offset. 

Results: Defeated 23 yeas to 29 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms.DeLauro 

Ms.Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms.Meng 

Ms. Pingree 

Mr.Pocan 

Mr. Price 

Mr. Quigley 

Mr. Rooney 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wasserman Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr.Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Dent 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs.Roby 

Mr. Rogers 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
174 


Insert offset folio 193 here HR244.004

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROIL CALL NO. 4 

Date: July 19, 2017 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2018 

Motion by: Ms. Wasserman Schultz 

Description of Motion: Increase funding for Centers for Medicare and Medicaid Services program 

management and strike certain provisions related to the Affordable Care Act; no offset. 

Results: Defeated 21 yeas to 29 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms.DeLauro 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms.Meng 

Ms. Pingree 

Mr.Pocan 

Mr. Price 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wasserman Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Dent 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
175 


Insert offset folio 194 here HR244.005

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. 5 

Date: July 19, 2017 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2018 

Motion by: Mr. Pocan 

Description of Motion: Increase the maximum Pell Grant award by $135. 

Results: Defeated 21 yeas to 29 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms. DeLauro 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms. Meng 

Ms. Pingree 

Mr.Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Members Voting Nay 

Mr. Aderholt 

Mr.Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Dent 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs.Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
176 


Insert offset folio 195 here HR244.006

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. 6 

Date: July 19,2017 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2018 

Motion by: Mrs. Lowey 

Description of Motion: Restore funding for title X family planning program and strike provision prohibiting 

such funding; no offset. 

Results: Defeated 23 yeas to 27 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms.DeLauro 

Mr. Dent 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms.Meng 

Ms. Pingree 

Mr.Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wasserman Schultz 

Members Voting Nay 

Mr.Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
177 


Insert offset folio 196 here HR244.007

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are ptinted below: 

ROLL CALL NO. 7 

Date: July 19,2017 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2018 

Motion by: Ms. DeLauro 

Description of Motion: Restore funding for SAMHSA mental health programs; no offset. 

Results: Defeated 21 yeas to 28 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms.DeLauro 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms.Meng 

Ms. Pingree 

Mr.Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wasserman Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr.Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Dent 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. FortenberrY 

Mr. Frelinghuysen 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins · 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs.Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
178 


Insert offset folio 197 here HR244.008

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. 8 

Date: July 19, 2017 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2018 

Motion by: Mr. Price 

Description of Motion: Increase funding for various senior programs; no offset. 

Results: Defeated 22 yeas to 30 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms. DeLauro 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms.Meng 

Ms. Pingree 

Mr.Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. W asserrnan Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr.Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Dent 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Mooienaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
179 


Insert offset folio 198 here HR244.009

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. 9 

Date: July 19, 2017 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2018 

Motion by: Ms. Kaptur 

Description of Motion: Require the Department of Health and Human Services to report on prescription drug 

spending. 

Results: Defeated 24 yeas to 27 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms. DeLauro 

Ms. Herrera Beutler 

Mr. Jenkins 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms.Meng 

Ms. Pingree 

Mr.Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wasserman Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Dent 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
180 


Insert offset folio 199 here HR244.010

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLLCALLNO. 10 

Date: July 19,2017 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2018 

Motion by: Ms. Wasserman Schultz 

Description of Motion: Strike section 536, related to conscience protection. 

Results: Defeated 21 yeas to 29 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Ms.DeLauro 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms.Meng 

Ms. Pingree 

Mr.Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wasserman Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr.Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Cuellar 

Mr. Culberson 

Mr. Dent 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
181 


Insert offset folio 200 here HR244.011

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. 11 

Date: July 19, 2017 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2018 

Motion by: Ms. Lee 

Description of Motion: Restore funding for Teen Pregnancy Prevention and shift funding from sexual risk 

avoidance programs to CDC school health programs. 

Results: Defeated 23 yeas to 29 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms.DeLauro 

Mr. Dent 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms.Meng 

Ms. Pingree 

Mr.Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wassennan Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr.Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs.Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
182 


Insert offset folio 201 here HR244.012

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. 12 

Date: July 19,2017 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2018 

Motion by: Ms. DeLauro 

Description of Motion: Restore funding for 21" Century Community Learning Centers program; no offset. 

Results: Defeated 21 yeas to 29 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Cartwright 

Ms.C1ark 

Mr. Cuellar 

Ms.DeLauro 

Ms.Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms.Meng 

Ms. Pingree 

Mr.Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visc!osky 

Ms. Wasserman Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr.Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Dent 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Palazzo 

Mrs.Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
183 


Insert offset folio 202 here HR244.013

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. 13 

Date: July 19,2017 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2018 

Motion by: Mrs. Lowey 

Description of Motion: Prohibit the Department of Health and Human Services from changing regulations 

related to contraception. 

Results: Defeated 22 yeas to 29 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms. DeLauro 

Ms.Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms.Meng 

Ms. Pingree 

Mr.Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wasserman Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr. Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Dent 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
184 


Insert offset folio 203 here HR244.014

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLLCALLNO. 14 

Date: July 19, 2017 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2018 

Motion by: Ms. Lee 

Description of Motion: Restore funding for various minority-serving programs; no offset. 

Results: Defeated 23 yeas to 29 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms.DeLauro 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms. Meng 

Ms. Pingree 

Mr.Pocan 

Mr. Price 

Mr. Quigley 

Mr. Rooney 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wasserman Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr.Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Dent 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
185 


Insert offset folio 204 here HR244.015

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLLCALLNO. 15 

Date: July 19, 2017 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2018 

Motion by: Mr. Ryan 

Description of Motion: Restore funding for various education programs; no offset. 

Results: Defeated 23 yeas to 29 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms.DeLauro 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms.Meng 

Ms. Pingree 

Mr.Pocan 

Mr. Price 

Mr. Quigley 

Mr. Rooney 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wassennan Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr.Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Dent 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs.Roby 

Mr. Rogers 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
186 


Insert offset folio 205 here HR244.016

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLLCALLNO. 16 

Date: July 19, 2017 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2018 

Motion by: Ms. DeLauro 

Description of Motion: Restore funding for various labor enforcement agencies; no offset. 

Results: Defeated 22 yeas to 30 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms.DeLauro 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms.Meng 

Ms. Pingree 

Mr. Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wasserman Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr.Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Dent 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Simpson 

Mr. Stewart 

Mr. taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
187 


Insert offset folio 206 here HR244.017

FULLCONrnnTTEEVOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. 17 

Date: July 19, 2017 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2018 

Motion by: Ms. Roybal-Allard 

Description of Motion: Prohibits any education funds from being spent unless title IX is implemented 

consistent with a 2011 Dear Colleague and 2014 Questions and Answers document concerning sexual 

violence. 

Results: Defeated 22 yeas to 29 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms. DeLauro 

Ms. Herrera Beutler 

Ms.Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms.Meng 

Ms. Pingree 

Mr.Pocan 

Mr. Price 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wasserman Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr.Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Dent 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
188 


Insert offset folio 207 here HR244.018

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLLCALLNO. 18 

Date: July 19, 2017 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2018 

Motion by: Ms. Clark 

Description of Motion: Strike section 529 in the bill, relating to prohibited health care entities. 

Results: Defeated 23 yeas to 28 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms.DeLauro 

Mr. Dent 

Ms. K.aptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms.Meng 

Ms. Pingree 

Mr.Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wasserman Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
189 


Insert offset folio 208 here HR244.019

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLLCALLNO. 19 

Date: July 19,2017 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2018 

Motion by: Mr. Rogers 

Description of Motion: To report the bill to the House, as amended 

Results: Adopted 28 yeas to 22 nays 

Members Voting Yea 

Mr. Aderholt 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Dent 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Yoder 

Mr. Young 

Members Voting Nay 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms.DeLauro 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms.Meng 

Ms. Pingree 

Mr.Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wasserman Schultz 

Insert offset folio 2 here 23920A.071

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

TITLE I--DEPARTMENT OF LABOR 

EMPLOYMENT AND TRAINING ADMINISTRATION 

Training and Employment Services 

Grants to States: 

Adult Training, current year. 

Advance from prior year .. 

FY 2D19 ... 

Subtota 1. 

Youth Training. 

Dislocated Worker Assistance, current year. 

Advance from prior year. 

FY 2019 .. 

Subtotal. 

Subtotal, Grants to States. 

Current Year. 

FY 2019. 

0 

NA 

D 

D 

D 

NA 

D 

FY 2017 

Enacted 

103,558 

(712,000) 

712.000 

- - --- -

815,556 873,416 

160,860 

(860,000) 

860,000 

FY 2018 

Request 

102,370 

(712,000) 

388,000 

-- -- ---

490,370 

523,667 

160,485 

(860,000) 

455,000 

... 

Bill vs. 

Bi 11 Enacted 

64,736 -38,820 

(712,000) ... 

712,000 .. 

--- -- 8-

776,736 -38,820 

831,842 ·41 ,574 

155,530 -5,330 

(860,000) ... 

860,000 ·--

-----

,. __ ... .. 

1,020,860 615,485 1,015,530 -5,330 

Bill vs. 

Request 

·37,634 

... 

+324,000 

-------- - -

+286, 366 

+308, 175 

-4,955 

---

+405,000 

- -

+400,045 

--------- ......... .. .. .............. ___________ .. _ 

2,709,832 1,629,522 2,624,108 -85,724 +994,586 

(1, 137,832) (786,522) ( 1 ' 052 . 1 08) (-85,724) (+265,588) 

(1,572,000) (843,000) (1 ,572,000) --- (+729,000) 

FF 

FF 

FF 

Insert offset folio 3 here 23920A.072

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL 

(Amounts in Thousands) 

National Programs: 

Dislocated worker Assistance National Reserve: 

Current year. - .. ''. D 

Advance from prior year. '' ... , . ''' ''' NA 

FY 2019 .................... ''' .. '.' '' D 

Subtotal . ' ... ' 

Subtotal, Dislocated Worker Assistance. 

Native American programs .. ''''.' ... '' D 

Migrant and Seasonal Farmworker programs. D 

YouthBuild activities ........... '.' ....... D 

Technical assistance. ' ... ' '.' ... ' D 

Reintegration of Ex-Offenders. . ' ' . ' ' . ' . ' ' D 

Workforce Data Quality Initiative. .. ''. ''. D 

Apprenticeship programs ... .. '•· D 

Total, National Programs. 

Current Year ..... ., ' ... ' 

FY 2019. 

FY 2017 

Enacted 20,859 

(200,000) 

200,000 

------- - --

220,859 

FY 2018 

Request 

67,000 

(200,000) 

30,000 

---

117,000 

Bi 11 

130,000 

(200,000) 

---

-- - --

130,000 

Bill vs. Bill vs. 

Enacted Request 

+109, 141 +43,000 

--- ---

-200,000 -30,000 

- M W ------ - ----

-90,859 +13,000 

------- -----. -- --- ----- -

--- --------- --- ------- ---- ------- ---- --

1,241 '719 732,485 1,145,530 -96,189 +413,045 

50,000 49,905 50,000 --- +95 

81,896 - - 72,000 -9,896 +72,000 84,534 84,373 84,534 -- +161 

2,500 5,226 --- -2,500 -5,226 

88,078 77,911 82,078 -6,000 +4' 167 

6,000 --- --- -6,000 ---

95,000 89,829 --- -95,000 -89,829 

--

·-- -- - -- -- --

628,867 424,244 418,612 -210,255 -5,632 

(428,867) (394,244) (418,612) (-10,255) (+24,368) 

(200,000) (30,000) --- (-200,000) (-30,000) 

Insert offset folio 4 here 23920A.073

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FO

(Amounts in Thousands) 

Total, Training and Employment Services (TES) .. 

Current Year ... ' ' ' ' ' . . ' ' . . ' . . ' . . . ' . . . ' . . ' . ' 

FY 2019 .. ' ... ' . . ' . ' . . . . . . 

Job Corps 

Operations ................ ...... . .. ,, D Construction, Rehabilitation and Acquisition. D 

Administration ........................ '''. D 

Total, Job Corps. .. , . . .... 

Current Year ........... . . . . . ' . 

Community Service Employment For Older Americans D 

Federal Unemployment Benefits and Allowances 

(indefinite). ''.' ''''.' M 

FY 2017 

Enacted 

* 8 • --

3,338,699 

( 1 ' 566 ' 699) 

(1,772,000) 

1 '587. 325 

84,500 

32,330 

FY 2018 

Request Bi 11 

Bill vs. 

Enacted 

---

2,053,766 3,042,720 -295,979 

(1 '180,766) (1,470,720) ( -95 '979) 

(873,000) ( 1 '572' 000) (-200,000) 

1,341 '318 1. 572' 886 -14,439 

74,857 83,000 -1,500 

32,269 32,269 -61 

Bill vs. 

Request 

-w-- -

+988,954 

(+289.954) (+699,000) 

+231 ,568 

+8, 143 

------------. ----------- w- ------------- ---.---------- --------- .. ---

1 '704, 155 1,448,444 1 '688, 155 -16,000 +239,711 

(1 '704, 155) (1,448,444) (1 ,688, 155) (-16,000) (+239,711) 

400,000 --- --- -400,000 ---

849,000 790,000 790,000 -59,000 

FF FF FF 

Insert offset folio 5 here 23920A.074

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FO

(Amounts in Thousands) 

State Unemployment Insurance and Employment 

Service Operations 

Unemployment Compensation (UI): 

State Operations ..... . 

National Activities. 

Subtotal, Unemployment Compensation 

Employment Service (ES): 

Grants to States: 

Federal Funds. 

Trust Funds. 

Subtotal, Grants to States .. 

ES National Activities. 

Subtotal, Employment Service. 

Federal Funds. 

Trust Funds. 

TF 

TF 

D 

TF 

TF 

FY 2017 

Enacted 

2. 687,600 

14,897 

* - ---

2,702,497 

21 ,413 

650,000 

FY 2018 

Request 

2,635,775 

12,000 

Bi 11 

2,665,775 

13,000 

--- -~~·~· ~~~~-~~~~-·-- ----

2, 647,775 2,678,775 

21,372 ---

394,516 ---

Bill vs. Bi 11 VS. 

Enacted Request 

-21,825 +30,000 

-1 ,897 +1 ,000 

- K K- -- -- ----

-23,722 +31 '000 

-21 ,413 -21 '372 

-650,000 -394,516 

---- ~-------- ----- -------- ------------- ----------- w-.. ----------- --

671,413 415,888 --- -671 ,413 -415,888 

19,818 19,780 19,818 --- +38 

------------- ------------- ------------- --------------

. 

------------

691,231 435,668 19,818 -671 ,413 -415,850 

(21 ,413) (21. 372) ( -21 ,413) (-21 ,372) 

(669,818) (414,296) (19,818) ( -650' 000) (-394,478) 

FF 

FF 

FF 

Insert offset folio 6 here 23920A.075

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Foreign Labor Certifications and Related Activities: 

Federal Administration. 

Grants to States 

Subtotal, Foreign Labor Certification. 

One-Stop Career Centers/Labor Market Information .. 

Total , State UI and ES. 

Federal Funds ..... 

Trust Funds 

TF TF 

D 

FY 2017 

Enacted 

48,028 

14,282 

FY 2018 

Request 

47,937 

14,255 

-- - - ----

-

-- --

62,310 62,192 67,653 67,524 

Bill 

48,028 

14,282 

------ ---- - --

62,310 

70,000 

Bi 11 vs. Bill VS. 

Enacted Request 

--- +91 

--- +27 

- -

-- -- - -- - --

--- +118 

+2,347 +2 ,476 

--------- *.-- ---------- ------------- -------------- ----------- --

3,523,691 3,213,159 2,830,903 -692,788 -382,256 

(89,066) (88,896) (70,000) (-19,066) ( 18,896) 

(3,434,625) (3,124,263) (2 ,760' 903) ( -673 ,722) ( -363' 360) 

FF 

Insert offset folio 7 here 23920A.076

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Program Administration 

Training and Employment ... 

Trust Funds ... 

Employment Security .. 

Trust Funds ..... . 

Apprenticeship Services 

Executive Direction. 

Trust Funds .. 

Total, Program Administration. 

Federal Funds .. 

Trust Funds. 

Total, Employment and Training Administration. 

Federal Funds ..... . 

Current Year. 

FY 2019. 

Trust Funds ..... . 

0 

TF 

0 

TF 

D 

D 

TF 

FY 2017 

Enacted 

62,040 

8,639 

3,440 

39,264 

36,160 

7,034 

2,079 

FY 2018 

Request 

59,960 

8,623 

3,462 

39' 189 

33,935 

7,021 

2.075 

-------•--w .. w -----------•• 

158,656 154,265 

( 108' 674) ( 104' 378) 

(49,982) (49,887) 

Bill vs. 

Bill Enacted 

61,000 -1,040 

B,623 -16 

3,440 ... 

39.189 -75 35,000 -1 '160 

7,021 -13 

2,075 -4 

---

.. 

-

- - -

-

-

-

-

.. .. 

--

-

-

156,348 -2,308 

(106,461) (-2,213) 

(49,887) (-95) 

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

9,974,201 7,659,634 8,508,126 ·1,466,075 

6,489,594 4,485,484 5,697,336 -792,258 

(4,717,594) (3,612,484) (4, 125,336) ( -592,258) 

(1,772,000) (873,000) (1,572,000) ( -200' 000) 

3,484,607 3,174,150 2,810,790 -673,817 

Bi 11 vs 

Request 

+1,040 

-22 

+1,065 

+2,083 

(+2,083) 

+848,492 

+1,211,852 

(+512,852) (+699, 000) 

-363,360 

Insert offset folio 8 here 23920A.077

COMPARATIVE STATEMENT OF NEW BUDGET {OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

EMPLOYEE BENEFITS SECURITY ADMINISTRATION (EBSA) 

Salaries and Expenses 

Enforcement and Participant Assistance 

Policy and Compliance Assistance ..... . 

Executive Leadership, Program Oversight and 

Administration. . .... 

Employee benefits security programs .. 

Total, EBSA. 

PENSION BENEFIT GUARANTY CORPORATION (PBGC) 

Pension Benefit Guaranty Corporation Fund 

Consolidated Administrative budget .. 

WAGE AND HOUR DIVISION, Salaries and Expenses .. 

OFFICE OF LABOR-MANAGEMENT STANDARDS, Salaries and 

Expenses. 

D 

D 

D 

D D 

NA 

0 

0 

FY 2017 

Enacted 

147,400 

26,901 

6,699 

181,000 

(519,506) 

227,500 

38,187 

FY 2018 

Request 

183,926 183,926 

(522,917) 

230,068 

46,634 

Bi 11 

142,067 

26,901 

6,632 

175,600 

(424,417) 

217,500 

41 '129 

Bill vs. 

Enacted 

-5,333 

-67 

-5,400 

( -95, 089) 

-10,000 

+2.942 

Bi 11 V$. 

Request 

+142,067 

+26,901 

+6,632 

-183' 926 

-8,326 

( -98,500) 

-12,568 

-5,505 

Insert offset folio 9 here 23920A.078

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

OFFICE OF FEDERAL CONTRACT COMPLIANCE PROGRAMS, 

Salaries and Expenses. 

OFFICE OF WORKERS' COMPENSATION PROGRAMS 

Salaries and Expenses. . ''''.' ..... ' .. ''' 

Trust Funds. .. ' ...... 

. '''.' 

Total, Salaries and Expenses ................. 

Federal Funds ................. 

. ' ' ' ' ' . ' 

Trust Funds .................... 

. ' ' ' . 

Special Benefits 

Federal Compensation Benefits. '' .. ''' 

Longshore and Harbor Workers' Benefits .. 

Total, Special Benefits .......... 

0 

D 

0 

TF 

M 

M 

FY 2017 

Enacted 

104,476 115,424 

2,177 

FY 2018 

Request 

88,000 

113,109 

2,173 

117,601 115,282 

( 115,424) (113, 109) 

(2, 177) (2, 173) 

217,000 217' 000 

3,000 3,000 

220,000 220,000 

Bill vs. Bill vs. 

Bi 11 Enacted Request 

94,500 -9,976 +6,500 

114,377 -1 ,047 +1 ,268 

2,173 -4 

-

---

116,550 -1 ,051 +1 ,268 

(114,377) ( -1 ,047) (+1 ,268) 

(2, 173) (-4) 

217,000 

3,000 

220,000 

Insert offset folio 10 here 23920A.079

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED lN THE BILL FOR 

(Amounts in Thousands) 

Special Benefits for Disabled Coal Miners 

Benefit Payments .. 

Administration., 

Subtotal, FY 2016 program level. 

Less funds advanced in prior year. 

Total. Current Year 

New advances, 1st quarter, FY 2019. 

Total, Special Benefits for Disabled Coal Miners 

Energy Employees Occupational Illness 

Compensation Fund 

Administrative Expenses. 

M 

M 

M 

11 

M 

FY 2017 

Enacted 

75,000 

5,319 

FY 2018 

Request 

65,000 

5,319 

Bi 11 

65,000 

5,319 

Bill vs. Bill vs. 

Enacted Request ~10,000 ~-- ~·~~u•~~ _,.,.,.,.~-.~--~ - ---~w•~"'"--~~ ~-~,.,._.,.,..._~,.- -.. --- #. 

80,319 70,319 70,319 10,000 

·19,000 ·16,000 ·16,000 +3,000 ~------ ... - ""' .. -~~---- ·~- ... -~------ .. ........ ~,._ .. ____ .. ----- - -----

61,319 54,319 54,319 -7,000 

16,000 15,000 15,000 ~1 ,000 

.. 

--

-

-

-

-

.... -"' - - ---"" ... -- ___ ,., ____ ,.., ~-~~-~-"""' ............ ~----------- 77,319 69,319 69,319 ~8,000 59,846 59,646 59,846 

Insert offset folio 11 here 23920A.080

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FO

(Amounts in Thousands) 

Black Lung Disability Trust Fund 

Benefit Payments and Interest on Advances ............. M 

Workers' Compensation Programs, Salaries and Expenses. M 

Departmental Management, Salaries and Expenses. M 

Departmental Management. Inspector General.... M 

Subtotal. Black Lung Disability .. 

Treasury Department Administrative Costs .. 

Total, Black Lung Disability Trust Fund. 

Total, Workers' Compensation Programs. 

Federal Funds. 

Current year. 

FY 2019. 

Trust Funds. 

.. M 

FY 2017 

Enacted 

302,115 

38,246 

31,994 

330 

FY 2018 

Request 

345,635 

38,246 

30,595 

330 

Bill vs. Bill vs. 

Bi 11 Enacted Request 

345,635 +43,520 

38,246 ---

30,595 -1 ,399 

330 

------------- ------------- ------------- -------------- -------------

372,685 

356 

373,041 

847,807 845,630 

(829,630) 

(16,000) 

2,177 

414,806 

356 

415,162 

879,609 877,436 

(862,436) 

(15,000) 

2,173 

414,806 

356 

415,162 

880,877 878,704 

(863,704) 

(15,000) 

2,173 

+42, 121 +42,121 +33,D70 +33,074 

(+34,074) 

( -1 ,000) 

-4 

+1 ,268 

+1 ,268 

(+1,268) 

Insert offset folio 12 here 23920A.081

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION (OSHA) 

Salaries and Expenses 

Safety and Health Standards .. 

Federal Enforcement ...... . 

Whistleblower enforcement. 

State Programs. 

Technical Support. 

Compliance Assistance: 

Federal Assistance 

State Consultation Grants. 

Training Grants ....... . 

Subtotal, Compliance Assistance .. 

Safety and Health Statistics. 

Executive Direction and Administration. 

Total. OSHA. 

0 0 

D 

0 

D 

0 

D D D 

0 

D 

FY 2017 

Enacted 

18,()00 

208,000 

17,500 

100,850 

24,469 

70,981 

59,500 

10,537 

-------

141,018 

32,900 

10,050 

FY 2018 

Request 

18,176 

207,465 

17' 383 

100,658 

24,281 

72,351 

57,665 

--

Bi 11 

18,000 

194,250 

17,500 

100,850 

24,469 

72,351 

59,500 

---

Bill YS. 

Enacted 

-13,750 

---

---

+1,370 

-

-

-10,537 

----- ---------·--- ----------- --

130,016 131,851 -9,167 

34,326 34,300 +1 ,400 

10,952 10,250 +200 

Bill YS. 

Request 

-176 

-13,215 

+117 

+192 

+188 

+1 ,835 

------------

+1,835 

-26 

-702 

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

552,787 543,257 531,470 -21 ,317 -11,787 

Insert offset folio 13 here 23920A.082

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

MINE SAFETY AND HEALTH ADMINISTRATION 

Salaries and Expenses 

Coal Enforcement, 

Metal/Non-Metal Enforcement,, 

Standards Development., 

Assessments, , , 

Educational Policy and Development. 

Technical Support,, . , , , , , , 

Program Evaluation and Information Resources (PEIR),, 

Program Administration.,. 

Total, Mine Safety and Health Administration Total, Worker Protection Agencies .. , 

Federal Funds, 

Trust Funds. , 

0 

D D D 

0 0 

0 0 

FY 2017 

Enacted 

160,000 

94,500 

4,500 

6,627 

39,320 

35,041 

17,990 

15,838 

FY 2018 

Request 

157,026 

97,875 

5,460 

7,457 

37,365 34,330 

19,169 

16,490 

Bi 11 

149,000 

91 '700 

4,500 

6,627 

39,320 

35,000 

17,990 15,838 

Bill vs 

Enacted 

-11,000 

·2,800 

·-

--

---

-41 

-

-

. 

--

Bill VS, 

Request 

-8,026 -6,175 

-960 -830 

+1 ,955 

+670 

-1 '179 

-652 

============; ============= ============= ============== 373,816 375' 172 359,975 -13,841 -15,197 ============: ============= ============= ============== ============= 

1,595,367 1 '582' 339 1,536,724 ·58,643 -45,615 

(1 ,593, 190) (1 ,580, 166) (1,534,551) (-58,639) (-45,615) 

(2, 177) (2, 173) (2, 173) ( -4) 

Insert offset folio 14 here 23920A.083

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

BUREAU OF LABOR STATISTICS 

Salaries and Expenses 

Employment and Unemployment Statistics Labor Market Information Prices and Cost of Living. 

Compensation and Working Conditions. 

Productivity and Technology. . . , . 

Executive Direction and Staff Services. 

Total, Bureau of Labor Statistics ... 

Federal Funds 

Trust Funds ..... 

OFFICE OF DISABILITY EMPLOYMENT POLICY 

Salaries and Expenses .... 

0 

TF 

0 

0 

0 

D 

D 

FY 2017 

Enacted 

208,000 

65,000 

207,000 

83' 500 

10,500 

35,000 

FY 2018 

Request 

203,878 

64,876 

209,863 

82,880 

10,798 

35,547 

Bi 11 

203,878 

65,000 

211,444 

82,880 

10,798 

35,000 

Bill vs. Bill vs. 

Enacted Request 

-4,122 

-

- +124 

+4,444 +1,581 

-820 

+298 

... -547 

============= ========:==== ============== ============= 

809,000 607,842 609,000 --. +1 '158 

544,000 542,966 544,000 --. +1,034 

65,000 84,878 65,000 ... +124 38,203 27,203 36,800 -1 ,403 +9,597 

Insert offset folio 15 here 23920A.084

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

DEPARTMENTAL MANAGEMENT 

Salaries and Expenses 

Executive Direction 

Departmental Program Evaluation .. 

Leg a 1 Services .. 

Trust Funds. . .. , 

International Labor Affairs ... 

Administration and Management .. , .. Adjudication .. 

Women's Bureau, . 

Civil Rights Activities .. Chief Financial Officer .. 

Total, Departmental Management Salaries and 

expenses .. 

Federal Funds .. 

Trust Funds .. 

D 

D 

D 

TF 

D D D D 

0 

D 

FY 2017 

Enacted 

30,250 

8,040 

121,745 

308 

86,125 

28,834 

35,000 

12,530 

6,880 

5,132 

FY 2018 

Request 

30,951 

8,025 

126,933 

308 

18,500 

23,496 

31,939 

2,925 

6,867 9,914 

Bi 11 

30,250 

8,040 

122,445 

308 

26,500 23,496 

33,561 

11,466 

6,867 9,914 

Bill vs. Bi 11 vs. 

Enacted Request 

--- -701 

--- +15 

+700 -4,488 

--- ---

-59,625 +8,000 

-5,338 ----1,439 +1,622 

-1 ,064 +8,541 

-13 

+4,782 

=====;======= ;:=========== ============= ============== 

334,844 259,858 272,847 -61,997 +12,989 

(334,536) (259,550) (272,539) (-61,997) (+12,989) 

(308) (308) (308) 

Insert offset folio 16 here 23920A.085

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Veterans Employment and Training 

State Administration, Grants. 

Transition Assistance Program. 

Federal Administration .... 

National Veterans' Employment and Training Services 

Institute ... 

Homeless Veterans Programs .. 

Total, Veterans Employment and Training 

Federal Funds.. . ... 

Trust Funds .. 

IT Modernization 

Departmental support systems. 

Infrastructure technology modernization. 

Total, IT Modernization. 

TF 

TF 

TF 

TF 

0 

D 

D 

FY 2017 

Enacted 

175' 000 

14,600 

41 ,027 

3,414 

45,000 

279,041 

45,000 

234,041 

4,898 

13.880 

18.778 

FY 2018 

Request 

174,667 

16,073 

40,410 

3,408 

45,037 

279,595 

45,037 

234,558 

4,889 

24,833 

29,722 

Bi 11 

175,000 

16,073 

42,027 

3,414 

47,537 

284,051 

47,537 

236,514 

4,889 

15,880 

20,769 

Bi 11 vs 

Enacted 

+1,473 

+1 ,000 

+2,537 

+5,010 

+2,537 

+2,473 

-9 

+2,000 

+1 ,991 

Bill vs. 

Request 

+333 

+1 ,617 

+6 

+2,500 

+4,456 

+2,500 

+1 ,956 

-8,953 

-8,953 

Insert offset folio 17 here 23920A.086

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Office of Inspector General 

Program Activities ... . 

Trust Funds ... . 

Total, Office of Inspector General .. 

Total, Departmental Management. 

Federal Funds ... 

Current Year .. 

Trust Funds. , . 

Total, Workforce Investment Act Programs 

Current Year, , 

FY 2019. 

Total, Title I, Department of Labor ..... 

Federal Funds.... . , . , , ... 

Current Year. . .. , . . . .... 

FY2019 ...... . 

Trust Funds, . 

0 

TF 

FY 2017 

Enacted 

82,061 

5,660 

FY 2016 

Request 

80' 487 

5,649 

Bill 

83,487 

5,660 

Bill vs. 

Enacted 

+1 ,426 

---

Bill VS 

Request 

+3,000 

+11 

___ ,.._. ____ ~~-~--- --~ .......... _ 

-- ~~ .... -~ .. ___ -_.,.~_.,._,. .. .,.., .. ______ --

87,721 86,136 89,147 +1,426 +3,011 

==========;== ============= ==~========== ============== ~=:========== 720,384 655,311 666,814 -53,570 +11 ,503 

480,375 414,796 424,332 -56,043 +9,536 

(480,375) ( 414 ,796) (424,332) (·56' 043) (+9,536) 

240,009 240,515 242,482 +2,473 +1,967 ~=======~~=== ============= ============= ============== ============= 

5,042,854 3,502,210 4,730,875 -311 ,979 +1,228,665 

(3,270,854) (2,629,210) (3,158,875) ( -111 ,979) (+529,665) 

(1 '772,000) (873,000) (1 ,572,000) (-200,000) {+699,000) =====~~====== ============= ============= ============== ============= 

13,667,361 11,296,656 12,121 '791 -1,545,570 +825,135 

9,875,568 7,814,942 9,001,346 -874,222 +1 '186,404 

(8,087,568) (6,926,942) {7,414,346) (-673,222) (+487,404) 

(1. 788 ,000) (888,000) (1,587,000) ( -201 ,000) (+699,000) 

3,791,793 3,481,714 3,120,445 ·671 ,348 -361,269 

Insert offset folio 18 here 23920A.087

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

TITLE II --DEPARTMENT OF HEALTH AND HUMAN SERVICES 

HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) 

Primary Health Care 

Community Health Centers 

Free Clinics Medical Malpractice 

Total, Primary Health Care. 

Health Workforce 

Training for Diversity: 

Centers of Excellence 

Health Careers Opportunity Program .... 

Faculty Loan Repayment .. 

Scholarships for Disadvantaged Students. 

Total, Training for Diversity .. 

D 

D 

D D 

0 

D 

FY 2017 

Enacted 

1,490,522 

1,000 

FY 2018 

Request 

1,488,587 

100 

Bill 

1,491,422 

100 

Bill vs. Bill vs. 

Enacted Request 

+900 +2,835 

-900 

-

. 

----- ---

.. 

-

-----

- --

-

-

-

-

-- -"-- -- ---"""-"--H .. "" "--"-" """"" " 

1 '491 '522 

21 '711 

14,189 

1 '190 

45,970 

83,060 

1,488,687 1 '491 '522 

9,711 

1 '190 

45,970 

56.871 

---

-12,000 

-14,189 

-26, 1B9 

+2,835 +9,711 

+1 '190 

+45,970 

+56,871 

Insert offset folio 19 here 23920A.088

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Training in Primary Care Medicine 

Oral Health Training. 

Interdisciplinary Community-Based Linkages: 

D 

0 

Area Health Education Centers. D 

Geriatric Programs. . . . . . . . . . . . . . D 

Menta 1 and Behavori a 1 Health . . . . . . D 

Behavioral Health Workforce Education and Training D 

Total, Interdisciplinary Community Linkages ... 

Workforce Information and Analysis. 

Public Health and Preventive Medicine programs. 

Nursing Programs: 

Advanced Education Nursing ......... . 

Nurse Education, Practice, and Retention ... 

Nursing Workforce Diversity. . ... 

Nursing Corps Scholarship and Loan Repayment 

Program.. . ......... . 

Nursing Workforce Development. Nursing Faculty Loan Program. 

Total, Nursing programs 

D 

0 

D 

D 

D 

D 

D 

D 

FY 2017 

Enacted 

38,924 

36,673 

30,250 38,737 

9,916 

50,000 

128,903 

4,663 

17,000 

64,581 

39,913 

15,343 

83,135 

26,500 

229,472 

FY 2018 

Request 

4,654 

82,977 82,977 

Bi 11 

38,924 

36,673 30,250 

34,737 

9,916 

25,000 

99,903 

4,663 

83,135 

128,067 

211,202 

Bill vs. 

Enacted 

-4,000 

-25,000 -29,000 

-17,000 

-64,581 

-39,913 -15,343 

+128,067 

-26,500 

-18,270 

Bill vs. 

Request 

+38,924 +36,673 

+30,250 

+34 ,737 

+9,916 

+25,000 

+99,903 

+9 

+158 

+128.067 

+128,225 

Insert offset folio 20 here 23920A.089

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FO

(Amounts in Thousands) 

Children's Hospitals Graduate Medical Education 

National Practitioner Data Bank. 

User Fees ... 

Total, Health Workforce. 

Maternal and Child Health 

Maternal and Child Health Block Grant 

Sickle Cell Anemia Demonstration Program. 

Autism and Other Developmental Disorders .. 

Heritable Disorders 

Healthy Start .. 

Healthy Start Initiative (PL 114-254) .. 

Universal Newborn Hearing Screening ..... 

Emergency Medical Services for Children. 

Total, Maternal and Child Health. 

Ryan White HIVIAIDS Program 

Emergency Ass1stance. 

Comprehensive Care Programs. 

AIDS Drug Assistance Program 

Early Intervention Program. 

(ADAP) (NA). 

D D 

D 

D D D 

D 

D 

D D D 

D 

D 

NA 

D 

FY 2017 

Enacted 

300,000 

18,814 

-18,814 

838,695 

641,700 

4,455 

47,099 

13,883 

103,500 

15,000 

17,818 

20,162 

863,617 

655,876 

1 '315' 005 

(900,313) 

201,079 

FY 2018 

Request 

295,000 

18,000 

-18,000 

382,631 

666,987 

128,303 

795,290 

654,629 

1,312,505 

( -898 ,602) 

204,689 

Bi 11 

300,000 

1B,OOO 

-18,000 

748,238 

641,700 

4,455 

47,099 

13,883 

103,500 

17,818 

20,162 

848,617 

655,876 

1,315,005 

(900,313) 

201,079 

8i 11 vs 

Enacted 

-814 

+814 

-90,459 

-15,000 -15,000 

Bill vs. 

Request 

+5,000 

+365,605 

-25,287 

+4,455 

+47,099 

+13,883 

-24,803 

+17,818 +20, 162 

+53,327 

+1 ,247 

+2,500 

(+1,798,915) 

-3,610 

Insert offset folio 21 here 23920A.090

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Chi 1 dren, Youth, Women, and Famn i es .. 

AIDS Dental Services. 

Education and Training Centers. 

Special Projects of National Significance. 

Total, Ryan White HIV/AIDS program 

Health Care Systems 

D 

D 

D 

D 

Organ Transplantation........... . . . . . . . . . . . . D 

National Cord Blood Inventory. . . . . . 0 

CW Bill Young Cell Transplantation program. D 

3408 Drug Pricing program/Office of Pharmacy Affairs. D 

Poison Control.. . . . . . . . . . . . . . D 

National Hansen's Disease Program. . . . . . . . . . D 

Hansen's Disease Program Buildings and Facilities. D 

Payment to Hawaii, Treatment of Hansen's.. D 

Total, Health Care Systems. 

FY 2017 

Enacted 

75,088 

13,122 

33,611 

25,000 

2,318,781 

23,549 

12,266 

22,109 

10,238 

18,846 

15, 20El 

122 

1,657 

104,193 

FY 2018 

Request 

75,088 

13.097 

2,260,006 

23,504 

11 '245 

22,067 

10,219 

18,810 

11 ,653 

1 ~853 99,351 

Bi 11 

75,088 

13,122 

33,611 

25,000 

2,318,781 

23,549 

12,266 

22,109 

10,238 

18,846 

11,653 

1,857 

100,518 

Bill vs. 

Enacted 

-3,553 

-122 

-3,675 

Bill vs. 

Request 

+25 

+33,611 

+25 ,000 

+58' 773 

+45 

+1 ,021 

+42 

+19 

+36 

+4 

+1,167 

Insert offset folio 22 here 23920A.091

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FO

(Amounts in Thousands) 

Rural Health 

Rural Outreach Grants................. D 

Rural Health Research/Policy Development.. D 

Rural Hospital Flexibility Grants. . .. .. . D 

State Offices of Rural Health.. . .. . . . . .. . . . . D 

Black Lung Clinics. . . . . . . D 

Radiation Exposure Screening and Education Program. D 

Telehealth... .. .. . .. .. .. .. .. . D 

Total, Rural Health 

Family Planning. Program Management .. 

Total, Health resources and services (HRS). 

vaccine Injury Compensation Program Trust Fund 

Post-FY 1988 Claims. HRSA Administrative expenses 

Total, Vaccine Injury Compensation Trust Fund. 

Total, Health Resources and Services 

Administration. 

D D 

M 

TF 

FY 2017 

Enacted 

65,500 

9, 351 

43,609 

10,000 

7,266 

1,834 

18,500 

FY 2018 

Request 

50,811 

5,000 

------

6,753 

1,831 

10,000 

Bi 11 

65,500 

9,351 

43,609 

10,000 

7,266 

1,834 

18,500 

------- - -- -- --- - ---

156,060 74,395 156,060 

286,479 286,479 --

154,000 151 '993 151,993 

Bill vs. 

Enacted 

---

---

---

---

------

- -

Bi 11 vs 

Request 

+14,689 

+4,351 

+43,609 

+10,000 

+513 

+3 

+8,500 

* * • • a • • • * * • - * " 

--- +81 ,665 

-286,479 -286,479 

-2,007 

-------------

------------- ------------- -------------- -------------

6,213,347 5,538,834 5,815,727 -397,620 +276,893 

240,000 268,000 268,000 +28,000 

7,750 9,200 8,250 +500 -950 

------------- ------------- ------------ ------------ -------------

247,750 277,200 276,250 +28,500 -950 

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

6,461,097 5,816,034 6,091,977 -369,120 +275,943 

Insert offset folio 23 here 23920A.092

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

CENTERS FOR DISEASE CONTROL AND PREVENTION 

Immunization and Respiratory Diseases ...... 0 

Pandemic Flu balances (Public Law 111-32). NA 

Prevention and Public Health Fund 1/ ........ NA 

--

Subtotal .. ,,,.,,' ,,,,, 

HIV/AIDS, Viral Hepatitis, Sexually Transmitted 

Diseases, and Tuberculosis Prevention. '.,' ,, ''. D 

Emerging and Zoonotic Infectious Diseases ....... D 

Prevention and Public Health Fund 1/ ... NA 

Subtotal .......................... ' ' . ' . . ' . 

Chronic Disease Prevention and Health Promotion .. 0 

Prevention and Public Health Fund 1/. NA 

Subtotal. 

FY 2017 

Enacted 

455,000 

(15,000) 

(324,350) 

FY 2018 

Request 

497,228 

---

(203,600) 

Bi 11 

470,700 

---

(273,650) 

Bill vs. Bill vs. 

Enacted Request 

+15,700 -26,528 

(-15,000) --

(-50. 700) (+70,050) ---~~~ ~««~--- ~~ ------------- -------·---· -~~~~~ ------

(794,350) (700,828) (744,350) ( -50,000) (+43,522) 

1,117,278 934,000 1 '117' 278 . -- +183,278 

532,922 377,000 499,522 -33,400 +122,522 

(52,000) (137,000) (52,000) .. - (-85,000) 

--- - -- --- ~~~~~~-·-- ~~-- -- --- --------- ------------

584,922 514,000 551 '522 -33,400 +37,522 

777,646 452' 250 703,696 -73,950 +251,446 

(337,950) (500,000) (337,950) --- (-162,050) 

---- ---- - -

.. .. 

-

.. 

-

.. ---,... ----- - ----- -------- ------------

1 '115,596 952,250 1,041,646 -73,950 +89,396 

Insert offset folio 24 here 23920A.093

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FO

(Amounts in Thousands) 

Birth Defects, Developmental Disabilities, 

Disabilities and Health .. 

Subtotal . 

Public Health Scientific Services. 

Evaluation Tap Funding. 

Subtotal 

D 

NA 

D 

NA 

Environmental Health. . . . . . . . . . . . D 

Childhood lead poisoning prevention (PL 114-254). D 

Prevention and Public Health Fund 1/... NA 

Subtotal. 

Injury Prevention and Control. 

National Institute for Occupational Safety 

Energy Employees Occupational Illness 

Compensation Program 

D 

and Health. D 

M 

FY 2017 

Enacted 

137,560 137,560 

489,397 

(489, 397) 

163,750 

35,000 

(17,000) 

215,750 286,059 

335,200 

55,358 

FY 2018 

Request 

100,000 100,000 

317,032 

(142,968) 

( 460' 000) 

157,000 157,000 

216,165 200,000 

55,358 

Bi 11 

137,560 137.560 

328,697 

(150,700) 

( 479' 397) 

142,750 

( 17' 000) 

159,750 

286,059 

325,200 

55,358 

Bill vs. 

Enacted 

-160,700 

(+150,700) 

(-10,000) 

-21,000 -35,000 

-56,000 -10,000 

Bill vs. 

Request 

+37,560 +37,560 +11 ,665 

(+7,732) 

(+19,397) 

-14,250 

(+17,000) 

+2,750 

+69,894 

+125,200 

Insert offset folio 25 here 23920A.094

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Global Health .. ........................ D 

Public Health Preparedness and Response. D Buildings and Facilities .. ....... .. ....... D 

CDC-Wide Activities and Program Support 

Prevention and Public Health Fund 1/ .. ...... NA 

Office of the Director. ......... D 

Subtotal, CDC-Wide Activities. ' .. ' .... '' 

Total, Centers for Disease Control. 

Discretionary .... Evaluation Tap Funding (NA) 

Pandemic Flu balances (Public Law 111-32) .. Prevention and Public Health Fund 1/ .. 

Total, Centers for Disease Control Program Level 

NA 

NA 

NA 

FY 2017 

Enacted 

435,121 

1,405,000 

10,000 

( 160, 000) 

113,570 

(273,570) 

FY 2018 

Request 

350,000 

1 '266' 000 

20,000 

---

105,000 

( 105' 000) 

Bi 11 

435,121 

1,450,000 

10,000 

( 160,000) 

103,570 

(263,570) 

Bi 11 vs. 

Enacted 

+45,000 

-10,000 

(-10,000) 

Bill vs. 

Request 

+85, 121 

+184,000 

-10,000 

(+160,000) 

-1 ,430 

(+158,570) 

============= ============= ============= ===;========== ============= 6,348,861 5,047,033 6,065,511 -283,350 +1 ,018,478 

6,293,503 4,991,675 6,010,153 -283,350 +1 ,018,478 

--- (142,968) (150,700) (+150,700) (+7,732) 

(15,000) --- --- (-15,000) 

(891 '300) (840,600) (840,600) (-50 ,700) 

----- -- - --

(7,255, 161) (6,030,601) (7,056,811) (-198,350) (+1 ,026,210) 

Insert offset folio 26 here 23920A.095

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FO

(Amounts in Thousands) 

NATIONAL INSTITUTES OF HEALTH 

National Cancer Institute. D National Heart, Lung, and Blood Institute... D National Institute of Dental and Craniofacial Research D National Institute of Diabetes and Digestive and 

Kidney Diseases (NIDDK). . . . . D 

Juvenile Diabetes (mandatory).. . .. . . .. NA 

Subtotal, NIDDK program level. 

National Institute of Neurological Disorders and 

Stroke....... . .. .. D 

National Institute of Allergy and Infectious Diseases. D National Institute of General Medical Sciences. D 

Evaluation Tap Funding....... . . . . . . NA 

Subtotal, NGMS program level .. 

FY 2017 

Enacted 

5,389,329 

3,206,589 

425' 751 

1,870,595 

(150,000) 

2,020,595 

1 '783, 654 

4,906,638 

1,826,395 

(824,443) 

2,650,838 

FY 2018 

Request 

4' 174' 222 

2,534,803 

320,749 

1,449,534 

(150,000) 

1,599,534 1,312,998 

3,782,670 

1,405,509 

(780,000) 

2' 185' 509 

Bill 

5, 471 '181 

3,256,521 

432,363 

1,899,733 

(150,000) 

2,049,733 

1,810,011 

5,005,813 

1,889,332 

(824,443) 

2,713,775 

Bill vs. 

Enacted 

+81,852 +49,932 

+6,612 

+29, 138 +29, 138 

+26,357 +99, 175 

+62,937 +62,937 

Bi 11 vs. 

Request 

+1 '296, 959 

+721 ,718 

+111 ,614 

+450, 199 +450, 199 

+497,013 

+1,223,143 

+483,823 

(+44,443) 

+528,266 

Insert offset folio 27 here 23920A.096

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Eunice Kennedy Shriver National Institute of Child 

Health and Human Development... D 

National Eye Institute. . . . . . . . D National Institute of Environmental Health Sciences.. D National Institute on Aging................... D National Institute of Arthritis and Musculoskeletal 

and Skin Diseases. D 

National Institute on Deafness and Other Communication 

Disorders. . . . . . . D 

National Institute of Nursing Research. . . . . . D National Institute on Alcohol Abuse and Alcoholism. D National Institute on Drug Abuse...... D National Institute of Mental Health.. . . . . . . . . . . . D National Human Genome Research Institute.. D National Institute of Biomedical Imaging and 

Bioengineering.. .. .. .. . .. .. . .. .. .. . D 

National Center for Complementary and Integrative 

Health... .. .. .. .. .. .. .. . .. . D 

National Institute on Minority Health and Health 

Disparities. D 

FY 2017 

Enacted 

1,380,295 

732,618 

714,261 

2,048,610 

557,851 

436,875 

150,273 

483,363 

1,090,853 1 ,601 ,931 

528,566 

357,080 

134,689 

289,069 

FY 2018 

Request 

1 '032' 029 

549,847 533,537 

303,541 

417,898 

325,846 

113,688 

361,356 

864,998 

1,201 '901 

399,622 

282,814 

101,793 

214,723 

Bill 

1 '401 '727 

743,881 725,387 

2,458,733 

566,515 

443,624 

152,599 

490,796 

1 '107' 497 

1,625,461 

536,774 

362,506 

136,741 

293,583 

Bill vs. 

Enacted 

+21 '432 

+11,263 

+11 '126 

+410,123 

+8,664 +6,749 +2,326 +7,433 

+16,644 

+23,530 

+8,208 +5,426 

+2,052 +4,514 

Bill vs. 

Request 

+369,698 +194,034 +191,850 

+1 '155, 192 

+148,617 +117,778 

+38,911 

+129,440 +242,499 

+423,560 +137,152 

+79,892 +34,948 

+78,860 

Insert offset folio 28 here 23920A.097

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

John E. Fogarty International Center D 

National Library of Medicine (Nltl). . .. . . D 

National Center for Advancing Translational Sciences. 0 

National Institute for Research on Safety and 

Quality3/. .. .. 0 

Office of the Director. .. .. .. .. .. .. .. . .. 0 

Common Fund (non- add) . . NA 

Gabriella Miller Kids First Research Act (Common 

Fund add) . . . . .... , . . . , . . D 

NIH Innovation Account, CURES Act2/............... D 

Buildings and Facilities... .. . .. . . ..... D 

Total, National Institutes of Health (NIH) 

(Evaluation Tap Funding). 

Total, NIH Program Level. 

FY 2017 

Enacted 

72,213 

407,510 

705,903 

1 ,665,183 

(682,856) 

12,600 

352,000 

128,863 

33,259,557 

(824,443) 

FY 2018 

Request 

373,258 

557,373 

272,000 

1,329,833 

(441,823) 

12,600 

496,000 

98,615 

25,823,557 

(780,000) 

Bi 11 

73,353 

413,848 

718,887 

1,705,248 

(682,980) 

12,600 

496,000 

128,863 

34,359,557 

(824,443) 

( 34 • 084 ' 000) ( 26. 603 ' 55 7) ( 35 ' 184' 000) 

Bill vs. 

Enacted 

+1 '140 

+6,338 

+12,964 

+40,065 

(+124) 

+144,000 

+1 '100 ,000 

Bill vs. 

Request 

+73,353 

+40,590 

+161,494 

-272,000 

+375,415 

(+241,157) 

+30,248 

+8,536,000 

(+44,443) 

(+1 ,100,000) (+8,580,443) 

Insert offset folio 29 here 23920A.098

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FO

(Amounts in Thousands) 

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES 

ADMINISTRATION (SAMHSA) 

Mental Health 

Programs of Regional and National Significance. 

Prevention and Public Health Fund 11. 

Subtotal. 

Mental Health block grant. 

Evaluation Tap Funding. 

Subtotal . 

Children's Mental Health ....... . 

Grants to States for the Homeless (PATH). 

Protection and Advocacy ............ . 

Subtotal, Mental Health. 

(Evaluation Tap Funding). 

(Prevention and Public Health Fund 1/) 

Subtotal, Mental Health program level. 

D 

NA 

D 

NA 

D 

D 

D 

FY 2017 

Enacted 

386,659 

(12,000) 

FY 2018 

Request 

277,419 

... 

398,659 

541,532 

(21 ,039) 

(562,571) 

119,026 

64,635 36,146 

277,419 

400,000 

(15, 539) 

(415,539) 

118,800 

64,512 

36,077 

Bill 

308,861 

. -. 

--

. 

-

. 

-- --

308,861 

400,000 

(21,039) 

(421 ,039) 

119,026 

64,635 36,146 

Bill vs. Bill vs. 

Enacted Request 

-77' 79B +31 ,442 

(·12,000) 

- - - - h - - • - - - - - • - -

-89,798 +31 '442 

-141 ,532 

(+5,500) 

(·141 ,532) (+5,500) 

··- +226 

-·- +123 

--- +69 

------------- ------------- -------------

-------------- -------------

1 '147' 998 896, BOB 928,668 -219,330 +31 ,860 

(21,039) (15,539) (21,039) ... (+5,500) 

(12,000) (-12,000) 

----- - -- - ---- --------

(1 '181 ,037) (912,347) (949,707) ( -231 '330) (+37,360) 

Insert offset folio 30 here 23920A.099

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands} 

Substance Abuse Treatment 

Programs of Regional and National Significance. D 

Evaluation Tap Funding,. . ' ' ' ' . NA 

Subtotal. ' ... '. ''' '''' . . .. .. . .. 

Substance Abuse block grant. '' ... '' ''' 0 

Evaluation Tap Funding. ,, '' '' '' '' .. NA 

Subtotal. block grant .. ,,, ' ... 

Subtotal, Substance Abuse Treatment. ' . . . ' ' . ' 

(Evaluation Tap Funding). ,,, ' 

Subtotal Program level,., ,, ........ ... ''' 

Substance Abuse Prevention 

Programs of Regional and National Significance. D 

FY 2017 

Enacted 

352,427 

(2,000) 

.. 

---- -- --

.. 

(354,427) 

1 '778,879 

(79,200) 

---------

(1,858,079) 

FY 2018 

Request 

339,738 

(2,000) 

Bill 

351 '427 

(2,000) 

Bi 11 vs 

Enacted 

-1,000 

Bill VS, 

Request 

+11 ,689 

---------- -·- - ----- ------------

(341 ,738) (353,427) ( -1 ,000) (+11,689) 

1 '775' 497 1 '778,879 ·-- +3,382 

(79,200) (79,200) 

------------- ----

.. .. .. .. 

-

.. 

----

-

----

------

-----

(1,854,697) (1 ,858,079) ... (+3,382) 

-- -----

-

.... 

-

---

-

-----

-- ---

.. 

-

-- -- -------------- ----------. 

2,131 '306 2,115,235 2,130,306 ·1,000 +15,071 

(81 ,200) (81 ,200) (81,200} --- . --

(2,212,506) (2, 196,435) (2,211,506) ( ·1 ,000) (+15,071) 

223,219 149,703 165,373 -57,846 +15,670 

Insert offset folio 31 here 23920A.100

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 ANO BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Health Surveillance and Program Support ... , .... '' D 

Evaluation Tap Funding (NA). ' ... NA 

Subtotal ........ '' .. ',,' 

Total, SAMHSA. . . . ' . . ' ' ' . . ' 

(Evaluation Tap Funding). 

(Prevention and Public Health Fund 11) .. 

Total, SAMHSA Program Level. ''. ,, ' ' . . . ' 

AGENCY FOR HEALTHCARE RESEARCH ANO QUALITY (AHR0)3/ 

Healthcare Research and Quality 

Research on Health Costs, Quality, and Outcomes: 

Federal Funds. ' . ' . . ' . . ' . ' . . ''' .. D 

Medical Expenditures Panel Surveys: 

Federal Funds. ' ... '' ,, ''.' ,, . ' 0 

Program Support: 

Federal Funds. ..... ' .. ' '''' 0 

Total, AHRQ (Federal funds)31. 

Total, Public Health Service {PHS) appropriation 

Total, Public Health Service Program Level. 

FY 2017 

Enacted 

116,830 

(31,428) 

FY 2018 

Request 

108,922 

(23,426) 

Bi 11 

108,922 

(23,426) 

Bill vs. Bi 11 VS. 

Enacted Request 

-7,908 

(-8,002) 

---------

- -.. .. - - - - - - ...... - • N 8 - ------------- . ----------- .. 

148' 258 132,348 132,348 -15,910 

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

3,619,353 3,270,668 3,333,269 -286,084 +62,601 

(133,667) (120, 165) ( 125, 665) ( -8, 002) (+5,500) 

(12,000) --- --- ( 12,000) 

. 

-

.. 

-- - -

... 

-

------- - ____ .,.,.. ........ 

----

--

----- ------ -

(3,765,020) {3,390,833) (3,458,934) ( -306' 086) (+68, 101) 

187' 156 - - 167,156 -20,000 +167' 156 

66,000 --- 66,000 ·-- +66,000 

70,844 --· 66,844 -4,000 +66,844 

-------------

--- ---------

-------------

.. 

-------------

324,000 --- 300,000 ·24,000 +300,000 

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

50,012,868 39,957,292 50,150,314 +137,446 + 1 0 . 193 ' 022 

(51 '889' 278) (41,841,025) (52,091,722) (+202,444) (+10,250,697) 

Insert offset folio 32 here 23920A.101

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUOGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

CENTERS FOR MEDICARE AND MEDICAID SERVICES 

Grants to States for Medicaid 

Medicaid Current Law Benefits. . . , . , M 

State and Local Administration. . , , . , M 

Vaccines for Children. ,, ....... , . . . , . . . .. , . M 

Subtota 1 , Medicaid Program Leve 1 ... 

Less funds advanced in prior year.,..... M 

Total, Grants to States for Medicaid .. ,. 

New advance, 1st quarter, FY 2019 .. M 

Payments to Health Care Trust Funds 

Supplemental Medical Insurance., ... ... '' .... M 

Federal Uninsured Payment. ,.,,. ' .. ''. ,,,,, M Program Management, ... •' ''''' ......... 11 

General Revenue for Part D Benefit. ... ' ... ' M General Revenue for Part D Administration .......... M 

HCFAC Reimbursement. ... '.'' ,, .. , ...... M 

State Low-Income Determination for Part 0. ,, , ,,, . M 

Total, Payments to Trust Funds, Program Level. 

FY 2017 

Enacted 

354,223,901 

18,975,984 

4,386,584 

FY 2018 

Request 

384,608,394 

20,811,084 

4,598,358 

Bi 11 

384,608,394 

20.811,084 

4,598,358 

Bill vs, 

Enacted 

+30,384,493 

+1,835,100 

+211,774 

Bill vs. 

Request 

.. ______ ., .. ------------ --- .. 

--

.. 

------

377,586,469 410,017,836 410,017,836 +32,431,367 

-115' 582,502 -125,219,452 -125,219,452 ·9,636,950 

.. ,.. --- M .... ., ... - --. - - -----

262,003,967 284,796,384 284,798,384 +22' 794' 417 

125,219,452 134,847,759 134,847,759 +9,628,307 

214,944,000 245,396,000 245,396,000 +30,452,000 

147,000 132,000 132,000 ·15,000 

877,500 1 '104,000 1 '104,000 +226,500 

82,512,000 76,133,000 76,133,000 -6,379,000 

405,000 422,000 422,000 +17 ,000 

299,000 307,000 307,000 +8,000 

3,200 3,300 3,300 +100 

--

-- --- -

--

.. 

----

--

---- --

.. .. .. .. .. "' ---- ----- ........ _ ---------

299,187 '700 323,497,300 323,497,300 +24,309,600 

Insert offset folio 33 here 23920A.102

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Program Management 

Research, Demonstration, Evaluation. Program Operations. . ... 

State Survey and Certification. . .... . 

Federal Administration. . ...... . 

Total, Program management 

Health Care Fraud and Abuse Control Account 

Centers for Medicare and Medicaid Services. 

HHS Office of Inspector General. 

Medicaid/CHIP.. . ... 

Department of Justice .. 

Total, Health Care Fraud and Abuse Control. 

Total, Centers for Medicare and Medicaid Services 

Federal funds .. 

Current year. 

New advance, FY 2019 

Trust Funds. 

TF TF 

TF TF TF TF TF 

TF 

FY 2017 

Enacted 20,054 

2,519,823 

397,334 732,533 

FY 2018 

Request 

18,054 

2,441,274 

406' 135 

722,533 

Bi 11 

---

2,341,274 

397,334 712,533 

Bill vs. Bi 11 VS. 

Enacted Request 

-20,054 18,054 

-178,549 -100,000 

--- -8,801 

-20,000 -10,000 

------------- -------------

3,669,744 3,587,996 3,451 '141 -218,603 -136,855 

486,936 536,145 486,936 --- -49,209 

82,132 74,246 82,132 --- +7,886 82,132 74,246 82,132 -- +7,886 

73,800 66,363 93,800 +20,000 +27,437 

------------- ------------- ------------- -------------- -------------

725,000 751 ,000 745,000 +20,000 -6,000 

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

690,805,863 747,482,439 747,339,584 +56,533,721 -142,855 686,411,119 743' 143' 443 743,143,443 +56,732,324 

(561,191 ,667) (608,295,684) (608,295,684) (+47, 104,017) 

(125,219,452) (134,847,759) (134,847,759) ( +9 ' 628' 307) 

4,394,744 4,338,996 4, 196,141 -198,603 -142,855 

Insert offset folio 34 here 23920A.103

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

ADMINISTRATION FOR CHILDREN AND FAMILIES (ACF) 

Payments to States for Child Support Enforcement and 

Family Support Programs 

Payments to Territories ..... 

Repatriation .. 

Subtotal. 

Child Support Enforcement: 

State and Local Administration .. 

Federal Incentive Payments. 

Access and Visitation 

Subtotal, Child Support Enforcement, .. 

Total, Family Support Payments Program Level. 

M 

M 

M 

M 

M 

Less funds advanced in previous years .... , M 

Total, Family Support Payments, current year. 

New advance, 1st quarter, FY 2019. M 

FY 2017 

Enacted 

33,000 

1,000 

34,000 

3,680,840 

585,791 

10,000 

FY 2018 

Request 

33' 000 

1,000 

34,000 

3,763,200 

588,200 

10,000 

Bi 11 

33,000 

1,000 

34,000 

3,763,200 

588,200 

10,000 

Bill vs 

Enacted 

+82,360 

+2,409 

Bill VS, 

Request 

* .. ......... 

4,276,631 4,361,400 4,361,400 +84,769 

--

.... 

-------

.... .. 

- --- ----- -

...... ., 

-

,. .... 

------

.. -* .. -

4,310,631 4,395,400 4,395,400 +84,769 

-1,300,000 -1,400,000 ·1 ,400,000 ·100,000 

.... _______________ .. __ 

-----------

.,_ ....... 

3,010,631 2,995,400 2,995,400 ·15,231 

1,400,000 1,400,000 1,400,000 

Insert offset folio 35 here 23920A.104

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Low Income Home Energy Assistance (LIHEAP) 

Formula Grants ..... 

Refugee and Entrant Assistance 

Transitional and Medical Services. 

Refugee Support Services .. 

Victims of Trafficking .. 

Social Services ..... . 

Preventive Health. 

Targeted Assistance. 

Unaccompanied Minors .. 

Victims of Torture ... 

Total, Refugee and Entrant Assistance .... 

D 

D D 

D 

D 

D 

0 

D D 

FY 2017 

Enacted 

3,390,304 

490.000 

18,755 

155,000 

4,600 

47,601 

948,000 

10,735 

1,674,691 

FY 2018 

Request 

320,000 

159,321 

18,719 

948,000 

10,715 

1 '456' 755 

Bill 

3,390,304 

320,000 

175,321 

18,755 

498,000 

10,735 

-- --

1 ,022,811 

Bill vs. 

Enacted 

-170,000 

+175,321 

---

-155,000 

-4,800 

-47,601 

-450,000 

-651,880 

Bill vs. 

Request 

+3,390,304 

+16,000 

+36 

-450,000 

+20 

-433,944 

Insert offset folio 36 here 23920A.105

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FO

(Amounts in Thousands) 

Payments to States for the Child Care and Development 

Block Grant. . . . . . . . . . . . . . . . . . . . . . . D 

Social Services Block Grant (Title XX) .. M 

Children and Families Services Programs 

Programs for Children, Youth and Families: 

Head Start, current funded. 0 

Preschool Development Grants . . . . . D 

Consolidated Runaway, Homeless Youth Program. D 

Prevention Grants to Reduce Abuse of Runaway Youth D 

Child Abuse State Grants. .. .. . .. . .. D 

Child Abuse Discretionary Activities. . .. .. D 

Community Based Child Abuse Prevention. . . .. . D 

Child Welfare Services. 

Child Welfare Training, Research, or Demonstration 

projects. . .... 

Adoption Opportunities. 

Adoption Incentive grants. 

D 

D 

D 

D 

FY 2017 

Enacted 

2,856,000 

1,700,000 

9,253,095 

250,000 

101 ,980 

17' 141 

25,310 

33,000 

39,764 

268,735 

17,984 

39,100 

37,943 

FY 2018 

Request 

2,761,000 

9,168,095 

101,786 

17' 108 

25,262 

32,937 

39,688 

268,224 

17,950 

30,072 

37,871 

Bill 

2,860,000 

1,700,000 

9,275,000 

250,000 

101 '980 

17' 141 

25,310 

33,000 

39,764 

268,735 

17,984 

39,100 

37,943 

Bill vs. 

Enacted 

+4,000 

+21 ,905 

Bill vs. 

Request 

+99.000 

+1 ,700, 000 

+106,905 

+250,000 

+194 

+33 

+48 

+63 

+76 

+511 

+34 

+9,028 

+72 

Insert offset folio 245 here HR244.020

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Social Services and Income Maintenance Research ....... D 

Native American Programs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 

Community Services: 

Community Services Block Grant Act programs: Grants to States for Community Services ....... D 

Economic Development ........................ D 

Rural Community Facilities .................... D 

Subtotal, Community Services .. . ''''' ..... ,, '' 

Domestic Violence Hotline ............................. D 

Family Violence/Battered Women's Shelters ............. D 

Chafee Education and Training Vouchers ........... .... 0 

Disaster Human Services Case Management ............... 0 

Program Direction .............. ', ....... ' ...... , .... D 

Total , Chi 1 dren and Families Services Programs .. 

FY 2017 

Enacted 

6,512 

52,050 

715,000 

19,883 

7,500 

FY 2018 

Request 

6,500 

49,905 

---

--

---

Bi 11 

6,512 

52,050 

600,000 

10,000 

7,500 

-~-w----~~~--

.,,.,.,..,.M~•~-••• 

____ .,,..,.,.,,.~~-

742,383 --- 617,500 

8,250 8,250 8,750 

151,000 151,000 151,000 

43,257 43,175 43,257 

1,864 1,860 1,864 

205,000 204,610 194,610 

Bill vs. Bill vs. 

Enacted Request 

--- +12 

--- +2, 145 

-115,000 +600,000 

-9,883 +10,000 

--- +7,500 

w ...... ---- ...... "' .. --------··--

-124,883 +617,500 

+500 +500 

--- ---

--- +82 

--- +4 

-10,390 -10,000 

~~~M-~-------

-------------

~----~-----~-

--- -------· -------------

11 ,294, 368 10,204,293 11 '181 ,500 -112,868 +977,207 

Insert offset folio 38 here 23920A.107

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Promoting Safe and Stable Families. M 

Discretionary Funds ..... ' ' . . ' ' ' ' D 

Total, Promoting Safe and Stable Families. 

Payments for Foster Care and Permanency 

Foster Care. ,,, . ''.'. ..... M 

Adoption Assistance .. ''.' '' .... M 

Guardianship .. '' ... ...... , . '''' '' ',., ... ' M 

Independent Living ..................... ''' ,, M 

Total, Payments to States. '''' .. ' ... ' 

Less Advances from Prior Year ......... .... M 

Total, payments, current year. ' .. ' ...... '' 

New Advance, 1st quarter, FY 2019. . . . ' . . M 

Total, ACF. ' ' . . . . . . . . ' . ' ' ' . . . . ' . . . . ' 

Current year .. ''.' 

FY 2019. ' ... ' . . .. ''' ' .... 

Total, ACF Program Level. ' .. '.' 

--

FY 2017 

Enacted 

325,000 

59,765 

- k -

384,765 

4,992,000 

2,780,000 

152,000 140,000 

FY 2018 

Request 

345,000 

59,651 

., .. ________ 

-

404,651 

5,537,000 

2,867,000 

181,000 140,000 

---- -- --

.. 

--

--- ---

-

8,064,000 8,725,000 

-2,300,000 -2,500,000 

Bill vs. Bill vs. 

Sill Enacted Request 

325,000 -20,000 

59,765 +114 

.............. 

----

.. 

384,765 -·· -19,886 

5,537,000 +545,000 

2,867,000 +87,000 

181,000 +29,000 

140,000 

---

.. .. .. 

------ ·--

8,725,000 +661 ,000 

-2,500,000 -200,000 

. 

------------ ---

... ---.. ---- ------ ---....... -.... -.. - - ----- - -----

5,764,000 6,225,000 6,225,000 +461 ,000 

2,500,000 2,700,000 2,700,000 +200,000 

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

33,974,759 28,147' 099 33,859,780 ·114,979 +5,712,681 

(30,074,759) (24,047,099) (29 ,759' 780) ( -314,979) (+5,712,681) 

(3,900,000) (4, 100,000) (4, 100,000) (+200,000) 

------

.,. ____ --------- -

_______ ,._, ___ 

---------

33,974.759 28,147' 099 33,859,780 -114,979 +5,712,681 

Insert offset folio 39 here 23920A.108

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

ADMINISTRATION FOR COMMUNITY LIVING 

Aging and Disability Services Programs 

Grants to States: 

Home and Community-based Preventive Health .. 

Protection of Vulnerable 

Supportive Services. D 

...... D 

Older Americans-Title VII D 

Subtotal . 

Family Caregivers .... D 

Native American Caregivers Support D 

Subtotal, Caregivers 

Nutrition: 

Congregate Meals .. D 

Home Delivered Meals .... D 

Nutrition Services Incentive Program .. D 

Subtotal. 

Subtotal, Grants to States. 

FY 2017 

Enacted 

350,224 

19,848 

20,658 

FY 2018 

Request 

347,063 

19,810 

20,619 

Bill 

350,224 

19,848 

20,658 

Bill vs. Bill vs. 

Enacted Request 

+3, 161 

--- +38 

-.- +39 

-

.. ____________ .. 

----

-

. 

390,730 387,492 390,730 --- +3,238 

150,586 150,300 150,586 +286 

7,556 7,517 7,556 --- +39 

---- - ----- ----------- - ------------- ---- ---------

158,142 157,817 158,142 --- +325 

450,342 447,490 450,342 +2,852 

227,342 225,912 227,342 --- +1,430 

160,069 159,765 160,069 --- +304 

------ * 

--- ---

-

---

.... 

-- ------

837,753 833' 167 837,753 --· +4,586 

--

-

--- --- -

.. 

----- -- --

...... 

-

---

--

---

--

-------·---

-

1 '386 ,625 1,378,476 1,386,625 ·-- +8, 149 

Insert offset folio 40 here 23920A.109

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FO

(Amounts in Thousands) 

Grants for Native Americans 

Aging Network Support Activities. 

Alzheimer's Disease Demonstrations. 

Prevention and Public Health Fund 1/. 

Lifespan Respite Care. . .... 

Chronic Disease Self-Management Program .. 

Prevention and Public Health Fund 1/. 

Elder Falls Prevention. . ............ . 

Prevention and Public Health Fund 1/. 

Elder Rights Support Activities. 

Aging and Disability Resources ....... . 

Senior Community Service Employment Program. 

State Health Insurance Program ...... . 

Paralysis Resource Center ....... . Limb loss .. , ......... . 

Traumatic Brain Injury. 

D 

D D 

NA 

D 

D 

NA 

D 

NA 

D 

D 

D 

TF 

D 

0 

D 

FY 2017 

Enacted 

31,208 

9,961 

4,800 

(14,700) 

3,360 

---

(8,000) 

---

(5,000) 

13,874 

6.119 

---

47,115 

6,700 

2,500 

9.321 

FY 2018 

Request 

31 ,099 

9,942 

19,490 

3,354 

5,000 5,000 

11 ,851 

6,107 

3,162 

Bi 11 

31,208 

9,961 

19,500 

---

3,360 

5,000 

--

5,000 

---

11,874 

6,119 

300,000 

---

6,700 

2,500 

9, 321 

Bill vs. 

Enacted 

+14,700 

(-14,700) 

---

+5,000 

(-8,000) 

+5,000 

(-5,000) 

-2,000 

---

+300,000 

-47' 115 

Bill vs. 

Request 

+109 

+19 

+10 

+6 

+23 +12 

+300,000 

+6, 700 

+2,500 

+6, 159 

Insert offset folio 41 here 23920A.110

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Developmental Disabilities Programs: 

Partnerships for Innovation, Inclusion, and 

Independence. 

State Councils .. _ .... 

Protection and Advocacy ...... . 

Voting Access for Individuals with Disabilities. 

Developmental Disabilities Projects of National 

Significance .. 

University Centers for Excellence in Developmental 

Disabilities......... . ........ . 

Subtotal, Developmental Disabilities Programs. 

Workforce Innovation and Opportunity Act 

Independent Living. . ......... . 

National Institute on Disability, Independent 

Living, and Rehabilitation Research ... . 

Assistive Technology.. . ................ . 

Subtotal, Workforce Innovation and Opportunity 

Act. 

D 

D 

D D D 

D 

D D 

D 

D 

D 

FY 2017 

Enacted 

73,000 38,734 

4,963 

10,000 

38,619 

-

. 

--

.,., " '" ----

165,316 

101 '183 

103,970 

34,000 

FY 2018 

Request 

45,000 

38,660 

4,954 

7,600 

38,546 

--

134,760 

78,156 

95,127 

31,939 

Bi 11 

---

73,000 

38,734 

4,963 

7,600 

38,619 

---------- --

162,916 

101,183 

103,970 

34,000 

Bill vs. Bill vs. 

Enacted Request 

--- -45,000 --- +73,000 

. .. +74 

. 

- +9 

-2,400 

--· +73 

- - - - - - - - - - - M - - - - - - - -

·2,400 +28, 156 

. .. +23,027 

... +8,843 ... +2,061 

------*------ ---------- ------

__ .... _. 

--------- -----------

239,153 205.222 239' 153 +33,931 

Insert offset folio 42 here 23920A.111

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Program Administration. 

Total, Administration for Community Living (ACL) 

Federal funds. . ... 

Trust Funds.......... . .... 

(Prevention and Public Health Fund 1/). 

Total, ACL program level .. 

OFFICE OF THE SECRETARY 

General Departmental Management 

D 

General Departmental Management, Federal Funds.. D 

Teen Pregnancy Prevention Community Grants.. D 

Evaluation Tap Funding. . . . . . . NA 

Subtotal, Grants. 

FY 2017 

Enacted 

40,063 

1 ,966,115 

(1 ,919,000) 

(47,115) 

(27 ,700) 

1,993,815 

199,620 

101 ,000 

(6,800) 

(107,800) 

FY 2018 

Request 

37,987 

1 '851 '450 

(1,851,450) 

1,851,450 

203,500 

Bi 11 

37,987 

2,237,224 

(2,237,224) 

2,237,224 

199,620 

Bill vs. 

Enacted 

·2,076 

+271 '109 

(+318,224) 

( -47' 115) 

(-27,700) 

+243,409 

-101 ,000 

( -6,800) 

(-107,800) 

Bill vs. 

Request 

+385,774 

(+385,774) 

+385,774 

-3,880 

Insert offset folio 43 here 23920A.112

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Faith-Based Center. ... ' ''' ,,., .. 

Sexual Risk Avoidance .. '.''' .. 

Minority Health. . ' . ' ' ' . . . ' . . . . . 

Office of Women's Health .. 

Minority HIVIAIOS prevention and treatment ...... 

Embryo Adoption Awareness Campaign. 

Planning and Evaluation, Evaluation Tap Funding 

Total, General Departmental Management ...... 

Federal Funds .. ..... ... ,, 

(Evaluation Tap Funding). ' . . . . . . ' . . ..... 

Total, General Departmental Management Program. 

Office of Medicare Hearings and Appeals. . ' ... 

D 

D 

D 

D 

D D 

NA 

TF 

FY 2017 

Enacted 

1 ,299 

15,000 

56,670 

32,140 

53,900 

1 ,000 

(58,028) 

---- ---

. 

-

.. 

--

460,629 

(460,629) 

(64,828) 

. -. ... 

525,457 

107,381 

FY 2018 

Request 

1 ,299 

10,000 

56,562 

32,140 

1 ,000 

(57,465) 

Bill 

1,299 

20,000 

45,250 

25,712 

---

1 ,000 

(57,465) 

Bill vs. Bill vs. 

Enacted Request 

+5,000 +10,000 

-11 ,420 -11,312 

-6,428 -6,428 

-53,900 

--· 

( ·563) 

··-------

_____ ........... 

-------------

304,501 292,881 -167,748 ·11,620 

(304,501) (292,881) (·167,748) (-11,620) 

(57 ,465) (57,465) ( -7,363) 

-

--

-----

--- -

_____ .... 

---

·-

361 '966 350,346 ·175,111 -11,620 

117' 177 112.381 +5,000 -4,796 

Insert offset folio 44 here 23920A.113

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Office of the National Coordinator for Health 

Information Technology.,,., .. . '. '' .. ''''''. ''. '''' D 

Office of Inspector General 

Inspector General Federal Funds. .. , ..... '. 0 

HCFAC funding (NA),., .... ''' ,,,. . ........ NA 

Total, Inspector General Program Level ... ,.,, 

Office for Civil Rights 

Federal Funds. '''' .. ' D 

FY 2017 

Enacted 

60,367 

80,000 

(334,097) 

FY 2018 

Request 

38,381 

68,085 

---

Bill 

38,381 

80,000 

---

------ ------ ---------

(414,097) (68,085) (80,000) 

38,798 32,530 38,798 

Bill vs, 

Enacted 

-21,986 

---

(-334,097) 

-·-------

......... 

( -334,097) 

_,-

Bill vs, 

Request 

+11 ,915 

------·-·-

(+11 ,915) 

+6,268 

Insert offset folio 45 here 23920A.114

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands} 

Retirement Pay and Medical Benefits for 

Commissioned Officers 

Retirement Payments ....... ... ' ... '' .. ''.'' ''. M 

Survivors Benefits . . . . . . . M 

Dependents' Medical Care. '''' '' .. ' M 

Total ,Medical Benefits for Commissioned Officers 

Public Health and Social Services Emergency Fund 

(PHSSEF) 

Assistant Secretary for Preparedness and Response 

Operations. ... '' ..... ' ...... D 

Preparedness and Emergency Operations. . . ' . . D 

National Disaster Medical System. .. ... 0 

Hospital Preparedness Cooperative Agreement Grants: 0 

Formula Grants. '''. ' .. ' .. ' '''' .. 0 

Biomedical Advanced Research and Development D 

Authority (BARDA). . ' ' . ' ' .... D 

Policy and Planning. . ,, ' .. '' .... ' ... '' ,, . D 

Project BioShield. ' ..... . ' .. . .... D 

Subtotal, Preparedness and Response. D 

FY 2017 

Enacted 

457,459 

31,559 

141 '390 

FY 2018 

Request 

456,266 

31,583 

130,840 

Bill vs. 

Bi 11 Enacted 

456,266 -1 '193 

31,583 +24 

130,840 -10,550 

--

- -~~~~-~ ~~~~••••8ww•• ww••••• ---

630,408 618,689 618,689 -11,719 

30,938 30,879 30,938 ---

24,654 24,607 24,654 ---

49,904 49,809 49,904 ---

254,555 227,201 254,555 --

511,700 511,700 520,000 +8,300 

14,877 14,849 14,877 ... 

510,000 510,000 530,000 +20,000 ~~¥~*~~8 ~~~~-~~-- --- ---

1 '396, 628 1,369,045 1 '424, 928 +28,300 

Bill vs. 

Request 

- - -

+59 

+47 

+95 

+27,354 

+8,300 

+28 

+20,000 ~www•~~~w~- +55,883 

Insert offset folio 46 here 23920A.115

COMPARATIVE STATEMENT OF NEW BUOGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Assistant Secretary for Administration D 

Assistant Secretary for Administration, Cybersecurity. D 

Office of Security and Strategic Information. D 

Public Health and Science D 

Medical Reserve Corps ......... ,. ,, ., .... '''' D 

Pandemic Influenza Preparedness ..... 0 

Pandemic Flu balances (Public Law 111-32)., ... NA 

Subtotal, Pandemic Influenza Preparedness .... 0 

Subtotal, Non-pandemic flul8ioShield/Parklawn/Other 

construction, .... ,,, '' ,, ... D 

Total, PHSSEf., .... .......... ',,.' 

Account for the State Response to the Opioid Abuse 

Crisis, CURES Act2/. ''' ,, ' .. '' .. '' D 

FY 2017 

Enacted 

50,860 

7,470 

6,000 

57,000 

(15,000) 

FY 2018 

Request 

73,263 

7,456 

5,989 

206,863 

--

Bi 11 

50,860 

7,470 

6,000 

250,000 

Bi 1l vs. Bill vs. 

Enacted Request 

--- -22,403 

--- +14 

--- +11 

+193,000 +43, 137 

(-15,000) 

., • .,.~~~-~~~ .. ,.,.. ... ~---~-~,. .. "•••-w- --w-~ .......... w ..... ~-- _____ , .. ______ 

72,000 206,863 250,000 +178,000 +43, 137 

-~. .. ..,.-- __ ,.._.,. .......... _,....,..~ .. ~--- .. -- ---~ .... ___ ..,. ____ ----------~-- 950,958 945,753 959,258 +8,300 +13,505 

--M"'"'""' ---- -------·--- --~ ...... __________ .,.,. .. ,. .. .,. __ 

- -----· .... -~--- 1,517,958 1,862,616 1 '739, 258 +221 ,300 +76,642 

500,000 500,000 500,000 

Insert offset folio 47 here 23920A.116

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Total, Office of the Secretary ... 

Federal Funds .. . 

Trust Funds ..... . 

(Evaluation Tap Funding). 

Total, Office of the Secretary Program Level Total, Title II, Health and Human Services. 

Federal Funds. 

Current year .. 

FY 2019. 

Trust Funds. 

Total, Pandemic Flu balances (Public Law 111-32) 

Total, Prevention and Public Health Fund 1/. 

Title I! Footnotes: 

11 Sec.4002 of Public Law 111-148 

21 21St Century CURES Act (Public Law 114-255); FY2017 

funds provided in Public Law 114-254 

3/ FY2018 budget request proposes consolidating the 

Agency for Healthcare Research and Quality within 

the National Institutes of Health as the National 

Institute for Research on Safety and Quality 

FY 2017 

Enacted 

FY 2018 

Request Bi 11 

Bill vs. Bill vs. 

Enacted Request 

=========z=== ============= ============= 

3,395,541 3,341,979 3,420,388 +24,847 +78,409 

3,288,160 3,224,802 3,308,007 +19,847 +83,205 

107' 381 117,177 112,381 +5,000 -4,796 

(64,828) (57,465) (57,465) ( -7' 363) 

---

- ------- - ---

- - - - -

.,_ 

- - 8 ¥ 8 • -- - -- - - - - - -

----

3,475,369 3,399,444 3,477,853 +2,484 +78,409 

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

780,155,146 820,780,259 837,007.290 +56,852, 144 +16,227,031 775,598,156 816,314,866 832,690,518 +57,092,362 +16,375,632 

(646,478,704) (677,367,127) (693,742,759) (+47,264,055) (+16,375,632) 

(129,119,452) (138,947,759) (138,947,759) (+9,828,307) ---

4,556,990 4,465,373 4,316,772 -240,218 -148,601 

(30,000) --- --- (-30,000) 

(931,000) (840,600) (840,600) (·90,400) 

Insert offset folio 48 here 23920A.117

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

TITLE III · DEPARTMENT OF EDUCATION 

EDUCATION FOR THE DISADVANTAGED 

Grants to Local Educational Agencies (LEAs) 

Basic Grants: 

Advance from prior year. 

Forward funded .. 

Current funded. 

Subtotal, Basic grants current year approp .. Subtotal, Basic grants total funds available 

Basic Grants FY 2019 Advance. 

Subtotal, Basic grants, program level. 

Concentration Grants: 

Advance from prior year. 

FY 2019 Advance 

Subtotal. 

NA 

D 

D D 

NA 

D 

FY 2017 

Enacted 

(2,390,776) 

4,613,625 

5,000 

FY 2018 

Request 

(1 ,840, 776) 

2,733,460 

466,100 

Bi 11 

(1,840,776) 

4,613,625 

5,000 

Bill vs. Bill vs. 

Enacted Request 

(-550,000) 

... +1 ,880,165 ... -461 '100 

------

-

--- - .. ------- ------.------

4,618,625 3, 199,560 4,618,625 ... +1 ,419,065 

(7,009,401) (5,040,336) (6,459,401) ( -550' 000) (+1 ,419,065) 

, '840, 776 3,231,497 1 '840, 776 ... 1,390,721 

.. ------ -

.. 

------ --------- --- ---------- --- --

6,459,401 6,431,057 6,459,401 ... +28,344 

(1,362,301) (1,362,301) (1,362,301) 

1 '362' 301 1,362,301 1,362,301 

-- ----

.. 

---- ------- ------------- ----- ------- ---------

1,362,301 1 '362' 301 1,362,301 

FF 

Insert offset folio 49 here 23920A.118

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Targeted Grants: 

Advance from prior year. 

FY 2019 Advance. 

Subtotal. 

Education Finance Incentive Grants: 

Advance from prior year. 

FY 2019 Advance 

Subtotal 

Subtotal, Grants to LEAs, program level .. 

FOCUS Grants (ESIA-I-E). 

NA 

D 

NA 

0 

Innovative Approaches to Literacy 0 

Comprehensive literacy development 

State Agency Programs: 

grants .... .. D 

Migrant ................. . 0 

Neglected and Delinquent/High Risk Youth.. D 

Subtotal, State Agency programs. 

FY 2017 

Enacted 

(3,544,050) 

3,619,050 3,819,050 

(3,544,050) 

3,819,050 3,819,050 

15,459,802 

27,000 

190,000 

374,751 

47,614 

FY 2018 

Request 

(3,819,050) 

3,544,050 3,544,050 

(3,819,050) 

3,544,050 

3,544,050 

15,881,458 

1,000,000 

374,039 

47,523 

Bi 11 

(3,819,050) 

3,819,050 3,819,050 

(3,619,050) 

3,819,050 

Bi 11 vs 

Enacted 

(+275,000) (+275,000) 

. 

--

------

- -

- --

-

-

.... ,. .. . 

-

3,819,050 

Bill vs. 

Request 

+275,000 +275,000 +275,000 

------------

+275,000 

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

15,459,802 ... -421 '656 

-1,000,000 

27,000 -·· +27,000 

-190,000 ... 

374,751 . .. +712 

47,614 --- +91 

.............. 

--- - --

.... -... .. .. 

---

_____ .. ____ 

------

422,365 421,562 422,365 +603 

FF 

FF 

FF 

Insert offset folio 50 here 23920A.119

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Migrant Education: 

High School Equivalency Program., 

Total, Education for the disadvantaged 

Current Year. 

FY 2019 ...... 

Subtotal, Forward Funded. 

IMPACT AID 

Basic Support Payments. ''' .. ' Payments for Children with Disabilities. .. '. Faci 1 Hies Maintenance (Sec. 8008) .. '.'. 

Construction (Sec. 8007) .... ' ... ' ,,, .. 

Payments for Federal Property (Sec. 8002) 

Total, Impact aid, .. ' .... 

0 

D 

D 

D D 

D 

FY 2017 

Enacted 

44' 623 

FY 2018 

Request 44,538 

Bill 

44,623 

Bi 11 vs 

Enacted 

---

Bill vs. 

Request 

+85 

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

16,143,790 16,347,558 15,953,790 -190,000 -393,768 

(5,302,613) (4,665,660) (5,112,613) (-190,000) (+446,953) 

(10,841 ,177) (11 ,681 ,898) (10,841 '177) --- ( -840,721) 

(5,225,990) ( 3 ' 155 ' 022) (5,035,990) (-190,000) (+1,880,968) 

1' 189,233 1 '166,012 1 '194,233 +5,000 +28,221 

48,316 48,224 48,316 --- +92 

4,835 4,826 4,835 --- +9 

17,406 17,373 17,406 --- +33 

68,813 --- 68,813 ·-· +68,813 

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

1 '328, 603 1,236,435 1,333,603 +5,000 +97' 168 

Insert offset folio 51 here 23920A.120

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FO

(Amounts in Thousands) 

SCHOOL IMPROVEMENT PROGRAMS 

Supporting Effective Instruction State Grants.. . ... D 

Advance from prior year .......................... NA 

FY 2019. ''''' .. ' .. . ... '' D 

Subtotal, Supporting Effective Instruction 

State Grants, program level <' ,,, 

Supplemental Education Grants ....... . . . ' ' ' . . ' D 

21st Century Community Learning Centers. '' "''. 0 

State Assessments. ''' ' .. . ' ' ' ' 0 

Education for Homeless Children and Youth D 

Training and Advisory Services (Civil Rights). D 

Education for Native Hawaiians. 0 

Alaska Native Education Equity ... '' ' .. '.' .... 0 

Rural Education ....... ' . . ' . . . . . . . . . D 

Comprehensive Centers. ''' ... . ' ' . . . D 

Student Support and Academic Enrichment grants. D 

Total, School Improvement Programs ... 

Current Year. .... ''' ' .. ''' ..... ',,'' 

FY 2019. ...... ' .... ' 

Subtotal, Forward Funded. . . . ' . . . 

FY 2017 

Enacted 

374,389 

(1 ,681 ,441) 

1,681,441 

--- -

...... 

--

2,055,830 

16,699 

1' 191 ,673 

369,100 

77,000 

6,575 

33,397 32,453 

175,840 

50,000 

400,000 

FY 2018 

Request 

---

(1 '681 '441) 

---

Bill 

---

(1 ,681,441) 

Bill vs. 

Enacted 

-374,389 

---

-1,681 ,441 

------- ------ - -------------

--- --- -2,055,830 

16,667 16,699 ---

--- 1,000,000 -191 ,673 

377,281 369,100 

69,867 77,000 ---

6,563 6,575 ---

--- 33,397 ------ 32,453 --

175,506 175,840 --

51,347 50,000 ---

--- 500,000 +100,000 

Bi 11 VS, 

Request 

------------

+32 

+1,000,000 

-8,181 

+7' 133 

+12 

+33,397 +32,453 

+334 

1 ,347 

+500,000 

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

4,408,567 697.231 2,261,064 -2.147,503 +1 ,563,833 

(2 ,727' 126) (697,231) (2,261,064) ( -466,062) (+1 ,563,633) 

(1 ,681 ,441) --- ( -1 ,681,441) ---

(2,588,002) (622,654) ( 2 ' 121 . 940) ( -466,062) (+1 ,499,286) 

FF 

FF FF FF 

FF FF 

Insert offset folio 52 here 23920A.121

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

INDIAN EDUCATION 

Grants to Local Educational Agencies .. 

Federal Programs: 

Special Programs for Indian Children. 

National Activities ..... . 

Subtotal, Federal Programs. 

Total, Indian Education 

INNOVATION AND IMPROVEMENT 

D 

D D 

Education Innovation and Research, .... ,,, D 

American History and Civics Academies. 0 

American History and Civics National Activities.. 0 

School Leader Recruitment and Support . . . . . . . .. . . . 0 

Charter Schools Grants..... .. . .. .. .. D 

Magnet Schools Assistance.. . . . . . . . ..... , . D 

Teacher and School Leader Incentive Grants. . . . . D 

Ready-to-Learn Television.. 0 

Supporting Effective Educator Development (SEED).. D 

Arts in Education. .. .. .. .. D 

FY 2017 

Enacted 

100,381 

57,993 

6,565 

FY 2018 

Request 

100,190 

37,921 

5,554 

·--------- --

.. 

64,558 43,475 

Bill vs. 

Bi 11 Enacted 

100,381 --· 

57,993 ... 

6,565 

Bi 11 vs 

Request 

+191 

+20,072 

+1 ,011 

- ------

----------

-----------

64,558 . .. +21,083 

===========;; ======;====== ============= ============== ============= 

164,939 143,665 164,939 ... +21 ,274 

100,000 370,000 ... -100,000 -370,000 

1,815 --- -- -1,815 ---

1 '700 -.- 1 '700 +1,700 

14,500 ... --- 14,500 

342,172 500,000 370,000 +27,828 -130,000 

97,647 96,463 96,463 -1 '184 ---

200,000 199,563 200,000 ··- +437 

25,741 --- 25,741 +25 .741 

65,000 42,000 42,000 -23,000 

27,000 ... -27,000 

Insert offset folio 53 here 23920A.122

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Javits Gifted and Talented Students .......... '. ,, '' 0 

Total, Innovation and Improvement ...... 

Current Year. ... ' 

SAFE SCHOOLS AND CITIZENSHIP EDUCATION 

Promise Neighborhoods. '' .. ' ' ' . . ' 0 

School Safety National Activities .............. D 

Full-Service Community Schools. . ' ... ' ... ' D 

Total, Safe Schools and Citizenship Education. 

ENGLISH LANGUAGE ACQUISITION 

Current funded. .. ' ... ' ······················· D 

Forward funded. . . , ... ' >' ' •• D 

Total, English Language Acquisition. 

FY 2017 

Enacted 

12,000 

FY 2018 

Request Bill 

12,000 

Bill vs. Bi 11 vs. 

Enacted Request 

.. +12,000 

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

887,575 1,208,026 747,904 -139,671 -460' 122 

(887,575) ( 1 '208' 026) (747,904) ( -139,671) ( -460, 122) 

73,254 60,000 60,000 ·13,254 

68,000 74,857 68,000 --- -6,857 

10,000 10,000 --- +10,000 

============= ============= ============= =========::::: ============= 

151,254 134,857 138,000 -13,254 +3, 143 

47,931 47,840 47,931 ... +91 

689,469 688,158 689,469 ... +1 '311 

============= =====:======= =============: ============= 

737,400 735,998 737,400 ··- +1 '402 

FF 

Insert offset folio 54 here 23920A.123

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FO

(Amounts in Thousands) 

SPECIAL EDUCATION 

State Grants: 

Grants to States Part B current year ...... D 

Part B advance from prior year. NA 

Grants to States Part 8 (FY 2019) .. > ••••••• D 

Subtotal, program level. ......... ' . . . . . . . . ' 

Preschool Grants ... ''' ... ' '.'' '. . ''. '''' ''' D 

Grants for Infants and Families. '. '''''' 0 

Subtotal, program level. '.' .... ' .. 

IDEA National Activities (current funded): 

State Personnel Development .. D 

Technical Assistance and Dissemination (including 

Special Olympics Education) ....... D 

Personnel Preparation. ' ..... ' ... ' D Parent Information Centers. '' ... ' D 

FY 2017 

Enacted 

2,719,465 

(9,283,363) 

9,283,383 

FY 2018 

Request 

1,766,099 

(9,283,383) 

10,124,103 

-- ----

12,002,648 11,890,202 

368,238 367,538 

458,556 457,684 

Bi 11 

1 '036, 024 

(9,283,383) 

11,184,824 

- -- ---- -

12,202,848 

368,238 

458,556 

Bill vs. Bi 11 vs. 

Enacted Request 

-1 ,681 ,441 -728,075 

--- ---

+1 ,881,441 +1 ,040, 721 

---

- 8 - -

+200 ,000 +312,646 

--- +700 

--- +872 

- - - 4 W A -- - - - - - - - - - - - - - - - - - - - - - - - W - W W - - - - - - - - - - w - -- - - - - W - - - W - - 4 - - - -

12,829,642 12,715,424 13,029,642 +200,000 +314,218 

38,630 41 ,551 38,630 --- -2,921 

56,928 44,261 44,261 -12,667 

83,700 83,541 83,700 +159 

27,411 27,359 27,411 --- +52 

FF 

FF FF 

Insert offset folio 55 here 23920A.124

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

EducationalTechnology, Media, and Materials. ...... D 

Subtotal, IDEA National Activities .......... 

Total, Special education. 

Current Year. '' .... . ..... ''''' 

FY 2019. '''.'.''' ''' '''' ''. 

Subtotal, Forward Funded ...................... 

REHABILITATION SERVICES 

Vocational Rehabilitation State Grants. '' .. ' M 

Client Assistance State grants. . . . . ' . . D 

Training. D 

Demonstration and Training programs ...... D 

Protection and Advocacy of Individual Rights (PAIR). D 

Supported Employment State grants. .. ''. ''. ''. D 

Independent Living: 

Services for Older Blind Individuals. D 

Helen Keller National Center for Deaf/Blind Youth and D 

Adults .... ... ''' .. '' D 

Total, Rehabilitation services. 

--- --

FY 2017 

Enacted 

28,047 

-· 

234,716 

FY 2016 

Request 

29,990 

--- -----

226,702 

Bill vs. Bill vs. 

Bill Enacted Request 

28,047 --- -1 ,943 

---- -

---- ------- ----- -- ---

222,049 -12,667 -4,653 

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

13,064,358 12,942,126 13,251,691 +187,333 +309,565 

(3,780,975) (2,818,023) (2,086,867) ( -1 ' 694 ' 1 08) ( -731 '156) (9,283,383) (10, 124, 103) ( 11 ' 164 ' 824) (+1 ,881,441) (+1 ,040.721) 

(3,546,259) (2,591 ,321) (1 ,864,818) ( -1 ,681 ,441) (-726,503) 

3, 398,554 3,452,931 3,452,931 +54,377 

13,000 12,975 13,000 --- +25 

29,388 30,131 29,388 --- -743 

5, 796 5,7B5 5,796 -- +11 

17,650 17,616 17,650 --- +34 

27,548 --- --- -27,548 

33,317 33,254 33,317 --- +63 

10,336 10,316 10,500 +164 +184 

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

3,535,589 3,563,008 3,562,582 +26,993 -426 

Insert offset folio 56 here 23920A.125

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FO

(Amounts in Thousands) 

SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES 

American Printing House for the Blind......... D 

National Technical Institute for the Deaf (NTID): 

Operations. . . . . . . . . . . . . . . . . . . . . D 

Gallaudet University: 

Operations.... . . . . . . .. D 

Total, Special Institutions for Persons with 

Di sabi 1 it i es. 

CAREER, TECHNICAL, AND ADULT EDUCATION 

Career Education: 

Basic State Grants/Secondary & Technical Education 

State Grants, current funded. . . . . . . . . . . . 0 

Advance from prior year. . . . . . . . . . NA 

FY 2019. .. . .. . .. . .. . .. .. . .. .. D 

Subtotal, Basic State Grants, program level. 

National Programs. D 

Subtotal, Career Education. 

FY 2017 

Enacted 

25,431 

70,016 

121.275 

216,722 

326,598 

(791,000) 

791.000 

1 '117,598 

7,421 

1 '125, 019 

FY 2018 

Request 

25.383 

69.883 

121 '044 

216,310 

158,499 

(791,000) 

791,000 

949,499 

27,407 

976.906 

Bill 

26,431 

70,016 

128,000 

224,447 

326,598 

(791,000) 

791,000 

1 '117 ,598 

7,421 

1 ,125, 019 

Bill VS. 

Enacted 

+1 ,000 

+6,725 

+7,725 

Bi 11 vs 

Request 

+1 ,048 

+133 

+6,956 

+8, 137 

+168,099 FF 

+168,099 

-19,986 FF 

+148, 113 

Insert offset folio 57 here 23920A.126

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Adult Education: 

State Grants/Adult Basic and Literacy Education: 

State Grants, current funded .. 

National Leadership Activities. 

Subtotal, Adult education. 

Total, Career, Technical, and Adult Education. 

Current Year ..... . 

FY 2019. 

Subtotal, Forward Funded. 

STUDENT FINANCIAL ASSISTANCE 

Pell Grants --maximum grant (NA) .... Pell Grants. 

Federal Supplemental Educational Opportunity Grants .. 

Federal Work Study. 

Total, Student Financial Assistance (SFA). 

D D D 

NA 

0 

0 

D 

FY 2017 

Enacted 

581,955 

13,712 

FY 2018 

Request 

485' 849 

13,686 

.. 

595,667 499,535 

Bill vs. Bill vs. 

Bill Enacted Request 

581,955 --- +96, 106 

13,712 --- +26 

--- ----

595,667 --- +96, 132 

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

1,720,686 1,476,441 1,720,686 +244,245 

(929,686) (685,441) (929,686) --- (+244,245) 

(791 '000) (791 ,000) (791,000) --- ---

(929,686) (685,441) (929,686) -- (+244,245) 

(4,860) (4,860) (4,860) 

22,475,352 22,432,626 22,475,352 +42,726 

733,130 --- 733,130 +733, 130 

989,728 500,000 989,728 -- +489.728 

===;========= ============= ============= ============== ============= 24,198,210 22,932,626 24,198,210 --- +1,265,584 

FF FF 

Insert offset folio 58 here 23920A.127

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FO

(Amounts in Thousands) 

STUDENT AID ADMINISTRATION 

Salaries and Expenses . . . . . . ' .. . . ' ' . D 

Servicing Activities. .... '' ., .. D 

Total, Student Aid Administration .... 

HIGHER EOUCATION 

Aid for Institutional Development: 

Strengthening Institutions. ' .... D 

Hispanic Serving Institutions. . ' ...... D 

Promoting Post-Baccalaureate Opportunities for D 

Hispanic Americans. ........... ········ D 

Strengthening Historically Black Colleges (HBCUs). D 

Strengthening Historically Black Graduate D 

Institutions ........ ' .... ' 0 

Strengthening Predominantly Black Institutions. D 

Asian American Paci fie Islander ...... ' .. '' D 

Strengthening Alaska Native and D 

Native Hawaiian-Serving Institutions. D 

Strengthening Native American-Serving Nontribal D 

Institutions. D 

Strengthening Tribal Colleges. . ...... D 

Strengthening HBCU Masters programs. D 

Subtotal, Aid for Institutional development. 

FY 2017 

Enacted 

696,643 

880,211 

FY 2018 

Request 

680,711 

1 '017' 000 

Bi 11 

680,711 

1, 017' 000 

Bill vs. Bi 11 vs. 

Enacted Request 

-15,932 

+136,789 ========~==== ==========~== ============= ============== ============= 

1,576,854 1,697,711 1 ,697' 711 +120,857 

86,534 --- 86,534 --- +86,534 

107,795 107,590 107,795 --- +205 

9,671 9,653 9,671 +18 

244,694 244,229 244,694 +465 

63,281 63,161 63,281 --- +120 

9,942 9,923 9,942 --- +19 

3,348 3,342 3,348 --- +6 

13,802 13,776 13,802 --- +26 

3,348 3,342 3,348 +6 

27,599 27,547 27,599 +52 

7,500 7,500 --- +7,500 

-- ~~~~~~~~~- ~~ ---------- ------------~ -~w-~-~-~--~-- -------------

577,514 482,563 577,514 --- +94,951 

Insert offset folio 59 here 23920A.128

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FO

(Amounts in Thousands) 

International Education and Foreign Language: 

Domestic Programs. 

Overseas Programs,. 

Subtotal, International Education & Foreign Lang 

Postsecondary Program for Students with Intellectual 

Oi sabil it ies, , , , , . , , , , , . , , . , , , , , , .. 

Minority Science and Engineering Improvement, 

Tribally Controlled Postsec Voc/Tech Institutions., 

Federal TRIO Programs, 

GEAR UP., 

Graduate Assistance in Areas of National Need .. 

Teacher Quality Partnerships., , . , , . ,, .. , , , ,, 

Child Care Access Means Parents in School,,, 

Total, Higher Education. 

Academic Program. 

Endowment Program. 

HOWARD UNIVERSITY 

Howard University Hospital .. , 

Total, Howard University, 

0 

0 

D 

0 0 

D D 

0 0 0 0 

0 

D D 

FY 2017 

Enacted 

65,103 

7,061 

.. 

----- --

72,164 

11,800 

9,648 6,286 

950,000 

339,754 

28,047 

43,092 

15,134 

FY 2018 

Request 

---

---

-

... .... 

--

-

--

---

11 '778 

9, 630 

8,270 

808,289 

219,000 

5, 775 

------

Sill 

65,103 

--

Bill vs, 

Enacted 

-7,061 

Bi 11 vs, 

Request 

+65' 103 

.. ... w .. • .. ........ - - -

------

-- --

65,103 -7,061 +65, 103 

11,800 +22 

9,648 +18 

8,286 --- +16 

1,010,000 +60,000 +201 '711 

350,000 +10,246 +131 ,000 

5,775 -22,272 

--- -43,092 

--- -15,134 

============= ============= =======;====== ============= 

2,055,439 1 '545, 305 2,038,126 -17,313 +492, 821 

191,091 190,721 191,091 +370 

3,405 3,405 3,405 --· ---

27,325 27,273 27,325 --- +52 

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

221 ,821 221,399 221 '821 --- +422 

Insert offset folio 60 here 23920A.129

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

COLLEGE HOUSING AND ACAOEMIC FACILITIES LOANS PROGRAM. 0 

HISTORICALLY BLACK COLLEGE AND UNIVERSITY (HBCU) 

CAPITAL FINANCING PROGRAM ACCOUNT 

HBCU Federal Administration. HBCU Loan Subsidies. 

Total. HBCU Capital Financing Program 

INSTITUTE OF EDUCATION SCIENCES (IES) 

Research. Development and Dissemination. 

Statistics.. . .............. . 

Regional Educational Laboratories .. . 

Research in Special Education. 

Special Education Studies and Evaluations. 

Statewide Data Systems. 

Assessment: 

National Assessment. 

National Assessment Governing Board .. 

Subtotal, Assessment .. 

Total, IES. 

D 

D 

D 

D 

D D D 

D D 

D 

D D 

FY 2017 

Enacted 

435 

334 

20,150 

FY 2018 

Request 

434 

333 

20,112 

Bi 11 434 

333 

20,112 

Bi 11 vs. Bill vs. 

Enacted Request 

-1 

-1 

-38 

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

20,484 20,445 20,445 -39 

187,500 194,629 187,500 --- -7' 129 

109,500 111,787 109,500 --- -2,287 

54,423 54,320 54,423 --- +103 54,000 53,897 54,000 . .. +103 

10,818 10,797 10,818 --- +21 

32,281 34,473 32,281 --- -2,192 

149,000 148,717 149,00D --- +283 

7,745 8,219 7,745 --- -474 

-

.. 

-

. 

- - -

-----------

----- ---

--------

-- -------.- -

156,745 156,936 156,745 --· -191 

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

605,267 616,839 605,267 . .. -11 '572 

Insert offset folio 61 here 23920A.130

COMPARATIVE STATEMENT Of NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FO

(Amounts in Thousands) 

DEPARTMENTAL MANAGEMENT 

Program Administration: 

Salaries and Expenses. 

Building Modernization. 

Total, Program administration .. 

Office for Civil Rights ..... Office of Inspector General 

Total, Departmental management. Total, Title III, Department of Education. 

Current Year. . ........ . 

FY 2019 .. 

D 

0 

D 

D 

FY 2017 

Enacted 

431 '000 

1,000 

432,000 

108,500 

59,256 

599,756 

71,637,749 

(49,040,748) 

(22,597,001) 

FY 2018 

Request 

438,000 

... .. 

438,000 

106,797 

61 '143 

Bill vs. 

Bi 11 Enacted 

431,000 ·--

-1 ,000 

___ ., ___ .. _ 

431 '000 1,000 

108,500 ---

59,256 ---

Bill vs. 

Request 

-7,000 

--

.. 

----

-7,000 

+1,703 

-1,887 

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

605,940 598,756 -1 ,000 -7' 184 

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

66,342,354 69,476,876 -2,160,873 +3, 134,522 

(43,745,353) (46,679,875) ( -2' 360 '873) (+2,934,522) 

(22,597,001) (22 ,797' 001) (+200,000) (+200,000) 

Insert offset folio 62 here 23920A.131 CQ~PARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FO

(Amounts in Thousands) TITLE IV--RELATED AGENCIES COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY DISABLED. CORPORATION FOR NATIONAL AND COMMUNITY SERVICE Operating Expenses Domestic Volunteer Service Programs Volunteers in Service to America (VISTA). National Senior Volunteer Corps: Foster Grandparents Program. Senior Companion Program. Retired Senior Volunteer Program. Subtotal, Senior Volunteers Subtotal, Domestic Volunteer Service .. D D D D 0 FY 2017 Enacted 8,000 92,364 107' 702 45,512 48,903 FY 201B Request 6,117 4,910 117 117 117 Bi 11 8,000 92,364 107,702 45,512 48,903 Bill vs. Bill vs. Enacted Request +1 .883 --- +87,454 --- +107,585 -- +45,395 --- +48,786 ~----------- ----------- - ~~~~ .. ~~· -·-&~~-- -- ------------ 202,117 351 202,117 +201 ,766 - -- ~w-~-~~ ~-------- - -- #------ - - - - - - - .. - - .. - w - - --- 294.481 5,261 294,481 --- +289,220 

Insert offset folio 63 here 23920A.132

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

National and Community Service Programs: 

AmeriCorps State and National Grants. D 

Innovation, Assistance, and Other Activities. D 

Evaluation. .. ... D 

National Civilian Community Corps (NCCC)(subtitle 

E). . . ' . ' . . D 

State Commission Support Grants ...... D 

Subtotal, National and Community Service. 

Total, Operating expenses. ' ..... , ' 

National Service Trust ''.' ''' '' D 

Salaries and Expenses. . '' .. . . . . . ' ' D 

Office of Inspector General. . . . .. .. '' .. D 

Total, Corp. for National and Community Service. 

FY 2017 

Enacted 

386,010 

5,000 

4,000 

30,000 

16,538 

441,548 

FY 2018 

Request 

2,341 

---

---

24,087 

---

--

26,428 

Bill vs. Bi 11 vs. 

8i 11 Enacted Request 

386,010 --- +383,669 

5,000 --- +5,000 

4,000 --- +4,000 

30,000 --- +5,913 

16,538 --- +16,538 

- - --- --

441 '548 --- +415, 120 

------------- ------------- ------------- --------------

-------------

736,029 31,689 736,029 --- +704,340 

206,842 --- 206,842 --- +206,842 

81,737 99,735 81,737 --- -17,998 

5,750 3,588 5,750 -- . +2, 182 

;;::;;;;;;;:; ;;;;;;;;;;;;; ============== ============= 

1,030,358 134,992 1,030,358 -- +895,366 

Insert offset folio 64 here 23920A.133

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FO

(Amounts in Thousands) 

CORPORATION FOR PUBLIC BROADCASTING 

FY 2020 (current) with FY 2018 comparable. ,,,0 

FY 2019 advance with FY 2017 comparable (NA) .. NA 

Rescission of FY 2019 funds (NA). NA 

Subtotal, FY 2019 program level. 

FY 2018 advance with FY 2016 comparable (NA). NA 

Rescission of FY 2018 funds (NA) .......... NA 

Subtotal, FY 2018 program level ........ ' .... 

Public television interconnection system (current) D 

FY 2017 

Enacted 

445,000 

(445,000) 

---

FY 2018 

Request 

---

(445,000) 

(·445,000) ~-~ --~ ~--~~----~w~~ 445,000 ---

(445,000) (445,000) 

( -441 '500) 

Bi 11 

445,000 

(445,000) 

---

--------· .. ~~ -~-~-~ 445,000 

(445,000) 

Bi 11 vs. Bill vs. 

Enacted Request 

--- +445,000 

--- ---

-·- (+445,000) 

- - - - -- - - • N -

.. 

... +445,000 

--- (+441,500) 

----------

.. 

-------- ------ ~--- ------------- ----------

445,000 3,500 445,000 --· +441,500 

50,000 --- ... -50,000 

Insert offset folio 65 here 23920A.134

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

FEDERAL MEDIATION AND CONCILIATION SERVICE. D FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION. D 

INSTITUTE OF MUSEUM AND LIBRARY SERVICES. D 

MEDICAID AND CHIP PAYMENT AND ACCESS COMMISSION. 

MEDICARE PAYMENT ADVISORY COMMISSION. TF 

NATIONAL COUNCIL ON DISABILITY. D NATIONAL LABOR RELATIONS BOARD. '''' '' .. ' D NATIONAL MEDIATION BOARD. ''' .. D 

OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION. D 

RAILROAD RETIREMENT BOARD 

Dual Benefits Payments Account. ' ' ' . . . . . . ''' ... ' D 

Less Income Tax Receipts on Dual Benefits. D 

Subtotal, Dual Benefits. 

Federal Payments to the Railroad Retirement Accounts. M 

Limitation on Administration. ''' .. ' TF Limitation on the Office of Inspector General., TF 

FY 2017 

Enacted 

46,650 

17,184 

231,000 

7,765 

11,925 

3,250 

274,224 

13,800 13,225 

25,000 

-2,000 

FY 2018 

Request 

48,655 

17,053 

23,000 

6,700 

12,295 

3,211 

258,000 

13,205 12,615 

22,000 

-1,000 

Bill 

46,650 

17,134 

231 '000 

7,500 

12,175 

3,200 

249,000 

13,500 12,875 

22,000 

-1,000 

Bill vs. 

Enacted 

-50 

---

-265 

+250 

-50 

-25,224 

-300 -350 

-3,000 

+1 ,000 

Bi 11 VS, 

Request 

-2,005 

+81 

+208,000 

-1 ,200 

-120 

-11 

-9,000 

+295 +260 

-----.------- ------------- ------------- -------------- -------------

23,000 21,000 21,000 -2,000 

150 150 150 

113,500 111 '225 113,500 +2,275 

10,000 6,437 10,000 --- +1 ,563 

D 

Insert offset folio 66 here 23920A.135

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

SOCIAL SECURITY ADMINISTRATION 

Payments to Social Security Trust Funds. 

Supplemental Security Income Program 

Federal Benefit Payments. Benefic1ary Services. Research and Demonstration .. 

Afghanistan Special Immigrant Visa. Administration. 

Subtotal, SSI program level ... 

Less funds advanced in prior year. 

Subtotal, regular SSI current year. 

M 

M M 

M 

M 

0 

M 

New advance, 1st quarter, FY 2019.. M 

Total, SSI program. 

FY 2017 

Enacted 

11 ,400 

52,941,736 

89,000 

58,000 

---

5,029,427 

FY 2018 

Request 

11 ,400 

48,236,000 

159,000 

101 ,000 

- -

5,060,526 

Bill 

11,400 

48,236,000 

159,000 101,000 

---

5,095,635 

Bill vs. Bill vs. 

Enacted Request 

-4,705,736 

+70,000 

+43,000 

--- ---

+66' 208 +35,109 

------------- ------------- -•----- •----- -------------- -- •------. M--

58,118,163 53,556,526 53,591,635 -4,526,528 +35' 109 

-14,500,000 -15,000,000 -15,000,000 -500,000 

------------- ------------- ----------...... ----------- ... - ----------- .. -

43,618,163 38,556,526 38,591,635 -5,028,528 +35,109 

15,000,000 19,500,000 19,500,000 +4,500,000 

-- - ---------

.... 

----- ------

-- ------- ----

58,618,163 58,056,526 58' 091 '635 -526,528 +35' 109 

Insert offset folio 67 here 23920A.136

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Limitation on Administrative Expenses 

OASI/DI Trust Funds. 

HI/SMI Trust Funds. 

Social Security Advisory Board. 

SSI ......... . 

Subtotal, regular LAE ... 

User Fees: 

SSI User Fee activities. 

CBO adjustment ...... . 

SSPA User Fee Activities. 

CBO adjustment. 

Subtotal, user fees. 

Subtotal, Limitation on administrative expenses. 

Program Integrity: 

OASOI Trust Funds. 

SSI .... 

Subtotal, Program integrity funding. 

Total, Limitation on Administrative Expenses 

TF 

TF 

TF 

TF 

D 

D 

TF 

TF 

FY 2017 

Enacted 

5,145,407 

1 '684 '753 

2,300 

3,706,485 

FY 2018 

Request 

4,916,768 

2,012,556 

2,300 

3,671,376 

Bi 11 

5,145,407 

1,684,753 

2,300 

3,706,485 

Bi 11 vs. Bill vs. 

Enacted Request 

--- +228,639 

- - -327,803 

--- ---

--- +35' 109 ~~p ~-~-- ~~~ ---·~------~- ------------- -------------- -------------

10,538,945 10,603,000 10,538,945 - - -64,055 

126,000 118,000 118,000 -8,000 

-3,000 -3,000 -3,000 

1 ,000 1,000 1,000 

-1 ,000 -1,000 -1,000 

------------- ------------- ------------- -------------- ----------.--

123,000 115,000 115,000 -8,000 

--------- -- -

- -~-~W-~¥ ~~- ------- - -

10,661 '945 10,718,000 10,653,945 -8,000 -64,055 

496,058 345,850 345,850 -150,208 

1,322,942 1 ,389' 150 1 '389' 150 +66,208 

------------- ------------- ------------- -------------. -------------

1,819,000 1,735,000 1,735,000 -84,000 ===========~~ ============= ============= 

============~= ============= 

12,480,945 12,453,000 12,388,945 -92,000 -64,055 

Insert offset folio 68 here 23920A.137

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Office of Inspector General 

Federal Funds .. 

Trust Funds. 

Total, Office of Inspector General. 

D 

TF 

Adjustment: Trust fund transfers from general revenues TF 

Total, Social Security Administration 

Federal funds ...... . 

Current year. 

New advances, 1st quarter, FY 2019. 

Trust funds. . . . . . . . . . . . . . . . .......... . 

Total, Title IV, Related Agencies. 

Federal Funds.. . . .. . . ..... 

Current Year ... 

FY 2019 Advance .. FY 2020 Advance. 

Trust Funds. 

FY 2017 

Enacted 

29,787 

75,713 

FY 2018 

Request 

30,000 

75,500 

Bi 11 

30,000 

75,500 

Bill vs. Bill vs. 

Enacted Request 

+213 

-213 

-

-

----

105,500 105,500 105,500 

-5,029,427 -5,080,526 -5,095,635 -66,208 -35,109 

============; ============= ============== ============= 

66,186' 581 65,565,900 65,501,845 -684,736 -64,055 

58,782,350 58,212,926 58,248,035 -534,315 +35,109 

(43,782,350) (38,712,926) (38 ,748' 035) (-5,034,315) (+35, 109) 

(15,000,000) (19,500,000) (19,500,000) (+4,500,000) ---

7,404,231 7,352,974 7,253,810 -150,421 -99,164 

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

68,485,612 66,244,555 67,722,887 -762,725 +1,478,332 

80,945,956 58,759,624 60,333,402 -612,554 +1 ,573,778 

(45,500,956) (39,259,624) (40,388,402) (-5,112,554) (+1 '128, 778) (15,000,000) (19,500,000) ( 19 ' 500 '000) (+4,500,000) ---

(445,000) --- (445,000) --- (+445,000) 

7,539,656 7,484,931 7,389,485 150,171 -95,446 

Insert offset folio 69 here 23920A.138

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

RECAP 

Mandatory, total in bill. 

Less advances for subsequent years. 

Plus advances provided in prior years. 

Total, mandatory, current year .. 

Discretionary, total in bill .. 

Less advances for subsequent years. 

Plus advances provided in prior years ... 

Subtotal, discretionary, current year. 

Discretionary Scorekeeping adjustments: 

SSI User Fee Collection.. . . .. . . .. D 

CBO adjustment.. . . . . . . . . D 

Average Weekly Insured Unemployment (AWIU) 

Coot i ngent. . . . . . . . . . . . . . . . . . . . . . TF 

Medicare Eligible Accruals 

(permanent,indefinite)11......... .. . . . . D 

Adult employment and training activities 

(rescission). .. .. .. . . .. .. .. .. D 

Dislocated Worker training and employment 

activities (rescission). .. . . ... . .. . D 

Dislocated Workers assistance National Reserve 

(rescission)... . . . .. . . . . . . . .. . . . D 

FY 2017 

Enacted 

760,614,562 

-144' 135 ' 452 

133,701,502 

FY 2018 

Request 

815,765,698 

-158,462,759 

144,135,452 

Bill 

817,445,698 

-158,462,759 

144,135,452 

Bill vs. Bill VS. 

Enacted Request 

+56,831 '136 +1,680,000 

-14,327,307 

+10,433,950 

- ----------- --------------

750' 180 ' 61 2 801,438,391 803,118,391 +52' 937 '779 +1,680,000 

173,331,306 148' 898' 126 168,883,146 -4,448,160 +19,985,020 

-24,814,001 -23,470,001 -24,814,001 --- -1,344,000 

24,814,001 24,814,001 24,814,001 

------------- -------------

------------- -------------- -------------

173,331,306 150, 242 ' 126 168' 883' 146 -4' 448' 160 +18,641 ,020 

-126,000 -118,000 -118,000 +8,000 

3,000 3,000 3,000 

5,000 20,000 10,000 +5,000 -10,000 

28,594 32,484 32,484 +3,890 

-324,000 --- ... +324,000 -405,000 ... --- +405,000 

-75,000 -170,000 -200,000 -125,000 -30,000 

Insert offset folio 70 here 23920A.139

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FO

(Amounts in Thousands) 

H-18 (rescission) ... 

Rescissions (PL111-148): 

Independent Payment Advisory Board. 

Preexisting Condition Insurance program. 

Refugee and Entrant Assistance (PL 114-254): 

(Nonrecurring expenses fund) (by transfer) 

(Sec.170(a)) ....... . 

Unaccompanied Minors Contingency Fund ($200M, 

Sec.170(b)) (CBO estimate) .......... .. 

Nonrecurring expenses fund (rescission) 

(Sec.170(d)) ............. . 

Nonrecurring expenses fund (rescission) 

Childrens Health Insurance Program performance 

bonus (rescission). 

Childrens Health Insurance Program one-time 

CH 

CH 

CH 

D 

0 

D 

D 

CH 

payment (rescission). . . .. . . . . .. CH 

(Public Law 114-254, Sec.201(a)). . ...... CH 

Childrens Health Insurance Program State atlotment 

(Sec.301(b)) (rescission)..... CH 

Child Enrollment contingency fund (rescission). CH 

FY 2017 

Enacted 

-46,000 

-15,000 

(300,000) 

100,000 

-100' 000 

-100.000 

-5,750,000 

-541 ,900 

-170,000 

-1 '132' 000 

-570,000 

FY 2018 

Request 

-560.000 

-1 ,193' 000 

-3,279,000 

Bill 

-15,000 

-323,000 

-560,000 

-88,613 

-3,145,905 

-1 '143 '268 

Bi 11 vs. 

Enacted 

+46,000 

-323,000 

(-300,000) 

-100,000 

+100,000 

-460,000 

+5,661 ,387 

+541,900 

+170,000 

-2,013,905 

-573,268 

Bill vs. 

Request 

-15,000 

-323,000 

+1 '104' 387 

+133,095 

-1 '143, 268 

Insert offset folio 71 here 23920A.140

COMPARATIVE STATEMENT OF NEW BUDGET {OBLIGATIONAL) AUTHORITY FOR 2017 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FO

(Amounts in Thousands) 

Limitation on eligible health care entity ...... CH 

CHIPRA unspent allotment recoupment (rescission) CH 

Pell unobligated balances (rescission) ......... 0 

Pell: Restore year-round Pell with 150% cap .. CH 

Pell mandatory funds (rescission) .. CH 

SSA SSPA User Fee Co'llection ........ '' ''' ..... 0 

CBO adjustment .. . ' ' ' ' ' . . . ' . ' 0 

Traditional Medicare program. 0 

CNCS National Service Trust unobligated balances 

(rescission). 0 

Corporation for Public Broadcasting FY2018 advance 

{rescission). .. ,, D 

21ST Century Cures Act adjustment (PL 114-255) ... D 

Total, discretionary .. '''' ' ... ' .... 

Grand Total, current year ... . .. . .. '' ........ 

FY 2017 

Enacted 

---

-1,310,000 

254,000 

-254,000 

1 ,000 1 ,000 

305,000 

---

·--

-852,000 

-- ----- -

162,985,000 

FY 2018 

Request 

-330,000 

---

-3,900,000 

---

---

-1 ,000 

1 ,000 

---

-139,000 -414,550 

-996,000 

.. . .. 

-

---- -

138,469,060 

- -- ----

........... 

-

913,165,612 939,907,451 

Bi 11 vs. Bill vs. 

Bi 11 Enacted Request 

-330,000 -330,000 

-800,000 -800,000 -800,000 

-3,270,844 -1,960,844 +629,156 

--- -254,000 

--- +254,000 

-1,000 

1,000 

-- -305,000 --- +139,000 

--- -- +414,550 

-996,000 -144,000 

............ 

-

-- ------ --

.......... 

157,938,000 -5,047,000 +19,468,940 

-

-

........ 

-

------.... ----

961,056,391 +47,890,779 +21 '148,940 

===;========= ============= ============== ============= 
(260) 

MINORITY VIEWS OF REP. NITA LOWEY AND REP. ROSA 

DELAURO 

We would like to acknowledge the efforts of Chairman Frelinghuysen and Chairman Cole to hold a full committee markup of the 

Labor-HHS–Education bill for the third consecutive year. This bill, 

which includes some of the nation’s most important domestic programs, needs to be debated by the committee in public every year. 

We are disappointed, however, that Republicans introduced and 

approved a bill that would cut labor, health, and education programs by $5 billion compared to the fiscal year 2017 enacted level. 

We are concerned that such a severe cut would harm students, seniors, women, families, and workers. To make matters worse, the 

Labor-HHS-Education bill’s allocation is already $30 billion below 

the fiscal year 2010 level, after adjusting for inflation. 

The biggest economic challenge of our time is that too many people are in jobs that do not pay them a living wage. Too often, workers lack the skills and experience to access better jobs and earn 

family-sustaining wages. 

It used to be that workers with high school degrees were able to 

secure good paying jobs, in manufacturing and elsewhere, that allowed them and their families to prosper. But those jobs, and the 

high wages that used to go with them, have been in decline over 

the past 40years. 

We need to enact policies that ensure everyone can benefit from 

a growing economy, and that everyone has the skills and training 

to get a good job with high wages. We need a country that works 

for the middle class and the vulnerable, not just the wealthy and 

those with the most lobbyists. 

That’s why the Labor-HHS-Education bill is so important. The 

programs in this bill provide opportunities for hardworking Americans to improve their economic security and for our economy to 

grow. This committee must commit to investing in education and 

job training to fulfill this country’s potential. 

We must put at the center of our effort the 70 percent of Americans for whom a four-year college degree is not their preferred 

pathway. We must recognize and support their aspirations for their 

families and communities. 

If people are to achieve better lives for their families, we must 

build a pipeline of skilled workers. That means we need to have a 

public workforce development system that adapts to businesses’ 

changing needs. In many cases, work-based learning and apprenticeship programs are the best options to equip workers with the 

skills to get a good job with high wages. 

The federal government has a rich history of helping Americans 

learn and grow through workforce development and connecting 

businesses with a skilled workforce, and we need to reinvest in 

that system. We will describe below how this Republican LaborVerDate Sep 11 2014 09:20 Jul 25, 2017 Jkt 026329 PO 00000 Frm 00260 Fmt 6604 Sfmt 6604 E:\HR\OC\HR244.XXX HR244
261 

HHS-Education bill is a repudiation of the American tradition of 

the federal government improving schools, making college more affordable, training workers for better paying jobs, and providing 

health services for women. 

Of course, there are a few bright spots in this bill. We strongly 

support increases for NIH research, emergency preparedness, Special Education, and TRIO and GEAR UP. But even those increases 

show the fundamental insufficiency of the subcommittee’s allocation: the NIH increase is about half the size of the increase for each 

of the past two years, and Special Education funding continues to 

fall short. When adjusting for inflation, the increase for Special 

Education State Grants is an effective cut, taking us further away 

from living up to our commitment to fully fund IDEA. 

Overall, the modest increases in this bill are far outweighed by 

harmful cuts to programs that ought to be increased. 

LABOR-HHS-EDUCATION CUTS 

[Dollars in millions] 

FY 2017 

Enacted 

FY 2018 

House 

FY 2018 House comp to 

FY 2017 Enacted 

dollar percent 

Elementary & Secondary Education ............................................................... 23,822 21,337 ¥2,485 ¥10% 

Pell Grants (discretionary) ............................................................................. 22,475 22,475 0 0% 

Pell Grant Rescission (non-add) .......................................................... ¥1,310 ¥3,271 ¥1,961 150% 

Health Service and Resources Admin ........................................................... 6,206 5,824 ¥382 ¥6% 

Centers for Disease Control/Prevention ......................................................... 7,165 7,001 ¥163 ¥2% 

Substance Abuse and Mental Health ............................................................ 3,765 3,459 ¥306 ¥8% 

Agency for Healthcare Research/Quality ....................................................... 324 300 ¥24 ¥7% 

CMS Program Management ........................................................................... 3,975 3,451 ¥524 ¥13% 

Administration for Children and Families ..................................................... 19,275 18,514 ¥761 ¥4% 

Administration for Community Living ............................................................ 1,994 1,937 ¥57 ¥3% 

HHS GDM and other HHS agencies ............................................................... 812 620 ¥192 ¥24% 

Job Training (including Job Corps) ................................................................ 5,202 4,887 ¥314 ¥6% 

Senior Community Service Employment ........................................................ 400 300 ¥100 ¥25% 

UI & Employment Service Operations ............................................................ 3,524 2,831 ¥693 ¥20% 

Worker Protection Agencies ............................................................................ 1,595 1,537 ¥59 ¥4% 

International Labor Affairs ............................................................................ 86 27 ¥60 ¥69% 

EDUCATION—A KEY TO THE MIDDLE CLASS

The Department of Education is cut by $2.2 billion below the fiscal year 2017 enacted level, before accounting for the rescission of 

$3.3 billion from the Pell Grant program. 

We are deeply disappointed that the bill fails to make additional 

investments in Title I, which reaches 25 million students in more 

than 80 percent of our school districts, and imposes harmful cuts 

to the 21st Century Community Learning Centers program, which 

would deny 192,000 kids enrichment opportunities in before- and 

after-school and summer school programs. To restore these harmful 

cuts, we offered an amendment to return the program’s funding to 

the fiscal year 2017 level. Unfortunately, it was defeated. 

Despite the mountain of evidence that early childhood interventions work to reduce inequality and narrow achievement gaps, the 

bill provides level funding for Preschool Development Grants and 

nominal increases for Head Start and Child Care, meaning we will 

continue to fall behind in providing children and families with 

high-quality early education opportunities and care. 

262 

We proposed amendments to boost funding for these programs as 

well as the Child Care Access Means Parents in School program to 

help meet the needs of students with kids. Unfortunately, the 

amendments were defeated. 

This bill is fundamentally anti-teacher. It eliminates the Supporting Effective Instruction grants, which reduce class sizes and 

give teachers evidence-based professional development. Approximately 8,000 teachers across the country would lose their jobs. 

States represented by Members of this committee would lose a total 

of $1.7 billion if the majority’s proposal was enacted. 

We proposed an amendment to restore funding for this program 

and a number of other teacher programs proposed to be cut or 

eliminated in the bill because we know that strong leaders are the 

most important school-based factor in our kids’ academic success. 

While we attracted one member from across the aisle to join us, the 

amendment was ultimately defeated. 

The bill eliminates nearly a dozen education programs, including 

the largest reading program for low-income children and youth, 

Special Olympics, and funding to expand access to the arts in our 

most under-resourced communities.It imposes harmful cuts to proven education programs like Promise Neighborhoods. Cutting funding for the Special Olympics will not make a difference in reducing 

the Federal debt, but it will rob a segment of our population a 

chance at an enriching experience. 

We proposed amendments to reverse damaging cuts to these and 

other programs, in order to provide our children with tools for success. Unfortunately, while we had one member of the majority join 

us, all other Republicans opposed this amendment to restore funds. 

The bill threatens the very future of the Pell Grant program by 

slashing $3.3 billion and doing nothing to make college more affordable. It sets Pell on a dangerous path at a time when 44 million student borrowers have more than $1.3 trillion in student 

debt. 

We tried to improve the bill by offering an amendment to in- crease the maximum Pell Grant award by $135 to keep up with inflation. Our Republican colleagues rejected our effort to help make 

college more affordable by voting against the amendment. 

In addition, we offered an amendment to require the Secretary 

of Education to implement the Borrower Defense to Repayment 

regulation to safeguard students and taxpayer dollars from unscrupulous institutions that commit fraud and mislead students. The 

majority opposed, and the amendment failed. We also offered an 

amendment affirming that all students deserve to learn in an environment free from sexual violence. With the support of only one 

member from across the aisle, the amendment was defeated. 

HEALTH SERVICES

Setting aside the much-needed increase for research at the National Institutes of Health, the rest of the Department of Health 

and Human Services would be cut by more than $2 billion under 

this bill. 

The bill cuts access to Mental Health and Substance Abuse Prevention services by more than $300 million below the fiscal year 

2017 level, which is particularly distressing due to the ongoing 

263 

opioid crisis. We speak often about the opioid crisis, but when the 

opportunity arises to take strong action, we fail to fund these priorities in a meaningful way. 

Democrats proposed amendments to restore funding for mental 

health and substance abuse prevention, in addition to nurse training, tobacco prevention, immunizations, research in health care settings, and a slate of programs that disproportionately serve minority communities. We also proposed an amendment to provide $5 

billion in emergency funding to the Public Health Emergency Fund. 

Unfortunately, all of our efforts to improve health care services, 

train a health workforce, and fund a rapid emergency response 

were rejected. 

SENIORS

The bill cuts and eliminates programs designed to protect one of 

our most vulnerable populations: seniors. The State Health Insurance Assistance Program provides seniors with help in navigating 

the complex Medicare program; the Senior Community Service Employment Program provides unemployed low-income older adults 

with paid work experiences; and Elder Rights Support Activities 

helps protect our elderly through the prevention and detection of 

abuse. 

We proposed an amendment to restore the harmful cuts proposed 

to these critical programs, but it was rejected. 

WOMEN’S HEALTH SERVICES

This bill’s approach to women’s health pushes a dangerous and 

harmful ideological agenda. It eliminates funding for Title X Family Planning and the Teen Pregnancy Prevention program—a combined cut of about $400 million to reproductive health services for 

women—and includes new ideological riders that would block funding for Planned Parenthood and effectively block life-saving research using cells from fetal tissue. 

We proposed amendments to restore funding for Title X Family 

Planning and the Teen Pregnancy Prevention program. In addition, 

we offered amendments to strike several ideological riders that 

would be harmful to women’s health, including the riders that 

would block funding for Planned Parenthood and fetal tissue research. To our disappointment, the majority rejected restoring 

funds for reproductive health and retained each of the ideological 

riders that do not belong in this bill. 

THE UNEMPLOYED

The largest proportional department-level cut in the bill is the 

Department of Labor by $1.2 billion, or 10.1 percent, below the fiscal year 2017 level, before accounting for the rescission of $200 million from the Dislocated Worker National Reserve. That is baffling 

given the President’s campaign promises to American workers. 

This bill hurts workers by eliminating the Employment Service, 

which helped nearly six million unemployed workers, including veterans, find jobs in 2015. This funding goes to our One-Stops to help 

people looking for jobs get relevant skills. Cutting this funding is 

a betrayal of job seekers in our economy. 

264 

The bill also eliminates grants expanding the highly-effective 

Registered Apprenticeship model that connects job seekers with 

good paying jobs employers are desperate to fill. The bill includes 

cuts to programs that make our country more competitive, like Job 

Corps, slashes job training for dislocated workers, and eliminates 

a tool that helps us evaluate if workforce and education programs 

are effective. Why would we eliminate programs that have for so 

long been about economic opportunity and a ladder to the middle 

class? 

We proposed amendments to restore funding for job training programs and apprenticeships, as well as Job Corps and the Employment Service. We also fought to restore funding to crucial enforcement agencies and the Bureau of International Labor Affairs. Once 

again, the majority opposed our efforts and the amendments failed. 

PARTISAN POLICY RIDERS

In addition to riders that would limit a woman’s access to health 

care, this bill also attempts to block all funding for the Affordable 

Care Act. It continues to prohibit funding for gun violence prevention, which has had a chilling effect on gun violence research. And 

it prohibits the Department of Labor from ensuring that financial 

advisers act in the best interests of their clients. 

We proposed amendments to eliminate each of these ideological 

riders; unfortunately, the majority rejected each amendment. 

CONCLUSION

This bill stands in stark contrast to the bipartisan Labor-HHSEducation bill included in the fiscal year 2017 Omnibus. The funding in this bill fails to meet our country’s needs and breaks our 

promises to students, seniors, women, families and our workforce. 

It does not reflect our values of putting the middle class and the 

vulnerable first; instead, it benefits those with the most money and 

the most lobbyists. 

We hope our colleagues on the other side of the aisle will work 

with Democrats during the conference process to fix the many inadequacies in this bill. At that point, we look forward to working with 

Chairman Frelinghuysen and Chairman Cole to move forward on 

a bill we can all support. 

NITA M. LOWEY. 

ROSA DELAURO. 

Æ