21–909

109TH CONGRESS REPORT " HOUSE OF REPRESENTATIVES ! 1st Session 109–143

DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATION BILL, 2006

JUNE 21, 2005.—Committed to the Committee of the Whole House on the State of 

the Union and ordered to be printed 

Mr. REGULA, from the Committee on Appropriations, 

submitted the following 

R E P O R T 

together with 

MINORITY VIEWS 

[To accompany H.R. 3010]

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), and 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, Medicare Payment 

Advisory Commission, National Commission on Libraries and Information Science, 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, 2006, and for other purposes.

INDEX TO BILL AND REPORT 

Page number 

Bill Report 

Title I—Department of Labor: 

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

2

Page number 

Bill Report 

Employee Benefits Security Administration ..................................... 10 12

Pension Benefit Guaranty Corporation ............................................. 10 13

Employment Standards Administration ........................................... 11 13

Occupational Safety and Health Administration ............................. 16 14

Mine Safety and Health Administration ........................................... 19 15

Bureau of Labor Statistics ................................................................. 20 16

Office of Disability Employment Policy ............................................. 21 16

Departmental Management ............................................................... 21 16

Veterans Employment and Training ................................................. 22 18

Office of the Inspector General .......................................................... 22 18

General Provisions .............................................................................. 23 18

Title II—Department of Health and Human Services: 

Health Resources and Services Administration ............................... 25 19

Centers for Disease Control and Prevention .................................... 28 35

National Institutes of Health ............................................................. 31 55

Substance Abuse and Mental Health Services Administration ...... 39 113

Agency for Healthcare Research and Quality ................................... 40 119

Centers for Medicare and Medicaid Services .................................... 40 121

Administration for Children and Families ........................................ 44 125

Administration on Aging .................................................................... 52 139

Office of the Secretary ........................................................................ 52 141

General Provisions .............................................................................. 56 150

Title III—Department of Education: 

Education for the Disadvantaged ...................................................... 65 152

Impact Aid ........................................................................................... 66 157

School Improvement Programs .......................................................... 67 158

Indian Education ................................................................................. 68 162

Innovation and Improvement ............................................................. 68 163

Safe Schools and Citizenship Education ........................................... 69 167

English Language Acquisition ........................................................... 70 168

Special Education ................................................................................ 70 169

Rehabilitation Services and Disability Research .............................. 71 171

Special Institutions for Persons with Disabilities ............................ 72 174

Vocational and Adult Education ........................................................ 73 175

Student Financial Assistance ............................................................. 75 178

Student Aid Administration ............................................................... 75 179

Higher Education ................................................................................ 75 180

Howard University .............................................................................. 77 185

College Housing and Academic Facilities Loans .............................. 77 186

Historically Black College and University Capital Financing ........ 77 186

Institute of Education Sciences .......................................................... 78 186

Departmental Management ............................................................... 78 188

Office for Civil Rights ......................................................................... 78 190

Office of the Inspector General .......................................................... 78 190

General Provisions .............................................................................. 79 190

Title IV—Related Agencies: 

Committee for Purchase from People Who Are Blind or Severely 

Disabled ............................................................................................ 81 191

Corporation for National and Community Service ........................... 81 191

Corporation for Public Broadcasting ................................................. 88 194

Federal Mediation and Conciliation Service ..................................... 89 194

Federal Mine Safety and Health Review Commission ..................... 90 194

Institute of Museum and Library Services ....................................... 91 194

Medicare Payment Advisory Commission ......................................... 91 195

National Commission on Libraries and Information Science .......... 91 195

National Council on Disability ........................................................... 91 195

National Labor Relations Board ........................................................ 92 196

National Mediation Board .................................................................. 92 196

Occupational Safety and Health Review Commission ..................... 93 196

3

Page number 

Bill Report 

Railroad Retirement Board ................................................................ 93 197

Social Security Administration .......................................................... 95 198

Title V—General Provisions: 

House of Representatives Report Requirements ........ ...........

SUMMARY OF ESTIMATES AND APPROPRIATIONS

The following table compares on a summary basis the appropriations including trust funds for fiscal year 2005, the budget estimate 

for fiscal year 2006 and the Committee recommendation for fiscal 

year 2006 in the accompanying bill.

2006 LABOR, HHS, EDUCATION APPROPRIATIONS BILL 

[In millions of dollars] 

Fiscal year— 2006 committee

compared to—

2005 comparable 2006 budget 2006 committee 2005 comparable 2006 budget 

Department of Labor ............................................. $15,309 $14,756 $14,808 ¥$501 +$52

Advances ...................................................... 2,544 2,512 2,537 ¥7 +25

Department of Health and Human Services ......... 373,872 474,273 474,824 +100,952 +551

Advances ...................................................... 68,101 67,103 67,114 ¥987 +11

Department of Education ...................................... 59,213 58,939 63,715 +4,502 +4,776

Advances ...................................................... 15,022 15,022 15,022 0 0

Related Agencies ................................................... 49,256 49,194 49,066 ¥190 ¥128

Advances ...................................................... 11,330 11,110 11,510 +180 +400

Grand Total, current year ...................................... 497,650 597,162 602,413 +104,763 +5,251

Advances ...................................................... 96,997 95,747 96,183 ¥814 +436

Current year total using 302(b) scorekeeping ..... 496,900 596,798 601,942 +105,042 +5,144

Mandatory ..................................................... 354,222 455,208 459,428 +105,206 +4,220

Discretionary ................................................. 142,678 141,590 142,514 ¥164 +924

PROGRAM LEVEL DISCRETIONARY 

[In millions of dollars] 

Fiscal year— 2006 committee compared 

to—

2005 comparable 2006 budget 2006 committee 2005 comparable 2006 budget 

Department of Labor ............................................. $12,055 $11,586 $11,662 ¥$393 $76

Department of Health and Human Services ......... 63,782 62,507 63,149 ¥633 642

Department of Education ...................................... 56,577 56,219 56,695 118 476

Related Agencies ................................................... 11,046 11,608 11,479 433 ¥129

Subtotal Program Level ........................... 143,460 141,920 142,985 ¥475 1,065

GENERAL SUMMARY OF THE BILL

Funding levels in the fiscal year 2006 appropriation bill for the 

Departments of Health and Human Services, and Education and 

Related Agencies reflect the Committee’s attempt to establish priorities within the very stringent limitations. As in past years, the 

Committee has increased funding for programs that work for people and represent a core Federal responsibility. 

Bill total.—Total funding, including offsets, for fiscal year 2006 

in the Departments of Health, and Human Services and Education 

and Related Agencies Appropriations Act, 2006 is 

$601,942,078,000. 

4

Discretionary Programs.—For Discretionary accounts for 2006 

the bill provides $142,514,000,000, including offsets. This is 

$164,093,000 below the fiscal year 2005 comparable level. After adjusting for fluctuations in advance appropriations, the comparable 

program level decrease is $474,597,000. 

Mandatory programs.—The bill provides $459,428,078,000 for entitlement programs in fiscal year 2006. This is $105,206,218,000 

above the fiscal year 2005 comparable level, or an increase of 29.7 

percent. Over three quarters of the funding in the bill is for these 

mandatory costs. Funding requirements for entitlement programs 

are determined by the basic authorizing statutes. Mandatory programs include general fund support for the Medicare and Medicaid 

programs, Supplemental Security Income, Trade Adjustment Assistance and Black Lung payments. The following chart indicates 

the funding levels for the major mandatory programs in fiscal years 

2005 and 2006 and the growth in these programs.

MANDATORY 

[Dollars in thousands] 

Program Fiscal year 2005 Fiscal year 2006 Change 

Department of Labor: 

Federal Unemployment Benefits and Allowances .............................. $1,057,300 $966,400 ¥$90.900

Advances to the UI and other trust funds ........................................ 517,000 465,000 ¥52,000

Special Benefits ................................................................................. 233,000 237,000 +4,000

Special Benefits for Disabled Coal Miners ....................................... 257,997 232,250 ¥25,747

Energy Employees Occupational Illness Compensation Fund ........... 40,321 96,081 +55,760

Black Lung Disability Trust Fund ...................................................... 1,061,969 1,068,000 +6,031

Department of Health and Human Services: 

Vaccine Injury Compensation Trust Fund .......................................... 66,000 70,884 +4,884

Medicaid current law benefits ........................................................... 171,407,893 204,166,276 +32,758,383

Medicaid State and local administration .......................................... 9,318,602 9,803,100 +484,498

CMS Vaccines for Children ................................................................ 1,468,799 1,502,333 +33,534

Medicare Payments to Healthcare Trust Funds ................................ 114,608,900 177,742,200 +63,133,300

Welfare Payments .............................................................................. 24,000 34,300 +10,300

Child Support Enforcement ................................................................ 4,066,465 4,185,816 +119,351

Social Services Block Grant ............................................................... 1,700,000 1,700,000 0

Promoting Safe and Stable Families ................................................. 305,000 305,000 0

Payments to States for Foster Care and Adoption ........................... 5,037,900 4,852,800 ¥185,100

Medical Benefits for Commissioned Officers .................................... 330,636 328,552 ¥2,084

Department of Education: 

Vocational Rehabilitation ................................................................... 2,635,845 2,720,192 +84,347

Pell Grant Shortfall Payoff ................................................................. 0 4,300,000 +4,300,000

Related Agencies: 

Payments to Social Security Trust Funds .......................................... 20,454 20,470 +16

Supplemental Security Income .......................................................... 38,189,929 37,566,174 ¥623,755

EFFECT STATEMENTS

The Committee directs the Departments of Labor, Health and 

Human Services, Education and the Corporation for National and 

Community Service, and the Social Security Administration to provide it with effect statements within 45 days of enactment of this 

Act. 

5

TITLE I—DEPARTMENT OF LABOR 

EMPLOYMENT AND TRAINING ADMINISTRATION

TRAINING AND EMPLOYMENT SERVICES

(INCLUDING RESCISSION)

The Committee recommends $5,121,792,000 for this account, 

which provides funding authorized primarily by the Workforce Investment Act of 1998 (WIA). This is $215,980,000 below the fiscal 

year 2005 level and $66,279,000 below the budget request. 

The Training and Employment Services account is comprised of 

programs that enhance the employment and earnings of those in 

need of such services, operated through a decentralized system of 

skill training and related services. The account is mostly forwardfunded on a July to June cycle, with funds provided for fiscal year 

2006 supporting the effort from July 1, 2006 through June 30, 

2007. 

The Committee directs that Department take no action in fiscal 

year 2006 to amend, through regulatory or other administrative action, the definition established in 20 CFR 667.220 for functions and 

activities under title I of the Workforce Investment Act until such 

time as legislation reauthorizing the Act is enacted. 

Adult employment and training activities 

For adult employment and training activities, the Committee recommends $865,736,000. This is $30,882,000 below the fiscal year 

2005 level and the same as the budget request. Of the amount recommended $712,000,000 will become available on October 1, 2006. 

This program is authorized by the Workforce Investment Act of 

1998. The funds are allocated by formula to States and further distributed to local workforce investment boards. Services for adults 

will be provided through the One-Stop system and most customers 

receiving training will use their individual training accounts to determine which programs and providers fit their needs. The Act authorizes core services, available to all adults with no eligibility requirements, and intensive services, for unemployed individuals who 

are not able to find jobs through core services alone. 

Dislocated worker employment and training activities 

For dislocated worker employment and training activities, the 

Committee recommends $1,405,264,000. This is $70,800,000 below 

the fiscal year 2005 level and $61,680,000 above the budget request. Of the amount recommended, $1,060,000,000 will become 

available on October 1, 2006. Of the total, $1,193,264,000 is designated for State formula grants that support core services, intensive services, training, and supportive services. In addition, States 

use these funds for rapid response assistance to help workers affected by mass layoffs and plant closures. The bill includes 

$212,000,000 for the National Reserve, which supports National 

Emergency Grants to respond to mass layoffs, plant and/or military 

base closings, and natural disasters across the country, which cannot be otherwise anticipated, as well as technical assistance and 

training and demonstration projects. 

6

The Committee recommendation includes, as it has in past years, 

funding for disclocated worker projects aimed at assisting the longterm unemployed. 

The Committee requested that the Department submit its report 

on pilot and demonstration grants as required by the Workforce Investment Act by March 31, 2005. The Committee expects this report from the Department immediately. 

Youth activities 

For youth activities, the Committee recommends $950,000,000. This is $36,288,000 below the fiscal year 2005 level and the same 

as the budget request. 

The Workforce Investment Act of 1998 consolidated the Summer 

Youth Employment and Training Program and Youth Training 

Grants under the Job Training Partnership Act into a single youth 

training activity. The funds are allocated by formula to States and 

further distributed to local workforce investment boards. 

Job Corps 

For Job Corps, the Committee recommends $1,542,019,000. This is $9,841,000 below the fiscal year 2005 level and $25,000,000 

above the budget request. Of the amount recommended, 

$691,000,000 will become available on October 1, 2005. The Committee does not include a rescission of funds as requested within 

construction and rehabilitation account. The Committee understands that previously appropriated funds are available for the construction of two new centers. The Committee further understands 

that there is a backlog of construction and rehabilitation projects 

at existing centers. 

The Job Corps, authorized by the Workforce Investment Act of 

1998, is a nationwide network of residential facilities chartered by 

Federal law to provide a comprehensive and intensive array of 

training, job placement and support services to at-risk young 

adults. The mission of Job Corps is to attract eligible young adults, 

teach them the skills they need to become employable and independent, and place them in meaningful jobs or further education. 

Participation in the program is open to economically disadvantaged 

young people in the 16 to 24 age range who are unemployed and 

out of school. Most Job Corps students come from disruptive or debilitating environments, and it is important that they be relocated 

to residential facilities where they can benefit from the highly 

structured and carefully integrated services provided by the Job 

Corps program. A limited number of opportunities are also available for non-residential participation. The Committee supports the 

effort of the Workforce Investment Act of 1998 to more fully integrate Job Corps centers in their local communities. 

The Committee recognizes the shortage of health care professionals and the need to provide access to health care vocational opportunities for many disadvantaged young people. The Committee 

is also aware that the Job Corps is uniquely qualified to utilize the 

Department of Health and Human Services (HHS) Health Resources and Services Administration (HRSA) grant programs to 

train students to pursue health careers while generating more 

health care professionals to serve economically disadvantaged communities. 

7

The Committee commends the common mission of the Job Corps 

and HRSA in exposing under-represented minorities and disadvantaged students to seek strategically important careers. Nearly 

three quarters of the nation’s 122 Job Corps Centers offer health 

occupations training as well as training in health care related 

fields. The Committee recognizes and commends the Job Corps success in training students with the skills they need to fill critical 

shortages through major national employer partners. Through preferred access to HRSA grant funds, Job Corps’ training can generate even more qualified and prepared allied health professionals 

in the coming decade. 

The Committee commends Job Corps for establishing partnerships with national employers, and encourages Job Corps to continue to work with both larger employers and small businesses to 

ensure that student training meets current labor market needs. 

The Committee urges Job Corps to also strengthen and expand the 

program in order to help meet our nation’s needs for trained, entry 

level workers in three high growth industry sectors: health care, 

homeland security, and national defense. In addition, Job Corps 

should intensify its efforts to upgrade its vocational offerings and 

curricula to reflect industry standards and required certifications 

recognized by employers. 

The Committee is committed to promoting and expanding costeffective federal programs: that have proven records of success; 

that provide consistent and positive results for the people they 

serve; and that help address national labor shortages. Therefore, 

the Committee supports the incremental expansion of Job Corps. 

The Committee supports the concept of ‘‘High Growth Job Corps 

Centers’’ that are focused on addressing the country’s most vital 

workforce needs in high growth, high demand industries such as 

automotive, construction, financial services, health professions, hospitality, information technology, homeland security, and transportation. 

The Committee commends the Job Corps program for developing 

mutually beneficial partnerships with community colleges across 

the country. Community college partners including the Mississippi 

Gulf Coast Community College and the Cincinnati State and Technical Community College find that it is efficient to work with Job 

Corps because they share the same basic goals of providing access 

and opportunity for disadvantaged Americans and they have the 

ability to partner with employers looking for high-skilled workers. 

The Committee encourages the Department of Labor’s Community 

College Initiative to collaborate with the Job Corps program to 

offer advanced co-enrollment programs, increase opportunities for 

disadvantaged youth pursuing a career in high growth areas, and 

maximize access to industry-recognized certification programs. The 

Committee also directs a minimum of $10 million of the Community College Initiative funding dedicated to community colleges 

partnerships with Job Corps centers. The Committee requests this 

portion be designated to: (1) develop strategic partnerships with 

community colleges, business and industry leaders, and Job Corps 

centers to train students in high, growth, high demand industries; 

and (2) design ‘‘dual enrollment’’ programs based on reciprocal 

agreements between Job Corps and adjacent community colleges. 

8

The Committee recognizes the significant impact that the home 

building industry continues to have on the health of the U.S. economy, and its efforts to expand opportunities for homeownership to 

all of our nation’s working families. The Committee notes the ongoing shortage of skilled laborers in the residential construction industry and the industry’s need to alleviate that shortage in order 

to continue to meet the demand for affordable housing in the 

United States. The Committee also recognizes the essential role 

played by the Home Builders Institute (HBI), the workforce development arm of the National Association of Home Builders, in training Job Corps youth for careers in this high growth industry. The 

Committee commends HBI on its 31-year partnership with Job 

Corps and its proven results in developing our nation’s workforce 

by providing at-risk youth with the skills training and employment 

opportunities they need to have successful careers in residential 

construction. The Committee encourages the Department to identify existing and future sites for potential expansion of construction 

trades training by employer-based industry groups like HBI, to 

help alleviate the shortage of skilled workers and to further the 

goal of American homeownership. 

The Committee believes that Job Corps’ partnerships with national non-profit faith founded organizations such as Joint Action 

in Community Services (JACS), Women in Community Services, 

and the YWCA are essential to the success of Job Corps. The Committee commends JACS and its national network of nearly 3,000 

volunteers for their proven record in providing at-risk young adults 

supportive services as they transition from Job Corps back to their 

home communities and into the world of work. As such, the Committee encourages the Department to expand its Job Corps partnership with such national volunteer programs in order to ensure 

the continued availability of youth of transition services that are 

national in scope, yet local in focus. 

Native Americans 

For Native Americans, the Committee recommends $54,238,000. 

This is the same as the fiscal year 2005 level and the budget request. This program, authorized by the Workforce Investment Act 

of 1998, is designed to improve the economic well being of Native 

Americans (Indians, Eskimos, Aleuts, and Native Hawaiians) 

through the provision of training, work experience, and other employment-related services and opportunities that are intended to 

aid the participants to secure permanent, unsubsidized jobs. The 

Department of Labor allocates formula grants to Indian tribes and 

other Native American groups whose eligibility for such grants is 

established in accordance with Department regulations. 

Migrant and seasonal farmworkers 

For Migrant and Seasonal Farmworkers, the Committee recommends $75,759,000. This is the same as the fiscal year 2005 

level. The budget request did not include funds for this program. 

The Committee recommendation includes bill language directing 

that $4,546,000 of this amount be used for migrant and seasonal 

farmworker housing grants. The bill language further directs that 

not less than 70 percent of this amount be used for permanent 

housing grants. The recommendation also provides that the reVerDate jul 14 2003 07:43 Jun 22, 2005 Jkt 021909 PO 00000 Frm 00008 Fmt 6659 Sfmt 6602 E:\HR\OC\HR143.XXX HR143
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maining amount be used for State service area grants, including 

funding grantees in those States impacted by formula reductions at 

no less than eighty-five percent of the comparable 1998 levels for 

such States. Within the National Activities/Other line item, the 

Committee includes $500,000 to be used for Section 167 training, 

technical assistance and related activities, including continuing 

funding for migrant rest center activities at the current level. 

This program, authorized by the Workforce Investment Act of 

1998, is designed to serve members of economically disadvantaged 

families whose principal livelihood is derived from migratory and 

other forms of seasonal farmwork, or fishing, or logging activities. 

Enrollees and their families are provided with employment training 

and related services intended to prepare them for stable, yearround employment within and outside of the agriculture industry. 

National programs 

This activity includes Workforce Investment Act authorized programs in support of the workforce system including technical assistance and incentive grants, evaluations, pilots, demonstrations 

and research. 

Pilots, Demonstrations and Research: The Committee recommends $74,000,000 for grants or contracts to conduct research, 

pilots or demonstrates that improve techniques or demonstrate the 

effectiveness of programs. This is $11,167,000 below the fiscal year 

2005 level and $44,000,000 above the budget request. 

Evaluation: The Committee recommends $7,936,000 to provide 

for the continuing evaluation of program conducted under the 

Workforce Investment Act of 1998, as well as of federally funded 

employment-related activities under other provisions of law. This is 

the same as the fiscal year 2005 level and the budget request.

Responsible Reintegration of Youthful Offenders: The Committee 

does not include funding for the Responsible Reintegration of 

Youthful Offenders program. The budget did not request funds for 

this program. The fiscal year 2005 level was $49,600,000. 

Prisoner Re-entry: The Committee recommends $19,840,000 for 

the Prisoner Re-entry initiative. The is the same as the fiscal year 

2005 level and $15,160,000 below the budget request. 

The Committee notes the importance of providing adjudicated 

youth with opportunities to expand and cultivate job skills that can 

provide them with successful careers. The Committee recognizes 

Project CRAFT (Community, Restitution, and Apprenticeship-Focused Training), a program of the Home Builders Institute (HBI), 

the workforce development arm of the National Association of 

Home Builders, as a noteworthy effort in the rehabilitation and reduced recidivism of adjudicated youth. The Committee believes that 

Project CRAFT serves as an example of the success achieved during the Youth Reintegration pilot demonstration, and applauds 

HBI for its ongoing dedication to serving the workplace education 

needs of this segment of the youth population. The Committee also 

recognizes the role Project CRAFT plays in preparing young people 

to join the residential construction workforce and the continuing 

importance of the home building industry to our nation’s economy. 

The Committee encourages the Department to replicate Project 

CRAFT so that its outcomes-oriented approach will assist adjuVerDate jul 14 2003 07:43 Jun 22, 2005 Jkt 021909 PO 00000 Frm 00009 Fmt 6659 Sfmt 6602 E:\HR\OC\HR143.XXX HR143
10

dicated juveniles to become productive members of the industry’s 

workforce. 

Community Based Job Training Initiative: The Committee recommends $125,000,000 for the Community Based Job Training Initiative and rescinds $125,000,000 in funds provided in fiscal year 

2005 for this program. 

The Committee’s recommendations reflect efforts to improve the 

efficiency of the workforce system and support opportunities to get 

people back to work. Therefore the Committee has not funded the 

new Community Based Job Training Initiative at the level requested by the Administration, but has instead increased funding 

for Dislocated Worker Assistance. 

The Committee is concerned by the Department’s first solicitation for grant applications (SGA) under the President’s Community 

Based Job Training initiative issued on May 3, 2005 which restricts 

eligible applicants to community colleges. The Committee has on 

numerous occasions encouraged the Secretary to ensure that funds 

used for the Community Based Job Training Initiative strengthen 

partnerships between community colleges, employers, and local 

workforce investment boards. During the fiscal year 2005 budget 

hearings and in multiple communications with the Department, the 

Committee conveyed its interest in broad eligibility for application 

to the Community Based Job Training Initiative. Specifically, the 

Committee had made clear its interest that One Stop Career Centers be eligible to compete for these funds. The Committee is concerned that the Department has misunderstood or ignored the 

Committee’s interest in including One Stop Career Centers as an 

eligible applicant for funding under the Community Based Job 

Training Initiative. Therefore, the Committee directs that future 

solicitations for grant applications for the Community Based Job 

Training initiative include One Stop Career Centers as an eligible 

applicant. 

Within the funds provided, the Committee encourages the Department of Labor to structure the Community Based Job Training 

initiative in a manner that allows community college to use federal 

funding to partner with a high school or career and technology center. Such partnerships would provide educational services to traditional and non-traditional students in a larger geographic area 

than would otherwise be served if the community college was not 

taking part in such a partnership. 

Technical Assistance: The Committee recommends $2,000,000. 

The funds recommended support the development of performance 

management systems, the provision of quality services, and promoting accountability and collaboration. This is $1,486,000 below 

the fiscal year 2005 level and the same as the budget request. 

Rescissions: The Committee has included language rescinding 

$20,000,000 in unobligated Health Care Tax Credit Funds and 

$5,000,000 in unobligated funds provided for emergency response 

activities. 

COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS

The Committee recommends $436,678,000 for community service 

employment for older Americans. This is the same as the fiscal 

year 2005 level and the budget request. 

11

The community service employment for older Americans program 

provides grants to public and private nonprofit organizations that 

subsidize part-time work in community service activities for unemployed persons aged 55 and older, whose family’s annual income 

does not exceed 125 percent of the poverty level. 

FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES

The Committee recommends $966,400,000. This is $90,900,000 

below the fiscal year 2005 level and the same as the budget request. 

The Trade Adjustment Assistance Program provides assistance to 

certified workers adversely affected by imports and trade with 

countries covered by the North America Free Trade Agreement. 

Funding will continue the implementation of the TAA program 

with an emphasis on integrating the program into the One-Stop 

System. The Trade Adjustment Assistance Reform Act of 2002 increased the possibility of training and income support benefits. 

STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE

OPERATIONS

The Committee recommends $3,470,366,000 for this account. 

This is $166,343,000 below the fiscal year 2005 level and the same 

as the budget request. Included in the total availability is 

$3,339,381,000 authorized to be drawn from the Employment Security Administration Account of the Unemployment Trust Fund and 

$130,985,000 to be provided from the general fund of the Treasury. 

The funds in this account are used to provide administrative grants 

and assistance to State agencies that administer Federal and State 

unemployment compensation laws and operate the public employment service. 

For Unemployment Insurance Services, the Committee rec- ommends $2,632,915,000. This is $40,541,000 below the fiscal year 

2005 level and the same as the budget request. The total includes 

$2,622,499,000 for State Operations and $10,416,000 for national 

activities. Included in the amount provided for State Operations is 

up to $10,000,000 to station staff in One-Stop Centers to conduct 

Unemployment Insurance eligibility interviews. 

The Committee suggests that the Department encourage states 

to consider supporting Rapid Reemployment Pilot demonstration 

programs that use an already-developed tool for building re ́sume ́s 

over the phone to assist unemployment insurance claimants to 

quickly move back into the job market. 

For the Employment Service, the Committee recommends 

$696,000,000, which includes $23,300,000 in general funds together 

with an authorization to spend $672,700,000 from the Employment 

Security Administration Account of the Unemployment Trust Fund. 

This is $84,592,000 below the fiscal year 2005 level and the same 

as the budget request. The Committee recommends $33,766,000 for ES national activities. This is $31,210,000 below the fiscal year 2005 level and the 

same as the budget request. The Committee recommends $87,974,000 for America’s Labor 

Market Information System. This is $10,000,000 below the fiscal 

year 2005 level and the same as the budget request. This funding 

supports core employment statistics, universal access for cusVerDate jul 14 2003 07:43 Jun 22, 2005 Jkt 021909 PO 00000 Frm 00011 Fmt 6659 Sfmt 6602 E:\HR\OC\HR143.XXX HR143
12

tomers, improving efficiency in labor market transactions, and 

measuring and displaying WIA performance information. 

The Committee recommendation includes $19,711,000 for the 

Work Incentives Grants program, the same as the 2005 level and 

the budget request, to help persons with disabilities find and retain 

jobs through the One-Stop Career Center system mandated by the 

Workforce Investment Act. Funding will support systems building 

grants intended to ensure that One-Stop systems integrate and coordinate mainstream employment and training programs with essential employment-related services for persons with disabilities. 

ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS

The Committee recommends $465,000,000. This is $52,000,000 

below the fiscal year 2005 level and the same as the budget request. The appropriation is available to provide advances to several 

accounts for purposes authorized under various Federal and State 

unemployment compensation laws and the Black Lung Disability 

Trust Fund, whenever balances in such accounts prove insufficient. 

PROGRAM ADMINISTRATION

The Committee recommends $206,111,000. This is $36,010,000 

below the fiscal year 2005 level and the same as the budget request. This includes $118,123,000 in general funds and authority 

to expend $87,988,000 from the Employment Security Administration Account of the Unemployment Trust Fund. Within the 

amounts provided, the Committee has included $6,993,000 for Executive Direction. This is $148,000 below the fiscal year 2005 comparable level and the same as the request. General funds in this 

account provide the Federal staff to administer employment and 

training programs under the Workforce Investment Act of 1998, 

the Older Americans Act, the Trade Act, and the National Apprenticeship Act. Trust funds provide for the Federal administration of 

employment security functions under title III of the Social Security 

Act and the Immigration and Nationality Act. 

WORKERS COMPENSATION PROGRAMS

The Committee rescinds $120,000,000 in unobligated emergency 

response funds as requested by the Administration. 

EMPLOYEE BENEFITS SECURITY ADMINISTRATION

SALARIES AND EXPENSES

The bill provides $137,000,000 for the Employee Benefits Security Administration, $5,787,000 above the fiscal year 2005 level and 

the same amount as the budget request. 

The Employee Benefits Security Administration (EBSA) is responsible for the enforcement of Title I of the Employee Retirement 

Income Security Act of 1974 (ERISA) in both civil and criminal 

areas. This involves ERISA fiduciary and reporting/disclosure requirements. EBSA is also responsible for enforcement of sections 

8477 and 8478 of the Federal Employees’ Retirement Security Act 

of 1986. The agency was also given responsibilities under the 

Health Insurance Portability and Accountability Act of 1996. 

13

PENSION BENEFIT GUARANTY CORPORATION

The Corporation’s budget for fiscal year 2005 is $296,978,000, 

which is $30,648,000 above the fiscal year 2005 level and the same 

as the budget request. 

The Corporation is a wholly owned government corporation established by the Employee Retirement Income Security Act of 1974 

(ERISA). The law places it within the Department of Labor and 

makes the Secretary of Labor the chairperson of its board of directors. The Corporation receives its income from insurance premiums 

collected from covered pension plans, collections of employer liabilities imposed by ERISA, and investment earnings. It is also authorized to borrow up to $100,000,000 from the United States Treasury. 

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

or go out of existence. 

The bill includes language permitting obligations in excess of the 

amount provided in the bill after approval by both the Office of 

Management and Budget as well as the Committee on Appropriations. The Committee has an interest in approving obligations that 

may change the total amount available to any agency. 

EMPLOYMENT STANDARDS ADMINISTRATION

SALARIES AND EXPENSES

The bill includes $416,332,000 for this account. This is 

$15,485,000 above the fiscal year 2005 level and the same as the 

budget request. The bill includes $414,284,000 in general funds for 

this account and contains authority to expend $2,048,000 from the 

Special Fund established by the Longshore and Harbor Workers’ 

Compensation Act. 

The Employment Standards Administration is involved in the administration of numerous laws, including the Fair Labor Standards 

Act, the Immigration and Nationality Act, the Migrant and Seasonal Agricultural Workers’ Protection Act, the Davis-Bacon Act, 

the Family and Medical Leave Act, the Federal Employees’ Compensation Act, the Longshore and Harbor Workers’ Compensation 

Act, and the Federal Mine Safety and Health Act (black lung). The 

agency also administers Executive Order 11246 related to affirmative action by Federal contractors and the Labor-Management Reporting and Disclosure Act. 

SPECIAL BENEFITS

The bill includes $237,000,000. This is $4,000,000 below the fiscal year 2005 appropriation and the same as the budget request. 

This appropriation primarily provides benefits under the Federal 

Employees’ Compensation Act (FECA). The payments are required 

by law. In fiscal year 2005, an estimated 155,000 injured Federal 

workers or their survivors will file claims; 55,500 will receive longterm wage replacement benefits for job-related injuries, diseases, or 

deaths. 

SPECIAL BENEFITS FOR DISABLED COAL MINERS

The Committee recommends an appropriation of $232,250,000 for 

special benefits for disabled coal miners. This is in addition to the 

14

$81,000,000 appropriated last year as an advance for the first quarter of fiscal year 2005, the same as the budget request. These funds 

are used to provide monthly benefits to coal miners disabled by 

black lung disease and to their widows and certain other dependents, as well as to pay related administrative costs. 

The Committee recommends an advance appropriation of $74,000,000 for the first quarter of fiscal year 2006, the same as 

the budget request. These funds will ensure uninterrupted benefit 

payments to coal miners, their widows, and dependents. 

The Black Lung Consolidation of Administrative Responsibility 

Act of 2002 amends the Black Lung Benefits Act to transfer part 

B black lung benefits responsibility from the Commissioner of Social Security to the Secretary of Labor. 

ADMINISTRATIVE EXPENSES, ENERGY EMPLOYEES OCCUPATIONAL

ILLNESS COMPENSATION FUND

The bill includes $96,081,000 for the Energy Employees Occupational Illness Compensation Program authorized by Title XXXVI of 

the National Defense Authorization Act of 2001. This is 

$55,760,000 above the fiscal year 2005 level and the same as the 

budget request. Funds will be used to administer the program that 

provides compensation to employees or survivors of employees of 

the Department of Energy (DOE), its contractors and subcontractors, companies that provided beryllium to DOE, and atomic weapons employees who suffer from a radiation-related cancer, beryllium-related disease, or chronic silicosis as a result of their work 

in producing or testing nuclear weapons, and uranium workers covered under the Radiation Exposure Compensation Act. 

BLACK LUNG DISABILITY TRUST FUND

The bill includes $1,068,000,000 for this account. This is 

$6,031,000 above the comparable fiscal year 2005 level and the 

same as the budget request. The bill language provides such sums 

as may be necessary to pay for benefits. 

The Trust Fund pays all black lung compensation/medical and 

survivor benefit expenses when no responsible mine operator can 

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

are incurred in administering the benefits program and operating 

the Trust Fund. 

The basic financing for the Trust Fund comes from a coal excise 

tax for underground and surface-mines coal. Additional funds come 

from reimbursement payments from mine operators for benefit payments made by the Trust Fund before the mine operator is found 

liable. The advances to the Fund assure availability of necessary 

funds when liabilities may exceed other income. The Omnibus 

Budget Reconciliation Act of 1987 continues the current tax structure until 2014. 

OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION

SALARIES AND EXPENSES

The bill includes $477,199,000 for the Occupational Safety and 

Health Administration. This is $13,041,000 above the fiscal year 

2005 level and $10,218,000 above the budget request. This agency 

15

is responsible for enforcing the Occupational Safety and Health Act 

of 1970 in the Nation’s workplaces. 

The Committee directs OSHA to take no further action regarding 

respiratory protection for occupational exposure to TB until such 

time as the CDC has completed the ongoing revisions to the TB 

guidelines. The Committee further directs that upon completion of 

the TB guidelines OSHA should modify its rules so that OSHA respiratory regulations with regard to TB are not more strenuous 

than the CDC recommends. The Committee is disappointed that 

OSHA applied its general industry respiratory protection standard 

(GIRPS) to occupational exposure to tuberculosis (TB). Occupational exposure to TB is unique to healthcare facilities and currently is governed by the CDC’s TB Guidelines, which, according 

to the CDC, have reduced the number of TB cases in the United 

States by over forty percent in recent years and controlled outbreaks in healthcare facilities. In light of this fact, and the CDC’s 

Advisory Council for the Elimination of Tuberculosis’ (ACET) letter 

urging OSHA not to apply the general industry respiratory standard to occupational exposure to TB, the Committee feels that this 

arbitrary regulation is unnecessarily burdensome for healthcare facilities, who have already shown success in reducing the number of 

TB cases. 

The Committee is once again disappointed with the lack of 

progress on the agency’s regulation concerning Employer Payment 

for Personal Protective Equipment, the public comment period for 

which ended over six years ago. The Committee is especially concerned because the rate of worker deaths and injuries, which has 

decreased in the last decade for all American workers, has increased among Hispanic workers during that same time because 

they take on a disproportionate number of jobs in the nation’s most 

dangerous professions, including the construction industry. Despite 

some recent promising trends in workplace injury and death rates 

for Hispanic workers, the Department cannot attribute the trends 

to better provision of personal protective equipment because the 

Department has not issued the regulation. The Committee expects 

the Secretary to report to the Committee, within 30 days of the enactment of the bill, the definitive status of this regulation, the 

agency’s reasons for not issuing the regulation sooner, and a timetable for its issuance. 

MINE SAFETY AND HEALTH ADMINISTRATION

SALARIES AND EXPENSES

The bill includes $280,490,000 for this agency. This is $1,354,000 

above the fiscal year 2005 comparable level and the same as the 

budget request. This agency enforces the Federal Mine Safety and 

Health Act in underground and surface coal and metal and nonmetal mines. 

The Committee includes a provision granting authority for continued MSHA participation with the Holmes Safety Association to 

continue to promote miner safety and welfare. 

16

BUREAU OF LABOR STATISTICS

SALARIES AND EXPENSES

The total funding recommended by the Committee for the Bu- reau of Labor Statistics (BLS) is $542,523,000. This is $13,520,000 

above the fiscal year 2005 comparable level and the same as the 

budget request. The bill includes $464,678,000 in general funds for 

this account and authority to spend $77,845,000 from the Employment Security Administration Account of the Unemployment Trust 

Fund. The BLS is the principal fact-finding agency in the Federal 

government in the broad field of labor economics. Its principal surveys include the Consumer Price Index and the monthly unemployment series. 

The Committee is aware of a report by the Government Accountability Office titled, ‘‘Current Government Data Provide Limited Insight into Offshoring of Services’’ that found that government data 

do not adequately capture business transactions that offshoring can 

encompass; and government data provide only limited information 

about the effects of offshoring on the U.S. employment and the U.S. 

economy. The Committee therefore encourages the Department of 

Labor to examine ways to improve data collection on the impact of 

offshore outsourcing on employment trends and the U.S. economy. 

OFFICE OF DISABILITY EMPLOYMENT POLICY

SALARIES AND EXPENSES

The bill includes $27,934,000 for the Office of Disability Employ- ment Policy, which is $19,230,000 below the fiscal year 2005 comparable level and the same as the budget request. The Office provides leadership to eliminate employment barriers to people with 

disabilities. 

DEPARTMENTAL MANAGEMENT

SALARIES AND EXPENSES

The bill includes $244,423,000 for Departmental Management ac- tivities. This is $76,265,000 below the fiscal year 2005 level and the 

same as the budget request. The bill includes $244,112,000 in general funds for this account along with authority to transfer 

$311,000 from the Employment Security Administration Account of 

the Unemployment Trust Fund. 

The Departmental Management appropriation finances staff is 

responsible for formulating and overseeing the implementation of 

Departmental policy and management activities. In addition, this 

appropriation includes a variety of operating programs and activities that are not involved in Departmental Management functions, 

but for which other salaries and expenses appropriations are not 

suitable. 

The Committee recommendation includes $29,504,000 for Executive Direction, $2,784,000 below the fiscal year 2005 level and the 

same as the budget request. 

The bill provides $29,760,000 for the Department-wide information technology crosscut, the same as the fiscal year 2005 comparable level and the budget request. The Committee commends 

the Department in streamlining its information technology infraVerDate jul 14 2003 07:43 Jun 22, 2005 Jkt 021909 PO 00000 Frm 00016 Fmt 6659 Sfmt 6602 E:\HR\OC\HR143.XXX HR143
17

structure into a single, uniform system and encourages the Department in this effort. 

The bill provides $1,700,000 for the Departmental Management Crosscut. This is $3,260,000 below the fiscal year 2005 level and 

the same as the budget request. The bill includes $33,197,000 for the Administration and Management program that provides leadership and policy guidance for 

a number of Department-wide activities. This is $783,000 below the 

fiscal year 2005 level and the same as the budget request. 

The Committee is interested in ensuring that qualified job training programs of the Department of Labor fully extend priority of 

service for veterans as required by the Jobs for Veterans Act. Toward this effort, the Committee urges the Secretary to develop a 

guide for veterans in accessing workforce investment services; a 

guide for assisting veterans service organizations and homeless veteran service providers in accessing workforce investment funds and 

workforce investment planning processes; and a guide to inform 

workforce systems on the employment services needs of veterans 

and the responsibility of such systems to prioritize veterans for 

services and to collaborate with veterans’ organizations and providers. 

The Committee urges the Secretary to instruct state workforce 

agencies to increase their outstationing of disabled veterans outreach program specialists and local veterans employment representatives in locations where homeless veterans congregate, including grantees under the homeless provider grant and per diem 

program and the homeless veterans reintegration program. 

The Committee is interested in better understanding the full impact of federal assistance programs, including the number of individuals who access multiple federal programs, either concurrently 

or during the course of their lifetime. As such, the Committee directs the U.S. Department of Labor to develop the infrastructure 

necessary to cross-reference individuals participating in multiple 

federal programs. As part of this effort, DOL is encouraged to partner with other federal agencies to develop common measures across 

all programs that will allow such cross-referencing to occur. The 

Department shall report to Congress, by March 1, 2006, on the status of this initiative, including a specific list of barriers that may 

preclude the agency from full compliance with this directive. 

The Committee directs that all financial service or other employee benefit products that are covered by the Employee Retirement Income Security Act (ERISA) carry the following warning, 

outlined in a box on the cover page, in nothing less than 16 point, 

bold Arial font: 

‘‘This product is covered by the Employee Retirement Income Security Act (ERISA). Under ERISA, recourse is greatly limited in 

disputes of service. It is the responsibility of the consumer to read 

all language pertaining to ERISA and/or consult with independent 

advisors prior to enrolling in this benefit plan.’’ 

The Committee is concerned about the implementation of the department’s ‘‘policy guidance’’ pursuant to Executive Order 13166, 

published on August 16, 2000, regarding limited English proficiency. The Committee feels it is important to keep track of the 

costs of this policy to make sure that the provision of language 

services is being done as cost effectively as possible. Therefore, the 

18

U.S. Department of Labor should report to the Committee the total 

funding spent on the provision of services in languages other than 

English, including publications costs, web site development and 

maintenance costs, outreach activities, translation activities, and 

language line contracts. 

ASSISTANT SECRETARY FOR VETERANS EMPLOYMENT AND TRAINING

The Committee recommends $224,334,000 for veteran employment and training activities. This is $1,501,000 above the fiscal 

year 2005 level and the same as the budget request. Within this 

amount, the bill includes $194,834,000 to be expended from the 

Employment Security Administration account of the Unemployment Trust Fund for the traditional State and Federal administration of veterans’ employment and training activities. 

Individuals leaving the military are at high risk of homelessness 

due to a lack of job skills transferable to the civilian sector, disrupted or dissolved family and social support networks, and other 

risk factors that preceded their military service. The Transition Assistance Program (TAP) has been established to ease the transition 

of separating service members to the civilian sector. The Committee instructs the Secretary of Labor to ensure that a module on 

homelessness prevention is added to the TAP curriculum. The module should include a presentation on risk factors for homelessness, 

a self-assessment of risk factors, and contact information for preventative assistance associated with homelessness. 

OFFICE OF THE INSPECTOR GENERAL

The bill includes $70,819,000 for the Office of the Inspector General (OIG). This is $1,824,000 above the fiscal year 2005 comparable level and the same as the budget request. This includes 

$65,211,000 in general funds for this account along with the authority to transfer $5,608,000 from the Employment Security Administration Account of the Unemployment Trust Fund. 

The OIG was created by law to protect the integrity of Departmental programs as well as the welfare of beneficiaries served by 

those programs. Through a program of audits, investigations, and 

program evaluations, the OIG attempts to reduce the incidence of 

fraud, waste, abuse, and mismanagement, and to promote economy, 

efficiency, and effectiveness throughout the Department. 

WORKING CAPITAL FUND

The Committee includes $6,230,000 for a new core accounting 

system for the Department of Labor, including hardware and software infrastructure. This is $3,690,000 below the comparable fiscal 

year 2005 level and the same as the budget request. 

GENERAL PROVISIONS

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

use of Job Corps funding for compensation of an individual at a 

rate in excess of Executive Level II. 

Sec. 102. The Committee modifies a provision permitting the Secretary of Labor to transfer up to one percent of any discretionary 

appropriation from an account. 

19

Sec. 103. The Committee includes a provision directing the Secretary to provide to the Department of Labor employees in the National Capital Region the full transit subsidy that they are eligible 

to receive. 

TITLE II—DEPARTMENT OF HEALTH AND HUMAN 

SERVICES 

HEALTH RESOURCES AND SERVICES ADMINISTRATION

HEALTH RESOURCES AND SERVICES

The bill includes $6,446,357,000 for health resources and services 

programs, which is $356,655,000 below the fiscal year 2005 comparable level for these activities and $480,213,000 above the budget 

request. This includes $500,000,000 that was previously provided 

in the Public Health and Social Services Emergency Fund for two 

bioterrorism programs administered by the Health Resources and 

Services Administration (HRSA)—$472,479,000 for hospital preparedness grants and $27,521,000 for education incentives for medical school curricula.

HRSA supports programs which 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. 

Community health centers 

The Committee provides $1,834,311,000 for community health 

centers, which is $100,000,000 above the fiscal year 2005 comparable level and $203,560,000 below the budget request. These 

funds support programs which include community health centers, 

migrant health centers, health care for the homeless and public 

housing health service grants. 

The Committee includes bill language similar to previous years 

limiting the amount of funds available for the payment of claims 

under the Federal Tort Claims Act to $45,000,000, which is the 

same as the budget request and the limitation in the fiscal year 

2005 bill. 

The Committee does not provide additional funds for loan guarantee authority for community health centers under section 330(d) 

of the Public Health Service Act. The Committee notes that $105 

million remains, of the $160 million appropriated in fiscal years 

1997 and 1998, for loan guarantee authority for guarantees of both 

loan principal and interest. 

The Committee supports the long-standing HRSA policy of approving specific qualified applications for future funding. This process enables high-quality applicants to take steps to develop and implement care delivery systems in their communities instead of 

wasting scarce resources to reapply for funding. The Committee intends that HRSA should use $56,000,000 of the funding provided 

above the fiscal year 2005 level for this purpose.

The Committee provides $26,000,000 as requested by the Administration for a new initiative to fund health centers in approximately 40 high poverty counties across the country, as well as 25 

planning grants. The Committee includes bill language requested 

20

by the Administration to direct this funding to high-poverty counties. 

The Committee encourages community health centers to make 

ultrasound services available to their patients. 

Free clinics medical malpractice 

The Committee does not provide fiscal year 2006 funding for payments of claims under the Federal Tort Claims Act to be made 

available for volunteer free clinic health care professionals. $99,000 

was provided for this purpose in fiscal year 2005 and claims are 

not expected against the fund until at least fiscal year 2007. The 

program extends Federal Tort Claims Act coverage to health care 

professional volunteers in free clinics in order to expand access to 

health care services to low-income individuals in medically underserved areas. According to Title 42, Section 233(o), a free clinic 

must apply, consistent with the provisions applicable to community 

health centers, to have each health care professional ‘deemed’ an 

employee of the Public Health Service Act, and therefore eligible 

for coverage under the Federal Tort Claims Act. 

Radiation exposure compensation act 

The Committee provides $1,900,000 for the radiation exposure compensation act, which is $58,000 below fiscal year 2005 comparable level and $36,000 below the budget request. This program 

provides grants for the education, prevention and early detection of 

radiogenic cancers and diseases resulting from exposure to uranium during its mining and milling at nuclear test sites. 

Healthy community access program 

The Committee does not provide funding for the healthy commu- nity access program, which is $82,993,000 below the fiscal year 

2005 comparable level and the same as the Administration request. 

The program was designed to increase the capacity and effectiveness of the variety of community health care institutions and providers who serve patients regardless of their ability to pay through 

development of community consortia. Congress has appropriated 

$541 million for this program since fiscal year 2000. 

Hansen’s disease services 

The Committee provides $16,066,000 for the Hansen’s disease 

program, which is $1,185,000 below the fiscal year 2005 comparable level and the same as the budget request. This program offers Hansen’s disease treatment to 11 long-term residents who continue to receive care from the National Hansen’s Disease Center 

and to others who receive care from grant-supported outpatient regional clinics. Other former long-term residents have been offered 

and elected to receive a living allowance from the program and now 

live independently. These programs provide treatment to about 

3,000 of the 6,000 Hansen’s disease sufferers in the continental 

United States. 

Buildings and facilities 

The Committee provides $222,000 for buildings and facilities, 

which is $25,000 below fiscal year 2005 comparable level and the 

same as the budget request. These funds are used to finance the 

21

repair and upkeep of buildings at the Gillis W. Long Hansen’s Disease Center at Carville, Louisiana. 

Payment to Hawaii for treatment of Hansen’s disease 

The Committee provides $2,016,000 for the treatment of persons with Hansen’s disease in the State of Hawaii, which is $1,000 

below the fiscal year 2005 comparable level and the same as the 

Administration request. The program, which provides a partial 

matching payment to the State of Hawaii, dates to the period of 

Father Damien’s facility for sufferers of Hansen’s disease. That facility now has only 40 residents who live there by choice, and the 

grounds have been converted to a historical site. Most patients diagnosed with Hansen’s disease in Hawaii are now treated in the 

same manner as new patients on the mainland; their care is handled on an out-patient basis, with the program paying for 247 active ambulatory Hansen’s Disease cases. 

Black lung clinics 

The Committee provides $5,912,000 for black lung clinics, which is the $39,000 below the fiscal year 2005 comparable level and the 

same as budget request. The program supports fifteen grantees 

that treat a declining population of coal miners with respiratory 

and pulmonary impairments. The clinics presently receive more 

than one-third of their funding from other sources, such as Medicaid and Medicare. Of the fifteen grantees, six receive health center funding as well as black lung grants. 

National Health Service Corps: Field placements 

The Committee provides $40,705,000 for field placements, which is $4,363,000 below the fiscal year 2005 comparable level and the 

same as the budget request. These funds are used to support the 

activities of National Health Service Corps (NHSC) obligors and 

volunteers in the field, including travel and transportation costs of 

assignees, training and education, recruitment of students, residents and clinicians and retention activities. Salary costs of most 

new assignees are paid by the employing entity. 

National Health Service Corps: Recruitment 

The Committee provides $86,091,000 for recruitment activities, 

which is $289,000 below the fiscal year 2005 comparable level and 

the same as the budget request. The program awards scholarships 

to health professions students and assists graduates in repaying 

their student loans. In return for every year of support, these individuals are obligated to provide a year of service in health professional shortage areas of greatest need. The minimum obligation is 

two years. 

The Committee believes that the inclusion of optometrists in the 

National Health Service Corps’ (NHSC) Student Loan Repayment 

Program would result in the expanded accessibility of eye care in 

communities where it is most needed. Accordingly, the Committee 

encourages HRSA to take immediate steps to fully utilize Doctors 

of Optometry in the NHSC Student Loan Repayment Program as 

part of an effort to make preventive eye care services more accessible in community health centers within rural and urban primary 

care health professional shortage areas. 

22

Health professions 

The Committee provides $197,119,000 for all health professions training programs, which is $253,094,000 below the fiscal year 

2005 comparable level and $36,585,000 above the budget request. 

The Committee was unable to restore much of the $289,679,000 reduction in health professions funding proposed by the Administration, but the Committee felt it was especially important to support 

programs for disadvantaged students and nurse training programs. 

The table at the end of the report identifies how funding is allocated for programs authorized by titles VII and VIII of the Public 

Health Service Act. 

The Committee commends HRSA for its efforts to address the 

growing gap between the size of the Nation’s aging baby boom population and the number of pulmonary/critical care physicians. The 

Committee is aware that HRSA has prepared a report on the 

healthcare workforce shortage issue, and that the portion of the report that will attempt to identify the causes of, and potential responses to, the critical care workforce shortage will be informed, in 

part, by The Critical Care Medicine Crisis: A Call for Federal Action prepared by the Critical Care Workforce Partnership. The 

Committee expects HRSA to provide a copy of this report to the 

Committee within 120 days. 

Centers of excellence 

The Committee provides $12,000,000 for centers of excellence, which is $21,609,000 below the fiscal year 2005 comparable level. 

The Administration did not request funding for this program. The 

program is designed to strengthen the national capacity to educate 

underrepresented minority (URM) students in the health professions by offering special support to those institutions which train 

a significant number of URM individuals. Funds are used for the 

recruitment and retention of students and faculty, information resources and curricula, faculty and student research, and the development of plans to achieve institutional improvements. 

Scholarships for disadvantaged students 

The Committee provides $35,128,000 for scholarships for dis- advantaged students, which is $12,000,000 below the fiscal year 

2005 comparable level and $25,297,000 above the budget request. 

The program provides grants to eligible health professions and 

nursing schools to provide scholarships to eligible individuals from 

disadvantaged backgrounds, including students who are members 

of racial and ethnic minority groups. By statute, not less than 16 

percent of the funds must go to schools of nursing. 

Advanced education nursing 

The Committee provides $57,637,000 for advanced education nursing, which is $523,000 below the fiscal year 2005 comparable 

level and $14,831,000 above the budget request. The program provides grants and contracts to eligible entities to meet the costs of: 

(1) projects that support the enhancement of advanced nursing 

education and practice; and (2) traineeships for individuals in advanced nursing education programs. The program prepares nurse 

practitioners, clinical nurse specialists, nurse midwives, nurse anesthetists, nurse educators, nurse administrators, public health 

23

nurses or other nurse specialists for advanced practice roles. Within the allocation, the Committee encourages HRSA to allocate funding at least at the fiscal year 2001 level for nurse anesthetist education. 

Nurse education, practice and retention 

The Committee provides $36,468,000 for nurse education, practice and retention, which is the same as fiscal year 2005 comparable level and 9,857,000 below the budget request. As amended 

by the Nurse Reinvestment Act of 2002, the nurse education, practice and retention program is a broad authority with targeted purposes under three priority areas—education, practice and retention—in response to the growing nursing shortage. 

Nursing workforce diversity 

The Committee provides $16,270,000 for nursing workforce diversity, which is the same as the fiscal year 2005 comparable level 

and $4,974,000 below the budget request. The program provides 

grants and contracts to schools of nursing and other eligible entities to meet the costs of special projects to increase nursing education opportunities for individuals who are from disadvantaged 

backgrounds, including racial and ethnic minorities, by providing 

student scholarships or stipends, pre-entry preparation, and retention activities. The program also contributes to the basic preparation of disadvantaged and minority nurses for leadership positions 

within the nursing and health care community. 

Loan repayment and scholarship program 

The Committee provides $31,369,000 for the nurse loan repay- ment and scholarship program, which is $113,000 below the fiscal 

year 2005 comparable level and the same as the budget request. 

This program offers student loan repayment to nurses or scholarships to nursing students in exchange for an agreement to serve 

not less than two years at a health care facility with a critical 

shortage of nurses. 

The Committee recognizes the ongoing nursing shortage crisis 

and believes that new strategies are needed to increase the numbers of nursing faculty to prepare the future nursing workforce. 

The Committee encourages the Secretary to designate schools of 

nursing as health care facilities for the purposes the Nurse Loan 

Repayment and Scholarship Program as authorized by the Public 

Health Service Act. The Committee further urges the Secretary to 

give increased consideration to eligible nurses in the loan repayment program with a commitment to working in a faculty setting. 

Comprehensive geriatric nurse education 

The Committee provides $3,426,000 for comprehensive geriatric 

nurse education, which is $24,000 below the fiscal year 2005 comparable level and the same as the Administration request. The 

comprehensive geriatric education program supports grants for (1) 

providing training to individuals who will provide geriatric care for 

the elderly; (2) develop and disseminate curricula relating to the 

treatment of the health care problems of elderly individuals; (3) 

train faculty members in geriatrics; or (4) provide continuing education to individuals who provide geriatric care. 

24

Nurse faculty loan program 

The Committee provides $4,821,000 for the nurse faculty loan 

program, which is $10,000 below the fiscal year 2005 comparable 

level and the same as the Administration request. The nurse faculty loan program supports the development of a student loan fund 

in schools of nursing to increase the number of qualified nursing 

faculty. Students may receive loans up to $30,000 per year for a 

maximum of 5 years. The program has a cancellation provision for 

up to 85 percent of the loan for recipients working full-time as 

nursing faculty for a period of 4 years. 

Children’s hospitals graduate medical education program 

The Committee provides $300,000,000 for the children’s hospitals 

graduate medical education program, which is $730,000 below the 

fiscal year 2005 comparable bill and $100,000,000 above the budget 

request. The program provides support for health professions training in children’s teaching hospitals that have a separate Medicare 

provider number (‘‘free-standing’’ children’s hospitals). The funding 

in this program is intended to make the level of Federal Graduate 

Medical Education support more consistent with other teaching 

hospitals, including children’s hospitals which share provider numbers with other teaching hospitals. Payments are determined by 

formula, based on a national per-resident amount. Payments support training of resident physicians as defined by Medicare in both 

ambulatory and inpatient settings. The Committee believes this 

program is vital to restoring the reimbursement inequity faced by 

pediatric hospitals, which provide very high quality care to children 

with difficult and expensive conditions. 

National practitioner data bank 

The Committee does not provide funding for the national practitioner data bank for fiscal year 2006, which is the same as both 

the fiscal year 2005 action on appropriations and the budget request. The Committee recommendation and the budget request assume that the data bank will be self-supporting, with collections of 

$15,700,000 in user fees. The national data bank receives, stores 

and disseminates information on paid medical malpractice judgments and settlements, sanctions taken by Boards of Medical Examiners, losses of membership in professional societies, and certain 

professional review actions taken by health care entities. Insurance 

companies, State licensure boards and authorities, and other 

health care entities and professional societies are required to report 

information to the data bank within 30 days of each action. The 

coverage of the data bank includes dentists and physicians, and, 

with respect to malpractice settlements and judgments, other categories of licensed health professionals. Hospitals are required to 

search the data bank when a health care provider applies for employment and once every two years thereafter. State licensing 

boards, other health care entities, licensing authorities, and professional societies also have access to the data bank. Traditional bill 

language is included to ensure that user fees are collected to cover 

the full costs of the data bank operations. 

25

Health care integrity and protection data bank 

The Committee does not provide funding for the health care integrity and protection data bank (HIPDB) for fiscal year 2006. The 

Committee recommendation and the budget request assume that 

the data bank will be self-supporting, with collections of $4,000,000 

in user fees. HIPDB receives, stores, and disseminates information 

on final adverse actions taken against health care providers, suppliers, and practitioners, health care related civil judgments and 

criminal convictions. This information is collected from and made 

available to Government agencies and health plans. 

Maternal and child health block grant 

The Committee provides $700,000,000 for the maternal and child health (MCH) block grant, which is $23,928,000 below both the fiscal year 2005 comparable level and the budget request. 

The MCH block grant provides funds to States to meet a broad 

range of basic and enabling health services, including personal 

health services; general, population-wide health services, such as 

screening; family support services; and integrated systems of care. 

The authorizing statute provides that, up to a funding level of 

$600,000,000, 85 percent of the funds are distributed to the States, 

with 15 percent of the funds set aside for special projects of regional and national significance (SPRANS). When the appropriation exceeds $600,000,000, 12.75 percent of the amount over 

$600,000,000 is directed to the Community Integrated Service Systems set-aside program. The remaining 87.25 percent is distributed 

by the same 85/15 percent allocation as in the basic block grant formula. 

The Committee has included bill language identifying $116,124,000 for the SPRANS set-aside. Within that total, 

$5,000,000 is provided for the continuation of oral health programs 

in the States. Through grants, cooperative agreements or contracts, 

these funds may be used to increase access to dental care for the 

most vulnerable low-income children, such as Medicaid, SCHIP, 

and Head Start children and to implement state-identified objectives for improving oral health. Anticipated activities include those 

targeting the reduction of early childhood caries and strengthening 

school-linked dental sealant programs. The Committee has also provided $4,000,000 within the SPRANS 

set-aside to support the continuation of the community-based sickle 

cell disease outreach and supportive service initiative. In addition, the Committee provides $3,000,000 within the 

SPRANS set-aside to continue the newborn screening for heritable 

disorders demonstrations begun two years ago. Newborn screening 

is used for early identification of infants affected by certain genetic, 

metabolic, hormonal or functional conditions for which there is effective treatment or intervention. Screening detects disorders in 

newborns that, left untreated, can cause death, disability, mental 

retardation and other serious illnesses. The Committee is aware 

that wide disparities exist on the number and types of conditions 

screened for in each State. The Committee commends HRSA for 

convening the Secretary’s Advisory Committee on Heritable Disorders and Genetic Diseases in Newborns and Children to make 

national recommendations to standardize newborn screening programs in the U.S. The Committee encourages HRSA to use some 

26

of the funds provided for the development of parental and provider 

education material and programs to promote the importance of 

newborn screening. The Committee has also provided $3,000,000 within the SPRANS 

set-aside to continue epilepsy demonstration programs. These programs are designed to improve access to health and other services 

regarding seizures and to encourage early detection and treatment 

in children and others residing in medically underserved and rural 

areas. The Committee is pleased that HRSA has partnered with a 

national voluntary epilepsy agency to carry out these activities. Of 

the amount provided, the Committee recommends that up to thirty 

percent be used to continue to fund the development and testing 

of a national public health awareness campaign to increase seizure 

recognition and improve access to care among minorities and underserved populations. 

The Committee reiterates its long-standing support for the continuation of funding that Maternal and Child Health Block Grant 

has provided to comprehensive thalassemia treatment centers 

under the SPRANS program. The Committee strongly encourages 

HRSA to continue this program and to coordinate with the relevant 

voluntary organizations. 

The Committee is aware that some States have made reductions 

in MCH resources that are allocated for children with special 

health needs. The Committee encourages HRSA to continue to 

work with State MCH programs to assure the availability of services for children with special health care needs, including medical 

and support services to maintain their physical, mental and emotional health and development. 

The Committee recognizes the critical role of hemophilia treatment centers funded through the SPRANS set-aside in providing 

needed comprehensive care for persons with bleeding disorders and 

the expanded role of these centers in addressing the needs of 

women with bleeding disorders and persons with clotting disorders 

such as thrombophilia. The Committee encourages HRSA to continue its support of this model disease management network. 

The Committee recognizes the contributions of the longstanding 

Provider’s Partnership program and encourages HRSA to continue 

its funding. The Partnership includes a series of state-level projects 

initiated to address female psychosocial issues through integration 

of medical care with psychosocial services. Such partnerships enhance service integration, minimize demands on individual providers, and facilitate movement between providers and agencies to 

create comprehensive care. 

Sickle cell anemia demonstration program 

The Committee does not provide funding for the sickle cell anemia demonstration program, which is the same as the budget request and $198,000 less than the fiscal year 2005 comparable level. 

This program was funded for the first time in fiscal year 2005. The 

Committee has provided $4,000,000 within the Maternal and Child 

Health SPRANS funding for sickle cell demonstrations. 

Traumatic brain injury 

The Committee provides $9,000,000 for the traumatic brain injury (TBI) program. This is $297,000 below the fiscal year 2005 

27

comparable level. The budget request did not fund the program. 

The TBI program funds the development and implementation of 

statewide systems to ensure access to care including prehospital 

care, emergency department care, hospital care, rehabilitation, 

transitional services, and long-term community support. Grants 

also go to State protection and advocacy systems. 

Healthy Start 

The Committee provides $97,747,000 for Healthy Start, which is $4,796,000 below the fiscal year 2005 comparable level and the 

same as the budget request. Healthy Start provides grants to select 

communities with high rates of infant mortality to help them identify, plan, and implement a diverse range of community-driven 

strategies that can successfully reduce disparities in perinatal 

health that contribute to the Nation’s high infant mortality rate. 

Since 1990, the Maternal and Child Health Bureau has worked 

in cooperative agreement to run the National Fetal Infant Mortality Review (NFIMR) program. NFIMR provides training and assistance to enhance cooperative partnerships among local community health professionals, public health officers, community advocates and consumers to reduce infant mortality. The goal is to improve local services and resources for women, infants and families, 

to remove barriers to care, and to ensure culturally appropriate, 

family friendly services. Such efforts are crucial to understanding 

and addressing infant health disparities in communities at highest 

risk. The Committee encourages HRSA to continue to use Healthy 

Start funds to support the NFIMR project. 

Universal newborn hearing screening 

The Committee provides $10,000,000 for the universal newborn hearing screening program, which is $208,000 above the fiscal year 

2005 comparable level. The Administration did not request funding 

for this program. The program provides competitive grants to 

States for universal newborn hearing screening by means of physiologic testing prior to hospital discharge, audiologic evaluation by 

three months of age, and entry into a program of early intervention 

by six months of age. 

Currently, 52 states and territories have received competitive 

grants for the purpose of implementing statewide early hearing detection and intervention (EHDI) programs. Since these grants have 

only been operational for a few years, the Committee believes that 

a small amount of continued Federal funding is critical at this time 

to ensure that state EHDI programs become fully operational and 

that screening programs are properly linked with diagnosis, early 

intervention, and the child’s routine medical care (often referred to 

as the child’s medical home). The Committee is concerned that 

even though approximately 90 percent of babies are now screened 

for hearing loss before 1 month of age, about one-third of those who 

are referred from screening do not receive diagnostic evaluations by 

3 months of age. Moreover, only about half of the infants and toddlers diagnosed with permanent hearing loss are enrolled in appropriate early intervention programs by 6 months of age. 

The Committee has provided an increase to: (a) enable states to 

institutionalize the State EHDI programs developed during the last 

3–5 years; (b) increase the availability of qualified pediatric audiolVerDate jul 14 2003 07:43 Jun 22, 2005 Jkt 021909 PO 00000 Frm 00027 Fmt 6659 Sfmt 6602 E:\HR\OC\HR143.XXX HR143
28

ogists; (c) educate health care providers and families about the importance and procedures for EHDI; (d) strengthen linkages between 

EHDI and early intervention programs funded by Part C of IDEA; 

(e) continue and expand the National EHDI Technical Assistance 

System; (f) evaluate the impact of statewide EHDI programs; and 

(g) increase the capacity of states to screen children for progressive 

and late-onset hearing losses. To minimize the loss to follow-up, the 

Committee urges HRSA to ensure that all infants identified 

through the screening process are linked to an identifiable and ongoing source of routine health care. 

To avoid duplication, the Committee expects HRSA to coordinate 

projects funded with this appropriation with projects related to 

early hearing detection and intervention by the National Center on 

Birth Defects and Developmental Disabilities, the National Institute on Deafness and Other Communication Disorders, the National Institute on Disability and Rehabilitation Research, and the 

Office of Special Education and Rehabilitative Services. 

Emergency medical services for children 

The Committee provides $19,000,000 for the Emergency Medical Services for Children (EMSC) program, which is $830,000 below 

the fiscal year 2005 comparable level. The Administration did not 

request funding for the program. The Committee recognizes that 

this program is the only Federal source of funding and expertise 

for improving EMS systems for children. The Committee commends 

the EMSC program for its twenty years of achievement in this 

arena and applauds its commitment to improving the delivery of 

emergency medical services to ill and injured children. 

Poison control centers 

The Committee provides $23,301,000 for poison control centers, which is $198,000 below the fiscal year 2005 comparable level and 

the same as the Administration request. These funds support a 

grant program for poison control centers. In addition, funds are 

used to maintain a national toll-free number and to implement a 

media campaign to advertise that number, as well as to support 

the development of uniform patient management guidelines and 

the improvement of data collection. 

Ryan White AIDS programs 

The Committee provides $2,058,296,000 for Ryan White AIDS 

programs, which is $10,000,000 above the fiscal year 2005 comparable level and the same as the budget request. The bill also 

makes available $25,000,000 in program evaluation funding under 

section 241 of the Public Health Service for special projects of national significance. Within the total provided, the Committee expects that Ryan White AIDS activities that are targeted to address 

the growing HIV/AIDS epidemic and its disproportionate impact 

upon communities of color, including African Americans, Latinos, 

Native Americans, Asian Americans, Native Hawaiians, and Pacific 

Islanders will be supported at no less than the fiscal year 2005 

level. 

The Committee is aware that over thirty percent of HIV-infected 

persons in the United States are also chronically infected with the 

hepatitis C virus (HCV). Chronic hepatitis C infection may lead to 

29

cirrhosis of the liver and liver cancer, and is the leading cause of 

liver transplantation in the U.S. In addition, chronic hepatitis C 

disease progresses more rapidly in HIV-infected persons, and end 

stage liver disease resulting from chronic hepatitis C infection is 

now a leading cause of death for people with HIV/AIDS. The Committee encourages HRSA to provide guidance to CARE Act grantees to encourage them to proactively address HCV care and treatment among their HIV/HCV co-infected patient populations, and 

encourages State AIDS Assistance Programs to provide coverage of 

therapies approved by the FDA for the treatment of HCV in HIV/

HCV co-infected patients. 

Emergency assistance 

The Committee provides $610,094,000 for the Part A, emergency 

assistance program, which is the same as the fiscal year 2005 comparable level and the budget request. These funds provide grants 

to metropolitan areas with very high numbers of AIDS cases for 

outpatient and ambulatory health and social support services. Half 

of the amount appropriated is allocated by formula and half is allocated to eligible areas demonstrating additional need through a 

competitive grant process. 

Comprehensive care programs 

The Committee provides $1,131,836,000 for Part B, comprehen- sive care programs, which is $10,000,000 above the fiscal year 2005 

comparable level and the same as the budget request. The funds 

provided support formula grants to States for the operation of HIV 

service delivery consortia in the localities most heavily affected, for 

the provision of home and community-based care, for continuation 

of health insurance coverage for infected persons, and for purchase 

of therapeutic drugs. The Committee has included bill language 

identifying $797,521,000 specifically to support State AIDS Drug 

Assistance Programs (ADAP) as requested by the Administration. 

In fiscal year 2005, $787,521,000 was designated for this purpose. 

The Committee is aware of the success HIV therapies have had 

on prolonging and enhancing the quality of life for those infected 

with HIV/AIDS. As the infected population lives longer and becomes increasingly resistant to current treatment regimens, there 

is a growing need to focus on access to newer therapies for treatment-experienced or ‘‘later stage’’ patients. The Committee encourages HRSA and state ADAPs to prioritize coverage of treatments 

for later stage patients so that there is parity of access to effective 

treatments for patients across the HIV disease spectrum. 

Early intervention program 

The Committee provides $195,578,000 for Part C, the early intervention program, which is the same as the fiscal year 2005 comparable level and the budget request. Funds are used for discretionary grants to migrant and community health centers, health 

care for the homeless grantees, family planning grantees, hemophilia centers and other private non-profit entities that provide 

comprehensive primary care services to populations with or at risk 

for HIV disease. The grantees provide testing, risk reduction counseling, transmission prevention, and clinical care; case management, outreach, and eligibility assistance are optional services. 

30

Pediatric HIV/AIDS 

The Committee provides $72,519,000 for Part D, pediatric AIDS 

demonstrations, which is the same as the fiscal year 2005 comparable level and the budget request. The program supports demonstration grants to foster collaboration between clinical research 

institutions and primary community-based medical and social service providers for the target population of HIV-infected children, 

pregnant women and their families. The projects are intended to 

increase access to comprehensive care, as well as voluntary participation in NIH and other clinical trials. 

AIDS dental services 

The Committee provides $13,218,000 for AIDS dental services, 

which is the same as the fiscal year 2005 comparable level and the 

budget request. The program provides reimbursements to dental 

schools and postdoctoral dental education programs to assist with 

the cost of providing unreimbursed oral health care to patients 

with human immunodeficiency virus disease. Dental students and 

residents participating in this program receive extensive training 

in the understanding and management of the oral health care 

needs of people living with HIV/AIDS. 

Education and training centers 

The Committee provides $35,051,000 for AIDS education and 

training centers (AETCs), which is the same as the fiscal year 2005 

comparable level and the budget request. The centers train health 

care personnel who care for AIDS patients and develop model education programs. 

Telehealth 

The Committee provides $3,888,000 for telehealth, which is 

$28,000 below the fiscal year 2005 comparable level and the same 

as the budget request. The telehealth program works with and supports communities in their efforts to develop cost-effective uses of 

telehealth technologies. These technologies bring health services to 

populations that are isolated from health care, and health-related 

education to the practitioners who serve them. 

Organ transplantation 

The Committee provides $23,282,000 for organ transplantation 

activities, which is $1,131,000 below the fiscal year 2005 comparable level and same as the budget request. The program supports a scientific registry of organ transplant recipients; the National Organ Procurement and Transplantation Network, which 

matches organ donors with potential recipients; and grants and 

contracts with public and private non-profit organizations to promote and improve organ donation. Several of the new authorities 

created in the Organ Donation Recovery and Improvement Act are 

funded in the Administration request, including demonstration 

grants for reimbursement of travel and subsistence expenses toward living organ donation. 

The Committee encourages the Administration to provide priority 

consideration to hospitals serving rural, medically underserved 

communities and those who have a long history of transplant surVerDate jul 14 2003 07:43 Jun 22, 2005 Jkt 021909 PO 00000 Frm 00030 Fmt 6659 Sfmt 6602 E:\HR\OC\HR143.XXX HR143
31

gery but whose accreditation is in jeopardy due to their declining 

number of transplant surgeries. 

The Committee is encouraged by the continuing success of the 

Organ Donation Breakthrough Collaborative and has included 

funds for its continuation, as requested by the Administration. This 

project is focused on increasing organ donation consent rates 

among the nation’s hospitals where the greatest number of donors 

exist. As a result, an additional 4,000 organs annually are expected 

to be made available for transplant. 

The Committee commends HRSA for its leadership in promoting 

increased organ and tissue donations across the nation and encourages the Division of Transplantation to continue its partnership 

with the pulmonary hypertension (PH) community in this important area. Moreover, the Committee encourages the Organ Procurement and Transplantation Network/United Network for Organ 

Sharing to continue to work with the PH community to address 

concerns regarding the methodology used to determine transplantation eligibility for PH patients. 

Cord blood bank 

The Committee does not provide additional funding for the cord 

blood program pending the HRSA response to the Institute of Medicine report on the structure and administration of such a program. 

$19,800,000 was provided for this purpose in fiscal years 2004 and 

2005, to remain available until expended. The Administration 

budget did not request funding for fiscal year 2006. 

Bone marrow program 

The Committee provides $25,416,000 for the bone marrow program, which is the same as the fiscal year 2005 comparable level 

and $2,500,000 above the budget request. In addition to funding 

from HRSA in fiscal year 2006, the National Marrow Donor Program (NMDP) is expected to receive $17,500,000 from the U.S. 

Navy. Funds are used for donor medical costs, donor centers, tissue 

typing, research, minority recruitment, and program administration. The Committee recognizes the important life-saving role of the 

Registry in the lives of thousands of Americans. The NMDP, which 

operates the Registry through a contract with HRSA, has facilitated more than 20,000 transplants since its inception. The Committee understands that the Registry lists three sources of blood 

forming non-embryonic stem cells used in transplantation: marrow 

and peripheral blood from adult donors, and umbilical cord blood 

units. The NMDP now lists 5,500,000 potential volunteer, adult donors of marrow and peripheral blood stem cells on the Registry. In 

addition, 17 of the 20 public cord blood banks are, or have applied 

to be, NMDP network members. The Committee strongly urges the 

NMDP to continue innovative, technological, and scientific advances in non-embryonic cell therapies that have the potential to 

help some of the hundreds of thousands of Americans with leukemia or other life threatening blood diseases. The Committee also 

strongly encourages the NMDP to continue the expansion of the 

Registry through its umbilical cord blood program to reduce racial 

and ethnic disparities and improve access for all Americans for this 

lifesaving therapy. The Committee encourages the NMDP to implement an education effort on the use of umbilical cord blood from 

32

all sources to increase donation and awareness of this resource. In 

addition, the Committee supports the NMDP’s important and expanding role in conducting and supporting research to improve the 

availability, efficiency, safety, and cost of transplants and the effectiveness of Registry operations; maintaining and expanding its 

medical emergency contingency response capabilities for national 

security; and increasing donor and patient outreach programs, especially for minorities and medically underserved population 

groups. 

Trauma care 

The Committee does not provide funding for the trauma care program, which is the same as the Administration request and 

$3,418,000 below fiscal year 2005 comparable level. The program 

has provided small grants to States to establish State offices to coordinate trauma systems within the States. Almost $17 million has 

been provided for these State grants in the past five years. 

State planning grants for health care 

The Committee does not provide funding for state planning 

grants, which is $10,910,000 below the fiscal year 2005 comparable 

level. The Administration did not request funding for this program. 

The program has made grants to States to gather and analyze information on problems of access to health insurance within the 

State and to develop plans for providing access to affordable health 

insurance coverage to all their residents. Almost $71 million has 

been provided for this demonstration program in the last five 

years. 

Rural outreach grants 

The Committee provides $10,767,000 for rural outreach grants, 

which is $28,511,000 below the fiscal year 2005 comparable level 

and the same as the budget request. The program supports projects 

that provide health services to rural populations not currently receiving them and that enhance access to existing services. 

Rural health research 

The Committee does not provide funding for rural health research, which is $8,825,000 below the fiscal year 2005 comparable 

level and $8,528,000 below the budget request. This activity supports several rural health research centers and the Secretary’s 

rural health advisory committee. 

Rural hospital flexibility grants 

The Committee provides $39,180,000 for rural hospital flexibility 

grants, which is the same as the fiscal year 2005 comparable level 

and $39,180,000 above the budget request. The program is comprised of two components: (1) flexibility grants to States to assist 

small, at risk rural hospitals that wish to convert to Critical Access 

Hospitals and receive cost-based payments from Medicare and (2) 

small hospital improvement grants that provide modest amounts to 

hospitals to assist them in automation and compliance with confidentiality requirements. Funding is to be allocated between the 

two programs consistent with the fiscal year 2005 distribution. 

33

Rural and community access to emergency devices 

The Committee provides $1,960,000 for the public access 

defibrillation demonstration grant program, which is $6,967,000 

below the fiscal year 2005 comparable level and the same as the 

budget request. The program assists both urban and rural communities in increasing survivability from sudden cardiac arrest by providing funding for the purchase, placement, and training in the use 

of automated external defibrillators (AEDs). 

Rural EMS 

The Committee does not provide funding for the new rural emergency training and equipment assistance program, which is 

$496,000 lower than the fiscal year 2005 comparable level and the 

same as the budget request. The Committee does not believe the 

program at its current level can provide adequate assistance nationwide and believes there are other emergency programs funded 

in the bill that can address some of these problems in rural areas. 

State offices of rural health 

The Committee provides $8,223,000 for State offices of rural 

health, which is $98,000 below the fiscal year 2005 comparable 

level and the same as the budget request. The State office of rural 

health program creates a focal point for rural health within each 

of the fifty States. In each State, the office collects and disseminates information on rural health, coordinates rural health resources and activities, provides technical assistance to rural providers and communities, and helps communities recruit and retain 

health professionals. 

Denali Commission 

The Committee has not included funding for the Denali Commission, which is $39,680,000 below the fiscal year 2005 comparable 

level and the same as the budget request. 

Family planning 

The Committee provides $285,963,000 for the family planning 

program, which is the same as the fiscal year 2005 comparable 

level and the budget request. The program provides grants to public and private non-profit agencies to support a range of family 

planning and reproductive services, as well as related preventive 

health services such as patient education and counseling, breast 

and cervical cancer examinations, STD and HIV prevention education, counseling and testing and referral, and pregnancy diagnosis and counseling. The program also supports training for providers, an information and education program, and a research program which focuses on family planning service delivery improvements. The Committee encourages HRSA to work with CDC to implement HIV/AIDS testing and counseling as a part of the services 

provided in family planning centers.

The bill repeats language from the 2005 appropriations bill making clear that these funds shall not be expended for abortions, that 

all pregnancy counseling shall be nondirective, and that these 

funds shall not be used to promote public opposition to or support 

of any legislative proposal or candidate for public office. 

34

Health care facilities and other programs 

The Committee has not provided funding for health care facilities. A total of $482,729,000 was provided for this purpose in fiscal 

year 2005; no funding was included in the budget request. This 

program provides funds to public and private nonprofit entities for 

construction or modernization of outpatient medical facilities. 

Bioterrorism hospital grants to States 

The Committee provides $500,000,000 for bioterrorism hospital 

grants to States. The Administration requested $510,000,000 for 

this program in the Public Health and Social Services Emergency 

Fund. Within this total, $472,479,000 is provided for hospital preparedness grants and $27,521,000 is provided for education incentives for medical school curriculum. The Committee intends that 

these bioterrorism activities continue to be coordinated with those 

in other parts of HHS and directs HRSA to work with the Office 

of the Secretary in the development of the Department-wide operating plan requested in the Public Health and Social Services 

Emergency Fund section of this report. 

The Committee includes $8,000,000 as requested by the Administration within the hospital grants program to continue the 

credentialing emergency system for advance registration of volunteer health professionals. The Committee directs HRSA to explore 

expansion of this program to provide cross-State information on 

volunteer health professionals. The Committee believes expansion 

of this ongoing program is preferable to the proposed new 

credentialing program within the Office of the Secretary and does 

not provide funding for that effort. 

Program management 

The Committee provides $145,992,000 for the cost of Federal 

staff and related activities to coordinate, direct and manage the 

programs of the Health Resources and Services Administration, 

which is $1,088,000 below the comparable fiscal year 2005 level 

and the same as the budget request. 

HEALTH EDUCATION ASSISTANCE LOANS PROGRAM

The Health Education Assistance Loans (HEAL) program insured loans provided by non-Federal lenders to students in health 

professions schools. Under the accounting rules established in the 

Budget Enforcement Act of 1990, one account is maintained to pay 

the obligations arising from loans guaranteed prior to fiscal year 

1992. A second account pays obligations and collects income from 

premiums on loans guaranteed in fiscal year 1992 and beyond. 

Each annual cohort of loans is independently tracked in this account. The authority for this program expired in fiscal year 1999. 

Fiscal year 1998 was the last year in which loans were obligated 

to previous borrowers under the HEAL authority. 

The Committee provides $4,000,000 to liquidate obligations from 

loans guaranteed prior to 1992, which is the same as fiscal year 

2005 level and the budget request. 

The Committee provides $2,916,000 for HEAL program management, which is $328,000 below the fiscal year 2005 comparable 

level and the same as the budget request. 

35

NATIONAL VACCINE INJURY COMPENSATION PROGRAM

The Committee makes available the release of $74,384,000 from 

the Vaccine Injury Compensation Trust Fund in fiscal year 2006, 

which is $5,233,000 above the fiscal year 2005 level and $668,000 

above the 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. Revenues raised by this tax 

are maintained in a Vaccine Injury Compensation Trust Fund. 

Trust funds made available in the bill will support the liability 

costs of vaccines administered after September 30, 1988. They will 

also support the $3,500,000 in costs incurred by the agency in the 

operation of the program, which is $349,000 above the comparable 

fiscal year 2005 level and $668,000 above the budget request. 

CENTERS FOR DISEASE CONTROL

DISEASE CONTROL, RESEARCH AND TRAINING

The Committee provides a program level of $6,103,786,000 for 

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

$294,781,000 below the fiscal year 2005 comparable level and 

$181,000,000 above the comparable request. Of the funds provided, 

$157,795,000 shall be derived from evaluation set-aside funds 

available under Section 241 of the Public Health Service Act, as 

proposed in the request. 

The Committee notes that it has included the $1,616,723,000 requested for CDC Terrorism Preparedness and Response within this 

account. These funds were provided in fiscal year 2005, and requested by the President for fiscal year 2006, within the Public 

Health and Social Services Emergency Fund. 

The budget request included an information technology reduction 

of $10,000,000, which is realized in project-specific areas across 

CDC’s budget. The Committee recommendation assumes the realization of these savings, including the reduction of $4,903,000 in information technology efficiencies within HIV/AIDS, STD and TB 

Prevention activities within Infectious Diseases. 

The CDC assists State and local health authorities and other 

non-governmental health-related organizations to understand, control, and reduce disease and other health problems affecting their 

people and communities. The activities of CDC focus on several 

major priorities, including providing core public health functions, 

responding to urgent health threats, monitoring the Nation’s 

health using scientific methods, building the Nation’s public health 

infrastructure to insure our national security against bioterrorist 

threats, promoting health throughout each life-stage, and providing 

leadership in the implementation of nationwide prevention strategies to encourage responsible behavior and adoption of lifestyles 

that are conducive to good health. 

The Committee considers the table accompanying this report and 

the numbers identified in the paragraphs that follow to be determinative of the CDC budget. Funds should be apportioned and alloVerDate jul 14 2003 07:43 Jun 22, 2005 Jkt 021909 PO 00000 Frm 00035 Fmt 6659 Sfmt 6602 E:\HR\OC\HR143.XXX HR143
36

cated accordingly, and any changes in funding are subject to the 

normal reprogramming and notification procedures. 

INFECTIOUS DISEASES

The Committee provides a program level of $1,717,323,000 for in- fectious diseases, which is $34,434,000 above the fiscal year 2005 

comparable level and $7,565,000 above the request. Of the funds 

provided, $12,794,000 shall be derived from evaluation set-aside 

funds available under Section 241 of the Public Health Service Act, 

as proposed in the request. 

Infectious diseases control 

The Committee provides $229,471,000 for infectious diseases con- trol, which is $3,882,000 above the fiscal year 2005 comparable 

level and $4,710,000 above the request. 

The program supports national surveillance of infectious diseases, the development of new or improved prevention and control 

methods and techniques, the acceleration of the general application 

of accepted prevention technologies, and strengthening of the capability to respond to outbreaks of new and re-emerging infectious 

diseases. 

Botulinum Neurotoxin Research.—The Committee understands 

that botulinum neurotoxin is one of the most toxic substances 

known to mankind and that a recent technological breakthrough, 

using fluorescent sensors, may for the first time enable the detection of neurotoxin activity in a person’s body and in living cells on 

a near real-time basis. The Committee encourages CDC to evaluate, develop, and validate the fluorescence resonance energy transfer assay for the detection of botulinum toxins to meet its mission 

requirements, and to incorporate it into its bioterrorism preparedness program. The Committee also encourages CDC to continue to 

investigate new and advanced methods for measuring botulinum 

toxins and other toxins using mass spectrometry. 

Emerging Infectious Diseases.—The Committee provides $102,650,000 to support CDC’s emerging infectious disease activities, which is $3,498,000 above fiscal year 2005. 

Hepatitis.—The Committee has included $17,912,000 to support 

activities of the Viral Hepatitis Division and to implement the National Hepatitis C Prevention Strategy. The Committee urges that 

this funding be focused on supporting the capability of state health 

departments, particularly to maintain resources available to the 

hepatitis C state coordinators. 

The Committee is concerned that more than 75% of the 4 million 

HCV positive individuals are unaware of their condition and therefore urges a public education campaign to urge appropriate screening and medical follow up of target populations. The Committee 

also is concerned with increasing rates of adult infections of Hepatitis A & B and urges an expanded vaccination program be 

launched in response to this critical public health issue. Finally, 

CDC is encouraged to focus on education and awareness programs 

targeted at specific populations where there is a high prevalence of 

hepatitis B and where therapeutic interventions are increasingly 

effective. 

Meningococcal Disease.—Meningococcal disease is one of the few 

diseases that can be fatal or severely debilitating to a victim within 

37

a matter of hours of initial onset and yet is vaccine-preventable in 

most cases. The Committee is aware of the recent improvements in 

the meningitis vaccine and of recent CDC efforts to increase the 

availability and focus of information on meningococcal disease and 

ways to prevent it so that the general public will be better educated on the symptoms and prevention methods. The Committee 

encourages the CDC to improve meningicocccal education and adolescent immunization programs, including giving consideration to 

partnering with relevant professional and voluntary health associations to ensure that all families, especially those with adolescents 

and young adults, are effectively educated on this disease, vaccine 

availability, and all methods of prevention. 

Prion Disease.—Within the funds provided, not less than $5,500,000 is for activities related to Prion diseases, including the 

work of the National Prion Disease Pathology Surveillance Center. 

Sepsis.—The Committee is aware that sepsis kills more than 

215,000 Americans every year. Despite new, increasingly effective 

treatments and a new diagnosis protocol, sepsis remains a leading 

cause of death because too few medical personnel know how to 

identify and diagnose it. The Committee applauds the CDC’s ongoing demonstration program to reduce hospital-based transmission 

of sepsis and other infections, but recognizes that significant reductions in morbidity and mortality could be achieved through improved, timely diagnosis and treatment. Within the funds provided, 

the Committee encourages CDC to consider establishing an education program to train critical care nurses, emergency room physicians, and infectious disease specialists, especially those in rural 

and traditionally underserved areas, in use of the new protocol to 

identify sepsis and improve patient outcomes. The Committee encourages CDC to work towards this end in collaboration with the 

relevant voluntary health organizations, such as the American Sepsis Alliance. 

West Nile Virus.—Within the funds provided, not less than $37,809,000 is for activities to detect, prevent and control the West 

Nile Virus. 

HIV/AIDS, STD and TB prevention 

The Committee provides $956,138,000 for HIV/AIDS, STD and 

TB prevention, which is $4,573,000 below the fiscal year 2005 comparable level and $145,000 below the request. Of the amount provided, $657,694,000 is for HIV/AIDS programs (the same as the request); $159,633,000 is for the STD program; and $138,811,000 is 

for the TB program. The Committee recommendation assumes the 

$4,903,000 in information technology savings proposed in the budget within HIV/AIDS, STD and TB Prevention activities. 

The HIV/AIDS programs support HIV research, surveillance, epidemiologic and laboratory studies, and prevention activities. CDC 

provides funds to state and local health departments to develop 

and implement integrated community prevention plans. The STD 

program awards grants to state and local health departments and 

other nonprofit entities to support a wide variety of public health 

activities to prevent and treat STDs. CDC directly conducts special 

investigations, surveillance and epidemiologic research. The tuberculosis program provides grants to States and large cities for a 

broad range of tuberculosis control activities. In addition, the CDC 

38

supports state and local laboratories and conducts research, epidemiological investigations, and education and training seminars. 

Minority HIV/AIDS Initiative.—Within the total provided, not 

less than the fiscal year 2005 amount is provided for activities that 

are targeted to address the growing HIV/AIDS epidemic and its 

disparate impact on communities of color, including African Americans, Latinos, Native Americans, Asian Americans, Native Hawaiians, and Pacific Islanders. 

Partner Notification.—The Committee supports CDC’s efforts to 

require state, territorial, and municipal grantees of HIV/AIDS prevention programs to conduct partner counseling and referral services of newly diagnosed individuals, with strong linkages to prevention and care services. The Committee understands that all states, 

territories, and large cities with HIV/AIDS prevention cooperative 

agreements with CDC must provide partner notification and counseling services. The Committee encourages CDC to ensure that all 

grantees are in compliance with this requirement. 

Tuberculosis.—The Committee understands that the CDC plans 

to undertake a new initiative, the Intensified Support and Activities to Accelerate Control (ISAAC). ISAAC targets tuberculosis in 

African Americans, tuberculosis along the U.S./Mexico border, allows for universal genotyping of all culture positive TB cases, and 

expands clinical trials for new tools for the diagnosis and treatment 

of TB. The Committee encourages the CDC to implement ISSAC to 

enhance and maximize strategies to accelerate the control and 

elimination of TB. 

Tuberculosis is an enormous public health crisis in the developing world, killing millions of people in the prime of their lives 

every year. To help stem this growing pandemic, the Committee 

encourages CDC to enhance ongoing efforts involving the TB vaccine research cooperative agreement. 

Immunization 

The Committee provides a program level of $531,714,000 for immunization, which is $38,126,000 over the fiscal year 2005 comparable level and $3,000,000 above the request. Of the amount provided, $12,794,000 is to be derived from section 241 evaluation setaside funds, as proposed in the request. In addition, the Vaccines 

for Children (VFC) program is expected to provide $1,502,333,000 

in vaccine purchases and distribution support in fiscal year 2005, 

for a total of $2,034,047,000 for immunization activities in fiscal 

year 2006. 

Immunization project grants are awarded to States and local 

agencies for planning, developing, and conducting childhood 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. The 

Committee notes that there are other Federal programs that provide immunizations to children, including the State Children’s 

Health Insurance Program (SCHIP), the Maternal and Child 

Health Block Grant, and community health centers. 

Immunization Safety.—The committee commends the CDC for 

moving the Immunization Safety Branch (ISB) out from under the 

39

National Immunization Program (NIP) to the office of the Director 

of Science. This is a positive step. The committee urges the CDC 

to carefully review and implement the recommendations in the Institute of Medicine report: Vaccine Safety Research, Data Access 

and Public Trust. The Committee is particularly interested in the 

CDC prioritizing IOM recommendations that the CDC (1) establish 

an independent oversight board to review CDC’s vaccine safety research agenda, study protocols, and changes in study protocols, and 

(2) initiate conversations with Managed Care Organizations involved in the Vaccine Safety Datalink to ensure that independent 

researchers have access to all VSD data, particularly post-2000 

data through the National Center for Health Statistics. 

Vaccine Safety Research.—The Committee recognizes the importance of directing additional funding toward vaccine safety research, specifically funding to develop better screening methods for 

children at risk for serious adverse reactions. The Committee recommendation includes $3,000,000 above the request for the CDC to 

expand funding for vaccine safety research, particularly with respect to investigator initiated, peer-reviewed, extramural research. 

Furthermore, the Committee urges that this funding be used for 

non-epidemiology research, to better understand risk factors for serious adverse reactions, to develop screening tools to eliminate from 

vaccination those children at greater risk for such reactions, and to 

develop effective treatments and interventions for children suffering severe adverse reactions. 

HEALTH PROMOTION

The Committee provides $983,647,000 for health promotion, 

which is $38,062,000 below the fiscal year 2005 comparable level 

and $19,226,000 above the request. 

Chronic disease prevention and health promotion 

The Committee provides $856,468,000 for chronic disease prevention and health promotion, which is $40,665,000 below the fiscal 

year 2005 comparable level and $15,610,000 above the request. 

Chronic diseases have had a profound human and economic toll 

on our nation. Nearly 125 million Americans today are living with 

some form of chronic condition, including cancer, cardiovascular 

disease, diabetes, arthritis, obesity and various neurological conditions such as epilepsy. Complications from these conditions include 

vision loss, kidney disease, limb loss, oral disease and paralysis. 

The National Center for Chronic Disease Prevention and Health 

Promotion at CDC supports research and programs to prevent the 

leading causes of death and disability (e.g., heart disease and 

stroke, cancer, diabetes, and arthritis) that are among the most 

prevalent, costly, and preventable of all health problems. CDC 

plays a leadership role in coordinating and catalyzing the efforts of 

numerous public and private partners, which allows CDC to substantially extend its effectiveness in reaching people at highest risk 

for chronic disease. The Committee recognizes the essential infrastructure that CDC has built in state health departments and encourages CDC to expand its state-based leadership in surveillance, 

public health education, communications and model programs and 

research. 

40

The Committee urges the CDC to examine ways of maximizing 

the federal investments in prevention, such as incorporating performance measures into state and local health department cooperative agreements where they may not currently exist, including incentives or requirements for state and local matches of federal 

funds, and/or streamlining funding mechanisms to focus on common risk factors among the leading chronic conditions. 

Within the total provided, the Committee includes the following 

amounts for chronic disease prevention and health promotion activities: $46,120,000 for heart disease and stroke, $1,502,000 above 

fiscal year 2005; $64,960,000 for diabetes, $1,503,000 above fiscal 

year 2005; $312,600,000 for Cancer Prevention and Control, 

$2,895,000 above fiscal year 2005 (including not less then 

$204,425,000 for the National Breast and Cervical Cancer Early 

Detection program); $22,920,000 for Arthritis and Other Chronic 

Diseases, $433,000 above fiscal year 2005; $104,370,000 for Tobacco, $25,000 above fiscal year 2005; $41,930,000 for Nutrition 

and Physical Activity, the same as fiscal year 2005; $25,870,000 for 

Health Promotion, $276,000 below fiscal year 2005; $56,760,000 for 

School Health, $14,000 above fiscal year 2005; $44,740,000 for Safe 

Motherhood/Infant Health, the same as fiscal year 2005; 

$12,000,000 for Oral Health, $796,000 above fiscal year 2005; 

$29,700,000 for Prevention Centers, the same as fiscal year 2005; 

$11,200,000 for Verb, $47,595,000 below fiscal year 2005; 

$44,300,000 for Steps for a Healthier U.S., $24,000 above fiscal 

year 2005; $34,513,000 for REACH, the same as fiscal year 2005; 

and $4,485,000 for Genomics. 

Adolescent Health.—The Committee encourages the CDC to 

maintain a focus on public health issues confronting adolescents, 

including maintaining support of the National Network of State 

Adolescent Health Coordinators (NNSAHC) Annual Meeting, which 

brings together specific expertise on the health issues that face 

adolescents and on the special programmatic considerations for this 

population. 

Alzheimer’s disease.—A growing body of evidence suggests that 

many of the same strategies that preserve overall health may also 

help prevent or delay the onset of Alzheimer’s disease and dementia. In fiscal year 2005, CDC, in cooperation with the Alzheimer’s 

Association, launched a new program aimed at educating the general public and health professionals on ways to reduce the risks of 

developing Alzheimer’s disease by maintaining a healthy lifestyle. 

The Committee supports this initiative and urges CDC to consider 

expanding it within the funds made available for fiscal year 2006. 

Breast and Cervical Cancer Screening.—The Committee commends the CDC for creating partnerships to address the early detection of breast cancer, particularly in historically underserved 

communities, including the Native American, Hispanic and African 

American populations. As part of this initiative, the Committee is 

very interested in the innovative approach of the Men Against 

Breast Cancer Partners In Survival Program focusing on the role 

of the male support-giver as an integral component of the early detection, patient care and survivorship of breast cancer. The Committee encourages CDC’s continued support of programs of this 

type that might also have secondary benefits, such as greater parVerDate jul 14 2003 07:43 Jun 22, 2005 Jkt 021909 PO 00000 Frm 00040 Fmt 6659 Sfmt 6602 E:\HR\OC\HR143.XXX HR143
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ticipation of the male support-giver in their own health management, including early-detection and health screening activities. 

Colorectal Cancer.—The Committee is pleased with the leadership of CDC’s National Colorectal Cancer Roundtable in promoting 

the availability and advisability of screening to both health care 

providers and the general public. The Committee encourages the 

CDC to continue to expand its partnerships with state health departments, professional and patient organizations, and private industry to combat this devastating disease. 

Cancer Survivorship.—The Committee supports the ongoing partnership between CDC and the Lance Armstrong Foundation (LAF) 

to address the needs of the nearly 10 million cancer survivors. The 

Committee encourages CDC to enhance support for the Live 

Strong, National Cancer Survivorship Resource Center, to serve 

cancer survivors and their families across the country. 

Diabetes.—The Committee commends CDC for implementation of 

SEARCH, a pilot study to determine the incidence and prevalence 

of diabetes in youth under the age of 20 years in six locations 

around the United States. The Committee encourages the CDC to 

consider developing a plan to use the information gathered from 

SEARCH to create a national registry of patients afflicted with juvenile diabetes. In addition, the Committee urges the CDC to examine the feasibility of collecting information about the standard 

of care available to people with diabetes nationwide and consider 

making samples from this study available to the research community. CDC should be prepared to report to the Committee on these 

issues during the fiscal year 2007 budget hearings. 

Epilepsy.—The Committee provides $8,000,000 for Epilepsy activities, which is $440,000 above fiscal year 2005. The Committee 

supports the CDC’s epilepsy program and applauds the collaboration the Agency developed with the Epilepsy Foundation in crafting 

the recommendations of Living Well With Epilepsy II. The Committee encourages CDC to maintain support for ongoing epilepsy 

public health programs as well to begin implementation of the new 

recommendations from Living Well With Epilepsy II as funds become available. It is also expected that CDC be prepared to report 

on the current results on implementation of those recommendations and future plans, including those involving coordination with 

other agencies, during the fiscal year 2007 budget hearings. 

Genomic Medicine.—The Committee understands that steps need 

to be taken now to prepare the public health system for the expected widespread future use of genetic technologies in healthcare. 

The Committee encourages CDC to move forward aggressively with 

the creation and implementation of partnerships with industry and 

the nonprofit sector to achieve the widest benefits from the coming 

era of genomic medicine. 

Heart Disease and Stroke.—The Committee understands that the 

CDC is creating a Heart Disease and Stroke Division to consolidate 

and elevate its efforts to prevent and control heart disease, stroke 

and other cardiovascular diseases and is supportive of this effort. 

The Committee supports the goal of implementing statewide heart 

disease and stroke prevention programs and urges the CDC to 

maintain and expand its support for these activities within the 

funds provided for fiscal year 2006. 

42

Infertility Prevention.—The Committee understands that there 

are other causes of infertility beyond sexually transmitted diseases, 

such as delayed child bearing, smoking, low or excessive body 

weight, exposure to hazardous environmental toxins, drug and alcohol abuse and, particularly for men, exposure to high temperatures. 

The Committee encourages CDC to consider expanding the scope of 

the Agency’s efforts regarding the prevention of infertility and to 

providing greater support to public education on the broader risks 

to fertility. 

Inflammatory Bowel Disease.—In fiscal year 2005, the Committee provided funds to continue a national IBD epidemiology program established through a partnership between CDC and the 

Crohn’s and Colitis Foundation of America. The Committee encourages the CDC to continue this initiative in fiscal year 2006. 

Interstitial Cystitis (IC).—The Committee is pleased by the establishment of a cooperative agreement between the CDC and the Interstitial Cystitis Association and has provided sufficient funds to 

continue the campaign to educate the public and professional community about IC. 

Kidney Disease.—The Committee urges the CDC to develop the 

capacity and infrastructure for a kidney disease surveillance, epidemiology, and health outcomes program, including awarding grants 

to support several state-based demonstration projects for chronic 

kidney disease prevention and control. Furthermore, the Committee urges CDC, in partnership with the relevant national voluntary health organization, or organizations, convene a consensus 

conference of experts in the area of kidney disease and other stakeholders to lay the groundwork for a formal Public Health Kidney 

Disease Action Plan for prevention and control of kidney disease. 

The Committee provides $1,800,000 to undertake this initiative. 

Oral Health.—The Committee is concerned about the rising obesity rate among America’s youth. Some eating habits can adversely 

affect not only body weight but also oral health. The Committee 

understands that the dental community has developed some instructional materials and encourages the CDC to work with the 

American Dental Association in producing an instructional video 

for school-aged children on the harmful effects of excessive consumption of high sugar products, such as soda. 

Obesity Prevention.—The multiple factors contributing to the 

overweight and obesity epidemic took years to develop. Reversing 

the epidemic will require a long-term, well-coordinated, concerted 

approach to reach Americans were they live, work, play, and pray. 

Effective collaboration among the public, voluntary, and private 

sectors is critical to reshape the social and physical environment of 

our nation’s communities and provide the necessary support, information, tools, and realistic strategies needed to reverse the current 

obesity trends nationwide. 

To reduce consumer confusion about the myriad of health messages about obesity, diabetes, and cardiovascular disease, the Committee strongly urges CDC to design and develop mechanisms for 

fast-tracked translation of research into reasoned guidance for the 

American public. 

In addition, the Committee urges CDC to develop evidencedbased recommendations on body fat measurement to be used in the 

evaluation of obesity prevention programs. 

43

The Committee also is very concerned about the adverse health 

toll that the twin epidemics of diabetes and obesity are taking on 

the health of minorities. The Committee encourages CDC to collaborate with organizations directed by and serving individuals 

from communities with disproportionate diabetes and obesity rates 

to ensure that the Agency’s prevention efforts effectively reach all 

communities. 

To prevent unhealthy weight gain and maintain healthy weight 

among children and adolescents, CDC is urged to work with the 

U.S. Department of Education to issue a report with recommendations about reintroducing school physical education into the school 

day. 

Finally, the Committee supports research into the link between 

disadvantaged or physically and sexually abused youth, and obesity 

programs that target the physical health of children who have been 

abused and are in treatment programs. The CDC is encouraged to 

partner with organizations that treat or otherwise serve youth who 

have been abused in efforts to identify links between abuse and 

obesity and programs to address childhood obesity among this population. 

Osteoporosis.—The Committee is aware of the report issued by 

the Surgeon General on Bone Health and Osteoporosis requested in 

the fiscal year 2002 Appropriations bill. In the report, the Surgeon 

General calls for a national action plan for bone health. The Committee urges the CDC to consider supporting the development of an 

action plan and to ensure that all relevant federal agencies and 

public and private stakeholders, including the National 

Osteoporosis Foundation, be involved in the development of any 

such plan. 

Pulmonary Hypertension.—The Committee continues to be interested in pulmonary hypertension (PH), a rare, progressive and fatal 

disease that predominantly affects women, regardless of age or 

race. Because early detection of PH is critical to a patient’s survival 

and quality of life, the Committee continues to encourage CDC to 

work in partnership with the pulmonary hypertension community 

to foster greater awareness of the disease. 

REACH.—The Committee recognizes the strengths that national/

multi-geographical minority organizations can provide to the 

REACH Initiative. Such organizations often have the capacity to 

influence communities through coalitions and collaborative relationships that have already been established and provide essential 

support to local organizations that may lack the infrastructure 

needed to implement the full scale of programmatic activities required for this important program. The Committee urges CDC to 

include such organizations among the entities that are eligible to 

compete for funding without preventing other applicants from receiving these grants. 

School Health.—The Committee urges the CDC to prioritize obesity prevention in proportion to its burden on childhood and adolescent health through the Division of Adolescent School Health 

(DASH). CDC should urge states to use existing program funds to 

address this critical epidemic. 

Sleep Disorders.—The Committee remains concerned about the 

prevalence of sleep disorders and recognizes the need for enhanced 

public and professional awareness on sleep and sleep disorders. 

44

The Committee encourages CDC to work with other agencies, such 

as the National Center on Sleep Disorders Research, and voluntary 

health organizations, such as the National Sleep Foundation, to 

support the development of a sleep education and public awareness 

initiative. 

VERB.—The Committee provides $11,200,000 for the Verb program, a national multi-ethnic media campaign that promotes regular physical activity among youth ages 9–13. The campaign was 

launched in June 2002. Evaluation results over the first two years 

show that the Verb campaign has contributed to higher levels of 

physical activity among targeted youth. The funds provided for fiscal year 2006 are to be used to augment funding available in fiscal 

year 2005 in order to secure a national media program commensurate with the first three years of the program. 

Vision Screening and Education.—The Committee commends 

CDC for its partnership with a leading voluntary health association 

dedicated to fighting blindness and saving sight, to improve education and early detection of potentially blinding eye diseases and 

encourages CDC to continue and expand this partnership. Despite 

the fact that half of all blindness can be prevented through education, early detection and treatment, it is estimated that the number of blind and visually impaired people will double by 2030 if 

nothing is done to curb vision problems. To address this growing 

public health problem, the Committee provides $2,500,000 to enhance the CDC national vision screening and education program 

and the CDC partnership with Prevent Blindness America.

Birth defects, developmental disabilities, disability and health 

The Committee provides $127,179,000 for birth defects, develop- mental disabilities, disability and health, which is $2,603,000 above 

the fiscal year 2005 comparable level and $3,616,000 above the request. This program collects, analyzes, and makes available data 

on the incidence and causes of birth defects and developmental disabilities. 

Within the total, the Committee provides the following amounts 

for birth defects, developmental disabilities, disability, and health 

activities: $39,130,000 for birth defects and developmental disabilities, which is $109,000 below fiscal year 2005; $67,868,000 for 

Human Development and Disability, which is $2,757,000 above fiscal year 2005; and $20,180,000 for Hereditary Blood Disorders, 

which is $46,000 below fiscal year 2005. 

Alpha-1 Antitrypsin Deficiency.—The Committee is aware that 

Alpha-1 Antitrypsin Deficiency (Alpha-1) is the major genetic risk 

factor for Chronic Obstructive Pulmonary Disease (COPD) and 

cryptogenic liver disease. Early detection allows individuals to engage in preventative health measures and receive appropriate 

therapies that significantly improve their health status. The Committee encourages CDC to consider collaborating with appropriate 

patient and professional organizations, such as the Alpha-1 Foundation, to actively support Alpha-1 targeted detection efforts that 

utilize public and professional education regarding obstructive lung 

disease, both genetic and tobacco related. 

Attention Deficit/Hyperactivity Disorder (AD/HD).—The Committee continues to support the National Resource Center on AD/

HD and has provided sufficient funds in fiscal year 2006 to conVerDate jul 14 2003 07:43 Jun 22, 2005 Jkt 021909 PO 00000 Frm 00044 Fmt 6659 Sfmt 6602 E:\HR\OC\HR143.XXX HR143
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tinue the activities at the Center, such as responding to requests 

for information and support services; reaching out to special populations in need; and educating health and education professionals 

on AD/HD. 

Autism.—The Committee is aware of the progress that has been 

made with the autism programs. The Committee acknowledges the 

importance of this work by the CDC in the area of autism surveillance and research, and urges this work to continue in a timely 

manner. Within funds provided, $15,500,000 is for autism activities, which is $627,000 above fiscal year 2005. Within that amount, 

$14,900,000 is provided for surveillance and research programs including the CADDRE and ADDM Network. The Committee is 

pleased to see the work being done in the area of the national 

awareness campaign and provides $600,000 for the Center to expand its work on this initiative. 

Birth Defects Surveillance, Research and Prevention.—The Committee commends the CDC’s work in the area of birth defects surveillance, research and prevention and encourages the CDC to continue its support for birth defects related programs. 

Cooley’s Anemia.—The Committee is pleased with the progress 

that CDC has made with regard to the establishment of a blood 

safety surveillance program for Cooley’s anemia patients, who are 

the largest consumers of red blood cells. Six treatment centers 

throughout the nation handle the medical monitoring and treatment; the Cooley’s Anemia Foundation provides education and 

awareness, patient recruitment, and other services; and, CDC has 

created an archive of tested and analyzed blood samples. As the 

program moves forward and start-up costs are met, the Committee 

expects CDC to direct an increasing amount of the funds available 

to education and awareness, patient recruitment and other services.

Down Syndrome.—The Committee understands that CDC has 

undertaken a study to estimate the number of people in the United 

States living with Down syndrome and identify them by age and 

ethnic group and that it is expected to have preliminary estimates 

of prevalence of Down syndrome among children and adolescents 

by the end of fiscal year 2005. The Committee further understands 

that a second study, to document the onset and course of secondary 

and related developmental and mental disorders in individuals 

with Down syndrome, will be initiated by the end of this fiscal 

year. The Committee recognizes the importance of this research 

and has provided sufficient funding to further develop the study relating to the onset of secondary and related developmental mental 

disorders in fiscal year 2006. 

Duchenne and Becker Muscular Dystrophy.—The Committee remains concerned with the pace of the development of the CDC 

Birth Defects Surveillance program covering the muscular dystrophies and is aware that the agency has made the commitment 

to enhance the internal staff commitment to the program. The 

Committee is encouraged by that new commitment and expects 

that CDC dedicate its efforts to organize, coordinate and implement 

the agency’s Duchenne MD surveillance program. The Committee 

provides $7,000,000 for fiscal year 2006, which is $1,073,000 above 

fiscal year 2005. Within that amount, the Committee recommends 

that $750,000 be used to continue a coordinated education and outVerDate jul 14 2003 07:43 Jun 22, 2005 Jkt 021909 PO 00000 Frm 00045 Fmt 6659 Sfmt 6602 E:\HR\OC\HR143.XXX HR143
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reach initiative through the Parent Project Muscular Dystrophy. 

Finally, the Committee requests that the CDC develop and submit 

to the Committees on Appropriations in the House and Senate by 

June 1, 2006 a five-year strategic plan for the Duchenne and Becker Muscular Dystrophy programs. 

Early Hearing Detection and Intervention.—Within the total pro- vided, $7,000,000, $839,000 over fiscal year 2005, is designated for 

the Early Hearing Detection and Intervention (EHDI) program for 

newborns, infants and young children with hearing loss. Currently, 

32 states are in the midst of completing projects funded through 

Cooperative Agreements from CDC to assist in developing strong 

surveillance and tracking systems to ensure that infants referred 

from newborn hearing screening programs receive appropriate and 

timely diagnostic and early intervention services. The Committee is 

concerned that about one-third of the babies who are referred from 

hearing screening programs do not receive diagnostic evaluations 

by the time they are 3 months of age. Moreover, only about half 

of the infants and toddlers diagnosed with hearing loss are enrolled 

in appropriate early intervention programs by 6 months of age. The 

Committee believes that increased funding is required to ensure 

that states develop appropriate surveillance and tracking systems 

to provide timely and appropriate diagnostic and intervention services to infants and toddlers. 

Funding may also be used to support applied research projects 

related to increasing the accuracy of newborn hearing screening, 

improving the effectiveness of tracking and surveillance programs, 

determining the etiology and epidemiology of childhood hearing 

loss, and analyzing the costs and benefits of such programs. The 

Committee encourages CDC to assist states in clarifying how EHDI 

surveillance, tracking, and data management programs are affected 

by the Health Insurance Portability and Accountability Act and the 

Family Education Rights and Privacy Act 

To avoid duplication and interference, the Committee urges CDC 

to coordinate projects funded with this appropriation with EHDI 

projects conducted by the Health Resources Services Administration, the National Institute on Deafness and Other Communication 

Disorders, the National Institute on Disability and Rehabilitation 

Research, and the Office of Special Education and Rehabilitative 

Services. 

Fetal Alcohol.—The Committee is concerned about the prevalence 

of Fetal Alcohol Syndrome (FAS) in the United States and notes 

that drinking during pregnancy is the nation’s leading known preventable cause of mental retardation and birth defects. The Committee commends the U.S. Surgeon General for releasing an updated advisory in February, 2005, on alcohol use in pregnancy, urging women who are pregnant or who may become pregnant to abstain from alcohol. The Committee urges CDC to work with partner 

organizations, such as the National Organization on Fetal Alcohol 

Syndrome, to generate awareness of the Surgeon General’s new 

FAS prevention advisory, especially among high-risk communities. 

Folic Acid.—The Committee provides $2,400,000 to support and 

expand the folic acid educational campaign, which is $212,000 

above fiscal year 2005. The Committee is pleased since fortification 

of U.S. grain products with folic acid, the rate of neural tube defects has decreased by 26% and encourages CDC to enhance the 

47

national campaign to increase the number of women taking folic 

acid daily. The Committee also encourages CDC to continue to support collaboration among the states on issues related to surveillance, research and prevention through support of the National 

Birth Defects Prevention Network. 

Fragile X.—The Committee is encouraged by the CDC’s progress 

in establishing a Fragile X public health program to expand surveillance and epidemiological research of Fragile X, as well as provide patient and provider outreach on Fragile X and other developmental disabilities. The Committee has provided sufficient funding 

to support the continuation of these activities. 

Hemophilia.—The Committee supports CDC’s efforts, in collaboration with the National Hemophilia Foundation, to carry out needed education, prevention, blood safety surveillance, and outreach 

programs for the millions of people in the United States affected 

by bleeding and clotting disorders, including hemophilia, women’s 

bleeding disorders, and thrombophilia. The Committee recognizes 

the strain these additional efforts place on the national hemophilia 

treatment center network. Within the resources provided, the Committee urges CDC to enhance its support where possible of the network to ensure continued access to this comprehensive chronic care 

model for all persons with bleeding and clotting disorders. 

Hereditary Hemorrhagic Telangiectasia (HHT).—The Committee 

is aware of interest in the establishment of an HHT National Resource Center through a partnership between the CDC and the national voluntary agency representing HHT families. The Committee 

encourages the CDC to examine carefully proposals to establish 

such a center and give every appropriate consideration to supporting it within the funds provided. 

Limb Loss Information Center.—The Committee recognizes that 

one of the greatest challenges facing individuals with limb loss is 

access to necessary health and rehabilitative services. The Committee applauds CDC for its partnerships with governmental, academic and voluntary health organizations, such as the Amputee 

Coalition of America, to advance the quality of life through research and support programs for people living with limb loss. The 

Committee continues to strongly support the CDC’s resource and 

information center which assist individuals living with disabilities, 

and their families, in need of information on medical, physical, and 

emotional needs, and resources and support to reintegrate socially 

and economically into society. The Committee urges CDC to continue its support of the Center at no less than the fiscal year 2005 

level. 

Spina Bifida.—The Committee provides $5,300,000, which is 

$475,000 above fiscal year 2005 for the National Spina Bifida Program in coordination with its external partners, such as the Spina 

Bifida Association of America. The Committee continues to support 

the partnerships CDC has developed and encourages CDC to allocate a portion of the increase provided for the maintenance and expansion of the National Spina Bifida Clearinghouse and Resource 

Center. In addition, the Committee supports the Memorandum of 

Understanding between CDC and the Agency for Healthcare Research and Quality to examine clinical treatment of Spina Bifida 

and improve quality of life. 

48

The Committee recognizes that the Agent Orange database of 

health and educational services composes the largest repository of 

longitudinal treatment information of people with Spina Bifida and 

can provide much-needed insight and understanding into the needs 

of people with Spina Bifida. The Committee commends the CDC 

and the Department of Veterans Affairs for their collaborative efforts to review and analyze the Agent Orange database to gain better understanding of the treatment, educational, and vocational 

benefits needs and utilization by people with Spina Bifida. The 

Committee encourages the on-going collaboration to analyze this 

data and requests a report summarizing the analysis of the data, 

including recommendations based on the analysis as to how to improve treatment and quality-of-life for people with Spina Bifida.

Tourette Syndrome.—The Committee commends CDC for its 

work regarding Tourette Syndrome and supports the continuation 

of its external partnership with the Tourette Syndrome Association 

to develop and implement a public health education and research 

program. The Committee provides $1,800,000 for fiscal year 2006 

to continue to educate parents, physicians, educators and other 

health care workers about Tourette Syndrome disorder and to expand on the scientific knowledge base on prevalence, risk factors 

and co-morbidities of Tourette Syndrome. The Committee intends 

that these resources be used to support the existing partnership. 

Tuberous Sclerosis Complex.—Tuberous sclerosis complex (TSC) 

is a genetic disorder that causes uncontrollable tumor growth. Because this disorder can affect multiple organs of the body, it is difficult to diagnose, track and properly treat. The Committee is 

aware of interest in developing a joint initiative between the CDC 

and a relevant voluntary health organization, such as the Tuberous 

Sclerosis Alliance, to collect and analyze data from the nationwide 

network of TSC clinics; support surveillance and epidemiological 

studies; and to educate health care professionals and teachers who 

come into contact with TSC patients. The Committee encourages 

the CDC to examine the feasibility of undertaking this initiative 

from within the funds provided. 

Vision Loss.—The Committee is aware of interest in the creation 

of a National Information Center on Vision Loss to address the 

need for appropriate public health information to prevent further 

impairment and disability among individuals who are blind or who 

have low vision. The Committee encourages CDC to consider this 

proposal, including partnering with a national non-profit organization that is recognized for leadership in providing information to 

persons who are blind or visually impaired, including published resource guides, directories of services for consumers in the field, 

scholarly journals on blindness and vision loss, assistive technology 

magazines, and talking books. 

HEALTH INFORMATION AND SERVICE

The Committee provides a program level of $223,799,000 for 

Health Information and Service, which is $4,874,000 below the fiscal year 2005 comparable level and the same as the request. Within the total, $28,730,000 is to be derived from section 241 evaluation set aside funds and is included to carry out National Center 

for Health Statistics surveys, Public Health Informatics evaluations, and health marketing evaluations. 

49

Health statistics 

The Committee provides a total of $109,021,000 for health statistics, which is the same as the fiscal year 2005 comparable level and 

the request. Within the amount provided $3,516,000 shall be derived from section 241 evaluation set-aside funds, as proposed in 

the request. 

The Health Statistics program is responsible for collecting, interpreting, and disseminating data on the health status of the U.S. 

population and the use of health services. Surveys include the National Vital Statistics System, the National Health Interview Survey, the National Survey of Family Growth, the National Health 

and Nutrition Examination Survey, and the National Health Care 

Survey. 

Chronic Obstructive Pulmonary Disease.—Chronic Obstructive 

Pulmonary Disease (COPD) is the fourth leading cause of death in 

the United States and the only one of the top ten causes of death 

that is on the increase. The Committee urges the CDC to expand 

its data collection efforts on COPD. Specifically, the Committee encourages the CDC to include questions on COPD in the National 

Health and Nutrition Examination Survey, the National Health 

Interview Study and the Behavioral Risk Factor Surveillance Survey that asks about COPD by name. 

Nontuberculous Mycobacteria.—The Committee is concerned that 

Nontuberculous Mycobacteria [NTM] incidence continues to rise. 

Mycobacteria are environmental organisms found in both water 

and soil that cause significant respiratory damage. The Committee 

encourages NCHS to include questions regarding NTM testing in 

ongoing surveys to gain a better understanding of the epidemiology 

of this emergent disease. 

Informatics and Health Marketing 

The Committee provides a total of $114,778,000 for informatics 

and health marketing, which is $4,874,000 below the fiscal year 

2005 comparable level and the same as the request. Within the 

total, $25,214,000 shall be derived from section 241 evaluation setaside funds, as proposed in the request. 

ENVIRONMENTAL HEALTH AND INJURY PREVENTION

The Committee provides $285,721,000 for environmental health 

and injury prevention, which is the same as the fiscal year 2005 

comparable level and $901,000 above the request. 

Environmental health 

The Committee provides $147,483,000 for environmental health, 

which is the same as fiscal year 2005 comparable level and 

$595,000 above the request. 

Asthma.—The Committee is pleased with the work that the CDC 

has done to address the increasing prevalence of asthma. However, 

the increase in asthma among children remains alarming. The 

Committee urges CDC to expand its outreach aimed at increasing 

public awareness of asthma control and prevention strategies, particularly among at-risk populations in underserved communities. 

To further facilitate this effort, CDC is urged to partner with relevant voluntary health organizations, such as the American Lung 

50

Association, to support program activity consistent with the CDC’s 

efforts to fund community-based interventions that apply effective 

approaches demonstrated in research projects within the scientific 

and public health community. 

Biomonitoring.—The CDC’s National Report on Human Exposure 

to Environmental Chemicals is a significant new exposure tool that 

provides invaluable information for setting research priorities and 

for tracking trends in human exposures over time. Accordingly, the 

Committee continues to support the CDC environmental health 

laboratory’s efforts to provide exposure information about environmental chemicals. In addition, the Committee encourages CDC to 

consider devoting a greater proportion of program resources to develop the necessary methods to interpret human biomonitoring concentrations in the context of potential health risks. The Committee 

applauds the CDC’s biomonitoring efforts and encourages the agency to continue this program and as well as improve its efforts to 

communicate these results in context. 

Childhood Lead Poisoning Prevention.—The Committee commends the CDC for its commitment to support the enhanced development of a portable, hand-held lead screening device that holds 

great promise for increasing childhood screening rates in underserved communities. The Committee understands that further development of this device will help ensure its application in community health settings. 

Dioxin Emission Reduction.—The Committee encourages the 

CDC to establish a public health awareness effort to inform the 

public of dioxin emissions that may originate from non-point 

sources and methods and/or techniques that the public can use to 

reduce the emissions of non-point source dioxins to the environment. 

Landmine Survivor Network.—The Committee commends CDC 

for its partnership with the Landmine Survivor Network that has 

developed peer support networks for landmine survivors in six 

mine-affected countries around the world. The Committee recommendation assumes continued support for the Network at no 

less than FY 2005 levels, to expand peer support networks and the 

number of survivors that are reached in network and non-network 

countries; strengthen the capacity of medical and rehabilitative 

care facilities to address the needs of amputees; enhance economic 

opportunities for survivors; and further CDC programs and research for victims of landmines, civil strife and warfare. 

Injury prevention and control 

The Committee provides $138,237,000 for the injury control program, which is the same as the fiscal year 2005 comparable level 

and $306,000 above the request. The injury prevention and control 

program supports intramural research, injury control research centers, extramural research grants, and technical assistance to state 

and local health departments. 

Gun Control Advocacy.—The Committee recommendation maintains language carried in the fiscal year 2005 bill and prior years 

prohibiting federal funds from being used to lobby for or against 

the passage of specific federal, state or local legislation intended to 

advocate or promote gun control. The Committee understands that 

the CDC’s responsibility in this area is primarily data collection 

51

and the dissemination of that information and expects that research in this area to be objective and grants to be awarded 

through an impartial, scientific peer review process. 

OCCUPATIONAL SAFETY AND HEALTH

The Committee provides $251,241,000 for occupational safety and health, which is $34,800,000 below fiscal year 2005 and 

$34,689,000 below the request. Of the amount provided, 

$87,071,000 is to be derived from section 241 evaluation set-aside 

funds, as proposed in the request. The Committee notes that after 

adjusting for the transfer of $34,800,000 for central business services and support outlined below, the recommendation is the same 

as fiscal year 2005 and $111,000 above the request. 

The National Institute for Occupational Safety and Health 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 workrelated diseases and injuries. This appropriation supports surveillance, health hazard evaluations, intramural and extramural research, instrument and methods development, dissemination, and 

training grants. 

The Committee understands that in the reorganization of CDC 

that NIOSH has been recognized as one of the agency’s 5 coordinating centers. Given its unique statutory requirements, the Committee concurs that this is the appropriate placement of NIOSH 

within CDC’s current structure. It is the expectation of the Committee that CDC will afford NIOSH all the rights and privileges of 

this status in the organization including participating on CDC’s Executive Leadership Board as well as the Management Council 

given that these are the policy and decision-making bodies of the 

Agency. 

The Committee recommendation includes a permanent transfer of $34,800,000 from the NIOSH budget activity to CDC’s centralized business services budget activity. This transfer, which is equal 

to the central business systems assessment for fiscal years 2004 

and 2005, brings NIOSH in line with the other coordinating centers 

and obviates the need for continued central business services assessments, except those required by the Department. Finally, the 

Committee directs CDC to treat any additional CDC assessment on 

the NIOSH budget activity as a reprogramming of funds and to 

comply with the process set forth in section 517 of this Act.

GLOBAL HEALTH

The Committee provides $309,076,000 for global health, which is 

$213,000 above the fiscal year 2005 comparable level and 

$2,997,000 above the request. 

Through its Global Health activities, CDC coordinates, cooperates, participates with, and provides consultation to other nations, 

U.S. agencies, and international organizations to prevent and contain diseases and environmental health problems and to develop 

and apply health promotion activities. In cooperation with Ministries of Health and other appropriate organizations, CDC tracks 

and assesses evolving global health issues and identifies and develops activities to apply CDC’s technical expertise to be of maximum 

public health benefit. Program areas include: the Global AIDS ProVerDate jul 14 2003 07:43 Jun 22, 2005 Jkt 021909 PO 00000 Frm 00051 Fmt 6659 Sfmt 6602 E:\HR\OC\HR143.XXX HR143
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gram, the Global Immunization Program, the Global Malaria Program, the Global Disease Detection Initiative, and Other Global 

Disease Activities. 

Within the total, the following amounts are included for global 

health activities: $123,883,000 for Global AIDS, which is $54,000 

above fiscal year 2005; $137,194,000 for Global Immunization, 

which is $68,000 above fiscal year 2005; $36,500,000 for Global 

Disease Detection, which is the same as fiscal year 2005, after adjusting for the avian flu funding in the Emergency Supplemental 

Appropriations Act for Defense, the Global War on Terror, and Tsunami Relief Act, 2005; $9,113,000 for the Global Malaria Program, 

which is the same as fiscal year 2005; and $2,386,000 for Other 

Global Disease Activities, which is the same as fiscal year 2005. 

TERRORISM AND PUBLIC HEALTH PREPAREDNESS AND RESPONSE

The Committee provides $1,616,723,000 for CDC terrorism preparedness and response activities, which is the same as the request 

and $6,034,000 below the fiscal year 2005 comparable level. 

Since fiscal year 2002, CDC terrorism and preparedness funds 

were requested and provided within the Public Health and Social 

Services Emergency Fund (PHSSEF). Now that these programs 

and activities are a part of the CDC’s annual appropriations, the 

Committee believes the funding more appropriately belongs within 

the managing Agency’s account. 

The Committee seeks to ensure that CDC’s bioterrorism activities continue to be coordinated with those in other parts of HHS 

and directs CDC to work with the Office of the Secretary in the development of the requested Department-wide operating plan. 

Within the funds provided, $853,300,000 is for Upgrading State 

and Local Capacity, including $790,000,000 to be provided to State 

and local health departments through grants and cooperative 

agreements (this amount is $67,337,000 below fiscal year 2005 and 

54,609,000 above the request), and $31,400,000 for Centers for 

Public Health Preparedness; $140,200,000 is for Upgrading CDC 

Capacity; $14,000,000 is for Anthrax; $79,223,000 is for the Biosurveillance Initiative; and $530,000,000 is for the Strategic National Stockpile (this amount is $63,300,000 above fiscal year 2005 

and $70,000,000 below the request). 

The Committee also understands that within the above amounts 

for terrorism preparedness and response, up to $34,400,000 will be 

used for CDC business services and support. In addition, 

$8,589,000 of the amounts available for the Strategic National 

Stockpile are to be transferred for the administration and management costs within the Office of the Secretary related to the BioShield program. 

Pandemic Preparedness and Avian Flu.—The Committee is increasingly concerned about the threat posed to public health by 

avian flu and pandemic influenza, which public health authorities 

estimate could kill 90,000 to 300,000 people in the United States. 

Public health preparedness with respect to a pandemic influenza 

cuts across a broad array of federal public health activities. As a 

result, the Committee recommendation includes funding to enhance 

several of CDC’s functions to assist in improving our nation’s capability of detecting, controlling, and responding to potential health 

53

threats related to influenza in general, and novel influenza strains 

in particular. Included is: $102,500,000, which is $3,498,000 above fiscal year 2005, 

within Infectious Diseases Control to, among other things, enhance the sentinel physician surveillance system, assist state 

and local health departments to improve vaccine delivery, and 

conduct research aimed at developing rapid molecular methods 

for characterizing influenza viruses; $36,500,000 for Global Disease Detection, which is 

$15,074,000 above the fiscal year 2005 enacted level, to build 

upon the $15,000,000 provided in the Emergency Supplemental 

Appropriations Act for Defense, the Global War on Terror, and 

Tsunami Relief Act, 2005, for combating the spread of the 

avian influenza virus in Southeast Asia, and to enhance the 

global surveillance and response network for infectious diseases; 

$265,680,000 for vaccine purchase grants, which is $35,441,000 above the fiscal year 2005 comparable level, to 

help improve the stability of the influenza vaccine market and 

ensure a plentiful supply of influenza vaccine for the 2004/2005 

flu season; and 

$530,000,000 for the Strategic National Stockpile, which is $63,300,000 above the fiscal year 2005 comparable level, to 

maintain and expand the Stockpile’s supplies and countermeasures for assisting State and local governments in responding to both terrorist and naturally occurring public health 

emergencies, including the purchase of influenza countermeasures. 

In addition, $120,000,000, which is $20,802,000 above fiscal year 

2005, is provided within the Public Health and Social Services 

Emergency fund for pandemic preparedness. The purpose of these 

funds is to ensure a year-round influenza vaccine production capacity in the U.S. and the development and implementation of rapidly 

expandable influenza vaccine production technologies. 

The Committee recognizes that although a combination of efforts 

will be needed to address an influenza pandemic, early in an outbreak, especially before a vaccine is available, use of antiviral 

drugs may ease some of the symptoms of individuals infected and 

might slow the spread of the pandemic. Given the lag time in production and the high demand from other countries, the CDC must 

commit now to purchasing an adequate stockpile. The Committee 

is aware that the World Health Organization has recommended 

that nations stockpile enough antiviral treatments to cover 25% of 

their population. The Committee is concerned that the United 

States currently has enough antiviral treatments stockpiled to 

treat only 1% of the population and urges the CDC, in conjunction 

with HHS and NVPO, to determine what percentage of the U.S. 

population antiviral stockpiles should have the capacity to treat 

and how many doses are needed to meet this benchmark and report back to the Committee with these findings by no later than 

January 1, 2006. 

The Committee understands antiviral treatments have repeatedly been shown to reduce the duration and severity of symptoms 

when given in the first 48 hours of influenza symptoms. Although 

there are gaps in knowledge about the efficacy of antivirals in a 

54

pandemic, it appears that these gaps should not be used as a reason for inaction. The Committee urges the Department to undertake an analysis to define optimal antiviral use, potential health 

impacts and cost-effectiveness of antiviral drugs in the setting of a 

pandemic and directs the Secretary to be prepared to report on the 

findings during the Committee hearings on the fiscal year 2007 

budget request. 

The Committee urges CDC to review and approve state pandemic 

influenza plans in order to ensure nationwide preparedness standards and to facilitate regional coordination. Further, CDC should 

recommend that States make approved plans publicly available. 

In addition, the Committee urges CDC to develop and implement 

a public education campaign about pandemic influenza and preparedness, including information concerning the potential need for 

general vaccination and personal precautionary measures. CDC 

should also develop a strategy for communicating with the business 

community to provide information about the economic disruptions 

and communiy needs that may arise during a pandemic period. 

Modified Vaccinia Ankara.—The Committee is concerned that individuals with weak immune systems, an estimated 20% of the 

U.S. population, cannot take the existing animal-derived and cellderived smallpox vaccines currently stored in the Strategic National Stockpile for emergency purposes. Funds have already been 

appropriated for the planned stockpiling of the Modified Vaccinia 

Ankara (MVA) Smallpox Vaccine for immuno-compromised Americans. The Committee supports the Department’s plans to purchase 

60 million doses of the new vaccine. 

PUBLIC HEALTH RESEARCH

The Committee provides $31,000,000 for public health research, 

which is the same as the fiscal year 2005 and the request. All 

funds provided shall be derived from section 241 evaluation setaside funds, as proposed in the request. 

Through this activity, CDC supports high-quality public health 

research that studies the best methods for making the transition 

from research to practice. Funds support research that is proposed 

by experienced investigators working with communities, health 

practitioners, and policymakers to address local priority health concerns. 

PUBLIC HEALTH IMPROVEMENT AND LEADERSHIP

The Committee provides $258,541,000 for public health improvement and leadership, which is $8,301,000 below fiscal year 2005 

and $52,000,000 above the request. 

This activity supports several cross-cutting areas within CDC. 

Included is the CDC’s Leadership and Management function, which 

funds the CDC Office of the Director, coordinating centers, and 

each constituent center and office. The Public Health Improvement 

and Leadership also supports the CDC’s public health workforce 

and career development efforts, the Director’s Discretionary Fund, 

and Congressional projects. 

55

PREVENTIVE HEALTH AND HEALTH SERVICES BLOCK GRANT

The Committee provides $100,000,000 for the preventive health 

and health services block grant, which is $18,526,000 below the fiscal year 2005 comparable level and $100,000,000 above the request. 

This block grant provides flexible funds to States by formula for a 

wide range of public and preventive health activities. The flexibility 

afforded to the states, allows them to target funds to address 

chronic diseases, such as diabetes, arthritis, heart disease, and 

stroke, to direct funds to meet challenges of outbreaks of infectious 

diseases, such as West Nile Virus and influenza, and/or to implement prevention and control programs related to injury and abuse. 

BUILDINGS AND FACILITIES

The Committee provides $30,000,000 for buildings and facilities, 

which is $239,708,000 below the fiscal year 2005 comparable level 

and the same as the request. 

These funds support construction and ongoing maintenance 

projects, as well as essential safety repairs and equipment purchases. Of the funds provided, $22,500,000 is to complete the replacement of the CDC’s Vector Borne Infectious Diseases Laboratory in Ft. Collins, CO. 

Data Security and Storage.—Within the amount provided sufficient funds are available for data center storage infrastructure 

hardware and software upgrades. This funding is to provide further 

for the remote mirroring of information between CDC data centers 

and recovery sites, and to provide heterogeneous connectivity to existing systems in use at the CDC, in order to ensure the protection, 

recovery, and availability of critical resources; as well as to provide 

for enhanced security-specific technologies and services in concert 

with critical infrastructure protection requirements. 

BUSINESS SERVICES AND SUPPORT

The Committee provides $298,515,000 for business services and 

support, which is $19,677,000 above the fiscal year 2005 comparable level and $34,800,000 above the request. The Committee 

notes that the recommendation includes $34,800,000 within this 

budget activity that was provided in fiscal year 2005, and in the 

request for fiscal year 2006, within the NIOSH budget activity. The 

result is to provide the NIOSH share of CDC centralized business 

systems and support within this activity and to obviate the need 

for additional taps and assessments. After making adjustment for 

this change, the recommendation is $15,123,000 below fiscal year 

2005 and the same as the request. 

NATIONAL INSTITUTES OF HEALTH

The Committee provides $28,506,805,000 for the twenty-six appropriations which together fund the programs of the National Institutes of Health (NIH). The total in the bill is $142,290,000 above 

the fiscal year 2005 comparable level and $2,979,000 below the 

budget request. This amount includes $97,021,000 for targeted research activities to develop radiological, nuclear and chemical 

threat countermeasures. The Administration had requested this 

funding in the Public Health Social Services Emergency Fund. 

56

Roadmap.—The Committee endorses the Administration’s proposal of supporting the NIH Roadmap for Biomedical Research at 

a funding level of $332,800,000 from funding contributed by the Institutes and Centers based on less than one percent of their budgets and out of the Director’s Discretionary Fund. The Committee 

believes the Roadmap is an important step to moving biomedical 

research forward to the next level of discovery at a pace that hastens its delivery to patients. The Roadmap addresses common 

needs across all disease areas and should produce research advances that will benefit many diseases and conditions. The Committee expects to be notified on a quarterly basis if the contribution 

from the Institutes and Centers or the allocation of funding by initiative changes from what is presented in the congressional justification. 

Biodefense.—The Administration’s fiscal year 2006 budget for 

NIH includes $1,791,000,000 for bioterrorism activities, including 

funds proposed in the Public Health and Social Services Emergency 

Fund. The Committee has included the $97,021,000 requested for 

NIH within the Emergency Fund directly in the NIH Office of the 

Director appropriation. The Committee has not identified a specific 

funding level for biodefense research, choosing to give the Director 

of NIH flexibility in determining what share of NIH resources 

should be considered biodefense activities. 

Balance in the research portfolio.—The Committee reiterates its 

longstanding view that NIH should distribute funding on the basis 

of scientific opportunity. The Committee urges the Director and the 

Administration to continue to resist pressures to earmark, set aside 

and otherwise politicize these resources. To enhance NIH’s flexibility to allocate funding based on scientific opportunity, the Committee has attempted to minimize the amount of direction provided 

in the report accompanying the bill. For example, there are no directives to fund particular research mechanisms, such as centers or 

requests for applications, or specific amounts of funding for particular diseases. 

In stating that scientific opportunity should be the basis for allocating research funding, the Committee understands that other factors also are relevant to NIH’s decisions, including such considerations as the infectious nature of a disease, the number of cases 

and deaths associated with a particular disease, the Federal and 

other costs of treating a disease, the years of productive life lost 

due to a particular disease, and the estimated proximity to research breakthroughs. The Committee does not presume to judge 

which criteria should take precedence or carry the greatest weight 

in individual funding decisions, but urges NIH to consider the full 

array of relevant criteria as it constructs its research portfolio. The 

Committee applauds the Director’s focus on the need to address 

chronic diseases with preemptive interventions before symptoms 

appear and function is lost. 

AIDS funding.—Consistent with the philosophy outlined above, 

the Committee has chosen not to earmark a specific dollar amount 

for AIDS research. The Committee understands that it would be 

NIH’s intent to allocate AIDS funding consistent with the Director’s recommendations. The Committee understands that this allocation may change before the beginning of the fiscal year. 

57

The Committee intends that the funds allocated for AIDS should 

be spent in a manner fully consistent with the AIDS research plan 

developed by the Office of AIDS Research (OAR) and expects the 

Director of NIH to use the full authority of his office to ensure that 

this occurs. The Committee has provided the Director of OAR, 

jointly with the Director of NIH, transfer authority to reallocate up 

to three percent of funds designated for AIDS research among Institutes, subject to normal reprogramming procedures. The Committee encourages NIH to use this authority whenever it believes 

that an adjustment in the allocation of AIDS funding between Institutes is appropriate to achieve scientific objectives or to facilitate 

promising research efforts. 

The Committee continues to support OAR, its leadership, and its 

coordinated budget planning process and expects the individual institutes and centers to fully cooperate with OAR’s work. The Committee has provided funding for the OAR within the Office of the 

Director and intends that the OAR will maintain its current structure and responsibilities, including the allocation of an emergency 

discretionary fund. 

NATIONAL CANCER INSTITUTE

The Committee provides $4,841,774,000 for the National Cancer Institute (NCI), which is $16,515,000 above the fiscal year 2005 

comparable level and the same as the budget request. The bill includes language requested by the Administration permitting up to 

$8,000,000 for repairs and improvements to the NCI intramural facility in Frederick, Maryland. 

Mission.—The 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 rapidly translate basic research findings into clinical practice. 

Prostate Cancer.—The Committee recognizes NCI’s commitment 

to prostate cancer research as laid forth in its ‘‘Prostate Cancer Research Plan, FY 2003—FY 2008’’. The Committee requests that 

NCI provide an annual update every January on its progress in 

prostate cancer research as it reflects the goals outlined in the plan 

for years fiscal years 2006–08. In developing this update, the Committee urges the NIH to consult and work closely with the research 

community, clinicians, and patient advocacy groups and the Congress. 

Breast cancer.—Breast cancer’s toll continues to threaten the 

lives and the quality of life of thousands of women. In addition to 

ongoing research activities underway at the Institute, the Committee hope that increased attention will also be given to areas of 

research that focus on helping women to more fully restore and improve their quality of life after treatment, including further research on lymphadema, stress, nutrition, exercise, weight, and environment. 

The Committee remains concerned about missed opportunities in 

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mittee encourages NCI to further accelerate advances in breast 

cancer screening technology and to capitalize on existing and create 

new technologies that improve early diagnosis, health outcomes, 

and survival. 

Ovarian cancer.—The Committee remains concerned that survival rates associated with ovarian cancer have improved only 

slightly over the past 20 years. Ovarian cancer is the deadliest of 

all gynecological cancers. For all women diagnosed with ovarian 

cancer, the five-year survival rate is 45 percent. More than twothirds of the women have advanced disease at the time of diagnosis, and for this group, the 5–year survival rate is 29 percent. 

The Committee commends NCI for its recognition of the importance of studying this deadly women’s disease and appreciates the 

NCI’s recent investment that is helping to increase the understanding of the unique molecular pathways associated with ovarian 

cancer through its SPOREs program. The Committee encourages 

NCI to sustain and strengthen its commitment to and investment 

in ovarian cancer and maintain the specialized programs of research excellence (SPORE) initiatives directed toward ovarian cancer in fiscal year 2006. 

Liver Cancer.—The Committee remains concerned with the increasing incidence of primary liver cancer, which is in sharp contrast to many other forms of cancer where the incidence is declining and the treatment options are rapidly increasing. The Committee is aware that NCI, working with NIDDK, has convened an 

Experts Conference and is moving ahead with plans to increase resources dedicated to this disease. The Committee urges NCI to 

make a strong commitment to research on primary liver cancer 

with particular focus on the development of drugs that target the 

cancer without killing healthy cells by interfering with the cellular 

pathways of the disease. The Committee further urges NCI to continue to support the NIDDK sponsored HALT–C clinical trial which 

has particular relevance to the NCI mission. 

Pancreatic cancer.—Pancreatic cancer is the country’s fourth 

leading cause of cancer death. Most patients present with advanced 

disease at diagnosis and the median overall survival rate for people 

diagnosed with metastatic disease is only about six months. The 

Committee is concerned that there are too few scientists researching pancreatic cancer and compliments the NCI’s past efforts for 

increasing the research field through its program of a 50 percent 

formalized extended payline for grants that were 100 percent relevant to pancreatic cancer. The Committee considers this an important method for attracting both young and experienced investigators to develop careers in pancreatic cancer. In 2004, the NCI established a new policy for awarding additional grants in pancreatic 

cancer research and extended this initiative to research that is 50 

percent relevant to pancreatic cancer. The Committee requests NCI 

to report in February, 2006 on how the two changes in policy have 

affected the pancreatic cancer portfolio, including the percentage 

relevancy of each grant to pancreatic cancer, and urges NCI to continue its commitment to fertilize the pancreatic cancer field. 

Lymphoma.—Lymphoma is the fifth most common cancer and 

the most common hematological cancer. Unlike many other cancers, lymphoma often strikes individuals in young adulthood and 

the middle years, significantly impacting their professional producVerDate jul 14 2003 07:43 Jun 22, 2005 Jkt 021909 PO 00000 Frm 00058 Fmt 6659 Sfmt 6602 E:\HR\OC\HR143.XXX HR143
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tivity and individual role in the family and society. The Committee 

recommends that NCI take bold action to address lymphoma as a 

public health problem and to capitalize on important research advances to date. The Committee encourages NCI to strengthen its 

investment in translational and clinical lymphoma research. 

The Committee commends NCI and the National Institute of Environmental Health Sciences (NIEHS) for convening a workshop on 

the viral and environmental links to lymphoma and recommends 

that steps be taken to strengthen the NCI investment in this area. 

The Committee recommends that NCI direct resources to: (1) studies of adequate scope to assure the identification of environmental 

risk factors for specific subtypes of lymphoma; (2) small studies designed to improve detection and quantification of historically difficult-to-measure environmental factors; (3) studies that are directed toward enhancing the understanding of the role of the immune system in the initiation and progression of lymphoma; and 

(4) studies that examine the simultaneous presence of a wide profile of infectious agents among individuals with lymphoma. 

The Committee recommends that resources be directed to research related to long-term survivors of both non-Hodgkin’s 

lymphoma and Hodgkin’s lymphoma. The report of the Leukemia, 

Lymphoma, and Myeloma Progress Review Group (LLM PRG) recommended that resources be invested in identifying the populations of patients that are at high risk of adverse outcomes from 

their treatment for lymphoma. 

Cancer centers at minority institutions.—The Committee commends NCI on the success of its cancer centers program. Given 

that minority populations suffer disproportionately from virtually 

every form of cancer, the Committee encourages NCI to give consideration to supporting the establishment of a comprehensive center at a minority institution focused on research, treatment, and 

prevention of cancer in African American and other minority communities. The Committee is pleased with NCI’s attention to this 

important matter. 

Neurofibromatosis (NF).—The Committee is pleased with NCI’s 

clinical trials of NF patients and encourages NCI to enhance its NF 

research portfolio in such areas as further development of animal 

models, natural history studies, therapeutic experimentation, and 

clinical trials. The Committee recognizes that basic research has 

successfully brought NF into the clinical era and encourages NCI 

to create, fund, and implement NF clinical trial infrastructures including NF centers, patient data bases, and tissue banks. The Committee further encourages NCI to apply existing cancer drugs to 

NF patients in clinical trials and to develop new drugs for NF 

which could then apply to the general population because of NF’s 

connection to many forms of human cancer. The Committee is 

aware of significant new advances in NF research in the past few 

years in the area of tumor suppression and encourages NCI to continue to coordinate its efforts with other NIH institutes and government agencies. 

Angiogenesis.—The Committee applauds NCI, working with 

other Institutes, for its leadership in planning and launching the 

Trans-NIH Angiogenesis Research Program (TARP) that promotes 

multidisciplinary research on the control and promotion of new 

blood vessel growth. This research has the potential to lead to the 

60

development of new therapeutic strategies for a variety of diseases, 

including cancer, diabetic eye disease, diabetic kidney disease, and 

others. 

Hemophilia.—The Committee understands that field work on the 

Multi-Center Hemophilia Cohort Study will be complete in September, 2005. This cohort offers a rich database for improving the 

understanding of hepatitis C virus and other concerns of major 

public health interest. The Committee expects NCI to take all necessary steps to ensure the samples obtained through this cohort are 

preserved and accessible for future research. The Committee also 

requests a report by March 31, 2006 on possible future research opportunities using the cohort samples. 

Tuberous sclerosis complex (TSC).—TSC is a genetic disorder 

that triggers uncontrollable tumor growth in multiple organs of the 

body, including the brain, heart, kidneys, lungs, liver, eyes or skin. 

In light of its similarities to the uncontrolled growth of cancer cells, 

many scientists believe that determining the cause of tumor growth 

in TSC could open the way for cures and treatments for cancer as 

well. To those ends, the Committee strongly encourages NCI to 

support programs examining the molecular and cellular basis of 

TSC, and the role of TSC in tumor development. 

American Russian Cancer Alliance (ARCA).—The Committee applauds the progress of ARCA in harnessing the scientific strengths 

of its partners in pursuit of novel research activities that ultimately benefit cancer patients worldwide. The Committee notes in 

particular the continued development of the unique ARCA projects 

in molecular imaging and radioisotope-targeted therapy that have 

strengthened the scientific collaborations with the leading Russian 

nuclear research centers and American cancer centers. Moreover, 

the Committee recognizes and commends NCI for providing support to the ARCA infrastructure and facilitating international exchange and communication between the American and Russian 

partners. The Committee encourages NCI to continue and enhance 

its support for the research programs of ARCA, recognizing both 

the scientific opportunities within the partnership and the national 

interest in fostering the international effort to develop new, productive avenues for the use of nuclear stockpiles previously earmarked 

for weapons development.

Cancer metastasis.—The NCI is encouraged to develop an interdisciplinary and integrated approach to study bone metastasis, by 

combining the expertise of oncologists, bone biologists and metastasis experts. Key issues to address include the generation of novel 

organ-like or mouse models which closely mimic tumor bone interactions that will pave the way for delineating novel mechanisms of 

how tumor cells go to the bone; designing novel targets for better 

prognosis; and effective therapeutic targeting. The Committee encourages NCI to continue supporting research that furthers the understanding of the causes and consequences of sarcoma. The Committee also recommends that NCI support research on 

osteosarcoma to improve survival and quality of life and to prevent 

metastatic osteosarcoma in children and teenagers who develop 

this cancer. 

Tobacco harm reduction.—The Committee recognizes and applauds the significant work of HHS and its agencies in the area of 

tobacco and health, particularly recent efforts aimed at facilitating 

61

smoking cessation. The Committee believes it is important to continue to explore additional methods to reduce smoking related mortality and morbidity in the 10 to 15 percent of the adult population 

who cannot or will not quit smoking. In a recent study funded by 

NCI, a panel of leading tobacco experts was asked to review scientific literature for the comparative mortality risks of low-nitrosamine smokeless tobacco products and conventional cigarettes. The 

panel of experts concluded that, based on published scientific literature, low-nitrosamine smokeless tobacco products pose a substantially lower risk to the user than conventional cigarettes. Given 

this important conclusion, the Committee urges NCI to continue its 

research into harm reduction strategies for cigarette smokers, and 

consider the role low-nitrosamine smokeless tobacco products may 

play in the overall effort to reduce the incidence of cigarette smoking in the U.S. 

Cancer biobank.—The Committee believes that the cancer 

biobank, because it will centralize and standardize molecular annotation of tissues, has the potential to greatly accelerate the understanding of cancer and the discovery and development of new biomarkers, new diagnostics and new therapeutic approaches. As it is 

established by NCI, the Committee believes that it will be most efficient to utilize existing technologies such as high-density microarrays, given the long time frame for the development of new technologies. 

Advanced technologies.—The Committee commends NCI for its 

goal of eliminating the suffering and death caused by cancer by the 

year 2015. The Committee encourages NCI to pursue the use of advanced technologies such as nanotechnology, proteomics, and imaging, to rapidly translate basic research discoveries into targeted 

interventions to ultimately achieve the 2015 goal. 

Informatics grid.—The Committee is pleased with NCI’s development of the cancer Biomedical Informatics Grid (caBIG) as a network to facilitate the integration of diverse data types and the 

sharing of interoperable analytic tools. NCI is encouraged to work 

with the Office of the National Coordinator for Health Information 

Technology to use CaBIG as a prototype for an interoperable clinical data network. 

NATIONAL HEART, LUNG, AND BLOOD INSTITUTE

The Committee provides $2,951,270,000 for the National Heart, 

Lung, and Blood Institute (NHLBI), which is $10,069,000 above the 

fiscal year 2005 comparable level and the same as the budget request. 

Mission.—The National Heart, Lung, and Blood Institute provides leadership for a national research program in diseases of the 

heart, blood vessels, lungs, and blood, in transfusion medicine, and 

in sleep disorders through support of basic, clinical, and population-based and health education research. 

Cardiovascular diseases.—The Committee continues to urge the 

Institute to place a high priority on research for heart disease, 

stroke and other cardiovascular diseases. The Committee encourages NHLBI to strengthen its research portfolio through all available mechanisms into the causes, cure, prevention and treatment 

of cardiovascular diseases. 

62

Heart failure clinical research network.—The Committee is concerned that in spite of advances in treatment, the number of newly 

diagnosed cases and the number of Americans suffering from heart 

failure continues to grow. The Committee encourages NHLBI to 

consider initiating a research network to conduct clinical studies 

using new approaches to improve outcomes for heart failure patients and to provide an infrastructure to enable rapid translation 

of promising research findings into enhanced patient care. The network would have the capability of implementing multiple concurrent clinical studies that may show promise for new therapies and 

provide background for larger clinical trials. 

Innovative technologies for engineering small blood vessels.—The 

Committee understands that the supply of natural blood vessels for 

multiple grafts does not meet the demand for patients undergoing 

heart artery bypass surgery and that prosthetic grafts for children 

born with complex heart defects fail at an unacceptable rate. The 

Committee encourages NHLBI to conduct research to advance the 

development of substitutes for natural blood vessels. 

Specialized centers of clinically oriented research (SCCOR) for 

vascular injury, repair, and remodeling.—Vascular diseases result 

from clogged, weakened or otherwise damaged blood vessels. The 

Committee encourages NHLBI to consider initiating a new SCCOR 

program to conduct interdependent clinical and multidisciplinary 

basic research projects on the molecular and cellular mechanisms 

of vascular injury, repair, and remodeling. Such a program would 

promote patient-oriented research to improve prevention, detection, 

and treatment of vascular diseases. The SCCOR would provide an 

environment for new clinical investigators to develop skills and research capabilities to conduct relevant research in this area. 

Cooley’s anemia.—The Committee remains strongly supportive of 

the focused research effort that is being undertaken by the thalassemia clinical research network, which is comprised the leading research institutions in the field of thalassemia, or Cooley’s anemia. 

The Committee believes that this network is just beginning to meet 

its promise and urges NHLBI to continue it and support the research projects undertaken by it. 

Hemophilia.—The Committee commends NHLBI for its leadership in advancing research on bleeding and clotting disorders and 

the complications of these disorders. The Committee encourages 

NHBLI to maintain its work in this area and applauds the Institute for its efforts, in cooperation with voluntary organizations, to 

support research on improved and novel therapies for these disorders. 

Pulmonary hypertension.—Pulmonary hypertension (PH) is a 

rare, progressive and fatal disease that predominantly affects 

women, regardless of age or race. PH causes deadly deterioration 

of the heart and lungs and is a secondary condition in many other 

serious disorders such as scleroderma and lupus. The Committee 

continues to view research in this area as a high priority and commends NHLBI’s efforts to promote PH-related research. The Committee encourages the Institute to support funding for basic research, gene therapy and clinical trials of promising pharmaceuticals, and to take appropriate measures to ensure the submission of high quality proposals in this area. 

63

Cardiovascular advanced screening program.—The Committee 

encourages NHLBI to sponsor a workshop on advanced screening 

methods for cardiovascular disease. This workshop would incorporate the Cardiovascular Health Study data, expertise from the 

National Cholesterol Education Project, and input from the cardiology community. The proceedings from this workshop could be 

used in the development of a Federal plan to address barriers to 

access to these advanced screening methods. 

Transmissible spongiform encephalopathies.—The Committee encourages NHLBI to continue its efforts to develop a diagnostic test 

for TSE that would be suitable for screening the blood supply. Currently, there is no suitable method for identifying TSE-infected 

blood. In addition, the Committee encourages NHLBI to seek new 

technologies and procedures for inactivating blood-borne causative 

agents for human TSEs, further ensuring a safe blood supply. 

Human TSEs, for which there are no known treatments, include 

Creutzfeld-Jakob disease and new variant Creutzfeldt-Jakob disease. 

National COPD education and prevention program.—The Committee is pleased that NHLBI held a preliminary workshop to formulate strategies towards implementing a national chronic obstructive pulmonary disease (COPD) education and prevention program. 

Since COPD is the fourth leading cause of death in the United 

States, the Committee urges NHLBI to continue its education efforts to bring advances in medical care to the public. Early identification of those at-risk for or who have COPD is essential in the 

effort to stem the growth of the population with COPD. The Committee encourages NHLBI to continue its efforts in this area, working with national lung organizations, to develop a national education campaign for providers and the public about COPD. 

Scleroderma.—The Committee is encouraged by NHLBI’s growing interest in scleroderma, a chronic and progressive disease that 

predominantly strikes women. Scleroderma is disfiguring and can 

be life-threatening, affecting multiple systems including the heart 

and lungs. The Committee is pleased that NHLBI funded the 

Scleroderma Lung Study, a large multi-center trial whose focus is 

to find a therapy that may alter the course of the inflammation of 

the lungs that occurs in approximately 40 percent of those diagnosed with the systemic scleroderma. The Committee also commends NHLBI for its commitment to finding a cause and improved 

therapies for pulmonary arterial hypertension. Pulmonary arterial 

hypertension occurs in approximately 50 percent of those diagnosed 

with systemic scleroderma. More research is needed to identify the 

causes of the complications of scleroderma that include pulmonary 

fibrosis, pulmonary hypertension, myocardial fibrosis, cardiac arrhythmias, pericarditis, and Raynaud’s Phenomenon. 

Neurofibromatosis (NF).—Significant advances continue to be 

made in research on NF’s implications with heart disease and, in 

particular, its involvement with hypertension and congenital heart 

disease. The Committee applauds NHLBI for its involvement with 

NF research and with NF patient advocacy groups and encourages 

NHLBI to continue to expand its NF research portfolio in light of 

the enormous implications for the general population.

Sleep disorders.—The Committee continues to recommend that 

the National Center on Sleep Disorders Research partner with 

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other federal agencies, such as the Centers for Disease Control and 

Prevention, as well as voluntary health organizations to develop a 

sleep education and public awareness initiative to serve as an ongoing, inclusive mechanism for public and professional awareness 

on sleep and sleep disorders. 

Marfan syndrome.—Marfan syndrome is characterized by aortic 

aneurysms, painful orthopedic issues, pulmonary issues and ocular 

manifestations that can result in blindness. The Committee commends NHLBI for its support of research opportunities to study 

this life threatening, degenerative genetic disorder. Recent advances in basic research are ready to be translated into promising 

clinical trials. The Committee suggests that NHLBI collaborate 

with other institutes to support a clinical trial for drug therapies 

to potentially reverse the cardiovascular and pulmonary manifestations of this disorder. 

Alpha-1 antitrypsin deficiency.—The Committee is aware that 

Alpha-1 antitrypsin deficiency is often misdiagnosed as asthma or 

Chronic Obstructive Pulmonary Disease (COPD). Alpha-1 is a 

major cause of liver transplantation in adults and children. The 

Committee recommends the establishment of an inter-institute coordinating committee to facilitate cooperation between NHLBI, 

NIDDK, NHGRI, and other institutes to enhance the NIH research 

portfolio, encourage targeted detection, raise public awareness 

about Alpha-1 and provide appropriate information to health professionals. 

Duchenne muscular dystrophy (DMD).—The Committee is 

pleased that NLHBI has enhanced its research and related activities surrounding pulmonary complications associated with DMD 

and urges the Institute to continue to enhance its work in this 

area. The Committee hopes that NHLBI will become more involved 

with NIH muscular dystrophy activities by joining the Muscular 

Dystrophy Coordinating Committee. 

Primary immunodeficiency diseases.—The Committee understands that NHLBI has begun to work with voluntary agencies as 

part of a national physician education and public awareness campaign for primary immunodeficiency diseases. The Committee encourages NHLBI to take further action in this regard and to continue to be an active participant in the development of educational 

materials, conferences, and related initiatives, as appropriate. 

Novel targets and therapy development for clot-based stroke.—The 

Committee recognizes that an urgent need exists to develop new 

therapies to reduce bleeding risk and minimize brain damage and 

loss of function from stroke. The Committee encourages NHLBI to 

consider initiating a collaborative effort to identify new molecular 

targets, explore promising agents, and develop innovative therapies 

to quickly restore blood flow to the brain to limit stroke damage. 

Nontuberculous mycobacteria [NTM].—Mycobacteria are environmental organisms found in both water and soil that can cause significant respiratory damage. The Committee is aware of the increasing incidence of nontuberculous mycobacteria [NTM] pulmonary infections in women, particularly involving rapidly growing 

mycobacteria, an inherently resistant subspecies. The Committee 

encourages NHLBI to collaborate with NIAID and other institutes 

leading to a better understanding of NTM and enhancing 

65

diagnostics and treatment and promoting appropriate education of 

health care providers. 

Lymphangioleiomyomatosis (LAM).—The Committee remains 

very interested in efforts to find a cure for LAM, a progressive and 

often fatal lung disease of women with no effective treatment. The 

Committee understands that very recent scientific findings have 

presented new treatment approaches for clinical testing, and that 

experimental trials with the drug sirolimus have begun. The Committee encourages NHLBI to explore opportunities for funding clinical treatment trials through both intramural and extramural 

means and to use all available mechanisms as appropriate, including support of state-of-the-science symposia, request for applications, and facilitating access to human tissues, to stimulate a broad 

range of clinical and basic LAM research. 

NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH

The Committee provides $393,269,000 for the National Institute 

of Dental and Craniofacial Research (NIDCR), which is $1,440,000 

above the fiscal year 2005 comparable level and the same as the 

budget request. 

Mission.—The NIDCR conducts and supports research and research training to improve craniofacial, oral and dental health. The 

Institute’s programs reflect the genetic, behavioral and environmental factors that result in complex human disease and are clustered into the following areas: inherited disorders; infection and immunity; oral, pharyngeal and laryngeal cancers; chronic and disabling conditions such as bone and joint diseases and chronic pain; 

behavioral science, epidemiology and health promotion; and tissue 

engineering and biomimetics research to improve diagnostics and 

tissue repair and regeneration. 

Saliva.—The Committee is aware that research on saliva has 

progressed rapidly and holds the potential to be an inexpensive 

non-invasive diagnostic tool for early detection of breast cancer, 

osteoporosis, hepatitis, HIV, and Sjogren’s disease. The Committee 

encourages NIDCR to work cooperatively with NCI and other appropriate institutes in pursing research initiatives on the development of saliva as a diagnostic tool. 

Dental abnormalities.—The Committee encourages NIDCR to 

continue its support of research aimed at the health of oral mineralized tissues. This includes studying the role of genetic factors 

and the potential for cell-based and pharmacological therapy and 

early screening for osteoporosis. Additionally NIDCR is urged to 

continue research on fibrous dysplasia/McCune Albright syndrome 

and to focus on the dental abnormalities associated with Paget’s 

disease. 

Scleroderma.—The Committee is encouraged by NIDCR’s interest 

in scleroderma, a chronic and progressive disease that predominately strikes women. Scleroderma is often associated with a number of dental and craniofacial complications, including xerostomia 

and microstomia. Additional concerns are increased frequency of 

caries, periodontal disease, fibrotic changes, fungal infections, 

telangectasia and bone resorption of the mandible. Additional research is needed to develop safe and effective treatments and to 

identify the causes of the serious complications from the disease. 

66

NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY

DISEASES

The Committee provides $1,722,146,000 for the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), 

which is $8,562,000 above the fiscal year 2005 comparable level 

and the same as the budget request. In addition, $150,000,000 in 

mandatory funds are available for juvenile diabetes research. 

Mission.—The NIDDK supports research in three major disease 

categories: diabetes, endocrinology, and metabolic diseases; digestive diseases and nutrition; and kidney, urologic, and hematologic 

diseases. The 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. The Institute also supports efforts to transfer the 

knowledge gained from its research program to health professionals, patients, and the general public. 

Type-2 diabetes.—Type-2 diabetes exacts an enormous human 

and economic toll on Americans. Diabetes costs the healthcare system more than $92 billion a year. Medical research has shown that 

achieving and maintaining a blood glucose level below 7 percent 

significantly lowers the risk of blindness, amputation, and other serious complications of diabetes. The Committee is concerned that, 

despite these advances, only about 2 in 5 diabetics report having 

a blood glucose level of less than 7 percent. The Committee recognizes that treatment guidelines for diabetes exist that include recommendations for achieving and maintaining appropriate glucose 

levels, and the Committee encourages NIDDK to promote greater 

use of treatment guidelines in clinical practice. The Committee requests that NIDDK examine the disparity in available guidelines 

and actual treatment and report to Congress within six months of 

enactment on actions the government can take that will rapidly 

close the disparity between treatment guidelines and the care diabetics receive within the first year of being diagnosed. 

Islet transplantation.—The Committee commends NIDDK and 

NIAID for the establishment of the Clinical Islet Transplantation 

Consortium and the islet transplantation clinical trial that will include Medicare-eligible individuals whose transplant and related 

costs will be covered by Medicare. Cooperation between the NIDDK 

and NIAID and members of the Consortium is urged to ensure the 

timely launch of these clinical trials. 

Drug screening.—The Committee applauds NIDDK for convening 

an exploratory workshop to investigate the potential of conducting 

a screen of FDA-approved pharmaceutical drugs for hyperglycemiainduced cellular injury leading to diabetic complications. Screens of 

this type have the potential to lead to the identification of new 

treatment strategies that can be rapidly translated into clinical applicability. The Committee urges the Institute to continue to promote research in this promising area. 

Rapid access to intervention development.—The Committee commends NIDDK and NCI for extending the rapid access to intervention development (RAID) pre-clinical resources to researchers working in the field of type 1 diabetes and its complications. The Committee encourages NIDDK to release to the public information on 

compounds to be produced for projects supported by RAID, much 

67

like the NCI releases for cancer-related projects on its public 

website. 

Pediatric kidney disease.—Kidney disease remains a persistent 

and poorly understood problem among infants, children and adolescents, impairing normal growth and development and often resulting in learning disabilities and mental retardation. Of urgent concern today is the explosion in the incidence of obesity among 

chilren and adolescents, a morbidity that places more than 15 percent of America’s children at risk for developing type 2 diabetes, 

hypertension, and chronic kidney disease (CKD). These morbidities 

not only represent a significant financial burden to the health care 

system but also are important risk factors for the development of 

cardiovascular disease. The Committee encourages NIDDK to continue to support research focused on the pathogenesis, prevention, 

and treatment of kidney disease in children. The Committee recommends that emphasis be placed on exploring the contributions 

of obesity, type 2 diabetes, and hypertension to progression of disease, and interventions that may limit cardiovascular morbidity in 

patients with CKD. 

Polycystic kidney disease (PKD).—The Committee recognizes that 

NIH research combined with grants from the private sector and the 

involvement of industry has produced the first clinical drug trial 

for PKD in humans, and has fostered the development of additional, innovative PKD therapies. The Committee recognizes that 

the four PKD centers of excellence have engendered a broad range 

of alternative model research systems and reagents shared worldwide among PKD investigators and have drawn a host of investigators from other disciplines into the PKD field. The Committee encourages NIDDK to facilitate PKD clinical trials by strengthening 

studies of pathophysiology and cellular pathobiology. 

Incontinence.—Many otherwise healthy, active individuals suffer 

from incontinence. Fecal incontinence, also called bowel incontinence, affects people of all ages and is associated with a wide variety of causes. The Committee encourages NIDDK to develop a 

standardization of scales to measure incontinence severity and 

quality of life and to develop strategies for primary prevention of 

fecal incontinence associated with childbirth. 

Interstitial cystitis (IC).—The Committee believes that the 2003 

NIDDK-sponsored scientific symposium on IC was very successful 

and encourages NIDDK to convene a similar symposium on IC in 

2006, collaborating with appropriate voluntary organizations. The 

Committee also encourages NIDDK to hold a separate meeting of 

leading international researchers involved in IC research to seek 

clarity on the definition of IC. The absence of a uniform definition 

which accurately captures the condition and the affected population 

is negatively affecting patients in terms of diagnosis and treatment 

as well as researchers in terms of literature review. The Committee 

was encouraged to learn that NIDDK is launching an IC awareness 

campaign and hopes that NIDDK will continue to work closely with 

the IC patient community on both developing the content and executing the campaign. 

Liver disease research action plan.—The Committee is pleased to 

note that NIDDK, working with the leading scientific experts in 

the field, has prepared and published a comprehensive liver disease 

research action plan to guide future research activities. The plan 

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is organized into 16 chapters and identifies numerous areas of research important to virtually every aspect of liver disease. The 

Committee recommends that steps be taken to begin to implement 

the plan immediately and be ready to report at next year’s hearings what has been accomplished to date, as well as future plans. 

Hepatitis B.—The Committee is concerned that a consensus 

treatment protocol for hepatitis B does not yet exist, but is pleased 

to learn that NIDDK is actively supporting preliminary research in 

order to convene a research workshop to plan a hepatitis B consensus development conference. The Committee is pleased that 

NIDDK is taking all necessary steps to plan a successful hepatitis 

B consensus development conference and hopes that this conference 

is held soon. 

Hepatitis C.—The Committee is pleased to learn that there have 

been 50 patent applications filed for new therapies for hepatitis C 

and there are at least 6 drugs currently in early human trials. In 

addition to developing new drugs, the Committee encourages 

NIDDK to study the improvement of existing drugs to reduce their 

toxicity and negative side effects. The Committee applauds NIDDK 

for formally adopting the goal of a 90% treatment effectiveness rate 

for hepatitis C within ten years. 

Fatty liver disease.—The Committee notes that there is an 

emerging obesity-related chronic liver disease, which may affect as 

many as one in four adults and a significant number of obese children. This diagnosis encompasses a spectrum of severity with many 

cases evolving into non-alcoholic steatohepatitis (NASH) and, ultimately, cirrhosis. NASH-related liver disease has already become 

an important indicator for liver transplantation, and in the absence 

of better treatments, the need for NASH-related liver transplantation will increase significantly over time. The Committee is 

pleased that NIDDK is funding a fatty liver disease clinical trial 

that includes both adult and pediatric populations. The Committee 

encourages NIDDK to focus research on the progression of fatty 

liver disease to cirrhosis and the impact of alcohol on the progression of fatty liver disease. 

Pediatric liver disease.—The Committee is pleased that NIDDK 

has taken steps to increase research on biliary atresia, the most 

common cause of liver transplantation in children, by creating ten 

centers within the Biliary Atresia Clinical Research Consortium. 

The Committee is also pleased that centers have been added with 

a special focus on additional neonatal liver diseases. 

Alpha-1 antitrypsin deficiency.—The Committee is aware that 

alpha-1 antitrypsin deficiency liver disease is a leading cause of pediatric transplantation and can manifest at any age. The Committee is encouraged that NIDDK has invested in research of this 

disorder and encourages NIDDK to collaborate with NHLBI and 

other institutes to enhance its research portfolio, encourage detection, raise public awareness about alpha-1 and provide appropriate 

information to health professionals. 

Digestive diseases.—Diseases of the digestive system continue to 

affect more than one-half of all Americans at some time in their 

lives. Serious disorders such as colorectal cancer, inflammatory 

bowel disease, irritable bowel syndrome, hemochromatosis, celiac 

disease, and hepatitis take a tremendous toll in terms of human 

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mends NIDDK on the success of its Digestive Disease Centers program in addressing a wide range of disorders. The Committee continues to encourage NIDDK to strengthen this important program 

with an increased emphasis on irritable bowel syndrome. 

Irritable bowel syndrome.—The Committee remains concerned 

about the increasing frequency of irritable bowel syndrome (IBS), 

a chronic complex of disorders that malign the digestive system. 

This common disorder strikes people from all walks of life, affecting 

between 25 and 45 million Americans. The Committee encourages 

NIDDK to provide adequate funding for irritable bowel syndrome/

functional bowel disorders research and to give high priority to 

funding grants that will continue to increase the IBS portfolio. The 

Committee requests NIDDK to report to the Committee by March 

15, 2006 its views on the appropriateness of developing a strategic 

plan for IBS research. 

Inflammatory bowel disease.—The Committee has been encouraged in recent years by discoveries related to Crohn’s disease and 

ulcerative colitis, collectively known as inflammatory bowel disease 

(IBD). These extremely complex disorders represent the major 

cause of morbidity from intestinal illness. The Committee commends NIDDK for its strong leadership in this area and encourages 

the Institute to give priority consideration to the following areas of 

IBD research: the cellular, molecular and genetic structure of IBD, 

identification of the genes that determine susceptibility or resistance to IBD in various patient subgroups, and translation of basic 

research findings into patient clinical trials as outlined in the research agenda developed by the scientific community entitled, 

‘‘Challenges in Inflammatory Bowel Disease.’’ The Committee also 

encourages NIDDK to continue to strengthen its partnership with 

the IBD community on innovative research projects. 

Scleroderma.—The Committee encourages NIDDK to support 

scleroderma-relevant research. Scleroderma is a chronic and progressive disease that predominantly strikes women. It is estimated 

that ninety percent of patients with systemic sclerosis have gastrointestinal (GI) involvement and that, of that number, fifty percent 

have clinically significant manifestations. GI involvement can 

manifest as gastroesophageal reflux disease, dysphagia, Barrett’s 

esophagus, gastroparesis, ‘‘watermelon stomach’’, malabsorption, 

and fibrosis of the small and large intestines. Renal crisis affects 

twenty percent of those with systemic sclerosis often within the 

first five years after diagnosis. More research is needed in order to 

develop safe and effective treatments and to identify the causes of 

the complications of scleroderma. 

Glomerular disease research.—The Committee continues to be 

pleased with the work of NIDDK in the area of glomerular disease 

research, particularly as it relates to focal segmental 

glomerulosclerosis. The Committee commends NIDDK for conducting the recent glomerular disease workshop and encourages 

NIDDK to use a program announcement or other appropriate 

mechanism to ensure the initiation of grant proposals, training positions, and other activities to expand the NIDDK portfolio in this 

important area of research. 

Tuberous sclerosis complex.—Tuberous sclerosis complex (TSC) is 

a genetic disorder that triggers uncontrollable tumor growth in 

multiple organs of the body including the kidneys, where patients 

70

are at risk for polycystic kidney disease, cancer or, most commonly, 

benign growths that can result in kidney failure. The Committee 

encourages NIDDK to support studies examining the molecular 

and cellular basis of these manifestations of TSC as well as preclinical and clinical studies. 

Osteoporosis.—The Committee encourages NIDDK to support research targeting new technologies and therapies to increase bone 

mass and combat osteoporosis through focus on: (1) genetics, environmental and lifestyle factors, and (2) the effects of disease, in 

order to address the research questions highlighted in the Surgeon 

General’s Report on Bone Health and Osteoporosis. 

Paget’s disease.—The Committee encourages NIDDK to study the 

functional consequences of the recently identified gene mutations 

in Paget’s disease as a means of identifying new therapeutic treatments for the disease. 

Mucopolysaccharidosis (MPS).—The Committee recognizes the 

efforts of NIDDK to enhance research efforts to achieve a greater 

understanding and pursue development of effective therapies for 

MPS disorders. In addition to the general overall support of broad 

based MPS research, the Committee supports efforts by NIDDK to 

reach out to NIAMS to improve collaborative bone and joint disease 

research in MPS disorders. Research focused on the underlying 

pathophysiology of bone and joint lesions, the gene mutations and 

substrates that are stored, and potential therapeutic approaches 

continue to be of significant interest of the Committee. The Committee commends NIDDK on its collaborations with NINDS, 

NICHD, NCRR, and ORD in advancing broad-based MPS-related 

research. 

Fragile X.—Fragile X mental retardation is a single-gene disorder that results from an unusual kind of mutation. Study of the 

chain of events set in motion by this mutation may lead to the 

identification of points in the process at which interventions may 

ameliorate symptoms. The Committee encourages NIDDK to enhance its research activities on fragile X and to coordinate these efforts with other Institutes working on related activities, including 

NIMH and NICHD. 

Cooley’s anemia.—The Committee continues to support the high 

quality research being conducted by NIDDK on such issues as iron 

chelation, non-invasive iron measurement, fetal hemoglobin, and 

other topics critical to improving the lives of Cooley’s anemia patients. The development of a less burdensome means of iron chelation is urgently needed. In addition, the Committee encourages 

NIDDK to continue to work closely with NIBIB to develop and perfect non-invasive means of iron measurement. 

Cystic fibrosis (CF).—The Committee commends NIDDK for supporting cystic fibrosis research and translational centers. When 

awarded later this year, they will provide resources for communication and collaboration between basic and clinical researchers to enhance the efficiency of research and foster cooperation within and 

among institutions with strong existing bases of cystic fibrosis (CF) 

research. The Committee also commends NIDDK for its support of 

the EPIC study, a longitudinal assessment of risk factors for and 

impact of Pseudomonas aeruginosa acquisition and early antipseudomonal treatment in children with CF. This study holds the 

promise of yielding critically important information about the optiVerDate jul 14 2003 07:43 Jun 22, 2005 Jkt 021909 PO 00000 Frm 00070 Fmt 6659 Sfmt 6602 E:\HR\OC\HR143.XXX HR143
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mal treatment of initial lung infections in children with CF. The 

Committee encourages NIDDK to continue its support of CF research efforts, including proteomics research. CF researchers are 

looking at the many proteins that play a role in CF, in hopes of 

identifying new drug targets to treat CF. The Committee commends NIDDK for its support of the program announcement for research proposals focusing on discovery and development of compounds that will correct protein misfolding. The Committee encourages NIDDK to further support this especially promising area of research. 

Hepatitis C virus (HCV) and bleeding disorders.—The Committee 

encourages NIDDK to work with appropriate voluntary organizations in developing and advancing research initiatives for addressing HCV within the bleeding disorders community. 

NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

The Committee provides $1,550,260,000 for the National Institute of Neurological Disorders and Stroke (NINDS), which is 

$10,812,000 above the fiscal year 2005 comparable level and the 

same as the budget request. 

Mission.—The NINDS supports and conducts basic 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. 

Stroke.—The Committee continues to place a high priority on 

stroke research and encourages NINDS to allocate resources to 

basic, clinical and translational research into stroke, which is a 

major contributor to late-life dementia and a leading cause of permanent disability. The Committee encourages NINDS to continue 

implementing the long-range strategic plan for stroke research and 

to continue searching for novel approaches to improve stroke diagnosis, treatment, rehabilitation and prevention. 

Epilepsy.—Epilepsy remains a major, unsolved public health 

problem affecting the lives of millions of Americans and their families. The Committee seeks intensified efforts by the Institute to 

produce breakthroughs in the prevention, treatment, and eventual 

cure of epilepsy. The Committee applauds the development of 

benchmarks for epilepsy research resulting from the ‘‘Curing Epilepsy: Focus on the Future’’ conference held in 2000 and encourages NINDS to address important research issues raised at the 

‘‘Living Well with Epilepsy II’’ conference held in 2003. The Committee encourages NINDS to continue to allocate resources to the 

anti-epileptic drug development program, and to report to the Committee in next year’s hearings on its activities to further these important areas of research. 

Alzheimer’s disease.—NINDS is currently supporting both preclinical and translational research intended to expand the pool of 

therapeutic agents for treating Alzheimer’s disease. For example, a 

recent NINDS-supported study tested a drug that interferes at a 

specific point in the cholesterol pathway that contributes to the 

generation of amyloid protein, a hallmark of Alzheimer’s. The study 

resulted in a 99 percent reduction in brain amyloid in a mouse 

72

model of the disease, suggesting that this may provide a novel approach for developing a therapeutic intervention for Alzheimer’s 

disease. The Committee encourages NINDS to continue to assign a 

high priority to Alzheimer research, and to work closely with NIA, 

NIMH and other institutes. 

Parkinson Disease.—The Committee supports the innovative 

multidisciplinary research and training concerning Parkinson’s disease provided by the Morris K. Udall Parkinson’s Disease Research 

Centers of Excellence. The additional research opportunities and 

discoveries made by Udall Center scientists are leading to improved diagnosis and treatment of patients with Parkinson’s. The 

Committee commends both the basic and clinical objectives of the 

Centers that, together, enhance research effectiveness in a multidisciplinary setting. 

The Committee commends NINDS for participating in a community-wide examination of private and pubic Parkinson’s disease research funding through the Parkinson’s Community Research Advisory Council. The Committee recommends that NINDS continues to 

participate in this effort. 

The Committee commends the Director for participating in the 

Neuroscience Blueprint, which create new opportunities for collaborative research across institutes and through public-private partnerships. Specifically, the Committee encourages collaborations 

with other institutes in the areas of genetics, cell biology, pathology/epidemiology, non-human models, biomarkers, neuroimaging, 

gene therapy, surgical approaches, drug development, cell replacement therapy (i.e., stem cells), and mental health. 

Transmissible spongiform encephalopathies (TSE).—The Committee recognizes the efforts of NINDS, in collaboration with 

NHLBI, to fund contracts for the development of a biological assay 

for TSE. The Committee requests that the Director of the Institute 

be prepared to report on the progress made toward the development of a TSE bioassay at the fiscal year 2007 appropriations hearing. The Committee is particularly interested in the success in detecting disease-causing agents in blood, saliva, cerebrospinal fluid, 

and other bodily fluids, as well as lymphoid tissue, especially tonsils. 

Peripheral neuropathy.—As many as 20 million Americans suffer 

from peripheral neuropathy, a neurological disorder that causes debilitating pain, weakness in the arms and legs, and difficulty walking. Peripheral neuropathy affects approximately one-third of diabetics, or about 5.1 million people, while other forms of neuropathy 

are inherited; associated with cancer, kidney disease, or infections 

like hepatitis, HIV/AIDS, or Lyme disease; or caused by 

autoimmunity, traumatic injuries, poor nutrition, toxins, and certain medications. While significant research is underway on diabetic neuropathy and HIV/AIDS-related neuropathy, the Committee encourages NINDS to strengthen its research portfolio on 

other forms of neuropathy. The Committee is pleased to learn that 

NINDS plans to convene a workshop with distinguished scientists 

to identify research goals aimed at expanding the research knowledge base and identifying potential therapies. 

Juvenile diabetic neuropathy.—The Committee commends 

NINDS for its recognition of diabetic neuropathy as a serious problem of juvenile diabetes. The Committee encourages the Institute 

73

to work with other agencies on the development of new animal 

models of diabetic neuropathies to aid in the development and testing of novel clinical treatments for diabetic peripheral and autonomic neuropathies. 

Charcot-Marie-Tooth disease (CMT).—The Committee welcomes 

the upcoming NINDS workshop on peripheral neuropathies, and 

encourages NIH to focus on CMT in this workshop, with a goal of 

producing outcomes which will be directly relevant to CMT research. The Committee encourages all relevant institutes and centers, including NIAMS, NIDDK, and NICHD, to participate in the 

workshop. In addition, the Committee encourages NIH to incorporate CMT research into the Blueprint for Neurosciences initiative. 

Traumatic brain injury (TBI).—The Committee encourages 

NINDS to build upon basic and translational research in brain injury rehabilitation at the National Center on Medical Rehabilitation and Research (NCMRR). NCMRR has awarded grants to eight 

bench science research centers and a data center to establish the 

cooperative multi-center traumatic brain injury clinical trials network. The Committee encourages NINDS to participate in supporting these centers and to support training grants for TBI researchers. 

Dystonia.—The Committee continues to support research on the 

neurological movement disorder dystonia, given that dystonia is 

the third most common movement disorder after essential tremor 

and Parkinson’s disease. The Committee encourages NINDS to 

support research on both focal and generalized dystonia, and to 

continue its study of the DYT1 gene. The Committee is pleased 

with progress made in expanding the dystonia research portfolio as 

a result of the joint dystonia research program announcement, and 

hopes that NINDS will consider options for continued progress once 

the program announcement expires in August 2005. 

Spina bifida.—The Committee strongly encourages NINDS to enhance research to address issues related to the outcome and recommendations of the 2003 Spina Bifida Research Conference. 

NINDS is urged to strengthen and prioritize research efforts in the 

prevention and treatment of spina bifida and associated secondary 

conditions, with a particular focus on improved treatment of hydrocephalus. The Director should be prepared to testify on its efforts 

to advance these areas of research at the fiscal year 2007 appropriations hearing. 

Tuberous sclerosis complex (TSC).—TSC is a genetic disorder 

that triggers uncontrollable tumor growth in multiple organs of the 

body, including the brain, heart, kidneys, lungs, liver, eyes or skin. 

Its victims—many of whom are infants and young children—face a 

lifetime of suffering with kidney failure, seizures, behavioral disorders, autism and mental retardation. Because of the effects of 

TSC on multiple organ systems, the Committee last year called 

upon the NIH Director to formulate an NIH-wide research agenda. 

The Committee understands that NINDS is assigned to implement 

and coordinate that effort, and looks forward to a yearly report on 

that effort. In the meantime, NINDS is urged to support research 

examining the molecular and cellular basis of central nervous system manifestations in TSC, including studies examining TSC-assoVerDate jul 14 2003 07:43 Jun 22, 2005 Jkt 021909 PO 00000 Frm 00073 Fmt 6659 Sfmt 6602 E:\HR\OC\HR143.XXX HR143
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ciated epilepsy and brain tumor formation, and the effect of tubers 

and seizures on cognition and behavior. 

Neurofibromatosis (NF).—Advances in NF research have linked 

NF to cancer, brain tumors, learning disabilities, memory loss and 

heart disease affecting millions of Americans. The Committee encourages NINDS to strengthen its NF clinical and basic research 

portfolios. The Committee commends NINDS for its leadership role 

in NF research and in coordinating efforts with other Institutes engaged in NF research. The Committee recognizes that basic research has now successfully brought NF research into the clinical 

era. The Committee encourages NINDS to continue its exemplary 

efforts in the creation, implementation and funding of NF clinical 

trials infrastructures and clinical trials using existing and new 

drugs on NF patients. The Committee hope that NINDS will continue to coordinate its efforts with the other institutes at NIH as 

well as other government agencies. 

Spinal muscular atrophy (SMA).—SMA is the leading genetic 

killer of infants and toddlers. The Committee understands that the 

severity of the disease, its relatively high incidence, and the possibility of imminent treatments have led NINDS to initiate the SMA 

Therapeutics Development Program. The Committee commends 

NINDS for this initiative and encourages the Institute to continue 

to commit the resources to ensure a timely completion of the 

project to identify and complete preclinical research and development of candidate therapeutics for treating SMA by 2007. To maximize program efficiency, it is also important that NINDS lead efforts to integrate therapeutics development efforts with emerging 

programs in the biotech and pharmaceuticals industry, academic 

medical centers and collaborations with voluntary health organizations to ensure that duplication of effort is avoided. The Committee 

understands that the strategy for developing a treatment for SMA 

will guide therapeutics development for other diseases including 

Duchenne muscular dystrophy, ALS, Huntington’s and Alzheimer’s. 

Down syndrome.—The Committee commends NINDS for sponsoring a down syndrome workshop to address research priorities relating to optimizing synaptic structure and function in neuronal 

circuits important for cognition. The Committee encourages NINDS 

to identify opportunities for investigating the genetic and cellular 

basis for abnormalities in the structure and function of these circuits in both the developing and mature nervous system. NINDS 

is also encouraged to work with NIA to develop strategies to investigate the biology of age-related disorders, such as Alzheimer’s disease and Parkinson’s disease, in people with Down syndrome. 

NINDS is also encouraged to work with the Office of the Director 

to develop a strategic plan for Down syndrome research and to coordinate its research with NICHD, NIA, NIMH and other institutes.

Mucopolysaccharidosis (MPS).—The Committee commends 

NINDS efforts in the development and release of a program announcement to enhance blood brain barrier research in lysosomal 

storage disorders. The Committee continues to encourage NINDS 

to collaborate with all appropriate institutes and centers to support 

ongoing MPS research, to study the blood brain barrier as an impediment to treatment, and to use all available mechanisms to furVerDate jul 14 2003 07:43 Jun 22, 2005 Jkt 021909 PO 00000 Frm 00074 Fmt 6659 Sfmt 6602 E:\HR\OC\HR143.XXX HR143
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ther stimulate efforts to better understand and treat MPS disorders. 

Fragile X.—Fragile X is a single-gene disorder, but both its 

symptoms and its cellular mechanisms suggest involvement of multiple genes and specific brain pathways which are associated with 

other neurological disorders, such as autism and seizures. Recent 

research offers clear evidence of disruption of fundamental brain 

circuitry in Fragile X. Thus, Fragile X research has the potential 

to contribute to the understanding of multiple disorders, such as 

seizure disorders, especially in the context of developmental disorders, and autism. The Committee encourages NINDS to intensify 

its research into these issues as they relate to Fragile X, and to coordinate this research with other institutes working on Fragile X, 

including but not limited to NIMH and NICHD. 

FXTAS.—Fragile X-associated tremor/ataxia syndrome, or 

FXTAS, is a newly discovered, progressive neurological disorder 

that affects older men who are carriers of a premutation in the 

same gene that causes Fragile X syndrome. Nearly 1 in 800 men 

in the general population carries this premutation and as many as 

30 percent of these carriers—roughly 1 in 3,000 men—may develop 

FXTAS later in life. Identification of older male carriers will lead 

to a better understanding of the true incidence of Fragile X syndrome and afford at-risk families of child-bearing age the opportunity to pursue genetic counseling. NINDS, in collaboration with 

NIA, is urged to strengthen research into FXTAS, including working with the other NIH institutes. 

Frontotemporal dementia (FTD).—The Committee encourages 

NINDS to support research into drug discovery efforts that focus 

on specific targets relevant to treating the mechanisms underlying 

brain degeneration due to frontotemporal dementia (FTD) such as 

Pick’s disease. The Committee is interested in research that will 

focus on methods for discovering the causes of this family of diseases, improving diagnostic accuracy, and providing longitudinal 

characterizations so that the success of intervention can be determined. 

NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES

The Committee provides $4,359,395,000 for the National Institute of Allergy and Infectious Diseases (NIAID), which is 

$43,445,000 below the fiscal year 2005 comparable level and 

$100,000,000 below the budget request. Bill language requested by 

the Administration is not included to permit the transfer of 

$100,000,000 to the global AIDS, tuberculosis, and malaria fund. 

Bill language requested by the Administration is included providing $30,000,000 for the construction of extramural facilities for 

research on infectious agents and countermeasures. 

Mission.—The NIAID supports and conducts basic and clinical 

research and research training programs in infectious diseases 

caused by, or associated with, disorders of the immune system. 

NIAID supported research includes research on acquired immunodeficiency syndrome (AIDS), asthma and allergies, tuberculosis, 

sexually transmitted diseases, tropical diseases, and emerging microbes. The goals of NIAID research are to better understand disease pathogenesis, to improve disease diagnosis, to develop new 

and improved drugs to treat diseases, and to develop new and imVerDate jul 14 2003 07:43 Jun 22, 2005 Jkt 021909 PO 00000 Frm 00075 Fmt 6659 Sfmt 6602 E:\HR\OC\HR143.XXX HR143
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proved vaccines to prevent disease, many of which significantly affect public health. 

Tuberculosis (TB).—The World Health Organization estimates 

that nearly one billion people will become infected with TB, 200 

million will become sick, and 70 million will die worldwide between 

now and 2020 of this disease. The Committee is pleased with 

NIAID’s efforts to develop an effective TB vaccine. The Committee 

encourages the Institute to continue its TB vaccine development 

work and to strengthen efforts to develop new drugs to treat TB. 

Hemophilia.—The Committee encourages NIAID to continue its 

efforts with voluntary organizations in developing and advancing 

research initiatives for addressing hepatitis C (HCV) within the 

bleeding disorders community. The Committee understands that 

HCV continues to have a devastating impact on this community, 

with nearly half of all persons with hemophilia having contracted 

HCV from blood clotting factor products. 

Primary immunodeficiency diseases.—NIAID is the lead agency 

for research into this class of diseases that is known to afflict about 

500,000 Americans and may affect an equal amount that have not 

yet been diagnosed. To address the complex research needs of this 

group of about 140 separate diseases, the NIAID has created a research consortium comprised of the leading experts in primary immunodeficiency diseases. The Committee requests that NIAID report by February 28, 2006 on the management of the consortium, 

as well as its plans for future research in this field. 

Psoriasis.—The Committee encourages NIAID to support research on psoriasis, a chronic, immune-mediated disease that affects between 5.8 and 7.5 million Americans. Safe and effective 

treatments for women of child-bearing age and for children are particularly lacking, and new research indicates mothers with psoriasis have a 50 percent increased risk of bearing a child with autism. The Committee asks NIAID to investigate the possible causes 

of this troubling finding, as well as related research on causes of 

and treatments for psoriasis. 

Inflammatory bowel disease (IBD).—The Committee continues to 

note with interest a scientific research agenda for Crohn’s disease 

and ulcerative colitis (collectively known as inflammatory bowel 

disease) entitled ‘‘Challenges to Inflammatory Bowel Disease’’. This 

report identifies strong linkages between the functions of the immune system and IBD. The Committee encourages the Institute to 

enhance its support of research focused on the immunology of IBD, 

as well as the interaction of genetics and environmental factors in 

the development of the disease. 

Asthma.—The Committee is pleased with NIAID’s leadership regarding asthma research and management. The Committee encourages NIAID to continue to improve its focus and effort on asthma 

management, especially as it relates to children. The Committee 

also encourages NIAID to collaborate more aggressively with voluntary health organizations to support asthma prevention, treatment, and research activities. Additionally, recent studies suggest 

that a variety of viral and bacterial agents may play a role in the 

development of asthma. The Committee recommends that the Institute consider expanding research into the role that infections and 

vaccines may play in the development of asthma. 

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Hepatitis C virus (HCV) vaccine development.—The Committee is 

encouraged to learn that a small hepatitis C vaccine human trial 

has been successfully completed. The Committee urges NIAID to 

begin to implement the results of the recent workshop that was 

held to discuss and evaluate efforts toward development of HCV 

vaccines with the goal of spurring their development and testing. 

The Committee also encourages NIAID to proceed with phase two 

of the human clinical trial as soon as it is scientifically practicable. 

Additionally, NIAID is urged to foster the development of an in 

vitro culture system for HCV as well as new animal models for 

basic research. The Committee continues to be concerned about the 

prevalence of hepatitis and urges NIAID to work with public health 

organizations to promote liver wellness, education, and prevention 

of hepatitis. 

Transplantation research.—The Committee is aware that while 

one-year organ transplantation survival has improved remarkably 

over the last fifteen years, there has been little success in reversing 

the decline in long-term graft and patient survival. The Committee 

suggests that NIAID convene an expert conference, in collaboration 

with NIDDK and NHLBI, to develop a five-year Transplantation 

Research Action Plan identifying the most urgently needed research to facilitate an increase in the success of organ transplantation. The expert conference should also focus on promising new 

technologies in pre-transplant organ care and post-transplant patient therapies. The Committee also suggests the initiation of a cohort study to assess the health outcomes of living donors, not only 

for the period immediately following the donation, but for the quality of life implications in the decades post-donation. 

Coinfection research.—The Committee is concerned that there is 

growing evidence of liver toxicity resulting from HIV treatment 

protocols such as highly active antiretroviral therapy (HAART) in 

those with chronic viral hepatitis and those with decompensated 

liver disease awaiting liver transplantation. There also appears to 

be an emerging problem of liver cancer in co-infected patients. The 

Committee encourages NIAID to initiate research initiatives in 

both of these areas. 

Scleroderma.—The Committee commends NIAID for their growing commitment to understanding the cause and to finding improved treatments for scleroderma, a chronic and progressive disease that predominantly strikes woman. Scleroderma is disfiguring 

and can be life threatening, affecting multiple systems including 

the heart, lungs, kidneys, and gastrointestinal tract. NIAID has 

provided a grant to fund the SCOT Study (Scleroderma Cytoxan or 

Transplant). This study will compare the differences between 

autologous stem cell transplant versus high dose cytoxan for the 

treatment of progressive systemic scleroderma. The Committee encourages NIAID to continue this commitment through inclusion of 

scleroderma in the Autoimmune Centers of Excellence and through 

continued collaboration with the institutes that are part of the 

Autoimmune Disease Coordinating Committee. 

Atopic dermatitis (AD).—The Committee was pleased to learn 

about NIAID research efforts related to atopic dermatitis undertaken through projects such as the Immune Tolerance Network and 

the Atopic Dermatitis and Vaccinia Immunization Network. Last 

year, the Committee encouraged NIAID to complement these efVerDate jul 14 2003 07:43 Jun 22, 2005 Jkt 021909 PO 00000 Frm 00077 Fmt 6659 Sfmt 6602 E:\HR\OC\HR143.XXX HR143
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forts by working with NIAMS to spearhead a multidisciplinary, 

multi-institute initiative to encourage investigator-initiated research projects on AD as it relates to smallpox vaccination as well 

as the progression to asthma and other allergic diseases. The Committee requests a report on efforts that have been made to foster 

investigator-initiated research in this area. 

Nasal aerosol and spray vaccine delivery systems.—The prevention of infectious diseases through the effective use of vaccines has 

saved mankind untold suffering and death. Recent developments 

exploring new routes of immunization such as delivery of measles 

vaccine via the aerosol route and nasal spray give great hope for 

achieving this goal, generating significant savings, and resulting in 

fewer side effects than immunization by injection. The Committee 

encourages NIAID to support research in developing and testing 

these new approaches and translating this research into public 

benefits. The Committee recommends that NIAID build upon the 

testing already completed in older children by investigating this delivery method in younger children. The Committee believes that 

NIAID and other institutes should collaborate with physicians and 

researchers working with these newer and possibly superior methods of vaccine delivery in the hopes of developing safer, more effective, and less expensive vaccine delivery modes. 

Meningococcal disease/Serogroup B immunization research.—Although meningococcal disease is vaccine-preventable in most cases, 

approximately 30 percent of the deaths and disabilities from this 

bacterial infection are attributed to serogroup B which is not vaccine-preventable. The Committee encourages NIAID to increase research efforts to develop an effective, low-cost vaccine against 

serogroup B that will help protect infants and adolescents in the 

near term. 

Food allergies.—The Committee is concerned about the high 

prevalence of food allergies, among children in particular, with up 

to eight percent affected. The Committee recognizes that 30,000 individuals require emergency room treatment for food allergies each 

year, that 100 to 200 individuals die each year from allergic reactions to food, and that there is currently no cure for food allergies. 

The Committee is encouraged by the March 2005 release of a report in The Journal of Allergy & Clinical Immunology containing 

guidelines for the definition of anaphylaxis, and hopes that these 

guidelines will improve the diagnosis, treatment, and understanding of food allergy and anaphylaxis. NIAID is encouraged to 

invest in research into the causes of food allergies and its potential 

treatments. 

Bioterrorism.—Respiratory pathogens that cause life-threatening 

pneumonia are commonly proposed agents of bioterrorism. The following are associated with acute pneumonia/lung injury: anthrax, 

smallpox, plague, and tularemia. The Committee encourages further research on the mechanisms of pneumonia by these respiratory pathogens and the development of new therapeutic interventions to reduce injury and death. 

Nontuberculous mycobacteria [NTM].—Mycobacteria are environmental organisms found in both water and soil that can cause significant respiratory damage. The Committee is aware of the increasing incidence of nontuberculous mycobacteria [NTM] pulmonary infections in women, particularly involving rapidly growing 

79

mycobacteria, an inherently resistant subspecies. The Committee 

encourages NIAID to advance diagnostic and treatment protocols 

for patients suffering from NTM diseases. Further, the Committee 

recommends additional focus on research leading to a better understanding of NTM by establishment of an inter-institute coordinating committee to facilitate cooperation between NIAID, NHLBI, 

and other institutes. 

Genetic tools for infectious disease research.—The Committee believes that, with regard to both biodefense and public health, the 

development by NIAID of multi-pathogen identification arrays that 

can be used to identify infectious agents through epidemiological 

outbreak surveillance is critically important. The use of whole genome expression, all exon transcription analysis and whole genome 

SNP analysis studies to identify and understand host biomarkers 

that may identify the type, severity and likely response to therapeutics of infectious agents holds great promise. The Committee encourages NIAID to pursue these lines of inquiry. 

Islet transplantation.—The Committee commends NIDDK and 

NIAID for the establishment of the Clinical Islet Transplantation 

Consortium and the islet transplantation clinical trial that will include Medicare-eligible individuals whose transplant and related 

costs will be covered by Medicare. The Committee urges cooperation between NIDDK and NIAID and members of the Consortium 

to ensure the timely launch of these clinical trials. 

Detection of disease and bioterror agents.—The Committee recognizes the potential threat to national security posed by terror attacks involving biological, chemical, nuclear, and radiological weapons. One of the challenges facing public health officials responding 

to such an attack is the limited ability to diagnose exposure to 

these agents in the non-sick-appearing and early illness individals. 

The Committee recognizes that disease outbreaks—such as SARS 

in Asia and Canada, avian influenza in East Asia, and Ebola and 

Marburg virus in Africa—demonstrate that the speed of diagnosis 

and implementation of public health measures can mean the difference between an isolated outbreak and a global pandemic. The 

Committee commends NIAID for its initiatives that provide comprehensive genomic, bioinformatics, functional genomics, and immune cell proteomic research resources to the scientific community 

conducting basic and applied research on infectious agents and the 

immune system. The Committee encourages NIAID to maintain its 

support of these programs, which provide a critical resource for the 

scientific community that could lead to the discovery and identification of novel targets for the next generation of drugs, vaccines, 

diagnostics and immunotherapeutics. 

NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES

The Committee provides $1,955,170,000 for the National Institute of General Medical Sciences (NIGMS), which is $11,103,000 

above the fiscal year 2005 comparable level and the same as the 

budget request. 

Mission.—The 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, and biological chemistry, study normal biological processes to better understand what goes wrong 

80

when disease occurs. In this way, NIGMS supports the new knowledge, theories, and technologies that can then be applied to the disease-targeted studies supported by other NIH components. NIGMSsupported basic research advances also find applications in the biotechnology and pharmaceutical industries. The Institute’s training 

programs help provides the scientists needed by industry and academia. 

Training programs.—The Committee continues to be pleased 

with the quality of NIGMS’s training programs, particularly those 

that have a special focus on increasing the number of minority scientists, such as the Minority Access to Research Careers (MARC) 

and Minority Biomedical Research Support (MBRS) programs. The 

Committee encourages NIGMS to continue to support these important initiatives, and is particularly pleased that NIGMS has supported biomedical research career opportunity programs for high 

school and undergraduate college students in conjunction with historically black health professions schools. The Committee encourages continued, long-term support of this program. 

Anesthesiology research.—The Committee urges NIGMS to continue to support and enhance research opportunities focused on discovering the mechanisms of anesthesia, perfecting agents for regional and general anesthesia, improving the safety of anesthesia, 

monitoring and protection of specific organs of patients under anesthesia and optimizing post-surgery prognosis. The Committee encourages NIGMS to continue to work with other appropriate Institutes to promote improvements in pain research. The Committee 

believes that NIGMS should strongly support training, innovation 

and scientific inquiry in these crucial areas of medical research. 

Cystic fibrosis (CF).—The Committee commends NIGMS for the 

renewal and expansion of its large-scale collaborative project 

awards. These cross-disciplinary, multi-institutional collaborative 

projects are important for moving burgeoning fields faster than 

through traditional investigator-initiated grants. The Committee 

encourages NIGMS to consider support for research on the barriers 

to productive protein folding and the creation of tools, reagents and 

advances in techniques for precision monitoring of folding. These 

tools will support ongoing research efforts to understand the underlying mechanisms of disease caused by improper protein folding, as 

well as efforts to develop therapies to correct this defect for CF and 

other diseases. 

NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT

The Committee provides $1,277,544,000 for the National Institute of Child Health and Human Development (NICHD), which is 

$7,223,000 above the fiscal year 2005 comparable level and the 

same as the budget request. 

Mission.—The NICHD conducts and supports laboratory and 

clinical research on the reproductive, developmental, and behavioral processes that determine and maintain the health and wellbeing of children, adults, families and populations. In addition, research in medical rehabilitation is supported. 

Preterm birth.—Last year, the National Center for Health Statistics reported the first increase in the U.S. infant mortality rate 

since 1958, and 61% of this increase was due to an increase in the 

birth of premature and low birth weight babies. The Committee is 

81

pleased that NICHD is one of the sponsors of an Institute of Medicine study now underway to define and address the health related 

and economic consequences of premature birth and encourages 

NICHD to develop a plan to implement the study’s recommendations once they are available. 

Genomic and proteomic research.—The Committee is pleased that 

NICHD has launched a major new research initiative to address 

the public health problem of premature birth, which affects one in 

eight babies born in this country and is the leading cause of newborn death. NICHD is encouraged to move forward with this initiative, which focuses on genomic and proteomics, in an effort to accelerate knowledge in the mechanisms responsible for premature 

birth. The Committee intends to closely monitor this effort because 

it assigns a high priority to promoting the birth of healthy infants. 

Stillbirth.—The Committee applauds NICHD efforts in addressing stillbirth, a major public health issue with morbidity equal to 

that of all infant deaths. The Committee understands that NICHD 

has established a cooperative network of clinical centers and a data 

center to address this issue with a standard protocol. The Committee encourages NICHD to strongly support this effort. 

Maternal-fetal medicine units network.—The Committee recognizes the efforts of NICHD, through its maternal fetal medicine 

units network (MFMU), to achieve a greater understanding of and 

pursue development of effective treatments for the prevention of 

pre-term births, low birth weight infants, and medical complications during pregnancy such as pregnancy related hypertension 

and diabetes. The Committee is pleased to learn that NICHD is 

proceeding with a competitive renewal of the MFMU network in 

2006 and encourages a sustained research investment in this program to facilitate resolution of these problems and promote the 

birth of healthy infants.

Spina bifida.—The Committee is pleased that the Institute cosponsored the 2003 spina bifida research conference. However, the 

Committee has heard concerns that NICHD has not engaged in 

adequate follow-up on the conference recommendations. The Committee encourages NICHD to enhance research to address issues 

related to the outcome of the conference and urges NICHD to 

jumpstart its research efforts in the prevention, and treatment of 

spina bifida and associated secondary conditions, with a particular 

focus on improved understanding of urological disorders among 

children and adults. The Director should be prepared to testify on 

its efforts to advance these areas of research at the fiscal year 2007 

appropriations hearing. 

Drug safety for children.—The Committee recognizes the importance of ensuring that drugs are safe and effective for use by children. The Committee strongly supports continued implementation 

of the Best Pharmaceuticals for Children Act, which supports the 

pediatric testing of off-patent drugs, as well as on-patent drugs not 

being studied through existing mechanisms. The Committee is 

pleased to note that in 2004 six studies were initiated and five additional studies are planned for 2005. In implementing this provision, NICHD should act as coordinator for all other Institutes within NIH for which pediatric pharmacological drug research may 

have therapeutic relevance and should consult with the Food and 

Drug Administration to ensure that the studies conducted are deVerDate jul 14 2003 07:43 Jun 22, 2005 Jkt 021909 PO 00000 Frm 00081 Fmt 6659 Sfmt 6602 E:\HR\OC\HR143.XXX HR143
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signed to yield improved pediatric labeling. The Committee notes 

that NICHD has made numerous outreach efforts to other Institutes and Federal agencies to further refine the priority listing 

process. The Committee requests NICHD to provide an update during its annual appropriations testimony which shall include the 

role of other Federal agencies in implementing the Best Pharmaceuticals for Children Act; information on the number of studies 

supported through the Research Fund; the estimated cost of each 

study undertaken; the nature and type of studies undertaken; the 

number of label changes resulting from completed studies; the patent status of the drugs studied; the number of drugs remaining on 

the priority list; and a summary of NICHD’s findings on the frequency of pediatric use for medications that may be considered for 

the priority list. 

The National Children’s Study.—The Committee remains interested in NICHD efforts to launch the National Children’s Study, 

which is intended to follow 100,000 children to age 21, examining 

the impacts and influences of many environmental and genetic factors on children’s health and development. 

Neurofibromatosis (NF).—Learning disabilities occur with high 

frequency in children with NF. Enormous advances have been 

made in the past few years in the successful treatment and curing 

of learning disabilities in pre-clinical NF animal models. The Committee encourages NICHD to issue requests for applications for NF 

research and to pursue funding of clinical trials for NF patients in 

the area of learning disabilities. 

Down syndrome.—The Committee commends NICHD for increasing support in fiscal year 2005 for increased production of an experimental mouse model of Down syndrome, the Ts65Dn mouse. 

NICHD is encouraged to partner with NINDS and other agencies 

to define additional mouse models needed to link important structural and functional abnormalities that underlie cognitive difficulties to the actions of specific genes and gene pathways. The Committee also encourages NICHD to work with the Office of Director 

to develop a strategic plan for Down syndrome research and to coordinate its research with NICHD, NIA, NIMH and other institutes. 

Fragile X.—The Committee is pleased that NICHD has funded 

three Fragile X centers and encourages NICHD to enhance the centers and recruit new researchers to the Fragile X field. The Committee also encourages NICHD to coordinate its Fragile X research 

efforts and to relate Fragile X research with that in other developmental disorders, such as autism research. 

Autism.—The Committee is aware of the important research supported by NICHD into the genetic basis of autism spectrum disorders and of its support for the Baby Sibling study on the incidence of autism among children in the same families. The Committee encourages the Institute to strengthen its support for the 

Baby SIBS study, and encourages the Institute to expand its work 

with similar public-private partnerships. 

Childhood diseases and the growing skeleton.—The Committee 

encourages NICHD to support studies investigating the effects of 

pharmaceuticals, lifestyle, and chronic childhood diseases on the 

growing skeleton and fracture risk and bone-formation interventions for children. NICHD is encouraged to support osteogenesis 

83

imperfecta research, especially in genetic therapies, animal models, 

drug treatment and rehabilitation. The Committee encourages 

NICHD to work with NIAMS to study the rare disorders 

osteopetrosis and juvenile Paget’s disease. 

Infertility and contraceptive research.—The Committee notes that 

infertility is a disease which affects over six million people in the 

United States and is concerned that the number appears to be 

growing as age, lifestyle, and environmental factors increasingly 

impact reproductive health outcomes. The Committee suggests that 

NICHD conduct additional research to improve reproductive health 

intervention outcomes. 

Demographic research.—The Committee commends NICHD for 

its strong support of demographic research. Given the tremendous 

changes occurring in the U.S. population, demographic research is 

necessary to analyze trends and determine consequences for the 

health and well-being of our nation. The Committee encourages the 

institute to ensure adequate support for demographic training and 

for critical demographic databases. 

Primary immunodeficiency diseases (PI).—The Committee continues to be impressed with NICHD’s contributions to the physician 

education and public awareness program conducted by a voluntary 

organization to reach earliest diagnosis of this class of about 140 

diseases. With regard to research on PI, the Committee is encouraged by the Institute’s commitment to develop newborn screening 

procedures for PI, particularly X-linked SCID, utilizing microarray 

technologies. 

Physical therapy.—The Committee recognizes the burgeoning 

growth in rehabilitation services provided to patients, especially 

the elderly, with musculoskeletal problems and the urgent need to 

establish a solid scientific basis for clinical practice in this area. 

The Committee encourages the establishment of a research program in the National Center for Medical Rehabilitation Research 

(NCMRR) to: (1) evaluate the efficacy and establish optimal schedules and settings for movement-based rehabilitation interventions, 

such as therapeutic exercise, to improve physical function in individuals with musculoskeletal conditions, including arthritis, back 

pain, hip fracture and major joint replacements, and (2) further 

knowledge of the underlying mechanisms of repair, regeneration 

and recovery of these interventions. The Committee encourages 

NIA, NIAMS, and NIBIB to collaborate on these initiatives. 

Glucose monitoring.—The Committee recognizes the importance 

of independent evaluation of blood glucose monitoring technologies. 

The Committee commends NICHD for its support of the Diabetes 

Research in Children Network (DirecNet), which aims to improve 

the management of diabetes in children by understanding how to 

best apply monitoring technology in this patient population. The 

Committee notes the unique infrastructure that DirecNet has developed to assess such technologies in children and encourages continued support for this important clinical research program. 

Pediatric kidney disease.—The Committee encourages NICHD to 

study pre- and post-natal exposures that increase the risk of kidney 

disease, hypertension, and the progression of chronic kidney disease from birth to early adulthood. The Committee encourages 

NICHD to support research toward understanding the physiologic 

mechanisms responsible for these risks to further prevent the deVerDate jul 14 2003 07:43 Jun 22, 2005 Jkt 021909 PO 00000 Frm 00083 Fmt 6659 Sfmt 6602 E:\HR\OC\HR143.XXX HR143
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velopment of kidney disease and the antecedents of cardiovascular 

disease. 

Spinal muscular atrophy (SMA).—The Committee recognizes the 

efforts at NINDS as the leading institute against SMA in recent 

years, and strongly encourages other institutes, notably NICHD, to 

expeditiously work collaboratively to support and strengthen the 

SMA Project. The Committee fully expects that NICHD will explore 

new potential avenues to collaborate with NINDS, given the fact 

that SMA is the leading genetic killer of infants and toddlers. 

NATIONAL EYE INSTITUTE

The Committee provides $673,491,000 for the National Eye Institute (NEI), which is $4,421,000 above the fiscal year 2005 comparable level and the same as the budget request. 

Mission.—The NEI conducts and supports basic and clinical research, research training, and other programs with respect to 

blinding eye diseases, visual disorders, mechanisms of visual function, preservation of sight, and the special health problems and 

needs of individuals who are visually-impaired or blind. In addition, the NEI is responsible for the dissemination of information, 

specifically public and professional education programs aimed at 

the prevention of blindness. 

Juvenile diabetes.—The Committee encourages NEI to continue 

its efforts to collaborate with other institutes on identification of 

genes that contribute to diabetic retinopathy by collecting and analyzing human samples through existing clinical studies and working to develop new animal models that mimic this condition. 

Diabetic retinopathy.—The Committee commends NEI for its continued support of the diabetic retinopathy clinical research network. The Committee encourages NEI to expand this network 

through collaboration with other institutes, such as NIBIB, and 

private and public partners and through the introduction of new 

treatments to prevent, treat, or cure diabetic retinopathy. 

Ocular albinism.—Ocular albinism is a hereditary, blinding disease that causes terribly distorted vision in children. Victims, who 

are usually boys and receive the defective gene from their mother, 

experience nystagmus, photophobia, lack of stereoscopic vision, 

strabismus, and other symptoms which deny these children normal 

vision. In recent years, research has made great strides in the 

search for improved diagnostic tools, and treatments. Recently, the 

OA1 gene, responsible for most cases of the disease, was identified, 

and a diagnostic screening test created to help women determine 

if they are at risk of passing the disease on to their children. As 

researchers move closer to understanding how this disease works, 

and developing potential treatments that could improve the vision 

of children with the condition, the Committee requests NEI to be 

prepared to report in next year’s hearing on advances in research 

on ocular albinism.

NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES

The Committee provides $647,608,000 for the National Institute 

of Environmental Health Science (NIEHS), which is $3,103,000 

above the fiscal year 2005 comparable level and the same as the 

budget request. 

85

Mission.—The NIEHS mission is to reduce the burden of environmentally related illness and dysfunction by understanding how 

environmental exposures affect health, how individuals differ in 

their susceptibility to these effects, and how these susceptibilities 

change over time. This mission is achieved through multidisciplinary biomedical research programs, prevention and intervention 

efforts, and communication strategies that encompass training, 

education, technology transfer, and community outreach.

Parkinson’s disease.—The Committee encourages NIEHS to continue funding research into environmental influences of Parkinson’s disease. The causes of Parkinson’s and other 

neurodegenerative disorders are increasingly shown to be a result 

of the inter-relation of environment and genes. Possible environmental triggers of Parkinson’s are pesticides and/or heavy metals. 

If these environmental toxins can be identified and the mechanisms elucidated, appropriate prevention or treatment may prevent 

many cases of Parkinson’s, especially in the concerning increasingly younger persons at risk. 

Mercury.—In order to properly research gaps in the area of mercury exposure and brain chemistry, and given recent hearings on 

mercury exposure and relationships between autism and Alzheimer’s disease and mercury exposure, NIEHS is encouraged to 

pursue studies of how inorganic mercury and organic mercury compounds (including ethyl, methyl, and other forms of mercury from 

all sources) are processed in the bodies of children and adults. 

NIEHS is also encouraged to support studies of the toxic effects of 

inorganic mercury and organic mercury compounds on the nervous 

systems of young children, adults, and the elderly and methods of 

properly removing mercury and mercury-containing compounds 

from the brains of affected humans.

Toxic exposure and brain development.—Notwithstanding the Institute of Medicine May 2004 report on autism, the Committee believes it is important to develop a more complete understanding of 

the impact that toxic exposures may have on brain development. 

There is a convergence of findings from tissue culture studies, animal models, and clinical studies of immune dysfunction in children 

with autism and other neurodevelopmental disorders (NDDs) that 

suggests a biological link between genetic sensitivity and damage 

to developing brains from certain toxins. It is important that NIH 

continue this research to better understand the impact that exposures to mercury (including thimerosal) and other toxins have on 

brain development. A more complete understanding of the impact 

of these exposures through research, including animal models, will 

help to develop more effective interventions. 

Toxicology validation reviews.—In order for the Interagency Coordinating Committee for the Validation of Alternative Methods 

(ICCVAM) to carry out its responsibilities under the ICCVAM Authorization Act of 2000, the Committee encourages NIEHS to 

strengthen the resources for methods validation reviews in fiscal 

year 2006. The Committee is encouraged by the National Toxicology Program’s Road Map and Vision for NTP’s toxicology program in the twenty-first century and encourages NIEHS to move 

rapidly to implement the programs, especially those directly aimed 

at strengthening the scientific basis for many alternative methods 

86

(such as Quantitive Structure-Activity Relationships), mechanistic 

screens, high throughput assays, and toxicogenomics). 

Risk analysis.—The Committee encourages NIEHS to establish a 

competitive, peer-reviewed extramural program of centers for risk 

sciences to conduct research in risk sciences, including assessment, 

management, analysis, and communication of risks from exposure 

to environmental chemicals. NIEHS is encouraged to work with 

these centers to develop scientifically-based methodologies used to 

determine, quantify, and communicate risk to the public’s health. 

Asthma.—Given the link between environmental factors and the 

onset of asthma, COPD, and pulmonary fibrosis, the Committee encourages NIEHS to further develop research initiatives, such as a 

large multi-site, long-term longitudinal, and maternal/birth cohort 

to understand the environmental and genetic risk factors for predisposing some individuals to and in controlling the severity of 

these lung diseases. 

NATIONAL INSTITUTE ON AGING

The Committee provides $1,057,203,000 for the National Insti- tute on Aging (NIA), which is $5,213,000 above the fiscal year 2005 

comparable level and the same as the budget request. 

Mission.—The NIA conducts biomedical, behavioral, and social 

research related to the aging process to prevent disease and other 

problems of the aged, and to maintain the health and independence 

of older Americans. 

Alzheimer’s disease.—The most common cause of dementia, Alzheimer’s disease has become a very serious threat to the nation’s 

health and economic well-being. Today, an estimated 4.5 million 

Americans—one in ten persons over age 65 and nearly half of those 

over 85—suffer from Alzheimer’s disease. Over the next decade, 

Medicare spending on beneficiaries with Alzheimer’s will more 

than triple, to $189 billion, while Medicaid spending over the same 

period will rise to $27 billion. In light of these social and economic 

imperatives, the Committee was troubled to learn that NIA’s investment in Alzheimer research declined in fiscal year 2004 from 

the previous year. The Committee believes that NIA should continue to assign the highest priority to this effort. 

Down syndrome.—The Committee commends NIA for its support 

of studies to examine the cellular, molecular and genetic bases for 

age-related neuropathological and cognitive abnormalities in people 

with Down syndrome. It encourages NIA to further examine these 

abnormalities and to devise new methods for diagnosing and treating them. Given that all people with Down syndrome develop the 

neuropathological changes of Alzheimer’s disease, and that many or 

most go on to suffer dementia, NIA is encouraged to consider how 

studies of the Down syndrome population might enhance the ability 

to understand, diagnose and treat Alzheimer’s disease. The Committee encourages NIA to coordinate its research with NICHD, 

NINDS, NIMH and other institutes. 

Parkinson’s disease.—The Committee commends NIA on its collaboration with Parkinson’s researchers at NINDS Udall Centers in 

helping to discover new Parkinson’s susceptibility genes, including 

dardarin, the most recently discovered Parkinson’s gene by a NIA 

scientist. This research will prove to be invaluable in the development of improved methods of diagnosis, as well as neuroprotective 

87

and neurorestorative treatment of Parkinson’s disease. The Committee encourages continued collaborations, including additional intramural activities, between NINDS, NIMH, and NIA to enhance 

understanding of neurodegenerative diseases, particularly Parkinson’s. 

Age-related bone health.—The Committee is aware that age-re- lated bone loss costs $17 billion annually. NIA is urged to address 

cell senescence and altered cell phenotype in age-related bone diseases, aging’s impact on bone response to loading, bone matrix and 

quality, and bone marrow; and the role of exercise, new anabolics, 

and stem cells in elderly bone. 

Quality of life.—The Committee encourages studies on quality of 

life in patients with osteoporosis before and after treatment, and 

strategies for optimizing treatment of frail nursing home patients 

at high risk for osteoporotic fracture. The Committee also encourages NIA to expand research on the role of environmental and lifestyle factors associated with osteoporosis and Paget’s disease and 

to work in conjunction with NIAMS on models for Paget’s disease. 

Roybal centers.—The Committee is very satisfied with the 

progress made by the Roybal Centers for Applied Gerontology Research in the application of research to direct service interventions 

resulting in the improvement in the quality of life for older adults. 

The Committee also views the collaboration between the Roybal 

Centers and the Demographic Centers as being very positive and 

encourages NIA to continue to promote such collaboration. 

Demographic and economic research.—The Committee commends 

NIA for supporting its Centers on the Demography of Aging program and expanding its program to include four new centers in 

2004. In particular, the Committee encourages NIA to support the 

Health and Retirement Survey and the National Long-Term Care 

Survey. Data from these surveys are particularly important for understanding the budgetary impact of population aging and for Congress as it deliberates potential changes to the Social Security, 

Medicare, and Medicaid programs. 

NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN

DISEASES

The Committee provides $513,063,000 for the National Institute 

of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), 

which is $1,906,000 above the fiscal year 2005 comparable level 

and the same as the budget request. 

Mission.—The NIAMS conducts and supports basic and clinical 

research and research training, and the dissemination of health information 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. 

Scleroderma.—The Committee is encouraged by NIAMS’s continued interest in scleroderma, a chronic and progressive disease that 

predominantly strikes women. Scleroderma is disfiguring and can 

be life-threatening, and effective treatments are lacking. The Committee encourages NIAMS to continue to collaborate with other institutes, including NHLBI, NIAID, NIDDK, and NIDCR, and 

through the NIH Autoimmune Coordinating Committee to generate 

additional research opportunities for scleroderma that may assist 

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to identify genetic risk factors and the development of safe and effective treatments. 

Burden of skin diseases.—The Committee notes the release of the 

recent report, Burden of Skin Diseases, which supports evidence 

gathered at the September 2002 workshop on the burden of skin 

diseases sponsored by NIAMS. Based on these findings, the Committee encourages NIAMS to continue to strengthen the research 

portfolio on skin disease. The Committee also recommends that 

NIAMS consider potential partnerships with the skin disease research community to address the challenges outlined by the Burden of Skin Diseases findings. 

Psoriasis.—Psoriasis is a chronic, immune-mediated disease that 

affects between 5.8 and 7.5 million Americans. The Committee recommends that NIAMS support additional research into this serious 

disease, both to identify the several genes believed to play a role 

in psoriasis pathogenesis, as well as to support additional clinical 

research on current and potential therapies for psoriasis and psoriatic arthritis. 

Vitiligo treatments for children.—Vitiligo is an environmental 

and genetic auto-immune disease of unknown origin which affects 

about three to six million Americans. Almost fifty percent develop 

the disease in childhood, with the median age of onset at four years 

of age. In its most severe forms, patients have milky white patches 

covering widespread areas of the body due to the loss of pigment 

in these areas. Especially for young children, the physical pain 

caused by severe burns from the harmful effects of sunlight and 

the emotional pain caused by people confusing vitiligo with an infectious disease diminish the quality of a patient’s life. There are 

no FDA-approved treatments for children. The Committee encourages NIAMS to enhance research efforts through all appropriate 

mechanisms to identify the causes of this disease and develop pediatric treatment options for vitiligo. 

Marfan syndrome.—The Committee commends NIAMS and its 

collaborative efforts with other institutes to provide support of research on Marfan syndrome, a life-threatening, progressive and degenerative genetic disorder which is characterized by aortic aneurysms, orthopedic disabilities and ocular manifestations which can 

result in blindness. Years of investment in basic research are ready 

to be translated to clinical studies of drug therapies with the potential of reversing many of the life-threatening and disabling symptoms of Marfan syndrome. These drug therapies may also prove to 

benefit people with other connective tissue disorders. The Committee encourages NIAMS to support clinical trials of new drug 

therapies through all available mechanisms, as appropriate. 

Tuberous sclerosis complex (TSC).—TSC is a genetic disorder 

that triggers uncontrollable tumor growth in multiple organs of the 

body, including the skin. The Committee encourages NIAMS to 

support programs examining the molecular and cellular basis of 

dermatological lesions in TSC as well as the development of nonsurgical treatments for skin manifestations. 

Mucopolysaccharidosis (MPS).—The Committee encourages 

NIAMS to work collaboratively with NIDDK in an effort to achieve 

a greater understanding of the bone and joint lesions in MPS disorders. The committee supports NIAMS research addressing the 

underlying pathophysiology of bone and joint lesions, the gene 

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mutations and substrates that are stored, and potential therapeutic 

approaches to treating these debilitating aspects of MPS and related disorders. 

Osteogenesis imperfecta.—The Committee commends NIAMS for 

its support of promising gene-targeting stem cell research that 

could represent a potential cure for osteogenesis imperfecta and encourages continued support of this research. 

Osteopetrosis.—The Committee encourages NIAMS to increase 

support of research on models, methods and modalities to increase 

bone formation and alter bone remodeling, and address the impact 

of aging, genetics, obesity, inactivity and exercise on bone at molecular, cellular, and tissue levels. NIAMS is encouraged to work with 

NICHD and NIDDK to strengthen research on the genetics and 

new treatments for the rare disorder osteopetrosis. 

Lupus.—The Committee is aware that the discovery of lupus susceptibility genes may be a prerequisite to developing exciting new 

therapies for lupus and ultimately a way to prevent and cure the 

disease. Advanced new technologies make finding these genes less 

expensive and more feasible than ever before. The Committee is 

also aware that new consortia within the lupus community have 

been formed to facilitate genetic research. The Committee urges 

the Institute to strengthen its work in support of the collection of 

DNA, serum, genotyping and subject information from lupus patients, their family members and healthy unrelated controls so that 

the identification of the relevant genes can be explained. 

NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION

DISORDERS

The Committee provides $397,432,000 for the National Institute 

on Deafness and Other Communication Disorders (NIDCD), which 

is $3,173,000 above the fiscal year 2005 comparable level and the 

same as the budget request. 

Mission.—The 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, the NIDCD is actively involved in health promotion and 

disease prevention, dissemination of research results, and supports 

efforts to create devices that substitute for lost and impaired sensory and communication functions. 

Hearing loss.—The Committee encourages the NIDCD to further 

research in the area of early identification of hearing loss and 

interventions strategies. The Committee urges NIDCD to continue 

to support research in the areas of inner ear protection, rescue, and 

regeneration, such as noise-induced hearing loss, ototoxicity and 

hair cell regeneration, as well as research on the central auditory 

system. In addition, the Committee encourages NIDCD to continue 

research on rehabilitative technologies and strategies, leading to 

improved prevention, treatment and management of hearing loss, 

tinnitus and dizziness. The Committee recommends that NICHD 

maintain support for the translation of basic research discoveries 

into better clinical diagnostic techniques and treatments. 

90

Early hearing detection and intervention (EHDI).—The Committee encourages NIDCD to enhance its EHDI research, especially 

as it pertains to the genetics of hearing loss, the causes of lateonset and progressive hearing loss, the benefits of early identification, and the identification of and effective intervention for children 

with monaural and milder degrees of hearing loss. To avoid duplication, NIDCD should coordinate its efforts with other institutes 

and agencies conducting EHDI activities. 

Neurofibromatosis (NF).—NF accounts for approximately five 

percent of genetic forms of deafness. Unlike other genetic forms of 

deafness, NF-associated deafness is potentially preventable or curable if tumor growth is halted before damage has been done to the 

adjacent nerve. Research is now being conducted to cure deafness 

in NF mice through gene therapy, with important implications for 

patients suffering from meningiomas and other tumors. The Committee encourages NIDCD to strengthen its NF research portfolio 

through all suitable mechanisms including RFAs and clinical trials.

NATIONAL INSTITUTE OF NURSING RESEARCH

The Committee provides $138,729,000 for the National Institute of Nursing Research (NINR), which is $657,000 above the fiscal 

year 2005 comparable level and the same as the budget request. 

Mission.—The NINR supports and conducts scientific research 

and research training to reduce the burden of illness and disability; 

improve health-related quality of life; and establish better approaches to promote health and prevent disease. 

NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM

The Committee provides $440,333,000 for the National Institute on Alcohol Abuse and Alcoholism (NIAAA), which is $2,056,000 

above the fiscal year 2005 comparable level and the same as the 

budget request. 

Mission.—The 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 of genetic and environmental factors involved in alcoholism; the mechanisms whereby 

alcohol produces its disabling effects, including organ damage; how 

to prevent alcohol misuse and associated damage 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. 

This program includes various areas of special emphasis such as 

medications development, fetal alcohol syndrome, genetics, and 

moderate drinking. 

Alcohol, obesity, and liver disease.—The relationship among the 

use of alcohol, the occurrence of obesity, and the presence of liver 

disease has become increasingly worrisome for clinicians. While alcohol’s negative impact on weight and liver wellness is long established, the current epidemic of obesity and its consequent increase 

in liver disease creates a new focus for research. The Committee 

encourages NIAAA to focus greater attention to this relationship 

with special emphasis on the differentiation of impact of alcohol 

consumption on the liver for specific populations, such as women, 

minorities, the elderly, and others. 

91

Translation.—The Committee is interested in ensuring that current research on the health effects of alcohol and alcoholism is 

more effectively communicated and disseminated within the alcohol 

abuse treatment community. The Committee recommends that 

NIAAA jointly work with related alcohol research organizations on 

a plan to broaden the reach and timely communication of funded 

alcohol and alcoholism research to the treatment community. 

NATIONAL INSTITUTE ON DRUG ABUSE

The Committee provides $1,010,130,000 for the National Insti- tute on Drug Abuse (NIDA), which is $3,711,000 above the fiscal 

year 2005 comparable level and the same as the budget request. 

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; the Institute works to 

ensure the transfer of scientific data to policy makers, practitioners, and the public. 

Drug abuse and HIV/AIDS.—The Committee understands that 

one of the most significant causes of HIV virus acquisition and 

transmission is drug taking practices and related risk factors in 

different populations. Drug abuse prevention and treatment interventions have been shown to be effective in reducing HIV risk. 

Therefore, the Committee encourages NIDA to continue its support 

of research focused on the development and testing of drug abuserelated interventions designed to reduce the spread of HIV/AIDS in 

these populations. 

Translation of research findings.—The Committee commends 

NIDA for its outreach and work with State substance abuse directors, also known as Single State Authorities (SSAs), to reduce the 

current 15- to 20-year lag between the discovery of an effective 

treatment intervention and its availability at the community level. 

In particular, the Committee applauds NIDA for working with 

SAMHSA on a recent RFA designed to strengthen State Substance 

Abuse agencies’ capacity to support and engage in research that 

will foster statewide adoption of meritorious science-based policies 

and practices. The Committee also encourages NIDA to continue 

collaborative work with SSAs to ensure that research findings are 

relevant and adaptable by State Substance Abuse systems. 

Prevention research.—The Committee remains interested in research on preventive medicine and encourages NIDA to conduct research on prevention of drug abuse by focusing on the role environment plays on neurobiological factors such as gene expression. 

Drug-induced liver injury.—The Committee notes that the mechanisms and causes of drug-induced liver injury related to over-thecounter and prescription medications are not well understood and 

merit further research. The Committee encourages NIDA to work 

collaboratively with NIDDK, FDA, industry, and the liver research 

community to address these priorities. 

Impact of prescription drugs.—The Committee encourages NIDA 

to conduct research on the use of prescription psychoactive medication in children and adolescents and their impact on the development of mental health and substance abuse problems across the 

life span of individuals. 

92

Hepatitis and drug abuse.—The Committee is concerned about 

the prevalence of hepatitis and substance abuse and urges NIDA 

to work with voluntary health organizations to promote liver 

wellness, education, and prevention of both hepatitis and substance 

abuse. 

Drug treatment in criminal justice settings.—The Committee is 

very concerned about the well-known connections between drug use 

and crime. Research continues to demonstrate that providing treatment to individuals involved in the criminal justice system decreases future drug use and criminal behavior, while improving social functioning. Blending the functions of criminal justice supervision and drug abuse treatment and support services create an opportunity to have an optimal impact on behavior by addressing 

public health concerns while maintaining public safety. The Committee supports NIDA’s efforts in this area, particularly the Criminal Justice Drug Abuse Treatment Studies (CJ–DATS), a multi-site 

set of research studies designed to improve outcomes for offenders 

with substance use disorders by improving the integration of drug 

abuse treatment with other public health and public safety systems. 

Reducing health disparities.—The Committee notes that the consequences of drug abuse disproportionately impact minorities, especially African American populations. The Committee is pleased to 

learn that NIDA formed a subgroup of its Advisory Council to address this important topic. The Committee applauds NIDA for 

working to strategically reduce the disproportionate burden of HIV/

AIDS among the African American population. Researchers should 

be encouraged to conduct more studies in this population and to 

target their studies in geographic areas where HIV/AIDS is high 

and/or growing among African Americans, including in criminal 

justice settings. 

NATIONAL INSTITUTE OF MENTAL HEALTH

The Committee provides $1,417,692,000 for the National Institute of Mental Health (NIMH), which is $5,759,000 above the fiscal 

year 2005 comparable level and the same as the budget request. 

Mission.—The NIMH is responsible for research activities that 

seek 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; 

these include childhood mental disorders such as autism and attention-deficit/hyperactivity disorder; eating disorders; Alzheimer’s disease; and other illnesses. NIMH supports and conducts fundamental research in neuroscience, genetics, and behavioral science. 

In addition to laboratory and controlled clinical studies, the NIMH 

supports research on the mental health needs of special populations and health services research. 

Down syndrome.—The Committee encourages NIMH to develop 

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mittee urges NIMH to coordinate its research on Down syndrome 

with NICHD, NINDS, NIA and other institutes. 

Alzheimer’s disease.—Combining imaging with genetics, a team 

of NIMH-funded scientists recently identified a possible genetic 

marker for Alzheimer’s disease, a variant of the gene that codes for 

APOE, a protein involved in metabolizing cholesterol. PET scans of 

normal individuals in their fifties and sixties who carry this variant showed decreased activity in regions of the brain known to be 

affected by Alzheimer’s. PET scans of younger individuals who 

carry this variant found lowered metabolism in the same brain 

areas, suggesting that the process at work in Alzheimer’s starts 

decades before memory deficits become apparent. The Committee 

strongly encourages NIMH to continue to advance understanding of 

Alzheimer’s disease. 

Fragile X.—Fragile X is the most common single-gene 

neuropsychiatric disease known. It causes cognitive impairment, 

mental disorders such as obsessive-compulsive disorder, and extreme anxiety. The Committee commends NIMH for spearheading 

three focused research meetings in the past four years devoted to 

identifying critical research needs. The Committee encourages 

NIMH to pursue the highest priority needs identified by the meeting panels. These include controlled studies of existing and new 

pharmacological treatments for Fragile X and identification of the 

key molecular targets which are likely candidates for designing 

drug treatments for Fragile X and related disorders such as autism. The Committee also recommends that NIMH include Fragile 

X in its studies of related neuropsychiatric disorders and to work 

with other Institutes such as NICHD and NINDS to develop cooperative research support mechanisms in this area. In addition, the 

Committee suggests that NIMH work with industry and academia 

to test available medications and bring new treatments to market. 

Adolescent depression and suicide.—Major depressive disorder in 

adolescence, one of the major risk factors for suicide, has become 

increasingly common. Suicide now accounts for 13 percent of all adolescent deaths and ranks third as a cause of death among teenagers. The Committee encourages NIMH to strengthen its investment in understanding the clinical epidemiology of suicidal behavior and thinking in children and adolescents; improving the criteria 

for identifying those at risk; and examining the outcomes of actions 

taken to assist those found to be at risk. 

Mental health for older Americans.—The Committee is aware 

that demographics will demand an increased focus on mental disorders in older persons. The Committee encourages NIMH to 

strengthen research in this area through all available mechanisms 

to advance the geriatric mental health research agenda. 

NATIONAL HUMAN GENOME RESEARCH INSTITUTE

The Committee provides $490,959,000 for the National Human 

Genome Research Institute (NHGRI), which is $2,351,000 above 

the fiscal year 2005 comparable level and the same as the budget 

request. 

Mission.—NHGRI coordinates extramural and intramural research, as well as research training, in the areas of genomics and 

genetics. The Division of Extramural Research supports research 

on sequence and function of both human and non-human genomes, 

94

human genetic variation, technology development for genome research, database management and analysis, and research on the 

ethical, legal, and social implications of human genome research. 

The Division of Intramural Research focuses on applying the tools 

and technologies of the successful Human Genome Project to understanding the genetic and environmental basis of disease, and 

developing DNA-based diagnostics and gene-based therapies. 

Targeting disease prevention.—The Committee commends 

NHGRI for its leadership of the international haplotype mapping 

(HapMap) project. The HapMap will provide a powerful new public 

resource to gain a deeper understanding of human biology, and discover the genetic and environmental factors that contribute to disease, predict potential disease risk, optimize drug prescribing for 

individuals, and identify and validate critical new targets for therapeutic development. 

Molecular libraries.—The Committee commends NHGRI for leadership in the NIH Roadmap Initiative on molecular libraries. This 

includes the founding of the NIH Chemical Genomics center, which 

will provide public sector researchers with access to high-throughput screens for small organic molecules, enabling development of 

new tools for exploration of health and disease. The Committee recognizes that advances in the use of these molecular libraries will 

enhance NIH’s global leadership in the future. 

Genome strategic plan.—The Committee commends the Institute’s efforts to contribute to the future possibility that comprehensive genome sequence information could become a part of each 

American’s individual health care plan. NIH has assembled significant resources of well-characterized populations to enable the testing and validation of genotyping and genome sequencing in diseases that are known to have a strong genetic basis, such as diabetes, hypertension, and several others. The Committee urges 

NHGRI to work together with other appropriate Institutes in this 

regard to develop models for the new era of molecular medicine. 

NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING

The Committee provides $299,808,000 for the National Institute 

of Biomedical Imaging and Bioengineering (NIBIB), which is 

$1,599,000 above the fiscal year 2005 comparable level and the 

same as the budget request. 

Mission.—The mission of the Institute is to improve health by 

promoting fundamental discoveries, design and development, and 

translation and assessment of technological capabilities in biomedical imaging and bioengineering, enabled by relevant areas of 

information science, physics, chemistry, mathematics, materials 

science, and computer sciences. 

Imaging for autoimmune disease.—The Committee is encouraged 

by the recent development of imaging technology being evaluated 

in clinical trials for detection of metastatic cancer in human patients. The Committee encourages the Institute to support the 

translation of imaging technologies to the detection and diagnosis 

of autoimmune diseases, in particular juvenile diabetes and organ 

transplantation. Non-invasive imaging approaches are critical to 

the detection of progression of disease or early rejection of transplanted organs or cells. 

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Bone imaging.—The Committee urges NIBIB to focus on improving musculoskeletal disease detection, monitoring and treatment 

through focused imaging and engineering advances. The Institute 

is encouraged to develop noninvasive techniques to measure bone 

quality and bone strength in humans. 

Liver imaging techniques.—Consistent with NIBIB’s mission to 

improve all diagnostic imaging technologies, the Committee encourages NIBIB to make liver imaging techniques a primary focus, 

speeding the development of new modalities that better capture the 

early stages of various liver diseases, including cancer, as well as 

offering the potential for combinations of diagnosis and treatment. 

This is also necessary to develop less invasive diagnostics for liver 

disease patients. The Committee recommends that NIBIB participate actively in trans-NIH initiatives that address these priorities. 

Long term budgets.—The Committee acknowledges receipt of the 

Five-Year Professional Judgment Budget for the National Institute 

of Biomedical Imaging and Bioengineering (NIBIB) requested in 

House Report 108–636. The Committee notes the budget’s central 

conclusion that biomedical imaging and bioengineering ‘‘are dynamic and ripe with opportunities for major scientific advances’’ 

that could be translated into dramatic improvements in health 

care. The Committee notes that the Five-Year Professional Judgment Budget recommends a measured, reasonable rate of growth 

for the NIBIB to achieve the goals of the important research areas 

enumerated in the report. As with all professional judgment budgets, the Committee considers them within the constraints of the annual budget, acknowledging that they represent the judgment of 

scientific opportunity but not competing demands. 

Interdisciplinary research.—The Committee also notes that the 

Five-Year Professional Judgment Budget recognizes the role of the 

NIBIB with respect to interdisciplinary research, the physical 

sciences, and technology development. NIBIB has taken a leadership role in efforts to examine the scientific questions that can be 

addressed by collaboration between life and physical scientists, the 

barriers to such collaboration, and the steps that need to be taken 

to bridge these disciplines. The Committee recommends that NIBIB 

serve as the primary home of any new NIH or interagency programs or initiatives at the crossroads of physical sciences and biomedicine. 

NATIONAL CENTER FOR RESEARCH RESOURCES

The Committee provides $1,100,203,000 for the National Center 

for Research Resources (NCRR), which is $14,887,000 below the fiscal year 2005 comparable level and the same as the budget request. 

The Committee does not include bill language identifying funding 

for extramural facility construction, which is the same as the Administration request. $29,760,000 was provided in fiscal year 2005 

for extramural construction. 

Mission.—The NCRR develops and supports critical research 

technologies and shared resources that underpin biomedical research. The NCRR programs develop a variety of research resources; provide resources for complex biotechnologies, clinical research and specialized primate research; develop research capacity 

in minority institutions; and enhance the science education of precollege students and the general public. 

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Institutional development awards (IDeA).—The Committee has 

identified $222,208,000 for this program, which is the same as the 

Administration request and the fiscal year 2005 level. The program 

is comprised of the Centers of Biomedical Research Excellence 

(COBRE) program and the IDeA Networks of Biomedical Research 

(INBRE) program. The Committee commends NCRR in its efforts 

to support the IDeA program to foster innovation and infrastructure in the IDeA-eligible states that have traditionally not been 

able to take advantage of biomedical research funding opportunities. 

Advancing clinical and translational sciences.—To capitalize on 

the revolutionary discoveries emerging from basic science, there is 

a pressing need to strengthen and accelerate the clinical research 

process, and to more efficiently transmit research findings to practitioners on the front lines of patient care. The Committee commends NIH for developing a proposal to overcome the challenges 

facing the translation of clinical research, which include: difficulty 

recruiting and retaining clinical researchers; increasing regulatory 

burden; fragmented training programs; and limitations/barriers 

due to NIH funding mechanisms, review and program structure. 

The Committee is supportive of NIH’s efforts to help grantee institutions create the academic home and integrated resources needed 

to advance the new intellectual discipline of clinical and 

translational sciences, create a cadre of well-trained investigators, 

and transform basic discovery research into clinical practice. The 

Committee looks forward to hearing more about how this effort will 

integrate NIH’s existing grants into more efficient awards, and how 

this will transform clinical and translational sciences. 

Clinical research curriculum award.—The clinical research curriculum award has been extremely effective in training successful 

clinical researchers. Funded programs report that over 60 percent 

of their graduates are active researchers who have already secured 

funding for their research. The Committee supports the NIH decision to increase the size of these awards from $200,000 to $300,000 

and would support a decision by the NIH Director to increase funding from the various institutes and centers that support the program in order to expand the number of institutions receiving this 

important award. 

Research centers at minority institutions.—The Committee continues to recognize the critical role played by minority institutions 

at both the graduate and undergraduate level in addressing the 

health research and training needs of minority populations. These 

programs help facilitate the preparation of a new generation of scientists at these institutions. The Research Centers in Minority Institutions (RCMI) Program continues to impact significantly on 

these problems. The Committee encourages NIH to strengthen participation from minority institutions and the resources available in 

this area. The Committee also encourages NIH to work with minority institutions with a track record of producing minority scholars 

in science and technology. 

Cystic fibrosis (CF).—The Committee commends NCRR for its efforts to improve systems for efficient conduct of clinical trials. 

NCRR support for the CF clinical trials system continues to contribute to the development of data collection and analysis systems 

and data safety monitoring efforts that are critical elements of the 

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CF system. The Committee encourages NCRR to strengthen its 

support for clinical trials systems, including CF work.

Clinical trials technology.—The Committee encourages NCRR to 

work with grantees in the Research Centers at Minority Institutions (RCMI) program and the General Clinical Research Centers 

(GCRC) program to upgrade their clinical trials data management 

capabilities. 

Islet cell resource (ICRs) centers.—The Committee applauds the 

goal of the ICRs to provide human islets for transplantation and 

basic scientific research. The Committee encourages the NCRR to 

ensure that the ICRs continue to improve the quality and consistency of islet isolation. The NCRR is also urged to maximize the 

data collection and analysis potential of the Administrative and 

Bioinformatics Coordinating Center, the coordinating center for the 

ICR consortium. 

NATIONAL CENTER FOR COMPLEMENTARY AND ALTERNATIVE

MEDICINE

The Committee provides $122,692,000 for the National Center 

for Complementary and Alternative Medicine (NCCAM), which is 

$587,000 above the fiscal year 2005 comparable level and the same 

as the budget request. 

Mission.—The Center 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 practices in order to provide the American 

public with reliable information about these practices. 

Ameliorating liver disease.—The Committee is pleased with 

NCCAM’s efforts to conduct clinical trials in collaboration with 

NIDDK regarding the use of milk thistle as a possible treatment 

in slowing the progression of nonalcoholic steatohepatitis and to reduce the side effects of hepatitis C interferon treatments. The Committee looks forward to the development and dissemination of the 

research results associated with the use of milk thistle as a treatment to ameliorate liver disease. 

Parkinson’s disease.—The Committee encourages NCCAM to continue exploration of aerobic exercise and Chinese exercises such as 

T’ai Chi Chuan in the treatment of Parkinson’s. Recent studies 

show exercise may increase neuroprotective chemicals in the brain 

and decrease falls in the elderly. The Committee also encourages 

continued research into magnetic stimulation for depression and 

the phytomedicine Valerian for sleep dysfunction, as both symptoms are significant non-motor co-morbidities in Parkinson’s. Finally, NCCAM is encouraged to work the Office of Dietary Supplements in investigating supplements which may be neuroprotective, 

such as berries, alpha lipoic acid, N-acetyl-L-cysteine, acetyl-L-carnitine, vitamin E, ginko biloba, vitamin D, vitamin B12, 

phosphatidylcholine, and glyconutrients. 

NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

The Committee provides $197,379,000 for the National Center on 

Minority Health and Health Disparities (NCMHD), which is 

$1,220,000 above the fiscal year 2005 comparable level and the 

same as the budget request. 

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Mission.—The Center conducts and supports research, training, 

information dissemination 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. 

Glomerular injury.—The Committee understands that glomerular injury, a group of diseases affecting the filtering mechanisms 

of the kidneys, is more prevalent among African-Americans than 

the general population. The Committee encourages NCMHD to explore collaboration with NIDDK to support research activities related to glomerular injury and requests a report on progress made 

in this area. 

Scleroderma.—The Committee encourages NCMHD to support 

research that furthers the understanding of causes and consequences of scleroderma, a chronic, degenerative disease of collagen production, present among African-Americans, Hispanic and 

Native American men and women. NCMHD is encouraged to establish epidemiological studies to address the prevalence of 

scleroderma among these populations, as statistics indicate that African-Americans have a slightly higher incidence of scleroderma. 

This population is also likely to be diagnosed at a younger age and 

tends to be diagnosed more often with the diffuse form of 

scleroderma. 

Lung disease.—The Committee is concerned with the disproportionate impact of lung diseases affecting minorities. The Committee 

encourages the Center to partner with other agencies within the 

NIH, including NHLBI, to develop an epidemiological approach to 

determine the disproportionate impact of airway disease on minority populations. 

Psoriasis.—The Committee encourages NCMHD to support research that furthers the understanding of causes and consequences 

of psoriasis, a chronic, immune-mediated disease that affects between 5.8 and 7.5 million Americans. New research indicates that 

psoriasis is twice as common among African-Americans as previously believed, and the research found suggestions that psoriasis 

among African-Americans may be more severe than among Caucasians. NCMHD is encouraged to establish epidemiological studies 

to address the prevalence of psoriasis among African-Americans, 

Hispanics, and other minority populations, as well as research into 

the apparent differences in psoriasis severity among different populations. 

Liver disease.—The Committee notes that many liver diseases, 

such as hepatitis C, hepatitis B and nonalcoholic steatohepatitis, 

are more common in the African-American, Hispanic, Asian Pacific 

Islander and Native American populations, than in European 

Americans. In addition, access to and acceptance of care is particularly problematic in these populations. The Committee encourages 

the Center to initiate and participate with NIDDK, NIDA and NCI 

in research focused on addressing and reducing these disparities. 

Cancer center at minority institutions.—The Committee commends NCMHD for its leadership in addressing the disproportionate impact of cancer in minority communities. The Committee 

encourages NCMHD to consider collaborating with NCRR and NCI 

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in supporting the establishment of a cancer center at a historically 

minority institution focused on research, treatment, and prevention 

of cancer in African-American and other minority communities. 

Research endowments.—The Committee commends NCMHD for 

its leadership in addressing the longstanding problem of health status disparities in minority and medically underserved populations. 

The Committee continues to encourage NCMHD to implement its 

successful Research Endowment program as an ongoing initiative. 

Project EXPORT.—The Committee commends NCMHD for its 

successful ‘‘Project EXPORT’’ initiative and recommends continued 

support for this important program.

Minority community based organizations.—The Committee believes that implementation of recommendations stemming from the 

IOM study, ‘‘Unequal Treatment: Confronting Racial and Ethnic 

Disparities in Health Care’’ offer significant opportunities for improving health across communities of color. NCMHD is urged to 

support minority organizations and minority community-based efforts to disseminate research-based health information that highlights health disparities experienced by different racial and ethnic 

groups. NCMHD is encouraged to engage minority national organizations and minority community-based organizations in educating 

diverse communities about the findings and recommendations of 

the Institute of Medicine report. 

JOHN E. FOGARTY INTERNATIONAL CENTER

The Committee provides $67,048,000 for the Fogarty Inter- national Center (FIC), which is $416,000 above the fiscal year 2005 

comparable level and the same as the budget request. 

Mission.—The FIC was established to improve the health of the 

people of the United States and other nations through international cooperation in the biomedical sciences. In support of this 

mission, the FIC pursues the following four goals: mobilize international research efforts against global health threats; advance 

science through international cooperation; develop human resources to meet global research challenges; and provide leadership 

in international science policy and research strategies. 

Chronic obstructive pulmonary disease (COPD).—The Committee 

notes that COPD is the fourth leading cause of death in the U.S. 

and encourages the Fogarty International Center to strengthen its 

COPD research and training activities. 

Tuberculosis training.—The Committee is pleased with the 

Fogarty International Center’s efforts to supplement grants in the 

AIDS International Training and Research Program (AITRP) or 

International Training and Research Program in Emerging Infectious Diseases (ERID), which train tuberculosis experts in the developing world. Given the magnitude of global tuberculosis, the 

Committee encourages FIC to develop a specific free standing TB 

training program. 

Fragile X.—The Fogarty International Center addresses global 

health challenges through innovative and collaborative research 

and training programs and supports and advances the NIH mission 

through international partnerships. International collaboration 

among scientists is an essential element in Fragile X research. The 

Committee encourages the Fogarty International Center to consider Fragile X syndrome through all appropriate programs, such 

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as the Fogarty International Research Collaboration Award and 

the FIC Brain Disorders in the Developing World Program. 

NATIONAL LIBRARY OF MEDICINE

The Committee provides $318,091,000 for the National Library of 

Medicine (NLM), which is $2,945,000 above the fiscal year 2005 

comparable level and the same as the budget request. In addition, 

$8,200,000 is made available from program evaluation funds as requested by the Administration to support the National Center on 

Health Services Research. The same amount was provided last 

year. 

Mission.—The National Library of Medicine collects, organizes, 

disseminates, and preserves biomedical literature in all forms, regardless of country of origin, language, or historical period. The Library’s collection is widely available; it may be consulted at the 

NLM facility on the NIH campus; items may be requested on interlibrary loan; and the extensive NLM bibliographic databases may 

be searched online by health professionals around the world. NLM 

has a program of outreach to acquaint health professions with 

available NLM services. The Library also is mandated to conduct 

research into biomedical communications and biotechnology; to 

award grants in support of health science libraries and medical 

informatics research and training; and to create specialized information services in such areas as health services research, environmental health, AIDS, hazardous substances, and toxicology. 

OFFICE OF THE DIRECTOR

(INCLUDING TRANSFER)

The Committee provides $482,216,000 for the Office of the Director (OD), which is $124,169,000 above the fiscal year 2005 comparable level and $97,021,000 above the budget request. Included 

within funding for the Office of the Director is $97,021,000 for radiological, nuclear and chemical countermeasures. The Administration had requested these funds as part of the Public Health and Social Services Emergency Fund. It is intended that the Director allocate these funds to those Institutes that support these areas of 

countermeasure research. 

The bill repeats language included in prior years authorizing the 

collection of third party payments for the cost of clinical services, 

providing the Director of NIH with one percent transfer authority, 

and allocating up to $500,000 of funds within the Office of the Director appropriation for the Foundation for the National Institutes 

of Health. The Committee provides $93,000,000 within the Office 

of the Director for the Director’s Discretionary Fund (DDF), which 

is the same as the Administration request and $23,560,000 above 

the fiscal year 2005 comparable level. $83,000,000 of this funding 

is intended to be used for Roadmap initiatives. The Committee has 

repeated last year’s bill language making up to $10,000,000 of this 

total available through the flexible research authority provided in 

section 217 of the Act. The Committee also includes bill language 

providing $10,000 for representation allowances when specifically 

approved by the Director of NIH. 

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tives. The Committee strongly supports this effort as a needed 

mechanism to review the NIH research portfolio as a whole and to 

address the issues raised by external groups about the coding of 

diseases for funding reporting. 

The Committee includes bill language from last year’s bill identifying the maximum funding that may be used for Roadmap activities and the method of calculating each Institute or Center’s contribution. The language also permits the transfer of Roadmap 

funds to a single location for the purpose of using a standardized 

accounting structure for supporting Roadmap activities. 

Mission.—The Office of the Director provides leadership to the 

NIH research enterprise and coordinates and directs initiatives 

which cross-cut the NIH. The 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 

operations of the NIH. 

Office of Research on Women’s Health 

The Office of Research on Women’s Health (ORWH) works in collaboration with the Institutes and Centers of NIH 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. The ORWH is responsible for ensuring 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. 

This Office 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 sex and gender factors in biology as 

a focus of medical/scientific research. 

The Committee is pleased with the increased focus on irritable 

bowel syndrome (IBS) at the ORWH. It is estimated that between 

25 and 45 million Americans, disproportionately women, suffer 

from IBS. 

Office of AIDS Research 

The Office of AIDS Research (OAR) is responsible for coordination of the scientific, budgetary, legislative, and policy elements of 

the NIH AIDS research program. The OAR develops a comprehensive plan for NIH AIDS-related research activities which is updated annually. The plan is the basis for the President’s budget 

distribution of AIDS-related funds to the Institutes, and centers 

within NIH. The Committee expects the Director of NIH to use this 

plan and the budget developed by OAR to guide his decisions on 

the allocation of AIDS funding among the Institutes. The Director 

of NIH also should use the full authority of his office to ensure that 

the Institutes and Centers spend their AIDS research dollars in a 

manner consistent with the plan. In addition, the OAR allocates an 

emergency AIDS discretionary fund to support research that was 

not anticipated when budget allocations were made. 

The Committee has included the same general provisions in bill 

language that were contained in the 2005 appropriations bill. This 

language permits the Director of OAR, jointly with the Director of 

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NIH, to transfer between Institutes and Centers up to three percent of the funding determined by NIH to be related to AIDS research. This authority could be exercised throughout the fiscal year 

subject to normal reprogramming procedures, and is intended to 

give NIH flexibility to adjust the AIDS allocations among Institutes 

if research opportunities and needs should change. The Committee 

also repeats language from last year’s bill making the research 

funds identified by NIH as being AIDS related available to the 

OAR account for transfer to the Institutes. This provision permits 

the flow of funds through the OAR in the spirit of the authorization 

legislation without requiring the Congress to earmark a specific 

dollar amount for AIDS research. 

Pediatric HIV research.—The Committee recognizes the importance of research into the long-term health implications of preventive HIV drug regimens in children, the psychological and social 

needs of HIV-infected children and appropriately targeted prevention services. The Committee requests the Director to identify the 

resources necessary for domestic and international research on the 

long-term effects of preventive drug regimens on HIV-exposed pediatric populations; the long-term health, psychosocial, and prevention needs for pediatric populations perinatally HIV-infected; the 

transition to adulthood for HIV-infected pediatric populations; and 

safer and more effective treatment options for pediatric populations 

with HIV disease. 

Pediatric HIV vaccine testing.—The Committee requests the Director of the National Institutes of Health to submit a report within 90 days of enactment of this bill on the status of activities related to the testing of potential HIV vaccine candidates in relevant 

pediatric populations, including infants, preadolescents, and adolescents. The report should include an analysis of regulatory or other 

barriers to developing an HIV vaccine and a comprehensive review 

of current and planned clinical trials in relevant pediatric populations. In addition, the Committee requests that the NIH Fiscal 

Year 2007 Plan for HIV-Related Research and future plans include: 

plans for expanding existing capacity for HIV vaccine candidate 

testing in relevant pediatric populations; plans for increasing coordination in advancing pediatric HIV vaccine testing across Federally funded HIV vaccine research programs, including, but not limited to the HIV Vaccine Trials Network, the Pediatric AIDS Clinical Trials Group, the Food and Drug Administration, the Centers 

for Disease Control and Prevention, and the Partnership for AIDS 

Vaccine Evaluation; opportunities for collaboration with the Office 

of the Global HIV/AIDS Coordinator; appropriate principles for initiating HIV vaccine testing in relevant pediatric populations, including recommendations for sequencing the enrollment of adults 

and relevant pediatric populations and for addressing issues related to human subjects protections for children involved in clinical 

research; and proposed community education efforts in support of 

the inclusion of relevant pediatric populations in HIV vaccine clinical trials. 

Office of Dietary Supplements 

The Office of Dietary Supplements (ODS) was established in recognition that dietary supplements can have an important impact 

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nance of health. ODS is charged with promoting, conducting, and 

coordinating scientific research within NIH relating to dietary supplements. 

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 science 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 integrate a biobehavioral 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 Rare Disease Research 

The Office of Rare Disease Research (ORD) 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 with 

Federal and non-Federal national and international organizations 

concerned with rare disease research and orphan products development; develops a centralized database on rare diseases research; 

and stimulates rare diseases research by supporting scientific 

workshops and symposia to identify research opportunities. 

Pediatric liver diseases.—The Committee is pleased that the ORD 

has continued to provide significant funding to support 10 centers 

within the Biliary Atresia Clinical Research Consortium. The Committee urges ORD to continue to address rare liver diseases including primary biliary cirrhosis, primary sclerosing cholangitis, and 

auto-immune hepatitis. 

Multi-Institute Research Issues 

Clinical Trials Technology.—The Committee recommends that 

the NIH Director and the Director of the NIH Clinical Center explore options for utilization of technology to improve efficiency, cost 

savings, and sharing of information in clinical trials being supported intramurally and extramurally. The Director is encouraged 

to investigate software systems that could reduce the administrative costs of clinical trials, improve the availability and transfer of 

clinical data for review or use by other researchers, and bring uniformity to the administration of NIH research. 

Clinical investigators.—The Committee has heard testimony that 

there is currently a shortage of adequately trained clinical investigators within every medical specialty who can translate basic 

science advances into the diagnosis, treatment and prevention of 

disease. This shortage inhibits clinical research productivity and 

slows the rate at which results from basic biomedical research efforts can be applied to the problems of patients. Improved clinical 

research will have a positive effect on the quality of health care 

and patient safety, and advance the application of the principles of 

evidenced-based medicine to routine patient care. The Committee 

has as a priority the training of physician-scientists through all 

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NIH institutes, to support studies of patient outcomes, medical effectiveness, and disease- and treatment-specific quality of life. 

Public access.—The Committee is pleased that NIH is moving 

forward to implement its public access policy and is hopeful that 

the policy will be a first step toward providing free and timely access to the published results of all NIH-funded biomedical research. 

The Committee endorses NIH’s expressed goals for the policy, 

namely to create an archive of NIH-funded research, to provide an 

opportunity to better manage the NIH research portfolio, and to 

provide enhanced public access to NIH research results. The Committee is concerned, however, that the final policy may not achieve 

these goals. For this reason, the Committee directs the Office of the 

Director to submit to the Committee by March 1, 2006 a comprehensive report on the progress achieved during the first eight 

months following the implementation of the new policy. Specifically, the Committee requests that the report provide: 1) the total 

number of applicable peer-reviewed articles deposited in PubMed 

Central since the May 2, 2005 implementation date; 2) the embargo 

period requested by the author for each deposited work; and 3) 

NIH’s best estimate of the total number of applicable peer-reviewed 

articles available for deposit during this time frame, together with 

an explanation of the mechanisms relied upon to determine this estimate. Additionally, the Committee is concerned that grant recipients may not fully understand the NIH policy and the steps required to post an article in PubMed Central. The Committee, therefore, directs NIH to develop an aggressive education and outreach 

initiative aimed at informing grant recipients about the policy in 

an effort to maximize full and prompt participation. 

Duchenne muscular dystrophy.—The Committee is disappointed 

with the time the Department took to implement the provisions of 

the MD Care Act. It is pleased that the Muscular Dystrophy Coordinating Committee (MDCC) eventually produced an MD Research and Education Plan, which is to be updated every two years 

and submitted to Congress. The Committee understands that NIH 

also submits an annual report to Congress on implementation of 

the MD Care Act. The Committee requests that it be included in 

the Congressional distribution of both of these periodic reports. The 

Committee asks that the annual report state NIH’s current research goals related to duchenne muscular dystrophy, the progress 

made toward each goal, the total amount of money invested toward 

each goal as well as projected spending for the present and future 

fiscal year, and all opportunities for translation research and external partnerships. 

The Committee is pleased that NIH has funded one additional 

Senator Paul Wellstone Muscular Dystrophy Cooperative Research 

Center and is working to fund two more, for a total of six. The 

Committee urges NIH to provide adequate funding and resources 

for each center. The NIH is also urged to devote separate resources 

to DMD translational research beyond the funding that is provided 

in Centers of Excellence programs. 

Duchenne muscular dystrophy translational research.—The Committee recognizes that several promising translational treatments 

and therapies for Duchenne and Becker muscular dystrophy are in 

development. The Committee requests NIH to develop a 

translational research initiative specific to muscular dystrophy to 

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ensure the effective coordination of these efforts and their acceleration. The Spinal Muscular Atrophy [SMA] Project may be an appropriate model for the initiative. The Committee believes the SMA 

model enhances the dialogue between program directors and investigators, facilitating and accelerating review and modifications of 

grant proposals that are in the best interest of the patients and 

that show the greatest promise for success. To achieve maximum 

effectiveness, the Committee urges NIH to assess the background, 

experience, and capabilities of staff needed to launch, perform, and 

sustain such a translational research initiative. The Committee requests a report by March 1, 2006 on the timeline to establish a 

DMD Translational Research Initiative. 

As a component of the Initiative, the Committee encourages NIH 

to conduct a workshop to explore the most promising potential approaches to Duchenne and Becker muscular dystrophy no later 

than February 2006 and to provide a full report to the Committee 

within 3 months of the workshop. 

Autism spectrum disorders.—The Committee is pleased with 

NIH’s autism research matrix and encourages NIH to devote sufficient resources to this research agenda. When implementing the 

autism research matrix, the Committee encourages NIH to coordinate with autism organizations already funding research initiatives 

to ensure the most efficient use of resources. The Committee also 

notes the promise of particular areas cited in the matrix, including 

genetic and behavioral characterization of the disorder, screening 

and early diagnosis. 

Autism and vaccines.—The Committee continues to be aware of 

concerns about reports of a possible association between the measles component of the measles-mumps-rubella (MMR) vaccine and 

a subset of autism termed autistic entercolitis. The Committee continues its interest in this issue and encourages the Interagency Coordinating Committee to continue to give serious attention to these 

reports. The Committee is aware that research is underway, supported by NIH, and encourages NIH to avoid further delays in this 

research. 

The Committee is also concerned that there is some evidence 

that infant exposures to thimerosal in the 1990s may be related to 

the epidemic of neurodevelopmental disorders in children. CDC’s 

most extensive review of Vaccine Safety Datalink data concluded 

that more research needs to be conducted in this arena to answer 

these questions with certainty and the Committee concurs with the 

need for this continued research. 

The Committee encourages NIH to dedicate significant resources 

to pursue the recommended research initiatives outlined in the Institute of Medicine’s (IOM) Immunization Review. These reports 

have identified the research needed to better understand why a 

number of children suffer severe adverse reactions to childhood 

vaccines. Continuation of this research to develop a better understanding of biological mechanisms is critical for knowing with certainty whether or not thimerosal and other vaccines exposures 

might cause increased risks for some children. 

Stem cell research.—Since the late 1960s bone marrow transplants and bone marrow stem cells have been used to treat cancer 

and blood diseases. In recent years, basic and clinical research has 

demonstrated the ability of adult stem cells to treat a broader 

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range of diseases through regenerative medicine including autoimmune diseases and tissue repair. The Committee urges NIH to 

place a high priority on investigating the plasticity and expansion 

of adult stem cells using more recently discovered multipotent 

adult stem cells from fat, dental pulp, heart, umbilical cord blood, 

and olfactory neurons. Clinical research, including FDA-approved 

clinical trials applying these novel sources of stem cells to the 

treatment of Parkinson’s disease, ALS, diabetes, heart disease, and 

other diseases should be pursued vigorously as well. 

The Committee requests the Director, through the new Office of 

Portfolio Analysis and Strategic Initiatives, to consider the distinctions between the various types of adult stem cell research as it develops tools to more accurately categorize and assess expenditures 

on stem cell research as a whole. By April 2006 the Committee requests a detailed report compiling the complete range of diseases 

being treated with all adult stem cells (including umbilical cord 

blood cells). This report should include a breakdown of spending 

among the various types of basic and clinical human adult stem 

cell research in a way that distinguishes traditional applications of 

bone marrow stem cells in the treatment of cancer and blood diseases from pioneering research into the novel use of multi-potent 

adult stem cells in regenerative medicine. Within six months of the 

release of this report, the Committee also requests that NIH develop an initiative to strengthen its portfolio of basic and clinical 

research into novel therapeutic uses of adult stem cells. 

Microbicides for the prevention of HIV/AIDS.—The Committee 

urges strengthened funding for microbicide research and development at NIH. In addition, the Committee has long advocated that 

NIAID establish a dedicated microbicide unit with clearly identified 

leadership to accelerate microbicide research. The Committee understands that NIAID has established the Microbicide Team in the 

Division of AIDS (DAIDS), which also coordinates a broader NIAID 

group with representatives from DAIDS and the Division of Microbiology and Infectious Diseases (DMD). The Office of AIDS Research, within the Office of the NIH Director, is continuing to coordinate microbicide research across NIH. Greater leadership and 

coordination on this issue is especially critical given that consideration is being given to the possibility of a microbicide-specific clinical trial network. 

Public-private partnerships in support of microbicides to prevent 

HIV/AIDS.—There is an urgent need to expand the development 

pipeline with more microbicide candidate products, particularly 

those that target HIV in new ways. In addition to candidates that 

may arise from NIH-funded basic research efforts, possibilities may 

be found within pharmaceutical companies where there are potential compounds already developed as therapeutics that could be 

tested as potential microbicides. NIH has mechanisms in place to 

encourage partnerships among researchers in academia, government and the private sector. The Committee strongly urges the 

leadership at NIH to support the microbicide field by encouraging 

partnering with the pharmaceutical industry and non-governmental organizations. In the past year, the International Partnership for Microbicides has entered into agreements with leading 

pharmaceutical companies to jointly test and develop leading AIDS 

drugs as microbicides. More partnerships like these between the 

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pharmaceutical industry and the non-profit community in collaboration with NIH will be critical, and should receive the active support of NIH leadership. 

Parkinson’s disease.—The Committee understands that the Director has scheduled a Parkinson’s disease research conference in 

June, 2005. The Committee requests the Director to report back to 

the Committee within six months of the conference on the conclusions from the summit, an examination of the existing Parkinson’s 

research portfolio, and recommendations of research goals for the 

next three years for diagnosis, better treatments and a cure for 

Parkinson’s disease. 

Autoimmune diseases.—Congress recognizes the cross-cutting nature of the NIH Autoimmune Diseases Coordinating Committee 

(ADCC) and its comprehensive Autoimmune Diseases Research 

Plan. The ADCC has been effective in fostering collaborative, integrated multi-Institute research on issues affecting the genetically 

related family of autoimmune diseases. The ADCC should focus on 

the role of environmental and infectious agents in the initiation 

and/or exacerbation of autoimmune diseases. Additionally, the 

Committee encourages the ADCC to be proactive in identifying 

promising areas of autoimmune research where collaboration 

among the NIH institutes enhances the potential for major advances. 

Heart disease research and prevention action plan.—Concerned 

that heart disease remains a major cause of permanent disability, 

the Committee encourages NIH to consider convening an interagency conference on heart disease to develop a comprehensive, 

long range research and prevention action plan. Participants 

should include representatives from all Federal agencies involved 

in heart disease research and prevention, including the NIH, CDC, 

AHRQ, DOD, and pertinent voluntary nonprofit organizations and 

experts in the field. The conference would be the basis for a longrange, strategic heart disease research and prevention action plan 

which would include quantifiable goals and benchmarks to measure 

progress in the battle against heart disease. 

Spina bifida.—The Committee recognizes that spina bifida is the 

leading permanently disabling birth defect in the U.S. and has 

heard concerns that NIH has not prioritized research into primary 

and secondary treatment of this condition. While spina bifida is 

highly preventable through proper nutrition, including appropriate 

folic acid consumption, too many pregnancies still are affected each 

year by this devastating birth defect. Since more than 70,000 individuals are living with spina bifida, the Committee urges NIH to 

allocate adequate resources to research into primary and secondary 

treatment of spina bifida. The Committee is pleased with the outcome of the 2003 Spina Bifida Research Conference and encourages 

NIH to consider organizing a follow-up national conference involving NICHD, NINDS, NIDDK, and the Office of Rare Diseases along 

with the National Center on Birth Defects and Developmental Disabilities, the Agency for Healthcare Research and Quality, and the 

National Institute on Disability and Rehabilitation Research to 

identify and explore improved treatment and outcomes for adults 

and children with spina bifida. 

Rett syndrome.—Rett syndrome is a neurological disorder resulting from a mutated gene that seen worldwide in most racial and 

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ethnic groups, almost exclusively in females. It is estimated to 

occur approximately one in fifteen thousand female births, although recent discoveries may reveal significantly more affected 

people than previously diagnosed. The Committee applauds NIH’s 

continued commitment to Rett syndrome research and encourages 

support for new animal models and genotype/phenotype investigations of Rett syndrome. Since Rett syndrome is a multi-faceted disorder, the Committee encourages NIH to redouble its effort to integrate the appropriate Institutes into this program area, including 

NIA, NIMH, NIDCD, NHLBI, NIAMS, NIDDK, and NIGMS, whose 

mandates include areas involved with understanding, treating and 

curing Rett syndrome. 

Cystic fibrosis (CF).—One of the priorities of the NIH Roadmap 

is the re-engineering of the clinical research system. There are a 

number of clinical trials systems that might serve as models for the 

re-engineering effort. One such model is the clinical trials system 

for testing therapies for CF, which includes centralized data management and analysis capability, centralized data safety monitoring, and the participation of 18 leading CF research centers. The 

Committee encourages the Director to evaluate and support the CF 

system as a model for the clinical trials reform effort. The structure 

and systems that achieve cost and research efficiencies in the CF 

network might be applicable to trial networks for other diseases. 

Charcot-Marie-Tooth disorder.—Charcot-Marie-Tooth disorder 

(CMT) is one of the most common inherited neurological disorders, 

affecting approximately one in 3,500 people in the United States. 

The Committee is concerned about the prevalence of this disease 

and its effect on people across the age spectrum and recognizes the 

value of CMT research for advancing understanding into other neuromuscular disorders. The Committee encourages NIH to identify 

new research opportunities on CMT that could lead to a relevant 

program announcement or request for applications. The Committee 

requests a report on NIH efforts on CMT and CMT-related disorders by March, 2006. 

Polycystic kidney disease (PKD).—The Committee is pleased that 

NIH-supported PKD research, combined with grants from the private sector and the involvement of industry, has not only produced 

the first clinical drug trial for PKD in humans, but has fostered the 

development of additional, innovative PKD therapies. Given the 

unprecedented momentum and therapeutic opportunities in PKD 

science, the Committee urges NIH to further implement its PKD 

Strategic Plan by facilitating PKD clinical trials and expanding 

knowledge-based studies of pathophysiology and cellular 

pathobiology. 

Lymphatic system research.—The lymphatic system is central to 

the progression of disease and the maintenance of health, yet scientific and medical knowledge of this important system has gaps. 

The Committee is pleased that a Trans-NIH Coordinating Committee on the Lymphatic System exists to ensure that scientific 

knowledge and understanding about this body system will be advanced and coordinated. The Committee is encouraged to learn that 

the Coordinating Committee is working with patient advocates to 

address the needs of the lymphatic disease and lymphedema patient communities. The Committee encourages NIH to consider initiatives such as a national lymphatic disease patient registry and 

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tissue bank; an NIH partnership funding program; intramural longitudinal studies; and multidisciplinary centers. 

Asian American and Pacific Islander (AAPI) populations.—The 

Committee encourages NIH, particularly NIDA, NIAAA, and 

NIMH, to strengthen its support of behavioral health research for 

AAPI populations. Additional research is needed to develop a body 

of knowledge addressing the bio-psycho-social aspects of substance 

abuse as well as co-occurring disorders among AAPI populations. 

Studies are also needed to address the biological differences that 

may exist within the diverse AAPI populations in terms of their reaction to the range of substances used and abused, and nature of 

substance abuse; effective prevention and treatment strategies; and 

culturally appropriate ways to evaluate these AAPI substance 

abuse services. 

Dystonia.—The Committee is very pleased with progress demonstrated by the NIH intramural research program in the treatment and understanding of dystonia. NIH intramural researchers 

have successfully utilized injections of botox to treat many patients 

who otherwise would be severely debilitated by dystonia. The Committee urges continued work in this important area of study and 

treatment. 

Fragile X.—The Committee notes the progress made by Fragile 

X researchers in understanding the basic neural defects that cause 

this developmental disorder. However, further efforts are required 

to translate these basic science findings into viable treatments. 

Specifically, collaborative efforts between industry, academia and 

NIH Institutes are likely to be necessary to develop promising 

therapeutic options for this orphan indication. The Committee further notes that while Fragile X is a relatively common genetic disease, the treatments being developed for Fragile X may also be effective for a much larger number of people with related autism 

spectrum disorders. Research has shown many possible treatment 

strategies which merit human Fragile X clinical trials. The Committee encourages the Director to facilitate and support public/private partnerships which will enable these important studies to proceed. NIH is urged to convene a yearly workshop with the research 

community to develop priorities for basic, clinical and translational 

research as they relate to Fragile X. 

Spinal muscular atrophy (SMA).—The Committee encourages the 

Office of the Director to ensure support of the SMA Project by providing active and ongoing support from the OD as well as from 

other related Institute Directors, particularly NICHD, since SMA is 

the leading genetic killer of infants and toddlers. 

Psoriasis.—The Committee encourages NIH to strengthen its 

work on psoriasis, a chronic, immune-mediated disease that affects 

between 5.8 and 7.5 million Americans. Safe and effective treatments for women of child-bearing age and for children are particularly lacking, and new research indicates mothers with psoriasis 

have a 50% increased risk of bearing a child with autism. New research also indicates psoriasis is twice as common among AfricanAmericans as previously believed. Psoriasis research involves many 

disciplines, and the Committee encourages NIH to intensify coordination of psoriasis research across its institutes and centers. 

Gene therapy research.—While the promise of gene therapy has 

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ising research done in the area of thalassemia, or Cooley’s anemia. 

It is concerned, however, that the most innovative gene therapy research is currently being done in Europe rather than in the United 

States. The Committee urges the Director to assess the prospects 

for the most promising areas for breakthroughs in this field and to 

develop a program to focus resources on it. The assessment should 

also include the prospects for successes in additional 

hemoglobinopathies and in an even broader range of diseases. 

Hereditary hemorrhagic telangiectasia.—Hereditary hemorrhagic 

telangiectasia (HHT), also known as Osler-Weber-Rendu Syndrome, 

is a multi-system vascular genetic disorder producing blood vessel 

malformations in the brain and lung which may result in stroke, 

hemorrhage, aneurysm and death. Sudden death or disability may 

occur in twenty percent of children and adults, but is largely preventable with proper intervention. Because this is a multi-system 

disorder, the Committee encourages the Director to formulate an 

NIH-wide research agenda with the participation of the NHLBI, 

NINDS and NIDDK Institutes. 

Osteoporosis.—The Committee is pleased that the Surgeon General has submitted the report on bone health requested in the FY 

2002 appropriations bill. The Surgeon General’s report on bone 

health and osteoporosis comes at a critical time when the aging 

population of the United States faces an increasing burden of musculoskeletal disease and disability. Osteoporosis, which the report 

recognizes will affect one in two Americans over the age of 50 by 

2020, will lead to disability, loss of independence and early mortality. The Surgeon General calls for a national action plan to 

achieve improved bone health. To this end, the Committee encourages NIH to establish a ‘‘Bone Health Research Blueprint’’ to 

achieve the Surgeon General’s objectives through enhanced cooperation between NIH institutes. The Blueprint should place particular emphasis on osteoporosis, osteogenesis imperfecta, Paget’s 

disease, other metabolic bone diseases and rare bone disorders such 

as osteopetrosis. The Committee requests a report on the status of 

the Bone Health Blueprint by March 1, 2006. 

Human tissue supply.—The Committee remains interested in 

matching the increased needs of NIH grantees and intramural researchers who rely upon human tissues and organs to study disease and search for cures. The Committee is aware that NIH has 

established a multi-institute initiative on human tissue supply. 

While this is promising, there is still an unmet demand for the use 

of human tissue in research. The Committee encourages the Director to strengthen the core support for this initiative and to broaden 

its scope to other Institutes such as NCI, NHLBI, and NINDS that 

have not previously participated in the initiative’s core support. 

Minority health professions schools.—The Committee continues to 

be pleased with the NIH Director’s implementation of various programs focused on developing research infrastructure at minority 

health professions institutions, including Research Centers at Minority Institutions and the National Center on Minority Health and 

Health Disparities. The Committee encourages the NIH Director to 

work closely with the Director of the NCMHD to establish a program of coordination among these mechanisms to partner with minority health professions schools to address their infrastructure 

needs. 

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Down syndrome.—The Committee urges the Director of NIH to 

establish an NIH Down syndrome research task force on cognition 

to develop a strategic plan for genetic and neurobiological research 

relating to the cognitive dysfunction and the progressive late-life 

dementia associated with Down syndrome. The purpose of the strategic plan is to provide a guide for coordinating Down syndrome research on cognition across NIH and for enhancing the development 

of new research efforts based on identification of areas of greatest 

scientific opportunity, especially as they relate to the development 

of future treatments. The plan should include short, intermediate 

and long-term goals for basic and clinical research with strategies 

for achieving goals and with specified timeframes for implementation. The Committee expects the NIH to report to the Committee 

by April, 2006 on the steps it is taking to develop a down syndrome 

research task force on cognition. 

Child abuse and neglect research.—The Committee recognizes the 

magnitude and significance of child abuse and neglect as a serious 

public health problem claiming an estimated 896,000 victims in 

2002, according to data reported by the Department of Health and 

Human Services. The Committee applauds NIH for developing a coordinated research agenda for child abuse and neglect involving 

relevant NIH institutes, including NIMH, NICHD, NIDA, NINR, 

and NIAAA, the Office of Behavioral Social Science and Research 

and other appropriate agencies, and the continued collaborative 

and cooperative efforts in child abuse and neglect research. In response to recommendations in the 1993 National Research Council 

report which examined the current state of research in this area, 

the NIH child abuse and neglect initiative first addressed the 

knowledge gaps in child neglect. The Committee encourages NIH 

to examine current gaps that exist in research on the abuse of children, including research on treatment interventions with substantiated cases of child maltreatment. The Committee requests that 

the Director be prepared to report on current and proposed NIH efforts in this area at the fiscal year 2007 hearings. 

Science education.—The Committee recognizes the success of grid 

computing as used by the Kentucky data research initiative, a partnership between elementary and secondary schools and postsecondary education research institutions to maximize research capabilities through computer resources. With the cooperation of the 

state of Kentucky and its local education agencies, the Kentucky 

data research initiative uses computers in local schools to provide 

additional computing capacity to cancer researchers at the Brown 

Cancer Center at the University of Louisville. During the hours the 

computers are not used, the excess computing capacity is harnessed 

so that cancer researchers in Louisville have a greater capacity to 

do more complex research. In exchange for the expanded research 

capabilities, scientists visit the schools to discuss their research to 

provide support for students interested in math and science. The 

Committee recognizes the success that this program has had in exposing students in elementary and high schools to careers in 

science and increasing the state’s capacity for cancer research. The 

Committee encourages the Office of Science Education within the 

Office of the Director to review the Kentucky program as a possible 

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search capabilities in the sciences and health-related fields or other 

appropriate fields of research. 

PubChem.—The Committee understands that the stated mission 

of the PubChem database, which is part of the NIH Roadmap Initiative, is to create a new and comprehensive database of chemical 

structures and their biological activities, and will house both compound information from the scientific literature as well as screening and probe data from the new NIH molecular libraries screening 

center network. The Committee is concerned that NIH is replicating scientific information services that already exist in the private sector. In order to properly focus PubChem, the Committee 

urges NIH to work with private sector providers to avoid unnecessary duplication and competition with private sector chemical databases. 

Neuroscience and the genome.—The Committee understands 

there are exciting developments in the field of neuroscience where 

integrating genomic-based methodologies with computer science 

and traditional neuroanatomy is being supported by private philanthropic (or voluntary could be used here) support. These developments could result in advancing our knowledge along a broad front 

of neurologic, psychiatric and neurodegenerative diseases, their 

causes and cures. NIH is encouraged to collaborate with these efforts in a public-private partnership as espoused in the Roadmap 

initiative or other appropriate mechanisms. 

Amyloidosis.—The Committee encourages NIH to intensify its research efforts into the amyloidoses, a group of rare diseases characterized by abnormally folded protein deposits in tissues. These diseases are often fatal and there is no known cure. Treatment involving large-dose intravenous chemotherapy followed by stem cell replacement or rescue is effective for many patients, but this procedure is risky, unsuitable for many patients, and not a cure. The 

Committee understands that NIH will be holding one or more conferences on amyloidosis and related diseases during 2005, and 

looks forward to receiving the results and recommendations (as requested in the FY 2005 Committee report) identifying the next 

steps that need to be taken to increase the understanding, prevention and treatment of this devastating group of diseases.

BUILDINGS AND FACILITIES

The Committee provides $81,900,000 for buildings and facilities, 

which is $28,388,000 below the fiscal year 2005 comparable level 

and the same as the Administration request. 

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 77 buildings on the main NIH campus in Bethesda, Maryland; the Animal Center in Poolesville, 

Maryland; the National Institute of Environmental Health Sciences 

facility in Research Triangle Park, North Carolina; and other 

smaller facilities throughout the United States. 

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SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES

The Committee provides a program level of $3,352,047,000 for 

the Substance Abuse and Mental Health Services Administration 

(SAMHSA), which is $39,722,000 below the fiscal year 2005 comparable level and $16,024,000 above the budget request. Within the 

total, $121,303,000 is provided through the evaluation set-aside as 

requested. 

SAMHSA is responsible for supporting mental health and alcohol 

and drug abuse prevention and treatment services nationwide 

through discretionary targeted capacity expansion and knowledge 

application grants, formula block grants to the States and associated technical assistance efforts. The agency consists of three principal centers: the Center for Mental Health Services, the Center for 

Substance Abuse Treatment, and the Center for Substance Abuse 

Prevention. The Office of the Administrator is responsible for overall agency management. 

The Committee expects that no less than the amounts allocated 

in fiscal year 2005 will be spent in fiscal year 2006 for activities 

throughout SAMHSA that are targeted to address the growing 

HIV/AIDS epidemic and its disparate impact on communities of 

color, including African Americans, Latinos, Native Americans, 

Asian Americans, Native Hawaiians, and Pacific Islanders. These 

activities include treatment of mental health disorders related to 

HIV disease and expansion of service capacity of substance abuse 

treatment and prevention programs that provide services to highrisk communities of color. 

Greater availability of a rapid HIV test can increase overall HIV 

testing and reduce the number of people, an estimated 225,000 

Americans, who are unaware of their HIV infection. The Committee acknowledges that treatment services provided by mental 

and behavioral health care providers for individuals testing positive are a necessary component of rapid HIV testing. The Committee commends SAMHSA for developing the Rapid HIV Testing 

Initiative (RHTI) to train substance abuse and mental health service providers on rapid HIV testing and prevention counseling. The 

Committee strongly supports the program and provides SAMHSA 

an additional $1 million towards the RHTI. 

The Committee is concerned about the intersection of methamphetamine abuse and the transmission of infectious diseases. 

Methamphetamine is a very dangerous, highly addictive, and toxic 

drug and is strongly linked to risky behaviors, increasing the risk 

of transmissions of infectious diseases such as HIV and Hepatitis 

C. SAMHSA and the Centers for Disease Control and Prevention 

(CDC) have funded crucial programs in methamphetamine prevention and treatment and infectious disease prevention and treatment programs, but there exists a gap on collaboration between the 

two agencies. Recognizing that CDC and SAMHSA have different 

responsibilities in responding to this epidemic, the Committee directs CDC and SAMHSA to draft a list of priorities to address the 

intersections of these two epidemics and to jointly provide a written 

report by April 1, 2006 designating a coordinating plan between 

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nity involvement representing populations at high-risk to coordinate prevention, community outreach, professional training, treatment and new and existing grant programs to effectively address 

the intersection of the crystal methamphetamine epidemic and rising HIV rates. The Committee then requests that the CDC and 

SAMHSA report on the effectiveness of the new plan by February 

2007. 

The Asian American and Pacific Islander (AAPI) population on 

the continental U.S., Hawaii, and the six Pacific Island jurisdictions are one of the fastest growing groups in the U.S. However, 

there are less than 10 culturally competent comprehensive substance abuse prevention and treatment programs designed to serve 

the AAPI population in the entire United States, and these few 

programs are located in just four states and one Pacific Island jurisdiction. The number and capacity of these comprehensive programs has remained essentially the same for over 15 years. The 

need for substance abuse services for this population continues to 

increase while the gap in the availability and access to culturally 

competent services is ever-widening. For many in this population 

services do not even exist. The Office of National Drug Control Policy found that AAPI parents are the least informed of any group 

regarding the nature and hazards of substance abuse among their 

teenagers. Treatment episodes in some cases have increased by 

over 50% for AAPI clients. SAMHSA should work with appropriate 

National AAPI organizations that provide substance abuse services 

to create a comprehensive system of outreach, training, information 

and resources, and prevention and treatment services that will be 

culturally competent and accessible to all AAPI populations across 

the United States. 

The Committee is concerned about the prevalence of hepatitis 

and substance abuse and urges SAMHSA to work with health organizations to promote education and prevention of both hepatitis 

and substance abuse. 

Center for Mental Health Services 

The Committee provides a program level total of $880,294,000 for 

the Center for Mental Health Services (CMHS), which is 

$21,023,000 below the fiscal year 2005 comparable level and 

$43,044,000 above the budget request. Within the total, 

$21,803,000 is provided through the evaluation set-aside as requested. 

Programs of regional and national significance 

The Committee provides $253,257,000 for mental health programs of regional and national significance, which is $21,040,000 

below the fiscal year 2005 comparable level and $43,044,000 above 

the budget request. The program includes studies that identify the 

most effective service delivery practices, knowledge synthesis activities that translate program findings into useful products for the 

field, and knowledge application projects that support adoption of 

exemplary service approaches throughout the country. 

The Committee provides $26,000,000 for the State incentive 

grants for transformation, the same level as the budget request. At 

this level, eight grants will be continued and three new grants will 

be awarded to States to plan and implement the transformation of 

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their State mental health programs across multiple service systems. These comprehensive State mental health plans will enhance 

the use of existing resources at the State and local levels and expand the options and array of available supports. These grants are 

not intended to provide direct services, but rather are to aid States 

in developing broad systems changes to better serve persons with 

mental illness. 

The Committee provides $84,000,000 for School Violence pro- grams. This is $17,187,000 more than the budget request. At this 

funding level it is the Committee’s intention that additional grants 

will be awarded to school districts with the goals of promoting the 

healthy development of children and youth, fostering their resilience in the face of adversity, and preventing violence. 

Within funds provided, the Committee recommends that no less 

than the funding allocated in fiscal year 2005 be provided in fiscal 

year 2006 for the National Child Traumatic Stress Initiative. This 

program has established 54 treatment development and community 

service centers to treat children who have experienced trauma. It 

is estimated that up to 40,000 traumatized children and their families will directly benefit from services delivered as a result of this 

initiative. 

The mental health needs of our Nation’s seniors are largely ignored within our mental health system. While many older Americans experience depression, dementia, anxiety and substance abuse 

disorders, far too often these conditions are not recognized or treated. Outreach to elderly persons conducted in places frequented by 

seniors, such as senior centers, meal sites, primary care settings 

and other locations, is needed. The Elderly Treatment and Outreach Program is the only federally funded services program dedicated specifically to the mental health care of older adults. It is for 

this reason that within the funds provided, the Committee recommends that no less than the level allocated in fiscal year 2005 

be allocated for the older adults program. 

Within funds provided, the Committee recommends that no less 

than level allocated in fiscal year 2005 be provided for grants for 

jail diversion programs. This program provides grants to States or 

localities, Indian tribes, and tribal organizations, acting directly or 

through agreements with other public or nonprofit entities, to develop and implement programs to divert individuals with a mental 

illness from the criminal justice system to community-based services. 

Preliminary data collected by the Centers for Disease Control 

and Prevention’s National Violent Death Reporting System reports 

a 5% increase in suicides for 2003. Comprehensive data from the 

2002 survey indicate that the rate of suicides among youth is growing faster than any other age cohort. In order to address this, the 

Committee recommends that within the funding provided, programs that address youth suicide prevention strategies be funded 

in fiscal year 2006 at no less than the amounts allocated in fiscal 

year 2005. 

The estimated number of AIDS cases from 1999 to 2003 has increased for racial and ethnic minorities, including African Americans, Latino/as, Asian Pacific/Islanders and American Indians/Alaska Natives. The Committee recognizes that many persons with HIV 

have a psychological and/or substance abuse disorder and that 

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mental health and substance abuse services can help stabilize the 

health and well-being of persons with HIV/AIDS. The Committee 

acknowledges that racial and ethnic minorities have less access 

and lower utilization of mental health and substance abuse services. The Committee recommends that no less than the level provided in fiscal year 2005 be allocated for the Minority AIDS Initiative to provide competent and accessible mental health and substance abuse services to persons of color living with HIV/AIDS. 

Over the last three years, collaboration between the Departments 

of Housing and Urban Development (HUD) and Health and Human 

Services (HHS) on homeless policy has improved through joint efforts such as the Policy Academies, which provide training for 

State officials on accessing mainstream resources for homeless people and the 2003 Collaborative Initiative to Help End Chronic 

Homelessness, a $55 million HUD, HHS, and Veterans Administration effort that has housed over 550 chronically homeless persons 

in 11 communities across the country. Although the fiscal year 

2006 budget request did not include a direct funding request within 

HHS for the Samaritan Initiative, the Committee encourages 

SAMHSA to continue to collaborate with HUD in sharing best 

practices information and in discussing ways in which resources 

can be maximized toward the goal of ending chronic homelessness. 

Mental health block grant 

The Committee provides a program level total of $432,756,000 for 

the mental health block grant, which is the same as the fiscal year 

2005 comparable level and the budget request. The block grant provides funds to States to support mental health prevention, treatment, and rehabilitation services. Funds are allocated according to 

statutory formula among the States that have submitted approved 

annual plans. The Committee notes that the mental health block 

grant funding represents less than 2 percent of total State mental 

health funding and less than 3 percent of State community-based 

mental health services. Within the total, $21,803,000 is provided 

through the evaluation set-aside as requested. 

The Community Mental Health Services Block Grant Program 

distributes funds to 59 eligible States and Territories through a formula based upon specified economic and demographic factors. Applications must include an annual plan for providing comprehensive community mental health services to adults with a serious 

mental illness and children with a serious emotional disturbance. 

Because the mental health needs of our Nation’s elderly population 

are often not met by existing programs and because the need for 

such services is dramatically and rapidly increasing, the Committee recommends that SAMHSA require that States’ plans include specific provisions for mental health services for older adults. 

Children’s mental health 

The Committee provides $105,129,000 for the grant program for 

comprehensive community mental health services for children with 

serious emotional disturbance, which is $17,000 above the fiscal 

year 2005 comparable level and the same as the budget request. 

Funding for this program supports grants and technical assistance 

for community-based services for children and adolescents up to 

age 22 with serious emotional, behavioral, or mental disorders. The 

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program assists States and local jurisdictions in developing integrated systems of community care. Each individual served receives 

an individual service plan developed with the participation of the 

family and the child. Grantees are required to provide increasing 

levels of matching funds over the six-year grant period. 

Grants to states for the homeless (PATH) 

The Committee provides $54,809,000 for the grants to States for 

the homeless (PATH) program, which is the same as the fiscal year 

2005 comparable level and the budget request. PATH grants to 

States provide 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 

The Committee provides $34,343,000 for the protection and advocacy program, which is the same as the budget request and the fiscal year 2005 comparable level. This funding is distributed to 

States according to a formula based on population and income to 

assist State-designated independent advocates to provide legal assistance to mentally ill individuals during their residence in Stateoperated facilities and for 90 days following their discharge. 

Center for Substance Abuse Treatment 

The Committee provides a program level total of $2,184,986,000 

for the Center for Substance Abuse Treatment (CSAT), which is 

$12,935,000 below the fiscal year 2005 comparable level and 

$37,621,000 below the budget request. Within the total, 

$83,500,000 is provided through the evaluation set-aside as requested. 

The Committee has concerns that people who are seeking substance abuse treatment are unable to access services due to the 

lack of an adequate clinical treatment workforce. People seeking 

treatment often have to wait for weeks or months before they are 

accepted into a treatment facility. The Committee requests that 

SAMHSA issue a report, after consultation with stakeholders and 

other Federal partners, on workforce development for substance 

abuse treatment professionals. The report should focus on both the 

recruitment and retention of counselors and on improving the skills 

of those already providing services as well as ways in which States 

can play a role. The Committee requests that this report be transmitted to the House and Senate Committees on Appropriations by 

March 1, 2006. 

The Committee is concerned about the incidence of drug addiction among pregnant and parenting women. The National treatment infrastructure has not kept pace with the demand or complexity of needs experienced by women and their children. Familybased substance abuse treatment, which addresses the needs of a 

parent, typically a mother, and her children, represents less than 

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mittee believes that increased capacity for family-based treatment 

programs is imperative. Increased family treatment capacity ensures child well-being, family stabilization, and healthy communities. 

Programs of regional and national significance 

The Committee provides a program level total of $409,431,000 for 

substance abuse treatment programs of regional and national significance, which is $12,935,000 below the fiscal year 2005 comparable level and $37,621,000 below the budget request. Within the 

total, $4,300,000 is provided through the evaluation set-aside as requested. The program supports activities to improve the accountability, capacity and effectiveness of substance abuse treatment 

services and services delivery. These activities include targeted capacity expansion initiatives to help communities respond to serious, 

emerging and unmet treatment needs and best practices initiatives 

to translate science into services through monitoring and accreditation of treatment programs, training, dissemination and knowledge 

application activities. The program promotes the adoption of 

science- and evidence-based treatment practices by developing and 

field-testing new treatment models in order to facilitate the provision of quality treatment services and service delivery. These activities are undertaken in actual service settings rather than laboratories and results are disseminated to State agencies and community treatment providers. The goal is to promote continuous, 

positive treatment service delivery change for those people who use 

and abuse alcohol and drugs. The Committee provides $99,200,000 for the Access to Recovery 

(ATR) substance abuse treatment voucher initiative; this is the 

same as the fiscal year 2005 level and $50,800,000 below the budget request. To the extent possible the Committee encourages 

SAMHSA to provide training and technical assistance to both current State grantees to enhance their programs and share best practices with States that are interested in establishing substance 

abuse treatment voucher programs in the future. In addition, the 

Committee expects that addictive disorder clinical treatment providers participating in the Access to Recovery program shall meet 

the certification, accreditation, and/or licensing standards recognized in their respective States. 

Within the funds provided, the Committee recommends 

$30,797,000 for the Screening, Brief Intervention, Referral, and 

Treatment (SBIRT) program as requested. This competitive grant 

program assists States, territories, and Tribes in targeting non-dependent drug users and is designed to avert the progression of patients from chronic substance abuse problems. The SBIRT program 

works in primary and general care settings to identify patients in 

need of treatment and to provide them with appropriate intervention and treatment options. 

Within the funds provided, the Committee has included 

$8,166,000 to maintain the funding at last year’s level for the Addiction Technology Transfer Centers. The Addiction Technology 

Transfer Centers (ATTC) program is a Nation-wide, multi-disciplinary resource that provides the latest science-based addiction information to treatment providers in community and faith-based agencies. The ATTCs develop an addiction workforce of competent 

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healthcare and related professionals reflective of the treatment 

population. 

Substance abuse prevention and treatment block grant 

The Committee provides a program level total of $1,775,555,000 

for the substance abuse prevention and treatment (SAPT) block 

grant, which is the same as the fiscal year 2005 comparable level 

and the budget request. Within the total, $79,200,000 is provided 

through the evaluation set-aside as requested. The substance abuse 

block grant provides funds to States to support alcohol and drug 

abuse prevention, treatment, and rehabilitation services. Funds are 

allocated among the States according to a statutory formula. State 

applications including comprehensive State Plans must be approved annually by SAMHSA as a condition of receiving funds. 

The Committee expresses its strong support for the SAPT block 

grant as the foundation of our publicly funded substance abuse system. The SAPT block grant, which provided support to over 10,500 

community-based organizations in 2001, distributes formula-based 

funding to every State and territory. The authorizing statute includes certain funding set-asides, including a 20 percent set-aside 

for prevention, an HIV/AIDS early intervention set-aside, and others. The overall goal of the block grant is to support and expand 

substance abuse prevention and treatment services, while providing maximum flexibility to the States. The SAPT block grant is 

vital given that SAMHSA found that in 2003, approximately 22 

million Americans abuse or are dependent upon alcohol, drugs or 

both and need some level of treatment service. 

Center for substance abuse prevention 

Programs of regional and national significance

The Committee provides $194,950,000 for the substance abuse 

prevention programs of regional and national significance, which is 

$10,601,000 above the budget request and $3,775,000 below the fiscal year 2005 comparable level. The program identifies and disseminates evidence-based substance abuse prevention approaches. 

Program management 

The Committee provides a program level total of $91,817,000 for 

program management, of which $16,000,000 is provided through 

the evaluation set-aside as requested. The fiscal year 2006 program 

level is $1,989,000 below the fiscal year 2005 comparable level and 

the same as the budget request. The appropriation provides funding to coordinate, direct, and manage the agency’s programs. Funds 

are used for salaries, benefits, space, supplies, equipment, travel 

and overhead. 

AGENCY FOR HEALTHCARE RESEARCH AND QUALITY

The Committee provides a total of $318,695,000 for the Agency 

for Healthcare Research and Quality (AHRQ), which is the same as 

the comparable fiscal year 2005 level and the budget request. Fiscal year 2006 support is provided by the Committee in budget authority, while the fiscal year 2005 level and the fiscal year 2006 

budget request are provided in program evaluation tap funding. 

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The mission of the agency is to generate and disseminate information that improves the delivery of health care. Its research goals 

are to determine what works best in clinical practice; improve the 

cost-effective use of health care resources; help consumers make 

more informed choices; and measure and improve the quality of 

care. 

The Committee provides $260,695,000 for research on health 

costs, quality, and outcomes, which is the same as the fiscal year 

2005 comparable level and the budget request. This program identifies the most effective and efficient approaches to organize, deliver, finance, and reimburse health care services; determines how 

the structure of the delivery system, financial incentives, market 

forces, and better information affects the use, quality, and cost of 

health services; and facilitates the translation of research findings 

for providers, patients, plans, purchasers, and policymakers. It also 

funds research that determines what works best in increasing the 

cost effectiveness and appropriateness of clinical practice; supports 

the development of tools to measure and evaluate health outcomes, 

quality of care, and consumer satisfaction with health care system 

performance; and facilitates the translation of information into 

practical uses through the development and dissemination of research databases. 

Within the total for research on health costs, quality, and outcomes, the Committee provides $84,000,000 for reducing medical 

errors, which is the same as the fiscal year 2005 comparable level 

and the budget request. This amount includes $50,000,000 for 

grants to support the health information technology initiative. The 

Committee urges AHRQ to play a key role in the initiative being 

developed in the Office of the National Coordinator for Health Information Technology. The Committee encourages AHRQ to conduct pilot projects to demonstrate the feasibility and value of 

standards-based electronic health care data interchange. 

Within the total for research on health costs, quality and outcomes, the Committee provides $15,000,000 for comparative clinical 

effectiveness research. This is the same as the fiscal year 2005 

comparable level and the budget request. 

The Committee is aware that a number of medical schools and 

medical centers in the U.S. are using high-tech patient simulators 

or medical simulators to improve doctor training, especially surgical and emergency room training. The Committee is also aware 

that AHRQ has a series of projects underway to evaluate the use 

of such simulators. The Committee strongly encourages AHRQ to 

continue these efforts and to expand them if necessary in order to 

evaluate effectively the utility of simulators in improving patient 

care and medical training, and decreasing medical mistakes. 

The Committee is pleased that AHRQ is studying care issues associated with patients who suffer from Duchenne muscular dystrophy. The Committee suggests that AHRQ build on this work by 

partnering with CDC to convene a consensus conference to develop 

these standards. 

The Committee supports the inter-agency agreement between 

AHRQ and the National Center on Birth Defects and Developmental Disabilities at CDC to examine clinical treatment and improve quality of care of patients with spina bifida. 

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The Committee is concerned about the prevalence of undiagnosed 

and untreated mental illness among older Americans. Affective disorders, including depression, anxiety, dementia, and substance 

abuse and dependence, are often misdiagnosed or not recognized at 

all by primary and specialty care physicians in their elderly patients. Research has shown that the treatment of mental illness 

can improve health outcomes for those with other chronic diseases. 

While effective treatments for these conditions are available, there 

is an urgent need to translate advancements from biomedical and 

behavioral research to clinical practice. The Committee encourages 

AHRQ to support evidence-based research projects focused on the 

diagnosis and treatment of mental illnesses in the geriatric population, and to disseminate evidence-based reports to physicians and 

other health care professionals. 

Despite the Healthy People 2010 recommendations to decrease 

primary cesarean section rates to 15 percent and repeat cesarean 

section rates to 63 percent, the Committee is aware that rates of 

primary elective cesarean section are progressively increasing and 

that vaginal birth after cesarean rates are steadily decreasing. The 

Committee encourages AHRQ to conduct a comprehensive metaanalysis of the best available research studies comparing short and 

long term risks for mothers and babies of cesarean versus vaginal 

birth and requests that AHRQ report back to the Committee with 

this information by next year. The Committee provides $55,300,000 for the Medical Expenditures Panel Surveys (MEPS), which is the same as the fiscal year 

2005 comparable level and the budget request. The MEPS provide 

data for timely national estimates of health care use and expenditures, private and public health insurance coverage, and the availability, costs, and scope of private health insurance benefits. This 

activity also provides data for analysis of changes in behavior as 

a result of market forces or policy changes on health care use, expenditures, and insurance coverage; develops cost/savings estimates of proposed changes in policy; and identifies the impact of 

changes in policy for subgroups of the population. 

For program support, the Committee provides $2,700,000 which 

is the same as fiscal year 2005 level and the budget request. This 

activity supports the overall direction and management of the 

agency. 

CENTERS FOR MEDICARE AND MEDICAID SERVICES

GRANTS TO STATES FOR MEDICAID

The Committee provides $156,954,419,000 for the Federal share 

of current law State Medicaid costs, which is $33,175,400,000 

above the fiscal year 2005 comparable level and the same as the 

budget request. This amount does not include $58,517,290,000 

which was advance funded in the fiscal year 2005 appropriation. In 

addition, the Committee provides an advance appropriation of 

$62,783,825,000 for program costs in the first quarter of fiscal year 

2007. The Committee has also included indefinite budget authority 

for unanticipated costs in fiscal year 2006. Fiscal year 2006 funding 

increases by $22,910,000,000 to shift the program to accrual accounting by making a one-time adjustment for incurred but not reported obligations. 

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Federal Medicaid grants reimburse States for 50 to 83 percent 

(depending on per capita income) of their expenditures in providing 

health care for individuals whose income and resources fall below 

specified levels. Subject to certain minimum requirements, States 

have broad authority within the law to set eligibility, coverage, and 

payment levels. Over 46 million low-income individuals will receive 

health care services in 2006 under the Medicaid program. State 

costs of administering the program are matched at rates that generally range from 50 to 90 percent, depending upon the type of cost. 

Total funding for Medicaid includes $1,502,333,000 for the entitlement Vaccines for Children program. These funds, which are transferred to the Centers for Disease Control and Prevention for administration, support the costs of immunization for children who 

are on Medicaid, uninsured or underinsured and receiving immunizations at Federally qualified health centers or rural health clinics. 

The Committee is concerned that by permitting manufacturers to 

exclude ‘‘authorized generics’’ for purposes of best price calculations 

under the Medicaid Rebate Program, CMS and States may be losing millions of dollars in rebates. Therefore, the Committee encourages CMS to review its practices with respect to Medicaid rebate 

calculations. Specifically, CMS should evaluate best price calculations to ensure the Medicaid Rebate Program is properly reimbursed by manufacturers that produce brand name pharmaceuticals and their authorized generics. 

The Committee is aware that Oklahoma hospitals are in an overpayment dispute with CMS regarding disproportionate share settlement payments. The Committee strongly urges the parties involved in this dispute to come to a timely resolution. 

The Committee is aware of an issue regarding the definition of 

‘‘hospital costs’’ incurred by the Commonwealth of Virginia for purposes of Medicaid reimbursement to the Commonwealth, and urges 

CMS to work with the Commonwealth to resolve the pending issue. 

PAYMENTS TO HEALTH CARE TRUST FUNDS

The Committee provides $177,742,200,000 for the Payments to 

the Health Care Trust Funds account, which is $63,133,300,000 

above the fiscal year 2005 comparable level and $80,000,000 lower 

than the budget request. The significant funding increase is due to 

the costs of the new prescription drug benefit. This entitlement account includes the general fund subsidy to the Federal Supplementary Medical Insurance Trust Fund for Medicare Part B benefits and for Medicare drug benefits and administration as well as 

other reimbursements to the Federal Hospital Insurance Trust 

Fund for benefits and related administrative costs, which have not 

been financed by payroll taxes or premium contributions. Funds 

were not provided for the reimbursement for Health Care Fraud 

and Abuse Control, since the Committee did not fund this new account. The Committee includes bill language requested by the Administration providing indefinite authority for paying the general 

revenue portion of the Part B premium match and provides resources for the Part D drug benefit program in the event that the 

annual appropriation is insufficient. 

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PROGRAM MANAGEMENT

The Committee makes available $3,180,284,000 in trust funds for 

Federal administration of the Medicare and Medicaid programs, 

which is $515,373,000 above the fiscal year 2005 comparable level 

and $2,806,000 above the budget request. Fiscal year 2006 is the 

first year that the administrative costs for the Medicare Modernization Act are scored to this account, rather than being directly 

funded through the authorization. The Administration request includes $560 million for these activities. 

Research, demonstration, and evaluation 

The Committee provides $65,000,000 for research, demonstration 

and evaluation, which is $12,494,000 below the fiscal year 2005 

comparable level and $19,806,000 above the budget request. These 

funds support a variety of studies and demonstrations in such 

areas as monitoring and evaluating health system performance; improving health care financing and delivery mechanisms; modernization of the Medicare program; the needs of vulnerable populations 

in the areas of health care access, delivery systems, and financing; 

and information to improve consumer choice and health status. 

Medicare operations 

The Committee provides $2,172,987,000 to support Medicare 

claims processing contracts, which is $450,003,000 above the fiscal 

year 2005 comparable level and $17,000,000 below the budget request. 

Medicare contractors partner with the Federal government to administer the Medicare fee-for-service program. Contractors pay 

over one billion Medicare fee-for-service claims annually, are the 

first line of defense against Medicare fraud, and are the primary 

contact for Medicare providers and beneficiaries. Without adequate 

funding, contractors are not able to pay claims, respond to beneficiary and provider inquiries timely, and effectively combat fraud 

and abuse. The Committee is pleased CMS eliminated the five percent cap on transferring funds among Medicare functions so that 

contractors have greater flexibility to manage their budgets in a 

manner that best matches program requirements. Budget flexibility is important to Medicare contractors, particularly in a tight 

funding environment. The Committee strongly recommends CMS 

give Medicare Contractors and Program Safeguard Contractors 

greater flexibility to manage their Medicare Integrity Program 

(MIP) funding in a manner that best matches program requirements including increases in workload. The Committee expects 

CMS to report on its plans to provide this flexibility to contractors 

in its fiscal year 2007 congressional justification. 

Revitalization plan 

The Committee provides $24,205,000 to remain available for two 

years, as the third year of investment in CMS’s efforts to make significant improvements to key aspects of managing both the agency 

and the Medicare program. This amount is the same as the budget 

request and fiscal year 2005 comparable level. Funding will target 

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service claims processing, modernization of the data environment, 

and reduction of the CMS security perimeter. 

State survey and certification 

The Committee provides $260,735,000 for State inspections of facilities serving Medicare and Medicaid beneficiaries, which is 

$2,000,000 above the fiscal year 2005 comparable level and the 

same as the budget request. 

Survey and certification activities ensure that institutions and 

agencies providing care to Medicare and Medicaid beneficiaries 

meet Federal health, safety and program standards. On-site surveys are conducted by State survey agencies, with a pool of Federal 

surveyors performing random monitoring surveys. Almost 76,000 

surveys and complaint investigations will be performed in fiscal 

year 2006. 

Federal administration 

The Committee provides $657,357,000 to support Federal administrative activities related to the Medicare and Medicaid programs, 

which is $75,864,000 above the fiscal year 2005 comparable level 

and the same as the budget request. The substantial increase over 

fiscal year 2005 is due to the costs of implementing the Medicare 

Modernization Act, which is being charged to this account for the 

first time rather than the authorizing bill. This amount includes 

$13,000,000 for the Healthy Start, Grow Smart program as requested by the Administration. The Committee includes language 

requested by the Administration that is similar to language in last 

year’s enacted bill to identify $79,934,000 for the contract costs of 

the Health-care Integrated General Ledger Accounting System. 

The Medicare, Medicaid, and Children’s Health Insurance programs ensure the health care security of over 85 million beneficiaries. The Federal Administration budget provides funds for the 

staff and operations of CMS to administer these programs. 

While CMS has initiated a commendable and important partnership with the State Health Insurance Programs (SHIPs) to facilitate the initiation of the new Medicare Part D drug benefit and the 

transition of the 6.5 million dually eligible beneficiaries from Medicaid prescription coverage to the Medicare drug benefit, considerable evidence indicates that low-income dual eligible persons with 

mental disabilities will need direct help with Part D enrollment decisions and both pharmaceutical and formulary changes. The Committee urges CMS to support one-on-one pharmaceutical benefits 

counseling through community-based organizations and safety net 

mental health providers, if endorsed by these groups, in order to 

address this need. 

The Committee is pleased that The Quality of Life Chemotherapy 

Demonstration project, included in the Medicare Modernization 

Act, is underway. This one-year demonstration project will provide 

a better understanding from cancer patients receiving chemotherapy on such important issues as their pain control management, minimization of nausea and vomiting, and the reduction of 

fatigue. The Committee is concerned that CMS has excluded oral 

chemotherapy patients from being included in the demonstration’s 

data collection. Regardless of the method of administering chemotherapy, the quality of life issues facing cancer patients are equally 

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important. To gather a complete understanding of the quality of 

life issues impacting cancer patients, the Committee encourages 

CMS to permit physicians to collect quality of life data from patients receiving oral chemotherapy and to do so under the same 

guidelines to the extent possible as prescribed under the Quality of 

Life project.

The Committee remains concerned about regulatory burdens on 

health care providers, which not only divert the time that can be 

spent on active patient care, but also impose large financial burdens on the health care industry. The Committee requests CMS to 

report to the Committee by no later than March 1, 2006, on the 

regulatory burdens, identified by MedPAC in its December 2001 report to Congress, that were not addressed within the Medicare 

Modernization Act. As part of this report, the Committee requests 

CMS to examine the prevalence and burden of CMS regulations, 

whether in effect or under development, that have no statutory requirement. The Committee supports MedPAC’s recommendation 

that providers and plans with sustained good performance should 

receive reductions from CMS in routine administrative compliance 

measures, and urges CMS to move forward in implementing this 

regulatory flexibility. 

The Committee requests that CMS report to the Committee what 

the expected annual costs, both administrative and programmatic, 

are for the revised Medicare obesity coverage policy announced in 

July, 2004. 

HEALTH CARE FRAUD AND ABUSE CONTROL

The Committee was not able to provide funding for this new dis- cretionary account. The Administration had requested $80,000,000 

as a contingent appropriation, with the funding to be made available as an adjustment to the 302(a) allocation for the Appropriations Committee. The conference budget resolution did not permit 

this scorekeeping adjustment. The Committee notes that 

$720,000,000 is available to CMS as a permanent appropriation for 

the Medicare Integrity Program, which will be available for the 

purposes of the proposed program. 

ADMINISTRATION FOR CHILDREN AND FAMILIES

PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND

FAMILY SUPPORT PROGRAMS

The Committee provides $2,121,643,000 for the Child Support 

Enforcement and Family Support programs, the same as the budget request. The bill also provides $1,200,000,000 in advance funding for the first quarter of fiscal year 2007 to ensure timely payments for the child support enforcement program, the same as the 

request. The bill provides estimated funding of $33,000,000 for 

Payments to Territories, $10,000,000 above the fiscal year 2005 

level and the same as the budget request. The bill provides 

$1,300,000 for the repatriation program, $300,000 more than the 

fiscal year 2005 level and the same as the budget request. 

LOW-INCOME HOME ENERGY ASSISTANCE

The Committee provides an appropriation of $1,984,799,000 for 

the Low-Income Home Energy Assistance State formula grants. 

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This is $100,000,000 more than the fiscal year 2005 comparable 

level and $184,799,000 above the budget request. The Committee 

provides all of these funds through the regular formula program 

and does not include funding for the contingent emergency reserve. 

The budget request included $1,800,000,000 in formula grants and 

$100,000,000 in contingent emergency funding. 

The low-income home energy assistance program (LIHEAP) provides assistance to low-income households to help pay the costs of 

home energy. Funds are provided through grants to States, Indian 

Tribes and territories, and are used for summer cooling and winter 

heating/crisis assistance programs. 

The Committee is concerned that rising natural gas prices are 

limiting the effectiveness and impact of LIHEAP. While American 

consumers pay the highest natural gas prices in the world, the rest 

of the world, on average, pays many times less per thousand cubic 

feet for natural gas. The Committee directs that not less than 150 

days after the date of enactment of this Act the Secretary of Health 

and Human Services shall submit a report on the estimated percentage of LIHEAP funds currently expended to assist consumers 

with natural gas bills; the degree to which this percentage will rise 

relative to future increases in the price of natural gas paid by 

American consumers; and the degree to which additional consumers may be served by LIHEAP should Congress enact policy 

changes which cause domestic natural gas prices to decrease in the 

future by 5 percent, 10 percent, 20 percent, or 50 percent. 

REFUGEE AND ENTRANT ASSISTANCE

The Committee provides $560,919,000 for refugee assistance programs. This is $76,525,000 more than the fiscal year 2005 comparable level and $8,879,000 more than the budget request. 

In addition, the bill provides the Office of Refugee Resettlement 

(ORR) the authority to carry over unexpended funds from fiscal 

year 2006 to reimburse the costs of services provided through September 30, 2008 for all programs within ORR’s jurisdiction. 

Transitional and medical services 

The Committee provides $264,129,000 for transitional and medical services. This is $72,101,000 more than the fiscal year 2005 

comparable level and the same as the budget request. The transitional and medical services program provides funding for the Stateadministered cash and medical assistance program that assists refugees who are not categorically eligible for TANF or Medicaid, the 

unaccompanied minors program that reimburses States for the cost 

of foster care, and the voluntary agency grant program in which 

participating National refugee resettlement agencies provide resettlement assistance with a combination of Federal and matched 

funds. 

Victims of trafficking 

The Committee provides up to $9,915,000 for the victims of trafficking program. This is the same as the fiscal year 2005 comparable level and the budget request. The funds will ensure continued administration of a National network for identification, tracking and certification of trafficking victims. 

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Social Services 

The Committee provides $160,000,000 for social services. This is $8,879,000 more than the budget request and $4,888,000 less than 

the fiscal year 2005 comparable level. Funds are distributed by formula as well as through the discretionary grant making process for 

special projects. The Committee intends that funds provided above 

the request shall be used for Refugee School Impact Grants and for 

additional assistance in resettling and meeting the needs of the 

Hmong refugees expected to arrive during 2006 and 2007. 

Within the funds provided, the Committee has included $19,000,000 for support to communities with large concentrations 

of Cuban and Haitian entrants of varying ages whose cultural differences make assimilation especially difficult, justifying a more intense level and longer duration of Federal assistance. 

Preventive health 

The Committee provides $4,796,000 for preventive health services. This is the same as the fiscal year 2005 comparable level and 

the budget request. These funds are awarded to the States to ensure adequate health assessment activities for refugees. 

Targeted assistance 

The Committee provides $49,081,000 for the targeted assistance 

program. This is the same as the fiscal year 2005 comparable level 

and the budget request. These grants provide assistance to areas 

with high concentrations of refugees. 

Unaccompanied minors 

The Committee provides $63,083,000 for the unaccompanied mi- nors program. This is $9,312,000 more than the fiscal year 2005 

comparable level and the same as the budget request. The program 

is designed to provide for the care and placement of unaccompanied 

alien minors who are apprehended in the U.S. pending resolution 

of their claims for relief under U.S. immigration law or released to 

an adult family member or responsible adult guardian. 

The Committee urges the Office of Refugee Resettlement (ORR) 

to maintain the privacy and confidentiality of all information gathered in the course of the care, custody and placement of unaccompanied alien children consistent with ORR’s role and responsibility 

under the Homeland Security Act to act as guardian in loco 

parentis in the best interests of the unaccompanied alien child. 

ORR should consider the needs and privacy of these children to 

guarantee the confidentiality of their information in order to be 

trusting and truthful to ORR, clinicians, and its agents for purposes of receiving appropriate quality care and placement services. 

The Committee urges ORR to allow individual abused, abandoned or neglected children in its custody, when appropriate, to access State dependency proceedings for ultimate care and placement 

in State foster care or under legal guardianship as a necessary 

predicate for their eligibility for special immigrant juvenile status. 

The Committee encourages ORR to fund pilot programs to study 

and assess the benefits of providing pro bono counsel to children 

in ORR custody. The Committee also encourages ORR to give high 

priority to the availability of pro bono legal counsel when selecting 

facilities for housing unaccompanied children in ORR custody. 

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The Committee understands that ORR carried out a successful 

pilot program in Chicago, Illinois through Heartland Alliance on 

the benefits of child advocates for unaccompanied children. The 

Committee encourages ORR to implement follow-up pilot programs 

to further develop the findings and best practices of the Chicago 

pilot program regarding the utilization of child advocates to identify the child’s best interests from a child welfare perspective so 

that such information can be taken into consideration by attorneys 

and judges involved in a child’s immigration proceedings. 

The Committee directs that not later than one year after the 

date of enactment of this Act the Secretary of Health and Human 

Services shall submit a report on progress made by ORR and programs funded under this Act to shift children from secured detention facilities to more age-appropriate shelter-based facilities for 

unaccompanied children in its custody. 

Victims of torture 

The Committee provides $9,915,000 to provide a comprehensive 

program of support for domestic centers and programs for victims 

of torture. This is the same as the fiscal year 2005 comparable level 

and the budget request. 

CHILD CARE AND DEVELOPMENT BLOCK GRANT

The Committee includes $2,082,910,000 for the Child Care and 

Development Block Grant program, $11,000 below the fiscal year 

2005 comparable level and the same as the budget request. 

The Child Care and Development Block Grant program was 

originally enacted in the Omnibus Budget Reconciliation Act of 

1990 to increase the availability, affordability and quality of child 

care by providing funds to States, Territories and Indian Tribes for 

child care services for low-income families. The authorization for 

mandatory appropriations for childcare in the amount of 

$2,717,000,000 is also requested for fiscal year 2006. 

SOCIAL SERVICES BLOCK GRANT

The bill provides $1,700,000,000 for the social services block 

grant (SSBG). This is the same as the fiscal year 2005 level and 

the budget request. 

SSBGs are designed to encourage States to furnish a variety of 

social services to needy individuals to prevent and reduce dependency, help individuals achieve and maintain self-sufficiency, prevent or reduce inappropriate institutional care, secure admission or 

referral for institutional care when other forms of care are not appropriate, and prevent neglect, abuse and exploitation of children 

and adults. 

Funds are distributed to the territories in the same ratio such 

funds were allocated in fiscal year 1981. The remainder of the appropriation is distributed to the States and the District of Columbia according to population. 

The bill includes a provision that modifies the percentage of 

funds that a State may transfer between the Social Services Block 

Grant and the Temporary Assistance to Needy Families programs 

to 10%. 

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CHILDREN AND FAMILY SERVICES PROGRAMS

The Committee provides a program level total of $8,701,207,000 

for children and family services programs. This is $317,063,000 less 

than the fiscal year 2005 comparable level and $304,414,000 more 

than the budget request. Within the total provided, $12,500,000 is 

provided through the evaluation set-aside. This account finances a 

number of programs aimed at enhancing the well-being of the Nation’s children and families, particularly those who are disadvantaged or troubled. 

Head Start 

The Committee includes $6,899,000,000 for the Head Start program for fiscal year 2005, an increase of $55,886,000 over the fiscal 

year 2005 comparable amount and $336,000 below the budget request. Of this total, the Committee continues the policy of advancing $1,400,000,000 of this account into fiscal year 2007. 

Head Start provides comprehensive child development services to 

economically disadvantaged children and their families. Intended 

primarily for preschoolers from low-income families, the program 

promotes school readiness by enhancing the social and cognitive development of children through the provision of educational, health, 

nutritional, social and other services. Head Start programs engage 

parents in their children’s learning and help them in making 

progress toward their educational, literacy and employment goals. 

At least ten percent of enrollment opportunities in each State are 

made available to handicapped children. 

Grants to carry out Head Start programs are awarded to public 

and private non-profit and for-profit agencies. Unless a waiver is 

approved grantees must contribute 20 percent of the total cost of 

the program from non-Federal funds; this is usually an in-kind contribution. No more than 15 percent of total costs may be for program administration. 

The Committee is aware that in May of 2005, the Secretary 

made $35,000,000 in additional fiscal year 2005 funds available to 

Migrant and Seasonal Head Start programs and that these funds, 

which will be awarded on competitive basis, will allow for at least 

4,000 additional children to access Migrant and Seasonal Head 

Start. The Committee acknowledges that these expansion funds 

will increase access to this important program, however additional 

funding may be necessary to adequately serve this population. The 

Committee requests that the Secretary submit a report on the 

Head Start Bureau’s ongoing plans to ensure that Migrant and 

Seasonal Head Start programs are able to serve a larger percentage of the children eligible for services. The Committee continues 

to point to the 2001 study published by the U.S. Department of 

Health and Human Services that documented that only 19 percent 

of eligible children were able to access Migrant and Seasonal Head 

Start. 

The Committee supports the provisions included in H.R. 2123, 

the School Readiness Act of 2005 as approved by the House Education and Workforce Committee, which would address concerns 

about the potential funding shortfall for Migrant and Seasonal 

Head Start Programs and would require the Secretary, in consultation with Migrant and Seasonal Head Start Programs, to establish 

130

systems to document the demand for Migrant and Seasonal Head 

Start on an ongoing basis. The system should accurately determine 

the number of children who are eligible for services across the 

country and document how many of these children are accessing 

services so that quantifiable information is available to the Secretary upon which future funding decisions can be made. H.R. 2123 

would ensure that additional resources are immediately available 

for these programs until such time that improved information is 

available to the Secretary. The Committee supports this effort that 

will enable policy makers and advocates to more effectively serve 

migrant and seasonal farmworker families and their children. 

The Committee is mindful of the conclusions of the Government 

Accountability Office in its May 17, 2005 report, ‘‘Head Start: Further Development Could Allow Results of New Test to be Used for 

Decision Making.’’ The Committee expects the Secretary to submit 

a report to Congress, within one year, that includes: (1) a detailed 

justification on the planned uses of the National Reporting System 

results and data, including its use for program evaluation, professional development, technical assistance, and other activities; (2) 

an itemization of the costs of development, implementation, and 

analysis of the National Reporting System, detailing by name, 

amount, and description of activities each contract or grant to persons or entities involved in its design, development, implementation, or analysis; and (3) the recommendations made by the Technical Working Group established by the Secretary, including an explanation of how the Secretary has addressed or plans to address 

the Working Group’s and the GAO’s recommendations. 

The Committee notes that the current Head Start Act includes 

the provision of training and technical assistance in the area of 

family literacy services—a provision that is retained in the House 

version of Head Start reauthorization legislation. Pending the final 

resolution of the Head Start reauthorization process, the Committee encourages the Secretary to ensure the continuity of the important services that are being provided through the Head Start 

Family Literacy Project. 

The Committee is aware that approximately one-third of Head 

Start programs are affiliated with public school systems and often 

combine or coordinate the transportation of Head Start, preschool, 

and K–12 students. In addition, many center-based Head Start programs coordinate with local transit authorities to provide supervised transportation to Head Start children whose parents work 

non-traditional hours or whose geographical distance from the parent’s place of employment creates a barrier to Head Start participation. Differences between Head Start transportation regulations, 

promulgated by the U.S. Department of Health and Human Services, and those promulgated by State and local authorities, may 

have the unintended consequence of reducing transportation services for Head Start students, and in turn, decrease transportation 

options for children. These differences may leave Head Start children without transportation or relying on parents to provide transportation in their vehicles. 

The Committee recognizes that children’s safety is the most important consideration and that many students participating in 

Head Start programs need access to safe and reliable transportation provided by public schools or local transit systems. The ComVerDate jul 14 2003 07:43 Jun 22, 2005 Jkt 021909 PO 00000 Frm 00130 Fmt 6659 Sfmt 6602 E:\HR\OC\HR143.XXX HR143
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mittee is aware that the Department of Health and Human Services currently offers a waiver option to local education agencies 

that dually serve as Head Start contractors, which will expire on 

January 1, 2006. In the absence of a permanent solution to this 

problem, the Committee directs the U.S. Department of Health and 

Human Services to extend another waiver option to local education 

agency-contracted Head Start programs that provide integrated 

transportation to Head Start students. In cases where public 

schools or local transit authorities provide Head Start services, 

local educational agencies should have the option to comply with 

transportation standards for preschool students mandated by the 

State or local education agencies a, transit agencies, State departments of Transportation or the U.S. Department of Health and 

Human Services. 

Furthermore, the Committee directs the Department to work towards a permanent fix to this problem in order to provide clearer 

standards and options to local education agencies transporting both 

Head Start and regular preschool and K–12 children. 

Consolidated runaway and homeless youth program 

The Committee provides $88,728,000 for runaway and homeless 

youth activities, an increase of $4,000 more than the fiscal year 

2005 comparable level and the same as the budget request. The 

Runaway, Homeless, and Missing Children Protection Act of 2003 

reauthorized the runaway and homeless youth programs and established a statutory formula distribution between the Basic Center 

Program and the Transitional Living Program. 

The runaway and homeless youth programs provide grants to 

local public and private organizations to establish and operate runaway and homeless youth shelters to address the crisis needs of 

runaway and homeless youth and their families. Grants are used 

to develop or strengthen community-based shelters, which are outside the law enforcement, juvenile justice, child welfare, and mental health systems. 

It is the Committee’s continued expectation that current transitional living program grantees will continue to provide transitional 

living opportunities and supports to pregnant and parenting homeless youth, as is their current practice. To further ensure that pregnant and parenting homeless youth are able to access transitional 

living opportunities and supports in their communities, the Committee encourages the Secretary, acting through the network of federally-funded runaway and homeless youth training and technical 

assistance providers, to offer guidance to grantees and others on 

the programmatic modifications required to address the unique 

needs of pregnant and parenting youth and on the various sources 

of funding available for residential services to this population.

Maternity group homes 

The Committee has not included funding for this new program. 

The budget request is $10,000,000. 

The Committee is aware of the need for and shares the Administration’s interest in funding residential services for young mothers 

and their children who are unable to live with their own families 

because of abuse, neglect, or other circumstances. The Committee 

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notes that pregnant and parenting youth are currently eligible for 

and served through the Transitional Living Program. 

Prevention grants to reduce abuse of runaway youth 

The Committee provides $15,179,000 for prevention grants to re- duce abuse of runaway youth. This is $1,000 more than the fiscal 

year 2005 comparable level and the same as the budget request. 

This program is designed to reduce the sexual abuse of runaway 

youth by providing grants to support street-based outreach and 

education to runaway, homeless, and street youth who have been 

sexually abused or who are at-risk of sexual abuse, in order to connect these young people with services so that they have a chance 

for a safe and healthy future. The street outreach program ensures 

rapid engagement with young people in an effort to prevent the 

most terrible situations that take place when they are subjected to 

life on the streets—physical and sexual abuse, assault, commercial 

sexual exploitation, disease, long-term homelessness, and even 

death. 

Child abuse state grants and discretionary activities 

For child abuse State grants and discretionary activities, the Committee provides $58,925,000. This is $5,000 more than the fiscal year 2005 comparable level and the same as the budget request. 

Within this total, the recommendation includes $27,280,000 for 

State grants and $31,645,000 for child abuse discretionary activities. 

Community-based child abuse prevention 

The Committee provides $42,859,000 for community-based child abuse prevention. This is $1,000 more than the fiscal year 2005 

comparable level and the same as the budget request. The Keeping 

Children and Families Safe Act of 2003 reauthorized and renamed 

this program and added voluntary home visiting programs as a 

core local service. Funds are provided to lead State agencies and 

are used to develop, operate, expand, and enhance communitybased efforts to strengthen and support families in order to prevent 

child abuse and neglect. 

Abandoned infants assistance 

The Committee provides $11,955,000 for the Abandoned Infants 

Assistance program. This is the same as the fiscal year 2005 comparable level and the budget request. The purpose of this program 

is to provide financial support to public and private community and 

faith-based entities to develop, implement, and operate demonstration projects that will prevent the abandonment of infants and 

young children exposed to HIV/AIDS and drugs; identify and address their needs; assist such children to reside with their natural 

families or in foster care; recruit, train and retain foster parents 

as well as health and social services personnel; provide respite care 

for families and foster families; and prevent the abandonment of 

infants and young children. 

Child welfare services and training 

The Committee provides $289,650,000 for child welfare services. 

This is the same as the fiscal year 2005 comparable level and the 

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budget request. This program, authorized by title IV B of the Social 

Security Act, provides grants to States to assist public welfare 

agencies to improve child welfare services. State services include 

preventive intervention in order for children to stay in their homes, 

alternative placement like foster care or adoption if it is not possible for children to remain at home, and reunification programs so 

that, if appropriate, children can return home. 

The Committee provides $7,409,000 for child welfare training. 

This is the same as the fiscal year 2005 comparable level and the 

budget request. The Committee recognizes the need for trained, 

skilled and qualified child welfare service workers. This program 

provides grants to institutions of higher education to develop and 

improve education and training programs and resources for child 

welfare service providers as well as students seeking degrees in social work. 

Adoption opportunities 

The Committee provides $27,119,000 for adoption opportunities. 

This is $3,000 more than the fiscal year 2005 comparable level and 

the same as the budget request. The Adoption Opportunities Program provides funding specifically targeted to improving the adoption of children, particularly those with special needs, and for providing innovative services that support families involved in adoption. 

Adoption incentives 

The Committee provides $31,846,000 for the adoption incentives 

program. This is the same as the fiscal year 2005 comparable level 

and the budget request. The Adoption Promotion Act of 2003 reauthorized this program and now targets incentives specifically for 

older children. Funds are awarded to States using three baselines: 

one for the total number of children adopted, one for children with 

special needs under the age of nine, and one for children aged nine 

and older. The goal of this program is to increase the number of 

adoptions nationwide. 

Adoption awareness 

The Committee provides $12,802,000 for the adoption awareness 

program. This is the same as the fiscal year 2005 comparable level 

and the budget request. This program was authorized in the Children’s Health Act of 2000. The adoption awareness program provides training to designated staff of eligible health centers in providing adoption information and referrals to pregnant women on an 

equal basis with all other courses of action included in non-directive counseling to pregnant women. 

Compassion capital fund 

The Committee provides $75,000,000 for the compassion capital 

fund. This is $20,451,000 more than the fiscal year 2005 comparable level and $25,000,000 less than the budget request. This 

program supports the creation of grants to public/private partnerships to support charitable organizations in expanding or emulating model social services agencies and provides capacity-building 

funds directly to faith- and community-based organizations. 

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The Committee is pleased that the budget request included funding to focus on street outreach strategies to prevent youth gang involvement. Within the total provided for the compassion capital 

fund it is the Committee’s intention that $25,000,000 be provided 

for the youth gang prevention initiative. 

Social services and income maintenance research 

The Committee provides a program level total of $10,621,000 for social services and income maintenance research, $8,000,000 of 

which is through the evaluation set-aside. This is $4,621,000 more 

than the budget request and $21,391,000 less than the fiscal year 

2005 comparable level. These funds support research, demonstration, evaluation and dissemination activities. Recent topics funded 

through this program include welfare-to-work strategies and programs to strengthen family relationships and promote healthy marriages. 

The Committee notes the Administration for Children and Family’s (ACF) efforts to assist States with meeting the extensive 

record-keeping, reporting and tracking requirements of the Temporary Assistance for Needy Families (TANF) program. Working 

through the State information technology consortium, ACF is providing States with the tools necessary to strengthen and improve 

the complex IT systems required to support TANF. Plans are now 

underway to pilot test a data exchange program that will offer 

States a faster, less expensive means of validating, accessing, modifying and recording TANF data elements. Similarly, on behalf of 

Child Support Enforcement, the consortium is helping to expand 

data exchange capabilities between the courts and State child support enforcement agencies as well as increase collection efficiency 

in States and tribal organizations. Next steps include accessing existing databases used as primary sources for collection-related data 

of non-custodial parents, and enhancing data-matching capabilities 

to ensure the integrity of the information being collected. 

Developmental disabilities 

For programs authorized by the Developmental Disabilities Assistance and Bill of Rights Act of 2000 as well as by the Help 

America Vote Act, the Committee provides $170,561,000. This is 

$1,986,000 more than the fiscal year 2005 comparable level and 

$2,000,000 more than the budget request. 

The account total includes $72,496,000 for allotments to the 

States to fund State Councils, the same as the budget request and 

the fiscal year 2005 comparable level. These Councils engage in 

such activities as planning, policy analysis, demonstrations, training, outreach, interagency coordination, and public education. They 

do not provide direct services to the developmentally disabled population. 

In addition, $38,109,000 will be available to the States to be used 

for operating a protection and advocacy system to protect the legal 

and human rights of the developmentally disabled. This is the 

same as the budget request and the fiscal year 2005 level. 

The Committee provides $14,879,000 for voting access for individuals with disabilities programs. This is the same as the fiscal 

year 2005 comparable level and the budget request. Within the 

funds provided, $9,919,000 is for payments to States to promote acVerDate jul 14 2003 07:43 Jun 22, 2005 Jkt 021909 PO 00000 Frm 00134 Fmt 6659 Sfmt 6602 E:\HR\OC\HR143.XXX HR143
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cess for voters with disabilities and $4,960,000 is for State protection and advocacy systems. These programs are intended to make 

polling places accessible and provide equal access and participation 

for individuals with disabilities. The protection and advocacy program will ensure that individuals can fully participate in the electoral process, including registering to vote, accessing polling places, 

and casting a vote. The Committee provides $11,529,000 for developmental disabil- ities projects of National significance. This is $13,000 less than the 

fiscal year 2005 comparable level and the same as the budget request. The Committee provides a total of $33,548,000 for the university 

centers for excellence in developmental disabilities. This is 

$1,999,000 more than the fiscal year 2005 comparable level and 

$2,000,000 more than the budget request. This funding provides 

discretionary grants to public or not-for-profit entities associated 

with universities. The grants provide basic operational and administrative core support for these agencies. In addition, these funds 

support interdisciplinary training, community services, research 

and technical assistance and information dissemination. Funding 

above the request is provided to fully fund the new centers established in fiscal year 2005 and to establish one to two new centers 

in fiscal year 2006. 

Native American programs 

The Committee provides $44,780,000 for Native American pro- grams. This is the same as the budget request and $6,000 less than 

the fiscal year 2005 comparable level. The Native American programs assist Tribal and Village governments, Native American institutions and organizations to support and develop stable, diversified local economies. In promoting social and economic self-sufficiency, this organization provides financial assistance through direct grants for individual projects, training and technical assistance, and research and demonstration programs. 

Community services 

The Committee provides $384,672,000 for community services activities. This is $359,973,000 more than the budget request and 

$341,834,000 less than the fiscal year 2005 comparable level. 

State block grant 

For the State block grant, the Committee provides $320,000,000. 

This is $316,793,000 less than the fiscal year 2005 comparable 

level. No funds were requested for this program. This program provides grants to States, territories and Indian Tribes for services to 

meet employment, housing, nutrition, energy, emergency services, 

and health needs of low-income people. By law, 90 percent of these 

funds are passed directly through to local community action agencies that have previously received block grant funds. 

Community economic development 

The Committee provides $32,731,000 for community economic development grants. This is the same as the fiscal year 2005 comparable level. No funds were requested for this program. These activities provide assistance to private, locally-initiated community 

136

development corporations that sponsor enterprises providing employment, training and business development opportunities for lowincome residents in poor communities. Within the total, $5,436,000 

is provided for the Job Opportunities for Low-Income Individuals 

program, which provides competitive grant to non-profit organizations to create new employment and business opportunities for 

TANF recipients and other low-income individuals. 

Individual development accounts 

The Committee provides $24,699,000 for individual development accounts. This is $5,000 less than the fiscal year 2005 comparable 

level and the same as the budget request. Individual development 

accounts are dedicated savings accounts that can be used by families with limited means for purchasing a first home, paying for 

postsecondary education or capitalizing a business. The intent of 

the program is to encourage participants to develop and reinforce 

strong habits for saving money. 501(c)(3) organizations are eligible 

to apply for the funds and applicants must match Federal funds 

with non-Federal funds.

Rural community facilities 

The Committee provides $7,242,000 for the rural community facilities program. This is the same as the fiscal year 2005 comparable amount. No funds were requested for this program. The 

Committee includes these funds to be used solely for the purpose 

of improving water and wastewater facilities in poor, rural communities. As in the past, these funds should be allocated to regional, 

rural community assistance programs. 

National youth sports 

The Committee concurs with the budget request not to include 

funding for National youth sports. The fiscal year 2005 funding 

level for this program is $17,856,000. These funds are made available to a private, non-profit organization to provide recreational activities for low-income youth, primarily in the summer months. College and university athletic facilities are employed in the program. 

Community food and nutrition 

The Committee concurs with the budget request not to include 

funding for the community food and nutrition program. The fiscal 

year 2005 funding level for this program is $7,180,000. This program provides grants to public and private agencies to coordinate 

existing food assistance programs, to identify sponsors of child nutrition programs and attempt to initiate new programs and to do 

advocacy work at the State and local levels. 

Violent crime reduction programs 

The Committee provides $125,991,000 for family violence prevention and services and battered women’s shelters. This is the same 

as the budget request and $361,000 more than the fiscal year 2005 

comparable level. This program is designed to assist States and Indian Tribes in efforts to prevent family violence and to provide immediate shelter and related assistance for victims of family violence and their dependents, and to provide for technical assistance 

and training relating to family violence programs to State and local 

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public agencies (including law enforcement agencies), nonprofit private organizations, and persons seeking such assistance. The Committee also includes $3,000,000 to continue funding the National domestic violence hotline. This is $224,000 less than the 

fiscal year 2005 comparable level and the same as the budget request. 

Early learning fund 

The Committee concurs with the budget request and does not 

provide funding for the early learning fund. The fiscal year 2005 

level for this program is $35,712,000. This program was begun in 

fiscal year 2001 to help facilitate the development of learning readiness in young children. 

Mentoring children of prisoners 

The Committee provides $49,993,000 for the mentoring children of prisoners program. This is $395,000 above the fiscal year 2005 

comparable level and the same as the budget request. This program supports competitively awarded grants to States and local 

governments, Indian tribes and consortia, and faith- and community-based organizations to mentor children of prisoners and those 

recently released from prison. 

Independent living training vouchers 

The Committee provides $50,000,000 for independent living training vouchers. This is $3,377,000 more than the fiscal year 

2005 comparable level and $9,999,000 less than the budget request. 

These funds support vouchers for college tuition or vocational training for individuals who age out of the foster care system, so they 

can be better prepared to live independently. 

Abstinence education 

The Committee provides a program level total of $114,500,000 for 

the community-based abstinence education program, which is 

$10,802,000 above the fiscal year 2005 comparable level and 

$28,045,000 below the budget request. Within the total, $4,500,000 

is provided through the evaluation set-aside as requested. The program provides support to public and private entities for implementation of community-based abstinence education programs for adolescents aged 12 through 18 as defined in sections (A) through (H) 

of Title 5, section 510(b)(2) of the Social Security Act. The entire 

focus of these programs is to educate young people and create an 

environment within communities that supports teen decisions to 

postpone sexual activity until marriage. There is no funding match 

requirement for these grants. The Committee intends that up to 

five percent of these funds be used to provide technical assistance 

and capacity-building support to grantees. Within the total, up to 

$10,000,000 may be used to carry out a National Abstinence Education Campaign. 

The Committee is concerned that the funding for training and 

technical assistance is not being used effectively to help communities develop abstinence-only programs and to support existing 

community-based programs. The Administration for Children and 

Families (ACF) should fully utilize the set-aside to ensure that programs around the country are using appropriate and approved curVerDate jul 14 2003 07:43 Jun 22, 2005 Jkt 021909 PO 00000 Frm 00137 Fmt 6659 Sfmt 6602 E:\HR\OC\HR143.XXX HR143
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ricula that are evidence-based and comply with the appropriate 

Federal legislation. To that end, the Committee directs ACF to 

issue a report to the House and Senate Committees on Appropriations by no later than 90 days of enactment of this Act on the use 

of the five percent set-aside since the transfer of the program from 

the Health Resources and Services Administration and the intended use of the fiscal year 2006 funds. Also include in this report 

the funds from the National Abstinence Education Campaign that 

are being used for training and technical assistance. 

The Committee reinforces the guidance from its report accompanying the fiscal year 2005 appropriation with respect to the abstinence messages given by the public health entities that are 

grantees in the community-based abstinence education program 

and to the conduct of evaluation activities for the program. 

The Committee encourages ACF to seek appropriate partnerships 

with the Corporation for National and Community Service to utilize its corps of volunteers to support and strengthen the community-based abstinence education program. The Corporation’s programs include volunteer and mentoring personnel that could be 

accessed to further bolster the goals of abstinence-only education. 

Faith-based center 

The Committee provides $1,400,000 for the faith-based center. This is the same as the budget request and $25,000 more than the 

fiscal year 2005 comparable level. The center will support implementation of faith-based and community initiatives in accordance 

with the President’s executive order. 

Program direction 

The Committee provides $185,217,000 for program direction expenses for the Administration for Children and Families. This is 

$7,000 more than the fiscal year 2005 comparable level and the 

same as the budget request.

PROMOTING SAFE AND STABLE FAMILIES

The Committee provides $404,000,000 for the promoting safe and stable families program. This is $414,000 more than the fiscal year 

2005 comparable level and $6,000,000 less than the budget request. 

PAYMENTS TO STATES FOR FOSTER CARE AND ASSISTANCE

The bill provides $4,852,800,000 for payments to States for foster care and adoption assistance. This is $185,100,000 less than the 

fiscal year 2005 level and the same as the budget request. The bill 

also includes an advance appropriation of $1,730,000,000 for the 

first quarter of fiscal year 2007 to ensure timely completion of first 

quarter grant awards. 

Of the total appropriation, including the advance appropriation 

from the prior year, the bill provides $4,685,000,000 for the foster 

care program to provide maintenance payments to States on behalf 

of children who must live outside their homes. This is the same as 

the budget request and $210,500,000 less than the fiscal year 2005 

level. 

Within the total appropriation, the bill provides $1,795,000,000 

for adoption assistance. This is $24,900,000 more than the fiscal 

year 2005 level and the same as the budget request. This program 

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provides training for parents and State administrative staff as well 

as payments on behalf of categorically eligible children considered 

difficult to adopt. This annually appropriated entitlement is designed to provide alternatives to long, inappropriate stays in foster 

care by developing permanent placements with families. 

Within the total appropriation for this account, the bill provides $140,000,000 for the independent living program. This is the same 

as the fiscal year 2005 level and the budget request. The program 

is designed to assist foster children age 16 or older to make successful transitions to independence. Funds assist children to earn 

high school diplomas, receive vocational training, and obtain training in daily living skills. Funds are awarded to States on the basis 

of the number of children on behalf of whom Federal foster care 

payments are received. 

ADMINISTRATION ON AGING

AGING SERVICES PROGRAMS

For programs administered by the Administration on Aging, the Committee provides a total of $1,376,217,000. This is $17,125,000 

less than the fiscal year 2005 comparable level and $7,189,000 

more than the budget request. This account finances all programs 

under the Older Americans Act in this bill, with the exception of 

the Community Services Employment Program, which is administered by the Department of Labor.

Supportive services and centers 

The Committee provides $354,136,000 for supportive services and 

centers. This is the same as the fiscal year 2005 comparable level 

and the budget request. Funds for supportive services and centers 

are awarded to States and territories for in-home and communitybased services for frail elderly persons who are at risk of losing 

their self-sufficiency due to physical or mental impairments. The 

funds contained in the bill will support a variety of activities including transportation services, information and assistance, and 

personal care services. 

Preventive health 

The Committee provides $21,616,000 for preventive health services authorized under part F of title III of the Act. This is the same 

as the fiscal year 2005 comparable level and the budget request. 

These funds are awarded to States and territories to support activities that educate older adults about the importance of healthy lifestyles and promote healthy behaviors that can prevent or delay 

chronic disease and disability. 

Protection of vulnerable older americans 

The Committee provides $19,360,000 for the protection of vulnerable older Americans, authorized by title VII of the Older Americans Act. This is the same as the budget request and $72,000 more 

than the fiscal year 2005 comparable level. Funding is provided for 

both the long-term care ombudsman program, which protects the 

rights and interests of residents in nursing homes, board and care 

homes, assisted living facilities and similar adult care facilities, as 

well as for the prevention of elder abuse, neglect, and exploitation 

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program, which trains law enforcement and medical professionals 

in how to recognize and respond to elder abuse. 

National family caregiver support program 

The Committee provides $155,744,000 for the family caregivers 

program. This is the same as the fiscal year 2005 comparable level 

and the budget request. The family caregiver program provides formula grants to States to provide a support system in each State 

for family caregivers. All States are expected to put in place five 

basic system components, including: individualized information on 

available resources; assistance to families in locating services from 

private and voluntary agencies; caregiver counseling, training and 

peer support; respite care; and other supplemental services. 

Native american caregiver support program 

The Committee provides $6,304,000 for the Native American 

caregiver support program. This is the same as the fiscal year 2005 

comparable level and the budget request. The program assists 

Tribes in providing multifaceted systems of support services for 

family caregivers as well as for grandparents caring for grandchildren. 

Nutrition programs 

For congregate and home delivered meals, as well as the nutrition services incentive program, the Committee provides 

$725,885,000. This is $7,188,000 more than the fiscal year 2005 

comparable level and $7,189,000 more than the budget request. 

These programs are intended to address some of the difficulties 

confronting older individuals, namely nutrition deficiencies due to 

inadequate income, lack of adequate facilities to prepare food, and 

social isolation. 

Grants for Native Americans 

The Committee provides $26,398,000 for grants for Native Americans. This is the same as the fiscal year 2005 comparable level 

and the budget request. Grants are distributed to tribal organizations to be used to help Native American elders remain healthy 

and independent by providing transportation, nutrition, health 

screening and other services. 

Program innovations 

The Committee provides $23,843,000 for program innovations. 

This is the same as the budget request and $19,443,000 less than 

the fiscal year 2005 comparable funding level. Funds under this 

program are used for competitive grants and contracts to support 

projects that develop new and promising practices to serve older 

adults and their families. 

Within the total the Committee provides $3,000,000 for social research into Alzheimer’s disease care options, best practices and 

other Alzheimer’s research priorities that include research into 

cause, cure and care, as well as respite care, assisted living, the impact of intervention by social service agencies on victims, and related needs. The Committee recommends this research utilize and 

give discretion to Area Agencies on Aging and their non-profit divisions in municipalities with aged populations (over the age of 60) 

141

of over 1 million, with preference given to the largest population. 

The Committee also recommends that unique partnerships to affect 

this research be considered for the selected Area Agency on Aging. 

The Committee is aware of innovative program models aimed at 

mobilizing older Americans, particularly the 77 million baby 

boomers, to serve their communities. The Committee encourages 

partnerships with organizations, such as Experience Corps, that 

enable older Americans to help meet critical social needs effectively.

Aging network support activities 

The Committee provides $13,266,000 for aging network support 

activities, which include five ongoing programs: the Eldercare Locator, Pension Counseling, Senior Medicare Patrols, the National 

Long-Term Care Ombudsman Resource Center, and the National 

Center on Elder Abuse. This is the same as the fiscal year 2005 

comparable level and the budget request. These established programs, which began as demonstration projects, provide critical support for the national aging services network. 

Alzheimer’s disease demonstration grants 

The Committee provides $11,786,000 for Alzheimer’s disease 

demonstration grants. This is the same as the budget request and 

the fiscal year 2005 comparable level. The program provides competitive grants to States to help them plan and establish programs 

to provide models of care to individuals with Alzheimer’s disease. 

Funds are used for respite care and supportive services, clearinghouses, training, and administrative costs for State offices. 

White House Conference on Aging 

The Committee concurs with the budget request and does not 

provide funding for the White House Conference on Aging. The fiscal year 2005 level, the third and final year of funding for the Conference, is $4,520,000. The Committee looks forward to the Conference, currently scheduled to occur December 11 through 14 of 

2005. Past White House conferences on aging have prompted the 

development of many of the programs that represent America’s 

commitment to the elderly. 

Program administration 

The Committee provides $17,879,000 for program administration 

expenses for the Administration on Aging (AoA). This is $422,000 

less than the fiscal year 2005 level and the same as the budget request. This activity provides administrative and management support for all Older Americans Act programs administered by AoA. 

OFFICE OF THE SECRETARY

GENERAL DEPARTMENTAL MANAGEMENT

The Committee provides $344,546,000 for general departmental 

management, which is $29,703,000 below the fiscal year 2005 comparable level and $14,630,000 below the budget request. Included 

in this amount is authority to spend $5,851,000 from the Medicare 

trust funds. In addition, the Office of the Secretary has access to 

$39,552,000 of policy evaluation funding. 

142

This appropriation supports those activities that are associated 

with the Secretary’s roles as policy officer and general manager of 

the Department. 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. This account also supports several small health promotion and disease prevention activities that 

are centrally administered. 

Adolescent Family Life 

The Committee provides $30,742,000 for the Adolescent Family 

Life program, which is $158,000 below the comparable 2005 level 

and the same as the budget request. The Committee includes bill 

language requested by the Administration allocating all funds for 

prevention demonstrations to be available for abstinence education 

activities under section 510(b)(2) of the Social Security Act. The 

program provides comprehensive and integrated approaches to the 

delivery of care services for pregnant and parenting adolescents, 

and prevention services that promote abstinence from sexual activity among non-parenting teens. 

Office of Minority Health 

The Committee provides $47,236,000 for the Office of Minority 

Health, which is $3,282,000 below the fiscal year 2005 comparable 

amount and the same as the budget request. The Office of Minority 

Health works with Public Health Service agencies and other agencies of the Department in a leadership and policy development role 

to establish goals and coordinate other activities in the Department 

regarding disease prevention, health promotion, service delivery 

and research relating to disadvantaged and minority individuals; 

concludes interagency agreements to stimulate and undertake innovative projects; supports research, demonstration, and evaluation 

projects; and coordinates efforts to promote minority health programs and policies in the voluntary and corporate sectors. 

IOM report on unequal treatment.—The Committee is committed 

to ensuring the overall improved health of the American people, 

and encourages the Secretary to intensify HHS efforts to work to 

implement recommendations developed by the Institute of Medicine’s Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care study. The recommendations offer significant 

guidelines and opportunities for eliminating health disparities and 

improving health across all populations. The Committee requests 

the Secretary to report on the progress of this action during next 

year’s appropriations hearings. 

Charles Drew University.—The Committee notes the challenges 

faced by Charles R. Drew University of Medicine and Science in 

Los Angeles. Because of problems with the health care delivery system in South Central Los Angeles, several of the key residency 

training programs sponsored by the institution are jeopardized. 

The Committee encourages the Office of Minority Health to take a 

leadership role in assisting the university in solving these challenges. The Office is urged to consider supporting faculty for the 

residency programs, and to coordinate a Public Health Service-wide 

program of support for the institution. 

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HIV/AIDS for faith-based communities.—The Committee commends the Department for its work with the National Coalition of 

Pastors’ Spouses to develop HIV/AIDS: A Manual for Faith Communities. The Committee encourages the Department to continue 

this partnership for the translation of this manual into Spanish 

and Swahili. 

Meharry Medical College.—The Committee encourages OMH to 

continue its successful cooperative agreement with Meharry Medical College aimed at meeting the challenges of academic opportunity for disadvantaged students and improving health care services in underserved communities. In addition, the Committee continues to encourage OMH to support strategic planning and development activities at the Morehouse School of Medicine. 

Office on Women’s Health 

The Committee provides $28,715,000 for the Office on Women’s 

Health, which is $103,000 below the fiscal year 2005 comparable 

level and the same as the budget request. The Office on Women’s 

Health advises the Secretary and provides Department-wide coordination of programs focusing specifically on women’s health. 

HIV/AIDS in minority communities 

The Committee provides $52,415,000 to be available to the Secretary to transfer to the Department’s operating agencies for specific program activities to address the high-priority HIV prevention 

and treatment needs of minority communities. This is the same as 

the fiscal year 2005 comparable level and the same as the budget 

request. These funds are provided to promote an effective culturally 

competent and linguistically appropriate public health response to 

the HIV/AIDS epidemic. 

Within the total provided, the Committee expects that activities 

that are targeted to address the growing HIV/AIDS epidemic and 

its disproportionate impact upon communities of color, including 

African Americans, Latinos, Native Americans, Asian Americans, 

Native Hawaiians, and Pacific Islanders will be supported at no 

less than last year’s funding level. 

Afghanistan 

The Committee includes $5,952,000, which is the same as the 

Administration and the comparable fiscal year 2005 level. These 

funds will be used for the joint Department of Defense and HHS 

initiative to improve the largest women’s hospital in Kabul, Afghanistan and to create four satellite teaching clinics. Bill language 

is included identifying the amount of assistance and citing as authority the Afghanistan Freedom Support Act of 2002. 

Embryo adoption awareness campaign 

The Committee provides $992,000 for the embryo adoption 

awareness campaign, which is the same as the Administration request and the comparable fiscal year 2005 level. These funds will 

be used for a competitive grant program to continue embryo adoption public awareness activities. 

144

Information technology security and innovation fund 

The Committee does not provide funding for the information technology security and innovation fund, which is $14,695,000 

below the fiscal year 2005 comparable level and $14,630,000 below 

the budget request. This fund supports HHS enterprise-wide investments in such areas as common IT infrastructure services, and 

security and infrastructure to enable common administrative systems. Almost $67 million has been appropriated for this function 

over the past four years, in addition to the substantial contributions made by the HHS operating divisions. 

Office of Population Affairs.—The Committee is concerned by reports that the State Attorneys General in several States are requesting records to determine any role family planning providers 

may have had in failing to report criminal activity such as statutory rape. The appropriations bill has had a longstanding provision 

(sec. 212 of the fiscal year 2005 bill) and continues the provision 

in sec. 213 of the fiscal year 2006 bill making clear that no family 

planning provider is exempt from any State law requiring notification or reporting of child abuse, child molestation, sexual abuse, 

rape or incest. The Committee directs the Office of Population Affairs to send Title X grantees a reminder notification of this Federal requirement. In addition, the Committee requests the Secretary to conduct an audit of a sample of Title X recipients to determine compliance with mandatory reporting requirements. 

Salt.—The Committee is aware that the Dietary Guidelines for 

Americans 2005 (published by the Department of Health and 

Human Services and the Department of Agriculture) recommends 

that Americans consume less salt because reducing salt intake may 

reduce blood pressure, lowering an individual’s risk of coronary 

heart disease, stroke, congestive heart failure, and kidney disease. 

That recommendation echoes the conclusion of both a 2002 report 

by the National Institutes of Health and a 2004 report by the Institute of Medicine. Older persons, African Americans, and people 

with high blood pressure tend to be especially sensitive to the blood 

pressure-raising effects of salt. While salt occurs naturally in some 

foods, the great majority of salt is consumed by eating processed 

foods. The Committee is also aware that in some processed foods 

salt—in addition to affecting taste—performs important functions, 

such as preventing the growth of bacteria. The Committee encourages the Secretary to focus on ways—including both voluntary actions by the food industry and regulatory actions by the Food and 

Drug Administration and the Department of Agriculture—to reduce 

salt in processed and restaurant foods. 

Cross-tracking program participants.—The Committee is interested in better understanding the full impact of federal assistance 

programs, including the number of individuals who access multiple 

programs, either concurrently or serially. As such, the Committee 

directs the U.S. Department of Health and Human Services to 

work with the Census Bureau to improve the Survey of Income and 

Program Participation (SIPP) and other infrastructure necessary to 

cross-reference individuals participating in multiple federal programs. As part of this effort, the Department of Health and Human 

Services is encouraged to partner with other federal agencies to improve Census Bureau survey measures of participation across all 

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145

partment shall report to Congress, by March 1, 2006, on the status 

of this initiative, including a specific list of barriers that may preclude the agency from full compliance with this directive. 

Limited English proficiency.—The Committee is concerned about 

the implementation of the department’s ‘‘policy guidance’’ issued 

pursuant to Executive Order 13166 regarding limited English proficiency. The Committee feels it is important to track the costs of 

this policy to make sure that the provision of language services is 

being done as cost effectively as possible. Therefore, HHS, should 

report to the Committee the total funding spent on the provision 

of HHS-conducted services in languages other than English, including publications costs, web site development and maintenance 

costs, outreach activities, translation activities, and language line 

contracts. The Department should report the same cost categories 

as provided in the Limited English Proficiency Report requested in 

House report 108–10. 

Men’s health.—The Committee understands that there is no entity in the Department responsible for the coordination and oversight 

of activities across the agency concerning men’s health. The Committee is aware of reports that men are 25 percent less likely than 

women to receive regular health screenings, and that one of the top 

problems facing men’s health is that men are not likely to visit a 

doctor when they notice a problem. The Committee encourages the 

Secretary to expand departmental disease prevention and health 

promotion activities among men and to give consideration to establishing an office for men’s health, similar to the HHS Office of 

Women’s Health. The Committee expects the Secretary to be prepared to discuss in the fiscal year 2007 appropriations hearings the 

activities that have been undertaken with regard to men’s health. 

Underage drinking.—The Committee strongly supports the efforts by the Department to combat underage drinking particularly 

the efforts by the Interagency Coordinating Committee to Prevent 

Underage Drinking (ICCPUD) to develop a National strategy on 

underage drinking. More than 7,000 teens under the age of 16 take 

their first drink every day. According to the latest data from Monitoring the Future, one in five eighth-graders report drinking in the 

past month, and that rises to one in three for 10th-graders and one 

in two for 12th-graders. The Centers for Disease Control and Prevention (CDC) reported that, for the last year for which data were 

available, more than 4,500 persons under the age of 21 died as a 

result of excessive drinking. In addition, NIH has reported significant findings about the negative consequences of underage drinking on adolescent brain development. The Committee therefore includes within the total for the Office of the Secretary the third year 

of funding necessary to continue the Ad Council’s parent-oriented 

National media campaign to combat underage drinking. Further, 

the Committee expects the public service announcement to be 

based on sound scientific research. 

HIV/AIDS grants.—The Committee is concerned that agencies at 

the state and local level which currently receive funding from multiple HHS agencies, such as those administering programs to prevent and treat HIV/AIDS, are burdened with inconsistent data collection and reporting requirements by Federal grants. In order to 

satisfy these requirements, agencies often must allocate funds to 

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146

rect services. In order to decrease administrative burden and make 

the most effective use of federal health care dollars, the Committee 

urges the Secretary to direct the HHS agencies engaged in cooperative agreements for HIV/AIDS services with State and local, private and public entities to address this situation by moving to coordinate data collection and reporting requirements for grantees. 

Sleep disorders.—At the National Institutes of Health’s Frontiers 

of Knowledge in Sleep and Sleep Disorders conference in March of 

2004, the U.S. Surgeon General reported on the profound impact 

that chronic sleep loss and untreated sleep disorders have on 

Americans of all ages and that the public health model is well suited to translate these essential health messages to society. The 

Committee encourages the Surgeon General to consider development of a Surgeon General’s Report on Sleep and Sleep Disorders. 

Prostate cancer.—The Committee encourages the Secretary to 

work with the Director of the NIH and the Administrator of the 

FDA to resolve, as quickly as possible, all issues related to the 

adoption of clinical trial surrogate endpoints for prostate cancer research and drug approval. The Committee requests the Secretary 

to submit a progress report to Congress by July 1, 2006. 

Hepatitis C–HIV co-infection.—The Committee is concerned with 

the growing co-infection of individuals with both HIV and hepatitis 

C and notes that the largest single cause of death of individuals 

with HIV infection is now liver disease. The Committee is pleased 

that, in response to this high co-infection rate, approximately 20 of 

the state AIDS Drug Assistance Programs (ADAP) have now included Hepatitis C pharmaceuticals on their formularies. The Committee notes that the Ryan White Care Act requires the Secretary 

to issue guidelines regarding appropriate treatments under the program and requests that the Secretary review and re-issue these 

treatment guidelines to address the treatment issues and formulary requirements associated with the significant co-infection 

rate of HIV and hepatitis C. 

Biosafety laboratories.—The Committee requests the Secretary of 

HHS to study if there is a need for additional biosafety level four 

(BSL–4) laboratories to combat biological threats from discovery to 

licensed products. With emerging infectious diseases, such as SARS 

and highly pathogenic avian influenza, increased incidence of drug 

resistant disease, and an increased potential for their use in biowarfare, the Committee wants to be certain that an adequate number of such facilities exists to ensure that prophylaxis, therapeutics 

and diagnostics are available to combat these threats. The Committee requests the Secretary to conduct a coordinated review with 

relevant agencies to: (1) assess any need for additional BSL–4 facilities specifically designed to conduct animal model studies under 

Good Laboratory Practice guidelines; and (2) define the cost, critical design features, and possible construction timetable to establish new high security BSL–4 research facilities. The Committee 

would like a report outlining the results of this review by no later 

than 180 days after enactment of this Act. 

NIH Library of Medicine infrastructure.—The Committee continues to support the work of the National Library of Medicine, the 

largest medical library in the world and the leader in digitized 

medical information resources. Previously, the Committee has 

taken steps to ensure that adequate funding was available for the 

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architectural planning and design of a new NLM building to house 

the National Center for Biotechnology Information and other activities related to digital information development. With the preliminary work complete, the Committee encourages the Secretary to 

consider the commitment of necessary resources to begin construction of new physical facilities for the NLM to enable it to keep pace 

with the rapid increase in medical publishing and biotechnology information research and development. 

Evidentiary standards.—The Committee encourages the Secretary to work across the Department to direct its limited funding 

toward programs with the highest evidentiary standards, such as 

randomized trials. For example, the Committee is aware of extensive evidence that Nurse-Family Partnership, an early home visitation program for first-time low-income mothers, prevents child 

abuse and childhood injury, helps develop positive parent-child relationships, and helps the brain development of the children 

served. The Committee instructs the Secretary to apply the hig evidentiary standards to programs across the Department, and to support agencies within the Department, such as HRSA and ACF, 

adopting evidence-based programs. 

Obesity.—The Committee notes the serious nature of rising obesity rates, especially among girls in underrepresented populations 

or geographic areas where higher obesity rates prevail. The Committee further recognizes the multi-institutional effort that is needed to attack the obesity problem in America and ensure that children and teens make healthy choices. The Committee understands 

that the Girl Scouts of the USA has begun a Healthy Living Initiative, which may be able to reach many of its members and their 

families with a healthy living, balanced lifestyle message to address obesity and other risky behaviors. The Committee encourages 

HHS to actively partner with organizations such as the Girl Scouts 

of the USA to promote the Department’s obesity and wellness initiatives. 

OFFICE OF MEDICARE HEARINGS AND APPEALS

The Committee provides $60,000,000 for this function, which was 

previously supported under an interagency agreement between the 

Centers for Medicare and Medicaid Services and the Social Security Administration. Consistent with the requirements of the Medicare Modernization Act of 2003, this function was transferred to 

the Office of the Secretary. This amount is $2,464,000 above the 

comparable fiscal year 2005 level and $20,000,000 below the Administration request. This office will support the hearing at the administrative law judge level of the third level of Medicare claims 

appeals. 42,000 appeals are expected to be heard in fiscal year 

2006. 

OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION

TECHNOLOGY

The Committee provides $75,000,000 for the new health information technology office, of which $58,100,000 is available in budget 

authority and $16,900,000 in program evaluation tap funding. No 

budget authority was provided in fiscal year 2005, but $32,779,000 

was made available via reprogramming from a combination of program evaluation tap funding and reallocated funds in the Agency 

148

for Healthcare Research and Quality and the Office of the Secretary. The Administration request is $2,750,000 above the amount 

provided by the Committee in the portion of the program supported 

by evaluation tap funding. In addition, $50,000,000 is available for 

health information technology activities in the Agency for 

Healthcare Research and Quality. This is the same as the Administration budget and the comparable fiscal year 2005 level. 

This program is intended to bring together decision-makers to 

develop standards for modern information technology, to devise certification procedures, to develop electronic information architecture 

and to test privacy standards. The ultimate goal is the accurate 

and rapid transfer of a patient’s health information electronically. 

The Committee is aware of several State e-health initiatives for 

sharing health care information among providers. The Committee 

encourages the Office of the National Coordinator for Health Information Technology (ONCHIT) to take advantage of the expertise of 

these States as it begins the process of developing standards and 

policies for a national health information network. The Committee 

urges the Office to address the information technology infrastructure needs of public and private non-profit community health care 

systems. 

OFFICE OF THE INSPECTOR GENERAL

The Committee provides $39,813,000 for the Office of the Inspector General (OIG), which is $117,000 less than the fiscal year 2005 

comparable level and the same as the budget request. A permanent 

appropriation for this office is contained in the Health Insurance 

Portability and Accountability Act of 1996. Total funds provided between this bill and the permanent appropriation would be 

$199,813,000 in fiscal year 2006. 

The Office of the Inspector General was created by law to protect 

the integrity of Departmental programs as well as the health and 

welfare of beneficiaries served by those programs. Through a comprehensive program of audits, investigations, inspections and program evaluations, the OIG attempts to reduce the incidence of 

fraud, waste, abuse and mismanagement, and to promote economy, 

efficiency and effectiveness throughout the Department. 

OFFICE FOR CIVIL RIGHTS

The Committee provides $34,996,000 for the Office of Civil 

Rights (OCR), which is $17,000 less than the fiscal year 2005 comparable level and the same as the budget request. This includes authority to transfer $3,314,000 from the Medicare trust funds. 

The Office for Civil Rights 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. 

MEDICAL BENEFITS FOR COMMISSIONED OFFICERS

The Committee provides an estimated $328,552,000 for medical 

benefits for commissioned officers of the U.S. Public Health Service. 

This is the same as the Administration request and $2,084,000 

below the fiscal year 2005 comparable amount. 

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This account provides for retirement payments to U.S. Public 

Health Service officers who are retired for age, disability or length 

of service; payments to survivors of deceased officers; medical care 

for active duty and retired members and dependents and beneficiaries; and for payments to the Social Security Administration 

for military service credits. 

PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND

The Committee provides $183,589,000 for the public health and 

social services emergency fund for homeland security related activities within the Office of the Secretary. Within the amount, 

$63,589,000 is for homeland security preparedness activities within 

the Office of the Secretary and $120,000,000 is for influenza preparedness. In addition, the Committee also provides $2,213,744,000 within 

the accounts of the managing agencies of jurisdiction, for homeland 

security activities requested in this account. The amounts are broken out by Agency as follows: $1,616,723,000 within the Centers 

for Disease Control and Prevention; $500,000,000 within the 

Health Resources and Services Administration; and $97,021,000 

within the National Institutes of Health for chemical, nuclear and 

radiological research. 

Since fiscal year 2002, terrorism preparedness and response 

funds have been requested and provided for within the Public 

Health and Social Services Emergency Fund (PHSSEF), with the 

exception of biodefense research funds within the National Institute of Allergy and Infectious Diseases. However, now that these 

programs and activities have become a central part of these Agencies annual management responsibilities, the Committee believes 

the funding more appropriately belongs within the managing Agency’s account.

After adjusting for these changes, the comparable total for homeland security related activities in the Committee recommendation 

is $2,397,333,000 for fiscal year 2006. This is $10,082,000 below 

the comparable fiscal year 2005 amount and $30,500,000 below the 

request. 

While the Committee has, for FY 2006, provided funding for 

these activities directly to the relevant agencies, the Committee expects Department-wide coordination to continue. The Committee 

directs the Secretary to submit to the Committee a detailed operating plan for bioterrorism preparedness activities, now funded in 

large measure in the agencies, prior to the commitment of funds for 

grants, or for contracts in excess of $1 million. 

The Committee bill also includes language to finance HHS’s 

Project BioShield procurement management costs through the appropriation for the Strategic National Stockpile, consistent with the 

requirements of section 319F–2(c)(7)(B)(ii) of the Public Health 

Service Act. To cover these costs, the bill authorizes the transfer 

of $8,589,000 from the SNS appropriation (CDC) to the Public 

Health and Social Services Emergency Fund. 

The Committee does not provide funding within the Office of the 

Secretary for healthcare provider credentialing. The Committee believes a better use of resources would be to expand the ongoing 

credentialing program operated by HRSA to permit cross-state 

credentialing. 

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Pandemic Preparedness.—The Committee directs the Department 

to finalize its August 2004 draft Pandemic Influenza Preparedness 

and Response Plan and make it publicly available. The final plan 

should provide the operational blueprint for the six pandemic 

phases as defined by the World Health Organization. 

The Committee believes that pandemic preparedness includes 

much more than just public health, and urges the Secretary to 

press for the appointment of a senior official, whose primary responsibility is to assure Cabinet-level planning and coordination 

between civil society (non-governmental economic infrastructure) 

and government during a pandemic period. 

The Committee commends the Secretary for taking steps to implement the draft Pandemic Influenza Preparedness and Response 

Plan, and it notes the important roles that both vaccines and 

antivirals will play in the event of pandemic. Given the potential 

lack of a match between available vaccines and a particular strain 

of influenza that could cause a pandemic, the Committee supports 

efforts to increase domestic manufacturing capabilities for rapid 

production of vaccines and antivirals and the purchase of vaccines 

and antivirals in the event of a pandemic influenza outbreak. 

GENERAL PROVISIONS

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 number of Public Health Service employees assigned to assist in child 

survival activities and to work in AIDS programs through and with 

funds provided by the Agency for International Development, the 

United Nations International Children’s Emergency Fund or the 

World Health Organization. 

Sec. 203. The Committee continues a provision to prohibit the 

use of funds to implement section 399F(b) of the Public Health 

Service Act or section 1503 of the NIH Revitalization Act of 1993. 

Sec. 204. The Committee continues a provision to limit the salary 

of an individual through an NIH, AHRQ, or SAMHSA grant or 

other extramural mechanism to not more than the rate of Executive Level I. 

Sec. 205. The Committee includes a provision limiting the compensation of an individual working in Head Start to the Federal 

Executive Level II salary.

Sec. 206. The Committee continues a provision to prohibit the 

Secretary from using evaluation set-aside funds until the Committee receives a report detailing the planned use of such funds. 

Sec. 207. The Committee continues a provision, although changes 

the percentage provided in the fiscal year 2005 bill, permitting the 

Secretary to use up to 1.3 percent of funds authorized under the 

PHS Act for the evaluation of programs. 

(TRANSFER OF FUNDS)

Sec. 208. The Committee modifies a provision permitting the Secretary of HHS to transfer up to one percent of any discretionary 

appropriation from an account. 

151

(TRANSFER OF FUNDS)

Sec. 209. 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. 210. The Committee continues a provision to make NIH 

funds available for human immunodeficiency virus research available to the Office of AIDS Research. 

Sec. 211. 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. 212. The Committee continues a provision related to the 

Medicare Advantage program. 

Sec. 213. 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. 214. The Committee continues a provision to exempt States 

from Synar provisions if certain funding criteria are met. 

Sec. 215. The Committee continues a provision to allow CDC 

international HIV/AIDS and other infectious disease, chronic and 

environmental disease, and other health activities abroad to be 

spent under the State Department Basic Authorities Act of 1956. 

Sec. 216. The Committee continues a provision to permit the Division of Federal Occupational Health to use personal services contracting to employ professional management/administrative and occupational health professionals. 

Sec. 217. The Committee includes a provision granting authority 

to the Office of the Director of the National Institutes of Health 

(NIH) to enter directly into transactions in order to implement the 

NIH Roadmap for medical research and permitting the Director to 

utilize peer review procedures, as appropriate, to obtain assessments of scientific and technical merit. 

Sec. 218. The Committee includes a provision that permits the 

Centers for Disease Control and Prevention and the Agency for 

Toxic Substances and Disease Registry to transfer funds that are 

available for Individual Learning Accounts to ‘‘Disease Control, Research, and Training’’. 

Sec. 219. The Committee includes a provision rescinding $15,912,000 of unobligated balances in the Health Professions Student Loan program. 

TITLE III—DEPARTMENT OF EDUCATION 

The Committee’s recommendations for the Department of Education for fiscal year 2006 will bring total departmental funding to 

$56,692,772,000, the highest level in the agency’s history. 

The Committee continues to emphasize the importance of developing clear, measurable outcomes for programs within the Department of Education as outlined in the Government Performance and 

152

Results Act. It is vital that the Committee be provided with information on the actual results achieved by the programs, not simply 

the number of students affected by the program or the quantity of 

materials distributed. Program outcomes should, to the extent possible, focus on the achievement improvements that result to students and teachers in the classroom as a result of the Federal investment. Programs that are able to demonstrate these results over 

time will be considered higher funding priorities than programs 

that are unable to clearly demonstrate their value to the American 

public. 

The Committee notes that urban school districts employ more 

people and manage larger budgets than many Fortune 500 companies. Yet many schools—particularly in inner cities—are failing to 

prepare students for higher education, employment and productive 

citizenship. The Committee encourages the Secretary to examine 

the effects that various local district governance structures, including elected and appointed school boards, have had on academic 

achievement in public schools and be prepared to respond to questions relating to this topic in the fiscal year 2007 budget hearings. 

The Committee is aware that, nationally, only 61.5 percent of 

public education operational budgets reach the classroom, according to the National Center for Educational Statistics. However four 

states (Maine, New York, Tennessee and Utah) spend over 65 percent of their budget in the classroom. The Committee encourages 

the Secretary to examine the impact this spending priority has had 

on the academic achievement of students in these states and to examine efforts that would result in a greater percentage of all school 

district budgets being spent on classroom instruction, such as classroom teachers, personnel, instructional aides, supplies, activities 

and tuition. 

EDUCATION FOR THE DISADVANTAGED

The bill includes $14,728,735,000 for the disadvantaged pro- grams. This amount is $1,702,738,000 less than the budget request 

and $115,239,000 below the fiscal year 2005 appropriation. Of the 

total amount available, $7,144,426,000 is appropriated for fiscal 

year 2006 for obligation after July 1, 2006 and $7,383,301,000 is 

appropriated for fiscal year 2007 for obligation on or after October 

1, 2006. This appropriation account includes compensatory education programs authorized under title I of the Elementary and 

Secondary Education Act of 1965; and title VIII of the Higher Education Act. 

The Committee is aware that the method some states currently 

employ to calculate school expenditures masks huge gaps in perpupil spending within districts. State funding analyses, and data 

which drive federal funding formulas, tend to average teacher salaries for entire districts instead of calculating the actual salaries of 

teachers assigned to any particular school. Many states actually 

spend less on teachers in schools serving low-income and minority 

students than they spend on teachers in schools serving more affluent students. The most highly-paid teachers, and therefore the 

more experienced and highly credentialed teachers, are concentrated in more affluent schools, leaving high-poverty and highminority schools with teachers who have less experience, less education, and face the most challenging assignments. The Education 

153

Trust has found that, in California, forty-two of the fifty largest 

school districts spend significantly more on teachers in their 

schools serving the fewest numbers of Latino and African-American 

students. For a student attending a high school that serves mostly 

Latino and African-American students, as much as $172,000 less 

may be spent on that student’s teachers over the course of a K–

12 career. 

The Committee urges the Secretary to examine this issue, determine how many states are using this practice, ascertain what effects the practice may have on title I grants to LEAs, and work 

with states to adopt data-collection policies that will make schoollevel teacher salary data publicly available, and to analyze and report on the factors that contribute to the teacher-spending gap, 

such as personnel and budgeting practices, in order to close the gap 

in teacher spending and quality within school districts. The Committee expects the Secretary to be prepared to report on this effort 

in the fiscal year 2007 budget hearings. 

Grants to local educational agencies 

Of the amounts provided for Title I programs, $6,934,854,000 is 

available for basic grants to local education agencies. This amount 

is the same as last year’s level and the request. The Committee rejects the inclusion of any 100% hold harmless provision because it 

unfairly penalizes underprivileged and immigrant children in 

states with growing populations. 

Funding for concentration grants, which targets funds to Local 

Educational Agencies in counties with high levels of disadvantaged 

children, is $1,365,031,000, the same as last year and the request 

level. The bill includes $2,269,843,000 for targeted grants, an increase of $50,000,000 above last year and $552,738,000 below the 

request. A total of $2,269,843,000 is also included for education finance incentive grants, $50,000,000 above the request and 

$50,000,000 above last year’s level. 

Financial assistance flows to school districts by formula, based in 

part on the number of school-aged children from low-income families. Within districts, local school officials target funds on school attendance areas with the greatest number or percentage of children 

from poor families. Local school districts develop and implement 

their own programs to meet the needs of disadvantaged students. 

Funds under this account will also be used to pay the Federal 

share of State administrative costs for title I programs. The maximum State administration grant is equal to 1 percent of title I 

local educational agency plus State agency grants to the State, or 

$400,000, whichever is greater. These funds are included in the 

grants to local educational agencies account, rather than being a 

separate line item. 

Recent studies have demonstrated that comprehensive school-improvement models, when well implemented, boost student achievement to a greater extent than other interventions designed to serve 

similar student populations. The Committee believes that comprehensive school reform provides an exemplary approach to raising academic achievement, particularly for schools that do not 

make adequate yearly progress under the No Child Left Behind 

Act. The Committee believes that States should utilize their four 

percent school improvement set aside funds, estimated at over 

154

$500,000,000 in fiscal year 2006, to support implementation of CSR 

models with demonstrated success. Further, the Committee intends 

that the Secretary shall notify States that schools currently receiving CSR subgrants shall receive priority for targeted grants and/

or technical assistance under section 1003(a) of ESEA. 

In addition, the Committee is concerned that in some cases, 

States have distributed the funds set aside within the title I program for school improvement purposes equally to each school identified in need of improvement. The Committee believes that this is 

resulting in allocations for each school that may be too small to effectively leverage needed reforms. The Committee strongly urges 

States to examine methods for distributing school improvement 

funds that will result in awards of sufficient size and scope to support the initial costs of comprehensive school reforms and to limit 

funding to programs that include each of the reform components 

described in section 1606(a) of the No Child Left Behind Act of 

2001 and have the capacity to improve the academic achievement 

of all students in core academic subjects within participating 

schools. 

Even Start 

The Committee provides $200,000,000 for Even Start, $25,095,000 below last year and $200,000,000 above the request. 

Even Start provides grants for programs focusing on the education 

of disadvantaged children, aged 1–7 years, who live in title I target 

school attendance areas, plus their parents who are eligible to be 

served under the Adult Education Act. These parents are not in 

school, are above the State’s compulsory school attendance age 

limit, and have not earned a high school diploma (or equivalent). 

Even Start funds are allocated to the States, generally in proportion to title I basic grants. 

Reading First State Grants 

The bill provides $1,041,600,000 for Reading First State grants, 

the same as the budget request and the same as the fiscal year 

2005 level. This program provides assistance to states and school 

districts in establishing scientific research-based reading programs 

for children in kindergarten through grade three. The program also 

provides for professional development and other supports to ensure 

that teachers can identify children at-risk for reading failure and 

provide the most effective early instruction to overcome specific 

barriers to reading proficiency. 

The Committee urges the Department to ensure accountability of 

States and local education agencies through ongoing, reliable 

screening and diagnostic and classroom-based assessments of the 

literacy programs funded with Reading First grants. 

Early Reading First 

The bill provides $104,160,000 for Early Reading First, the same 

as the budget request and the fiscal year 2005 level. This is a competitive grant program targeted toward children ages three through 

five, and would support the development of verbal skills, phonemic 

awareness, pre-reading development and assistance for professional 

development for teachers in evidence-based strategies of instruction. 

155

Striving Readers 

The bill provides $30,000,000 for Striving Readers, $170,000,000 below the budget request and $5,200,000 above last year’s level. 

Striving Readers will make competitive grants to develop, implement and evaluate reading interventions for middle- or high-school 

students who are reading significantly below grade level. 

Literacy through school libraries 

The bill provides $19,683,000 for literacy through school libraries, the same as the budget request and the fiscal year 2005 level. 

This program helps school districts provide students with increased 

access to up-to-date school library materials, a well-equipped, technologically advanced school library media center, and well-trained, 

and professionally certified school library media specialists. At appropriations of less than $100,000,000 the Department makes competitive awards to districts with a child poverty rate of at least 20 

percent. 

High school intervention 

The bill does not include funding for the high school intervention program proposed by the Administration at $1,240,000,000. The 

Committee supports the Administration’s goals in this program 

which are to increase the achievement of high school students, particularly students at risk of failing to meet challenging State academic content standards; eliminate gaps in achievement between 

students from different ethnic and racial groups and between disadvantaged students and their more advantaged peers; and enable 

all high school students to graduate with the education, skills, and 

knowledge necessary to succeed in postsecondary education and in 

a demanding, high-technology economy. However, the Committee 

notes that this program has not been authorized. 

State agency programs: migrant 

The bill includes $390,428,000 for the migrant education program, the same as the budget request and the fiscal year 2005 appropriation. This program supports formula grants to State agencies for the support of special educational and related services to 

children of migratory agricultural workers and fishermen. The purpose of this program is to provide supplementary academic education, remedial or compensatory instruction, English for limited 

English proficient students, testing, plus guidance and counseling. 

State agency programs: neglected and delinquent 

For the State agency program for neglected and delinquent chil- dren, the bill includes $49,600,000, the same as the budget request 

and the fiscal year 2005 appropriation. This formula grant program 

provides services to participants in institutions for juvenile 

delinquents, adult correctional institutions, or institutions for the 

neglected. 

Evaluation 

The Committee provides $9,424,000 for evaluation, the same as 

the 2004 appropriation and the budget request. Title I evaluation 

supports large scale national evaluations that examine how title I 

is contributing to improved student performance at the State, local 

156

education agency, and school levels. It also supports short-term 

studies that document promising models and other activities to 

help States and local education agencies implement requirements 

in the title I statute. 

Comprehensive school reform 

The bill includes $10,000,000 for the Comprehensive School Re- form (CSR) Program, $10,000,000 above the request and 

$195,344,000 below last year’s level, due to budget constraints. The 

Committee has provided sufficient funding to meet estimated continuation costs for the program in fiscal year 2006. The CSR program authorizes incentive grants of at least $50,000 per year, for 

3 years, for schools to implement effective, research-driven strategies for schoolwide reform. Recent studies have demonstrated that 

comprehensive school-improvement models, when well implemented, boost student achievement to a greater extent than other 

interventions designed to serve similar student populations. The 

Committee believes that comprehensive school reform provides an 

exemplary approach to raising academic achievement, particularly 

for schools that do not make adequate yearly progress under the 

No Child Left Behind Act. The Committee believes that States 

should utilize their four percent school improvement set aside 

funds, estimated at over $500,000,000 in fiscal year 2006, to support implementation of CSR models with demonstrated success. 

Further, the Committee intends that the Secretary shall notify 

States that schools currently receiving CSR subgrants shall receive 

priority for targeted grants and/or technical assistance under section 1003(a) of ESEA. 

In addition, the Committee is concerned that in some cases, 

States have merely divided the funds for school improvement purposes by the number of schools identified in need of improvement 

and that this is resulting in allocations for each school that may 

be too small to effectively leverage needed reforms. The Committee 

strongly urges States to examine methods for distributing school 

improvement funds that will result in awards of sufficient size and 

scope to support the initial costs of comprehensive school reforms 

and to limit funding to programs that include each of the reform 

components described in section 1606(a) of the No Child Left Behind Act of 2001 and have the capacity to improve the academic 

achievement of all students in core academic subjects within participating schools. 

Migrant education, high school equivalency program 

The bill includes $18,737,000 for the high school equivalency program. This amount is the same as the budget request and the fiscal 

year 2005 level. The high school equivalency program recruits migrant students aged 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. 

College assistance migrant programs 

The bill includes $15,532,000 for the college assistance migrant 

programs. This amount is the same as the fiscal year 2005 level 

and the budget request. The college assistance migrant program 

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(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. 

IMPACT AID

The bill provides $1,240,862,000 for Federal impact aid programs 

in fiscal year 2006, a decrease of $3,001,000 below the fiscal year 

2005 appropriation and the same as the budget request. This account supports payments to school districts affected by Federal activities. Impact Aid represents a federal responsibility to local 

schools educating children whose families are connected with the 

military or who live on Indian land. 

The bill also includes language ensuring that schools serving the 

children of military personnel continue to receive Impact Aid funds 

when the military parents who live on-base are deployed and the 

child continues to attend the same school and in cases in which an 

on-base military parent is killed while on active duty and the child 

continues to attend the same school. 

The Committee notes that the Department of Defense is making 

plans to bring back to the continental United States over 70,000 

U.S. military personnel currently stationed overseas, along with an 

estimated 100,000 family members. The Committee is concerned 

about the effect this action will have on the Impact Aid program 

and the schools enrolling approximately 32,000 military dependent 

students new to the Impact Aid Program. The Committee requests 

the Secretary to procure from the Secretary of Defense a timeline 

for this anticipated action along with the estimated total dollar 

savings this move will have on the Department of Defense Overseas Schools system and the financial impact the influx of these additional students will have on the Impact Aid Program and to report this information to the House and Senate authorizing and appropriation committees beginning October 1, 2005 and every six 

months thereafter. 

Basic support payments 

The bill includes $1,102,896,000 for basic support payments to 

local educational agencies, an increase of $27,878,000 above the fiscal year 2005 appropriation and the 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 $49,966,000 for payments on behalf 

of Federally-connected children with disabilities, the same as the 

budget request and the fiscal year 2005 appropriation. These payments compensate school districts for the increased costs of serving 

Federally-connected children with disabilities. 

Facilities maintenance 

The Committee recommends $5,000,000 for facilities maintenance, $2,838,000 below the fiscal year 2005 amount and the budget request. These capital payments are authorized for maintenance 

of certain facilities owned by the Department of Education. 

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Construction 

The Committee recommends $18,000,000 for the construction 

program, $27,544,000 below the budget request and $30,545,000 

below the fiscal year 2005 level. This program provides formula 

and competitive grants to eligible locally owned school districts for 

building and renovating school facilities. 

Payments for Federal property 

The bill provides $65,000,000 for payments related to Federal 

property, an increase of $2,504,000 above the fiscal year 2005 appropriation and the 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 bill includes $5,393,765,000 for school improvement programs. This amount is $225,891,000 less than the comparable fiscal year 2005 appropriation and $61,546,000 above the budget request for comparable programs. This appropriation account includes programs authorized under titles II, IV, V, VI, and VII of 

the Elementary and Secondary Education Act; the McKinney-Vento 

Homeless Assistance Act, title IV–A of the Civil Rights Act, and 

section 105 of the Compact of Free Association Amendments Act of 

2003. 

State grants for improving teacher quality 

The bill includes $2,916,605,000 for state grants for improving 

teacher quality, which is the same as the budget request and the 

fiscal year 2005 level. This program gives states and districts a 

flexible source of funding with which to meet their particular needs 

in strengthening the skills and knowledge of teachers and administrators to enable them to improve student achievement. States are 

authorized to retain 2.5 percent of funds for state activities, including reforming teacher certification, re-certification or licensure requirements; expanding, establishing or improving alternative 

routes to state certification; carrying out programs that include 

support during the initial teaching and leadership experience, such 

as mentoring programs; assisting school districts in effectively recruiting and retaining highly qualified and effective teachers and 

principals; reforming tenure systems; and developing professional 

development programs for principals. 

States send funding to the local level by formula and by competitive grant. Among other things, local uses of funds include initiatives to assist recruitment of principals and fully qualified teachers; 

initiatives to promote retention of highly qualified teachers and 

principals; programs designed to improve the quality of the teacher 

force; teacher opportunity payments; professional development activities; teacher advancement initiatives and hiring fully qualified 

teachers in order to reduce class size. 

The Committee is aware that funding under the teacher quality 

program can be used for professional development and support for 

principals as well as teachers. The Committee recognizes the 

unique role that the principal plays as the instructional leader and 

CEO of a school, and strongly encourages states and school disVerDate jul 14 2003 07:43 Jun 22, 2005 Jkt 021909 PO 00000 Frm 00158 Fmt 6659 Sfmt 6602 E:\HR\OC\HR143.XXX HR143
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tricts to devote a significant portion of professional development 

funds to providing high-quality, ongoing professional development 

opportunities to principals. Particularly recommended is professional development to enhance principals’ ability to work productively with families, provide staff development to teachers and 

other professionals, and to utilize data in decision-making. The 

Committee also encourages states and school districts to develop 

principals’ professional development that is based on sound research on the most current models of leadership. 

Early childhood educator professional development 

The bill includes $14,696,000 for early childhood educator professional development, the same as the budget request and the fiscal 

year 2005 level. This program provides competitive grants to partnerships to improve the knowledge and skills of early childhood 

educators and caregivers who work in communities that have high 

concentrations of children living in poverty. 

Mathematics and science partnerships 

The bill includes $190,000,000 for mathematics and science part- nerships, $79,000,000 below the budget request and $11,440,000 

above the fiscal year 2005 level. This program promotes strong 

math and science teaching skills for elementary and secondary 

school teachers. Grantees may use program funds to develop rigorous math and science curricula, establish distance learning programs, and recruit math, science and engineering majors into the 

teaching profession. They may also provide professional development opportunities. Grants are made to States by formula based on 

the number of children aged 5 to 17 who are from families with incomes below the poverty line, and States then award the funds 

competitively to partnerships which must include the State agency, 

and engineering, math or science department of an institution of 

higher education, and a high-need school district. Other partners 

may also be involved.

Innovative Education Program Strategies State Grants 

The bill includes $198,400,000 for State grants under Innovative 

Education Program Strategies, $98,400,000 above the budget request and the same as the fiscal year 2005 level. This program provides funding to State and local educational agencies for obtaining 

technology and training in technology related to the implementation of school based reform; acquiring and using educational materials; improving educational services for disadvantaged students; 

combating illiteracy among children and adults; addressing the 

educational needs of gifted and talented children; and implementing school improvement and parental involvement activities 

under ESEA Title I. 

Education technology 

The bill includes $300,000,000 for education technology activities. 

This amount is $196,000,000 below the comparable fiscal year 2005 

level. The President’s budget proposed to terminate this program. 

Under this program, states are required to direct ninety-five percent of the funds to school districts for increasing access to technology, especially for high-need schools; improving and expanding 

160

teacher professional development in technology; and promoting innovative state and local initiatives using technology to increase 

academic achievement. 

Supplemental education grants 

The bill provides $12,132,000 for supplemental education grants 

to the Federated States of Micronesia and $6,051,000 for supplemental education grants to the Republic of the Marshall Islands, 

the same as the budget request and the fiscal year 2005 level. The 

Compact of Free Association Amendments Act of 2003 (P.L. 108–

188) authorizes these countries to receive funding for general education assistance. 

21st century community learning centers 

The bill provides $991,077,000 for 21st century community learning centers, the same as the budget request and the fiscal year 

2005 level. This program is a formula grant to states. Ninety-five 

percent of funds are distributed on a competitive basis from the 

state to local school districts, community-based organizations and 

other public entities and private organizations. Grantees must target students who attend low-performing schools. Funds may be 

used for before and after school activities that advance student academic achievement including remedial education and academic enrichment activities; math, science, arts, music, entrepreneurial and 

technology education; tutoring and mentoring; recreational activities; and expanded library service hours. 

State assessments 

The bill includes $411,680,000 for state assessments, the same as 

the budget request and the fiscal year 2005 level. This program 

provides states with funding to develop annual assessments and to 

carry out activities related to ensuring accountability for results in 

the state’s schools and school districts. 

High school assessments 

The bill does not include funding for the high school assessment 

initiative, proposed for funding by the Administration at 

$250,000,000. The Committee notes that this program is not authorized. 

Javits gifted and talented education 

The bill does not include funding for gifted and talented education, the same as the budget request and $11,022,000 below fiscal year 2005 level. This program supports grants to build and enhance the ability of elementary and secondary schools to meet the 

needs of gifted and talented students. Competitive grants are 

awarded to states and school districts, institutions or higher education and other public and private entities. 

Foreign language assistance grants 

The bill does not include funding for foreign language assistance 

grants, the same as the budget request. The program was funded 

at $17,856,000 in fiscal year 2005. The program supports competitive grants to school districts and states to increase the quality and 

161

quantity of elementary and secondary-level foreign language instruction in the United States. 

Education for homeless children and youth 

For the education of homeless children and youth program, the Committee recommends $62,496,000, the same as the budget request and the fiscal year 2005 appropriation. Grants are allocated 

to States in proportion to the total that each State receives under 

the title I program. For local grants, at least 50 percent must be 

used for direct services to homeless children and youth, including 

tutoring or remedial or other educational services. 

Training and advisory services 

The bill includes $7,185,000 for training and advisory services 

authorized by title IV–A of the Civil Rights Act. This amount is the 

same as the budget request and the same as the fiscal year 2005 

amount. Title IV–A authorizes technical assistance and training 

services for local educational agencies to address problems associated with desegregation on the basis of race, sex, or national origin. 

The Department awards 3-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; training designed to develop educators’ skills in 

specific areas, such as the identification of race and sex bias in instructional materials; increasing the skills of educational personnel 

in dealing with race-based confrontations such as hate crimes; and 

providing technical assistance in the identification and selection of 

appropriate educational programs to meet the needs of limited 

English proficient students. 

Education for Native Hawaiians 

The Committee recommends $24,770,000 for education for Native 

Hawaiians, $7,854,000 below the budget request and $9,454,000 

below the fiscal year 2005 amount. A number of programs limited 

to Native Hawaiians are supported with these funds, including a 

model curriculum project, family-based education centers, postsecondary education fellowships, gifted and talented education 

projects, and special education projects for disabled pupils. 

Alaska Native education equity 

The Committee recommends $31,224,000 for the Alaska Native 

education equity program, the same as the budget request and 

$3,000,000 below the fiscal year 2005 amount. These funds are 

used to develop supplemental educational programs to benefit Alaska Natives. 

Rural Education 

The bill includes $170,624,000 for rural education programs, the 

same as the fiscal year 2005 level and the budget request. This 

fund includes two programs to assist rural school districts to improve teaching and learning in their schools. The small, rural 

schools achievement program provides funds to rural districts that 

162

serve a small number of students; the rural and low-income schools 

program provides funds to rural districts that serve concentrations 

of poor students, regardless of the number of students served by 

the district. 

Comprehensive Centers 

The bill includes $56,825,000 for comprehensive centers, the 

same as the fiscal year 2005 level and the budget request. The 

Committee intends these funds to be used for the new comprehensive centers that will provide training, technical assistance, and 

professional development in reading, mathematics, and technology, 

particularly to schools that fail to meet their State’s definition of 

adequate yearly progress. 

The Committee is pleased that the Department has decided to establish a Comprehensive Center in California and urges consideration be given for establishing such a center in southern California. 

Southern California has more than 60 percent of California’s 6.3 

million students, the majority of schools in need of program improvement, the highest number of English Language Learner students, and the largest number of schools targeted for restructuring. 

In addition, southern California has 1.6 million Title I students—

12 percent of the national total; 2,400 Title I schools—6 percent of 

the national total; and over 1 million Limited English Proficient 

students—22 percent of the national total. 

INDIAN EDUCATION

The bill includes $119,889,000 for Indian education. This amount 

is the same as the fiscal year 2005 appropriation and the budget 

request. This account supports programs authorized by part A of 

Title VII of the Elementary and Secondary Education Act and section 215 of the Department of Education Organization Act. 

Grants to local educational agencies 

The bill provides $96,294,000 for grants to local education agencies, the same as the budget request and $1,128,000 above the fiscal year 2005 amount. This program provides assistance through 

formula grants to school districts and schools supported or operated 

by the Bureau of Indian Affairs. The purpose of this program is to 

reform elementary and secondary school programs that serve Indian students, including preschool children. Grantees must develop 

a comprehensive plan and assure 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 $19,595,000 for special programs for 

Indian children, the same as fiscal year 2005 and the budget request. These programs make competitive awards to improve the 

quality of education for Indian students. This program also funds 

a new Indian Teacher Corps, which hopes to train over 1,000 Indian teachers over a five-year period to take positions in schools 

that serve concentrations of Indian children. 

163

National activities 

The bill provides $4,000,000 for national activities, $1,129,000 

below fiscal year 2005 and the same as the budget request. Funds 

under this authority support research, evaluation and data collection to provide information on the status of education for the Indian population and on the effectiveness of Indian education programs. 

INNOVATION AND IMPROVEMENT

The bill includes $708,522,000 for innovation and improvement 

programs. This amount is $384,121,000 less than the comparable 

fiscal year 2005 appropriation and $599,349,000 below the budget 

request for comparable programs. This appropriation account includes programs authorized under part G of title I and portions of 

titles II and V of the Elementary and Secondary Education Act. 

Troops to teachers 

The bill includes $14,793,000 for troops to teachers, the same as 

the budget request and the fiscal year 2005 level. This program is 

designed to assist eligible members of the armed forces to obtain 

certification or licensure as elementary and secondary school teachers, or vocational or technical teachers. The transition to teachers 

program is based on the model of the troops to teachers program 

and would address the need of high-need school districts for highly 

qualified teachers. 

Transition to teaching 

The bill includes $44,933,000 for transition to teaching, the same 

as the budget request and the fiscal year 2005 level. Transition to 

teaching is designed to help mitigate the shortage of qualified licensed or certified teachers in many of our Nation’s schools. The 

program provides grants to help support efforts to recruit, train 

and place talented individuals into teaching positions and to support them during their first years in the classroom. In particular, 

the program focuses on mid-career professionals with substantial 

career experience, and recent college graduates. Grants are made 

on a competitive basis. 

National writing project 

The bill provides $20,336,000 for the National Writing Project, 

the same as the fiscal year 2005 level. The President’s budget did 

not request funding for this program. Funds are provided to the 

National Writing Project, a nonprofit educational organization that 

supports teacher training programs in the effective teaching of 

writing, and supports classroom-level research on teaching writing 

that documents effectiveness in terms of student performance. To 

provide these services, the National Writing Project contracts with 

numerous institutions of higher education and nonprofit education 

providers to operate small teacher training programs. Federal 

funds support 50 percent of the costs of these programs, and recipients must contribute an equal amount. 

164

Teaching of traditional American history 

The bill includes $50,000,000 for the teaching of traditional American history, $69,040,000 below the budget request and the 

fiscal year 2005 level. This program supports competitive grants to 

school districts to promote the teaching of American history in elementary and secondary schools as a separate academic subject. 

School leadership 

The bill includes $14,880,000 for school leadership activities, the 

same as the fiscal year 2005 level. The President’s budget did not 

propose funding for this program. The program provides competitive grants to assist high-need school districts with recruiting, 

training, and retaining principals and assistant principals. 

Advanced credentialing 

The bill includes $16,864,000 for advanced credentialing, the same as the fiscal year 2005 level and $8,864,000 above the budget 

request. The program authorizes competitive grants to states, 

school districts, the National Board for Professional Teaching 

Standards (NBPTS) working with a district or states, the American 

Board for the Certification of Teacher Excellence working with a 

district or state, or another certification or credentialing organization working with a district or state. The program supports activities to encourage and support teachers seeking advanced certification or credentialing. The Committee intends that $9,920,000 of the funds be awarded 

to the National Board for Professional Teaching Standards and 

that $6,944,000 be awarded to the American Board for the Certification of Teacher Excellence. The Committee expresses concern 

that the National Board for Professional Teaching Standards has 

begun to move away from its primary focus of improving classroom 

teacher quality and into other arenas within the education field, 

such as school counseling. The Committee encourages the Board to 

retain its focus on improving the skills and credentials of classroom 

teachers. 

Charter schools 

The Committee recommends $216,952,000 for support of charter schools, $1,750,000 below the budget request and the same as the 

fiscal year 2005 amount. Charter schools are developed and administered by individuals or groups of individuals, which may include 

teachers, administrators, and parents. These groups enter into 

charters for operation of their schools, which must be granted exemptions from State and local rules that limit flexibility in school 

operation and management. Under this program, grants are made 

to State educational agencies in States that have charter school 

laws; the State educational agencies will in turn make sub-grants 

to authorized public chartering agencies in partnerships with developers of charter schools. 

The demand for enrollment in charter schools is likely to increase substantially as a result of the focus on school choice created 

by the No Child Left Behind Act. The Committee is aware that 

both charter schools that operate within a school district, as well 

as those that operate as a separate school district, have had difficulty obtaining funds on a basis equal to traditional school disVerDate jul 14 2003 07:43 Jun 22, 2005 Jkt 021909 PO 00000 Frm 00164 Fmt 6659 Sfmt 6602 E:\HR\OC\HR143.XXX HR143
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tricts and public schools. In addition, charter schools usually do not 

receive funding for facilities equivalent to traditional school districts. The Committee encourages the Secretary to examine means 

by which charter schools can receive their fair share of taxpayer 

dollars, particularly where federal funds are involved. 

Credit enhancement for charter school facilities 

The bill includes $36,981,000 for credit enhancement for charter 

school facilities, the same as the budget request and fiscal year 

2005. This program helps charter schools meet their facility needs 

by providing funding on a competitive basis to leverage other funds 

and help charter schools obtain school facilities by means such as 

purchase, lease and donation. Charter schools are more likely than 

traditional schools to have problems obtaining adequate facilities 

because they are perceived as more financially risky than other 

schools, and unlike traditional school districts, charter schools generally lack the ability to issue general obligation bonds backed by 

property taxes. 

Voluntary public school choice 

The bill includes $26,543,000 for voluntary public school choice, 

the same as the budget request and the fiscal year 2005 level. This 

program supports efforts to establish intradistrict and interdistrict 

public school choice programs to provide parents with greater 

choice for their children’s education. Funds are used to make competitive awards to states, school districts or partnerships. 

Magnet schools assistance 

The bill includes $107,771,000 for the magnet schools assistance 

program, the same as the budget request and the fiscal year 2005 

level. The magnet schools assistance program awards competitive 

grants to local educational agencies for use in establishing or operating magnet schools that are part of a desegregation plan approved by a court or by the Department of Education’s Office for 

Civil Rights. A magnet school is defined by the statute as ‘‘a school 

or education center that offers a special curriculum capable of attracting substantial numbers of students of different racial backgrounds.’’ A funding priority is given to local educational agencies 

that did not receive a grant in the preceding fiscal year. 

Fund for the improvement of education 

The bill includes $27,000,000 for the fund for the improvement 

of education, $387,079,000 below the fiscal year 2005 level and 

$129,296,000 below the comparable budget request. The fund for 

the improvement of education has a broad portfolio of activities. 

Under the fund, the Secretary of Education supports activities that 

identify and disseminate innovative educational approaches. Several separate program authorities are included in this line item, including Foundations for Learning grants. The Committee has included language allowing the Secretary to use funds under FIE to 

carry out an evaluation of the DC School Choice Incentive Act of 

2003. 

166

Teacher Incentive Fund 

The Committee has included $100,000,000 for a pilot program to 

develop and implement innovative ways to provide financial incentives for teachers and principals who raise student achievement 

and close the achievement gap in some of our Nation’s highest-need 

schools. The President requested $500,000,000 for this initiative.

The Committee intends that the Secretary use this funding to 

award competitive grants to local educational agencies (LEAs), including charter schools that are LEAs, States, or partnerships of 

(1) a local educational agency, a State, or both and (2) at least one 

non-profit organization to design and implement fair, differentiated 

compensation systems for public school teachers and principals 

based primarily on measures of gains in student achievement, in 

addition to other factors, for teachers and principals in high-need 

areas. 

The Committee intends that each applicant demonstrate a significant investment in, and ensure the sustainability of, its project 

by committing to pay for an increasing share of the total cost of the 

project, for each year of the grant, with State, local, or other nonFederal funds. The Committee further intends that the Department assess each funded project through an outside, independent 

evaluator, to inform others interested in implementing similar reforms. The Department may use a portion of the funds available 

for this initiative to pay the costs of this evaluation. 

Ready To Learn Television 

The bill does not include funding for the Ready to Learn Television program, $23,312,000 below both the budget request and the 

fiscal year 2005 level. Ready to Learn supports the development 

and distribution of educational video programming for preschool 

children, elementary school children and their parents. Only public 

telecommunications entities are eligible to receive awards. 

Dropout prevention programs 

The bill does not include funding for the dropout prevention program, the same as the budget request. This program was funded 

at $4,930,000 in fiscal year 2005. The dropout prevention program 

provides assistance to help schools implement effective school dropout prevention and reentry programs. This program has only been 

funded for two years, and has made only about two dozen awards. 

The Committee notes that districts desiring to implement dropout 

prevention programs can use funds under title I for innovative programs to support such efforts; hence there is no need for a separately funded line-item to accomplish this purpose. 

Ellender fellowships/Close-Up 

The bill includes $1,469,000 for Ellender fellowships, the same as 

the fiscal year 2005 level. The budget did not propose funding for 

this program. The Ellender fellowship program makes an award to 

the Close-Up Foundation of Washington D.C. This organization 

provides fellowships to students from low income families and their 

teachers to enable them to participate with other students and 

teachers for a week of seminars on government and meetings with 

representatives of the three branches of the Federal government. 

167

Advanced placement test fee program 

The Committee recommends $30,000,000 for advanced placement 

fees. This recommendation is $21,500,000 below the budget request 

and $240,000 above the fiscal year 2005 amount. The advanced 

placement test fee program awards grants to States to enable them 

to cover part or all of the cost of advanced placement test fees of 

low-income students who are enrolled in advanced placement classes and plan to take the advanced placement test. This program also 

supports competitive grants to states, school districts and national 

nonprofit educational agencies for programs that encourage greater 

participation by low-income students in advanced placement 

courses. 

SAFE SCHOOLS AND CITIZENSHIP EDUCATION

The bill includes $763,870,000 for school improvement programs. 

This amount is $96,901,000 less than the comparable fiscal year 

2005 appropriation and $367,103,000 above the budget request for 

comparable programs. This appropriation account includes programs authorized under parts of titles II, IV, and V of the Elementary and Secondary Education Act. 

Safe and drug-free schools and communities: State grants 

The Committee bill includes $400,000,000 for the State grants 

program, $400,000,000 above the budget request and $37,381,000 

below the fiscal year 2005 level. The program supports State formula grants for comprehensive, integrated approaches to drug and 

violence prevention. Local educational agencies must use their 

funds to implement a drug and violence prevention program for 

students and employees. 

Safe and drug-free schools and communities: National programs 

For the national programs under the Safe and Drug-Free Schools 

and Communities Act, the bill provides $152,537,000, the same as 

the fiscal year 2005 amount and $115,430,000 below the budget request. Under this program, the Secretary of Education administers 

a variety of activities to prevent the illegal use of drugs and violence among, and promote safety and discipline for, students at all 

educational levels, preschool through postsecondary. Within the 

amount provided, the Committee intends that the student drug 

testing pilot program be funded at a level of at least $10,000,000. 

Alcohol abuse reduction 

The bill does not include funding for grants to reduce alcohol 

abuse, the same as the budget request and $32,736,000 below the 

fiscal year 2005 level. This program awards competitive grants to 

districts to develop and implement innovative and effective programs to reduce alcohol abuse in secondary schools.

Mentoring programs 

The bill includes $49,307,000 for mentoring programs which provide competitive grants to school districts and community-based organizations to promote mentoring programs for children with the 

greatest need. This is the same as the budget request and the fiscal 

year 2005 level. 

168

Character education 

The bill includes $24,493,000 for character education, the same 

as the fiscal year 2005 level and the budget request. This program 

provides support for the design and implementation of character 

education programs in elementary and secondary schools. Grantees 

may select the elements of character that will be taught, and must 

consider the views of parents and students to be served by the program. 

Elementary and secondary school counseling 

The bill includes $34,720,000 for elementary and secondary 

school counseling, the same as the fiscal year 2005 level. The budget did not propose funding for this program. This program provides 

grants to school districts to enable them to establish or expand elementary school and secondary school counseling programs. 

Physical education for progress 

The bill includes $73,408,000 for the physical education for 

progress program, $18,408,000 above the budget request and the 

same as the fiscal year 2005 level. The Committee expects that 

funds will be used to develop programs that can provide information to states, school districts and other youth organizations on the 

most effective methods for encouraging all students—not simply 

those who are already participating in competitive sports—to develop positive attitudes about fitness and increased levels of personal fitness. 

Civic education 

The bill includes $29,405,000 for civic education, the same as the 

fiscal year 2005 level. The budget did not propose funding for this 

program. Program funds support the ‘‘We the People’’ and the Cooperative Education Exchange programs. ‘‘We the People’’ seeks to 

promote civic competence and responsibility among students. Cooperative Education Exchange provides support for education exchange activities in civics and economics between the United States 

and eligible countries in Central and Eastern Europe, the Commonwealth of Independent States, any country that was formerly a republic of the Soviet Union, the Republic of Ireland, the province of 

Northern Ireland and developing countries with a democratic form 

of government. 

State grants for incarcerated youth offenders 

The bill does not include funding for state grants for incarcerated 

youth offenders, the same as the budget request and $26,784,000 

below the fiscal year 2005 level. This program makes grants to 

state correctional agencies to assist and encourage incarcerated 

youths to acquire functional literacy skills and life and job skills. 

ENGLISH LANGUAGE ACQUISITION

The bill includes $675,765,000 for English language acquisition 

programs. This amount is the same as the budget request and the 

comparable fiscal year 2005 appropriation level. 

This program provides formula grants to states to serve limited 

English proficient students. Grants are based on each state’s share 

169

of the Nation’s limited English proficient and recent immigrant 

student population. Funds under this account also support professional development to increase the pool of teachers prepared to 

serve limited English proficient students and evaluation activities. 

SPECIAL EDUCATION

The bill includes $11,813,783,000 for programs for children with 

disabilities authorized under the Individuals with Disabilities Education Act (IDEA). This funding level is $312,347,000 below the 

budget request and $140,177,000 above the comparable fiscal year 

2005 appropriation. 

State Grants: Grants to States for special education 

The bill provides $10,739,746,000 for grants to States, $358,000,000 below the budget request and $150,000,000 above the 

fiscal year 2005 level. Out of the total made available for school 

year 2006–2007, $5,326,746,000 is appropriated for fiscal year 2006 

for obligation after July 1, 2006 and $5,413,000,000 is appropriated 

for fiscal year 2007 for obligation on, or after, October 1, 2006.

This program provides formula grants to assist the States in 

meeting the excess costs of providing special education and related 

services to children with disabilities. In order to be eligible for 

funds, States must make free appropriate public education available to all children with disabilities. Funds are distributed based 

on the amount that each State received from the fiscal year 1999 

appropriation, and the numbers of children in the general population and who live in poverty in the age range for which each 

State mandates free appropriate public education for children with 

disabilities. 

State grants: Preschool grants 

The bill provides $384,597,000 for preschool grants, the same as 

the fiscal year 2005 level and the budget request. This program 

provides grants to States on the basis of their proportionate share 

of the total number of children in the 3 through 5 age range and 

the number of these children living in poverty. These funds are 

provided in order to assist States to make a free appropriate public 

education available to all children with disabilities in the 3 through 

5 age range. 

State Grants: Grants for infants and families 

The bill provides $440,808,000 for grants for infants and families, the same as the fiscal year 2005 level and the budget request. 

This formula grant program assists States in developing and implementing statewide systems of coordinated, comprehensive, multidisciplinary, interagency programs to make available early intervention services to all children with disabilities, aged birth through 

2, and their families. 

IDEA National Activities: State improvement 

The bill includes $50,653,000 for State improvement, the same as 

the fiscal year 2005 appropriation. The budget did not request 

funding for this program. This program supports competitive 

grants to State educational agencies to assist them, in partnership 

with parents, teachers, institutions of higher education, interest 

170

groups, and others, to improve results for children with disabilities 

by reforming and improving their educational, early intervention, 

and transitional service systems. Among these systems are those 

for professional development, technical assistance, and dissemination of knowledge about best practices. Awards are based on State 

improvement plans developed by the States. 

Special Education—Vocational Rehabilitation Transition Initiative 

The bill does not include funding for a new program proposed by 

the Administration to develop systems for using data on secondary, 

employment and postsecondary school outcomes for students with 

disabilities. The Administration requested $5,000,000 for this initiative. 

IDEA National Activities: Technical assistance and dissemination 

The bill includes $49,397,000 for technical assistance and dissemination, the same as the budget request and $2,999,000 below 

the fiscal year 2005 appropriation. This program provides technical 

assistance and information through competitive awards that support institutes, regional resource centers, clearinghouses, and efforts to build State and local capacity to make systemic changes 

and improve results for children with disabilities. 

IDEA National Activities: Personnel preparation 

The bill includes $90,626,000 for personnel preparation, which is 

the same as the budget request and the fiscal year 2005 appropriation. 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 skills 

and knowledge they need to serve those children. Awards focus on 

addressing the need for personnel to serve low-incidence populations and high-incidence populations, leadership personnel, and 

projects of national significance. 

IDEA National Activities: Parent information centers 

The bill includes $25,964,000 for parent information centers, the 

same as the fiscal year 2005 level and the 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. 

IDEA National Activities: Technology and media services 

The bill includes $31,992,000 for technology and media services, 

which is $6,824,000 below the fiscal year 2005 appropriation and 

the same as the 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. 

171

The bill includes $11,400,000 for Recording for the Blind and 

Dyslexic Inc. These funds support continued production and circulation of recorded textbooks, increased outreach activities to 

print-disabled students and their teachers and accelerated use of 

digital technology. The Committee believes that the funds recommended will enable RFB&D to significantly expand its service 

to students with print disabilities and to continue the digital production and use of its extensive library of educational materials. 

The Committee continues to recognize the importance of very 

small businesses in increasing the quality and cost effectiveness of 

the television-captioning program. As this program transitions into 

a mandated program as authorized by the Telecommunications Act, 

the Department shall give full and fair consideration to the applications for very small businesses. 

REHABILITATION SERVICES AND DISABILITY RESEARCH

The bill includes $3,128,638,000 for rehabilitation services and 

disability research. This amount is $69,340,000 above the budget 

request and $54,064,000 above the fiscal year 2005 appropriation. 

The programs in this account are authorized by the Rehabilitation 

Act of 1973, the Helen Keller National Center Act, and the Assistive Technology Act of 1998. 

Vocational rehabilitation grants to States 

For vocational rehabilitation State grants, the bill includes 

$2,720,192,000, the same as the budget request and $84,347,000 

above fiscal year 2005. 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. 

Client assistance 

The bill includes $11,901,000 for the client assistance program, 

the same as the budget request and the fiscal year 2005 amount. 

A client assistance program is required in each State as a condition 

of receipt of a basic State grant. State formula grants are used to 

help persons with disabilities overcome problems with the service 

delivery system and improve their understanding of services available to them under the Rehabilitation Act. 

Training 

For training personnel to provide rehabilitation services to persons with disabilities, the bill includes $38,826,000, the same as 

the budget request and the fiscal year 2005 amount. 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.

172

Demonstration and training programs 

The bill includes $6,577,000 for demonstration and training pro- grams, the same as the budget request and $19,030,000 below the 

fiscal year 2005 level. These programs authorize discretionary 

awards on a competitive basis to public and private organizations 

to support demonstrations, direct services, and related activities for 

persons with disabilities. 

Migrant and seasonal farmworkers 

For programs serving migrant and seasonal farmworkers, the bill provides $2,302,000, which is the same as the fiscal year 2005 

amount and $2,302,000 above the budget request. This program 

provides discretionary grants to make comprehensive vocational rehabilitation services available to migrant and seasonal farmworkers with vocational disabilities. Projects emphasize outreach 

activities, specialized bilingual rehabilitation counseling, and coordination of vocational rehabilitation services with services from 

other sources. 

Recreational programs 

For recreational programs, the bill provides $2,543,000, the same as the fiscal year 2005 amount and $2,543,000 above the budget request. This program provides individuals with recreation and related activities to aid in their employment, mobility, independence, 

socialization, and community integration. Discretionary grants are 

made on a competitive basis to States, public agencies, and nonprofit private organizations, including institutions of higher education. 

Protection and advocacy of individual rights

For protection and advocacy for persons with disabilities, the bill provides $16,656,000, the same as the budget request and the fiscal 

year 2005 level. Grants are awarded to entities that have the authority to pursue legal, administrative, and other appropriate remedies needed to protect and advocate the rights of persons with disabilities. 

The Committee notes that returning military personnel who have 

sustained disabilities in the course of active service often encounter 

barriers that impede their ability to reenter civilian life. The Committee further notes that families of active duty service members 

that include children and other members with disabilities face 

many stresses and need assistance with accessing appropriate educational as well as health and other support services, such as respite care. The Committee urges the Secretary to provide outreach 

and advocacy services that supplement services and supports provided by the Veteran’s Administration and other veteran and military family organizations. 

Projects with industry 

For projects with industry, the bill provides $19,735,000, $1,890,000 below the fiscal year 2005 amount and $19,735,000 

above the budget request. This program is the primary Federal vehicle for promoting greater participation of business and industry 

in the rehabilitation process. The program provides training and 

experience in realistic work settings to persons with disabilities to 

173

prepare them for employment in the competitive labor market. 

Awards are made to a variety of agencies and organizations, including business and industrial corporations, rehabilitation facilities, labor organizations, trade associations, and foundations. 

Supported employment State grants 

For supported employment State grants, the bill includes 

$30,000,000, which is $7,379,000 below the fiscal year 2005 amount 

and $30,000,000 above the 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. In supported employment programs, persons with significant disabilities are given special supervision and assistance to enable them to work in an integrated setting. 

Independent living: State grants 

For State grants for independent living, the bill includes 

$22,816,000. This amount is the same as the budget request and 

the fiscal year 2005 level. This program supports formula grants to 

the States to provide services for independent living for persons 

with significant disabilities. 

Independent living: Centers 

For centers for independent living, the bill provides $75,392,000, 

which is the same as the budget request and the fiscal year 2005 

level. Discretionary grants support a network of consumer-controlled, nonresidential, community-based private nonprofit centers 

that provide a wide range of services to help persons with significant disabilities live more independently in family and community 

settings. Centers provide information and referral services, independent living skills training, peer counseling, and individual and 

systems advocacy. Discretionary grants are made to private nonprofit organizations. 

Independent living: Services for older blind persons 

For independent living services for older blind individuals, the 

bill provides $33,227,000. This amount is the same as the fiscal 

year 2005 amount and the budget request. Discretionary grants 

support services for persons 55 years old or over whose severe visual impairment makes gainful employment extremely difficult to 

obtain, but for whom independent living goals are feasible. 

Program improvement 

For program improvement activities, the bill provides $843,000, 

which is the same as the fiscal year 2005 level and the same as 

the budget request. The program: (1) provides technical assistance 

and consultative services to public and non-profit private agencies 

and organizations; (2) provides short-term training and technical 

instruction; (3) conducts special demonstrations; (4) collects, prepares, publishes and disseminates educational or informational materials; and (5) carries out monitoring and conducts evaluations. 

174

Evaluation 

The bill includes $1,488,000 for program evaluation, the same as 

the budget request and the fiscal year 2005 level. These funds are 

used to evaluate the impact and effectiveness of individual programs authorized under the Rehabilitation Act. Contracts are 

awarded on an annual basis for studies to be conducted by persons 

not immediately involved in the administration of the programs authorized by the Act. 

Helen Keller National Center 

For the Helen Keller National Center for Deaf-Blind Youth and 

Adults, the bill includes $8,597,000, $1,984,000 below the comparable fiscal year 2005 amount and the same as the budget request. These funds are used for the operation of the national center 

for intensive services for deaf-blind individuals and their families 

at Sands Point, New York and a network of 10 regional offices for 

referral and counseling and technical assistance. 

National Institute on Disability and Rehabilitation Research 

The bill includes $107,783,000 for the National Institute on Disability and Rehabilitation Research, the same as the budget request and the fiscal year 2005 level. The Institute supports research, demonstration and training activities that are designed to 

maximize the employment and integration into society of individuals with disabilities of all ages. 

Assistive technology 

For assistive technology activities, the bill provides $29,760,000, 

the same as the fiscal year 2005 amount and $14,760,000 above the 

budget request. Technology assistance activities are authorized 

under the Assistive Technology Act of 1998. This Act authorizes the 

following activities: discretionary grants to the States to assist 

them in developing statewide programs to facilitate the provision 

of devices for, and services to, persons with disabilities; protection 

and advocacy services related to assistive technology; discretionary 

grants to the states for alternative financing programs; and technical assistance activities. 

SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES

AMERICAN PRINTING HOUSE FOR THE BLIND

The bill provides $17,000,000 for the American Printing House 

for the Blind, an increase of $136,000 above the fiscal year 2005 

appropriation and the budget request. This appropriation subsidizes the production of educational materials for legally blind persons enrolled in pre-college programs. The Printing House, which 

is chartered by the State of Kentucky, manufactures and maintains 

an inventory of special materials that is 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. 

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NATIONAL TECHNICAL INSTITUTE FOR THE DEAF

The bill provides $56,137,000 for the National Technical Institute 

for the Deaf (NTID), an increase of $793,000 above the comparable 

fiscal year 2005 amount and $1,665,000 above the request. Within 

the total, $800,000 is specified for construction. The NTID was established by Congress in 1965 to provide a residential facility for 

postsecondary technical training and education for deaf persons 

with the purpose of promoting the employment of deaf 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 bill provides $107,657,000 for Gallaudet University, an increase of $3,100,000 above the fiscal year 2005 appropriation and 

the budget request. Gallaudet is a private, non-profit educational 

institution Federally-chartered in 1864 providing elementary, secondary, undergraduate, and continuing education for deaf persons. 

In addition, the University offers graduate programs in fields related to deafness for deaf and hearing students, conducts various 

research on deafness, and provides public service programs for deaf 

persons. 

VOCATIONAL AND ADULT EDUCATION

The bill includes $1,991,782,000 for vocational and adult education programs. This amount is $19,166,000 below the fiscal year 

2005 appropriation and $1,776,048,000 above the budget request. 

This appropriation account includes vocational education programs 

authorized by the Carl D. Perkins Vocational and Applied Technology Education Act. The account also includes adult education 

programs originally authorized by the Adult Education Act and reauthorized under the Workforce Investment Act of 1998. 

Vocational education basic grants 

This bill includes $1,194,331,000 for basic grants to States under 

the Carl D. Perkins Vocational and Technical Education Act of 

1998, which is the same as the fiscal year 2005 amount. The budget request proposed elimination of this program and moved the 

funds into the high school reform proposal. Out of the total for 

basic grants to States made available for school year 2004–2005, 

$403,331,000 is appropriated for fiscal year 2006 for obligation 

after July 1, 2006 and $791,000,000 is appropriated for fiscal year 

2007 for obligation on, or after, October 1, 2006. 

State grants support a variety of vocational education programs 

developed in accordance with the State plan. The Act concentrates 

federal resources on institutions with high concentrations of low-income students. The populations assisted by Basic Grants range 

from secondary students in pre-vocational courses to adults who 

need retraining to adapt to changing technological and labor markets. 

The Committee is concerned with instances where State agencies 

are not adequately communicating about the needs and supports 

for students with disabilities, especially those student with disabilVerDate jul 14 2003 07:43 Jun 22, 2005 Jkt 021909 PO 00000 Frm 00175 Fmt 6659 Sfmt 6602 E:\HR\OC\HR143.XXX HR143
176

ities who participate in vocational and technical education curriculums housed either on-site at the local education agency (LEA) or 

at a career and technology center (CTC) apart from the LEA. State 

Educational Agencies have an obligation under the Individuals 

with Disabilities Education Act to ensure that all students with 

disabilities receive a free appropriate public education in the least 

restrictive environment. The Committee strongly encourages States 

to improve collaboration between State agencies and programs to 

ensure that appropriate resources are provided to ensure that all 

students are able to participate appropriately in vocational and 

technical education programs. 

Tech-prep 

The bill includes $105,812,000 for tech-prep, the same as fiscal 

year 2005. The budget request did not propose separate line item 

funding for this program. This appropriation includes activities 

under title II of the Carl D. Perkins Vocational and Technical Education Act of 1998. The tech-prep education program provides planning and demonstration grants to consortia of local educational 

agencies and postsecondary institutions to develop and operate 

model technical education programs. These programs begin in high 

school and provide students with the mathematical, science, communications and technological skills needed to enter a 2-year associate degree or 2-year certificate program in a given occupational 

field, and to make a successful transition into further postsecondary education or begin their careers. The purpose of tech-prep 

is to develop structural links between secondary and postsecondary 

institutions that integrate academic and vocational education and 

better prepares students to make the transition from school to careers. 

National programs 

For national programs, the Committee provides $11,757,000, 

which is the same as the fiscal year 2005 amount. The budget did 

not request separate funding for this program. This authority supports the conduct and dissemination of research in vocational education, and includes support for the National Centers for Research 

and Dissemination in Career and Technical Education, five regional curriculum coordination centers, and other discretionary research. 

Tech-Prep Education Demonstration 

The bill does not include funding for the Tech-Prep Education 

Demonstration. The President’s budget did not request funding for 

it. Last year this program was funded at $4,899,000. The program 

makes competitive grants to consortia to establish Tech-prep programs in secondary schools located on the sites of community colleges. 

Occupational and Employment Information Program 

The bill does not include funding for the Occupational and Employment Information Program. The President’s budget did not request funding for it. Last year this program was funded at 

$9,307,000. The program provides career information and guidance 

177

services to students and adults through a network of state agencies. 

State programs for adult education 

For state grants, the Committee recommends $569,672,000, 

which is the same as the fiscal year 2005 amount, and 

$369,672,000 above the comparable budget request. State formula 

grants support programs to enable all adults to acquire basic literacy skills, to enable those who so desire to complete a secondary 

education, and to make available to adults the means to become 

more employable, productive, and responsible citizens. 

Grants are provided on a formula basis to States under the new 

Adult Education and Family Literacy Act. The formula provides an 

initial allotment of $25,000 for each state and $100,000 to each outlying area, with additional allotments distributed on the basis of 

population aged 16 through 60 who are without a high school diploma or equivalent who are not enrolled in secondary school. 

States may use 12.5 percent of their allotments for state leadership activities and may use an additional 5 percent or $65,000 for 

state administration. States and localities must give priority to 

adult education and literacy activities that are built on a strong 

foundation of research on effective practices and that effectively 

employ technology. Funds are provided on a forward-funded basis. 

The Committee notes that over 40 percent of new adult education 

entrants are seeking English as-a-second language (ESL) services 

and that ESL accounts for 51 percent of all adults receiving adult 

education services and 76 percent of the hours of instruction received. The Committee expects that the funds provided in this program will be used by states with large concentrations of students 

who seek English language proficiency training to meet the needs 

of those individuals. The Committee bill retains language similar 

to that contained in last year’s bill that guarantees a portion of the 

funds will be used to provide civics education services to new immigrants. 

National Programs—National Leadership Activities 

The Committee provides $9,096,000 for national leadership activities. This amount is the same as the fiscal year 2005 level and 

the budget request. Through applied research, development, dissemination, evaluation, and program improvement activities, this 

program assists State efforts to improve the quality of adult education. The funds support such projects as evaluations on the status and effectiveness of adult education programs, national and 

international adult literacy surveys, and technical assistance on 

using technology to improve instruction and administration that 

show promise of contributing to the improvement and expansion of 

adult education. 

National Institute for Literacy 

For the National Institute for Literacy, the bill provides 

$6,638,000, which is the same as the fiscal year 2005 amount and 

the budget request. The Institute supports research and development projects, tracks progress made toward national literacy goals, 

supports research fellowships, disseminates information through a 

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national clearinghouse, and coordinates literacy information data 

from national and State sources. 

Smaller learning communities 

The bill includes $94,476,000 for the smaller learning program, 

the same as the fiscal year 2005 level. The Administration did not 

request funding for this program. As in past years, the bill specifies 

that these funds shall be used only for activities related to the redesign of large high schools enrolling 1,000 or more students. 

Community technology centers 

The bill does not include funding for community technology cen- ters, $4,960,000 below the fiscal year 2005 level and the same as 

the request. The program provides competitive grants to create and 

expand community technology centers that offer disadvantaged 

residents of economically distressed urban and rural communities 

access to information technology and related training. Other Federal programs also exist that fund communities that want to establish and operate technology centers. 

STUDENT FINANCIAL ASSISTANCE

The bill provides $15,283,752,000 for student financial assistance programs, an increase of $1,018,003,000 over the comparable fiscal 

year 2005 appropriation and $232,775,000 above the budget request. 

Pell grants 

The bill increases the maximum Pell Grant to $4,100, $50 below 

the budget request and $50 above the fiscal year 2005 amount. The 

bill provides $13,383,000,000 in new budget authority for the Pell 

Grant program, $184,000,000 above the request and $1,018,003,000 

above the comparable fiscal year 2005 amount. Pell Grants provide 

portable education vouchers to postsecondary students who may 

use them at any of over 6,000 eligible schools. The bill does not include funding for enhanced Pell grants for state scholars, which the 

administration requested at $33,000,000. The Committee notes 

that this program has not been authorized. 

Federal Supplemental Educational Opportunity Grants 

The bill provides $778,720,000 for federal supplemental educational opportunity grants, the same as the request and the fiscal 

year 2005 level. The SEOG program provides grants through postsecondary institutions to qualified students who demonstrate exceptional financial need. Institutions have broad flexibility within 

the eligibility criteria for awarding these grants with the exception 

that priority must be given to Pell Grant recipients. 

Work-study 

The bill provides $990,257,000 for the work-study program, the 

same as the comparable fiscal year 2005 appropriation and the 

budget request. Funding for this program is provided through institutions to students who work part-time to meet the cost of education. Institutions receive funding according to a statutory formula and may allocate it for job location and job development centers. 

179

Perkins loans cancellations 

The bill provides $66,132,000 for federal Perkins loans cancellations, $66,132,000 above the budget request and the same as the 

fiscal year 2005 amount. The Federal Government reimburses institutional Perkins revolving loan funds for loan cancellations permitted under Federal law. Loans may be canceled when the borrower pursues a career in one of 12 statutorily-designated professions including corrections, medical technical work, and peace corps 

or VISTA service. 

Leveraging educational assistance partnership

The bill includes $65,643,000 for the leveraging educational assistance partnership (LEAP) program, the same as the fiscal year 

2005 level and $65,643,000 above the budget request. LEAP provides dollar-for-dollar matching funds to States as an incentive for 

providing need-based grant and work study assistance to eligible 

postsecondary students. Federally supported grants and job earnings are limited to $5,000 per award year for full-time students. By 

law, each State’s allocation is based on its relative share of the 

total national population of students eligible to participate in the 

programs, except that no state is to receive less than it received in 

1979. If LEAP amounts are below this level, each State is allocated 

an amount proportional to the amount of funds it received in 1979. 

If a state does not use all of its allocation, the excess funds are distributed to other States in the same proportion as the original distribution. States must, at a minimum, match LEAP grants dollar 

for dollar with state funds provided through direct state appropriations for this purpose. 

STUDENT AID ADMINISTRATION

The bill includes $124,084,000 in discretionary resources for the 

Student Aid Administration account. The Committee recommendation is $5,000,000 more than the comparable fiscal year 2005 funding level and $20,201,000 below the request, when adjusted for discretionary-scored spending. Funds appropriated to the Student Aid 

Administration account, in addition to mandatory funding available 

through Section 458 of the Higher Education Act, will support the 

Department’s student aid management expenses. The Federal Student Aid Office and the Office of Postsecondary Education have primary responsibility for administering Federal student financial assistance programs. The Committee bill does not include the Administration’s legislative proposal to fund this new account solely 

through annual appropriations. 

LOANS FOR SHORT-TERM TRAINING

The bill does not include a new program to provide loans for 

short-term training proposed for funding by the Administration at 

$11,000,000. This program would help dislocated, unemployed, 

transitioning or older workers and students acquire or upgrade specific job-related skills through short-term training programs of less 

than 10 weeks. The Committee notes that this program is not authorized. 

180

HIGHER EDUCATION

The bill provides $1,936,936,000 for higher education programs, 

a decrease of $179,762,000 below the fiscal year 2005 appropriation 

and $734,621,000 above the budget request. 

Strengthening institutions 

The bill provides $80,338,000 for the regular strengthening institutions program, the same as the budget request and the fiscal 

year 2005 level. This program provides general operating subsidies 

to institutions with low average educational and general expenditures per student and significant percentages of low-income students. Awards may be used for faculty and academic program development, management, joint use of libraries and laboratories, acquisition of equipment, and student services. 

Hispanic-serving institutions 

The bill provides $95,873,000 for the Hispanic-serving institutions program, the same as the budget request and $767,000 above 

the fiscal year 2005 level. The HSI program provides operating 

subsidies to schools that serve at least 25 percent Hispanic students of whom at least half are low-income students. 

Despite the gains by Hispanics in higher education, including a 

300 percent increase over the past 25 years in the enrollment of 

Hispanic-Americans at degree-granting institutions of higher education, the Committee is concerned that Hispanics continue to lag 

behind their non-Hispanic peers in overall education achievement. 

In 2001, only 21.7 percent of all Hispanics in the age group 18–24 

years were enrolled in degree-granting institutions, versus 39.3 

percent of all non-Hispanic white students. In 2001–2002, Hispanics earned only 6.4 percent of the bachelor’s degrees, 4.6 percent of the master’s degrees, and 3.2 percent of the PhDs awarded 

in the U.S. despite the fact that Hispanics comprise over 13 percent 

of the population. The Committee supports legislative efforts in the 

reauthorization of the Higher Education Act to expand graduate 

opportunities for Hispanic-serving institutions and encourages the 

Department to submit a budget request for graduate programs for 

HSIs in the event that such a program expanding graduate opportunities is authorized. 

Strengthening historically black colleges and universities 

The bill provides $240,500,000 for strengthening historically 

black colleges and universities (HBCUs), $1,924,000 above the fiscal year 2005 appropriation and the same as the budget request. 

This program provides operating subsidies to accredited, legally 

authorized HBCUs established prior to 1964 whose principal mission is the education of black Americans. Funds may be used to 

support both programs and management and 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. The minimum grant is $500,000. 

181

Strengthening historically black graduate institutions 

The bill provides $58,500,000 for the strengthening historically 

black graduate institutions program, the same as the budget request and $468,000 above the fiscal year 2005 appropriation. 

The program provides 5-year grants to the following 18 post-secondary institutions that are specified in section 326(e)(1) of the 

Higher Education Act: Morehouse School of Medicine, Meharry 

Medical School, Charles R. Drew Postgraduate Medical School, 

Clark-Atlanta University, Tuskegee University School of Veterinary Medicine, Xavier University School of Pharmacy, Southern 

University School of Law, Texas Southern University Schools of 

Law and Pharmacy, Florida A&M University School of Pharmaceutical Sciences, North Carolina Central University School of Law, 

Morgan State University qualified graduate program, Hampton 

University qualified graduate program, Alabama A&M qualified 

graduate program, North Carolina A&T State University qualified 

graduate program, University of Maryland Eastern Shore qualified 

graduate program, Jackson State qualified graduate program, Norfolk State University and Tennessee State University. Of the 

amount appropriated, the first $26,600,000 is used to make grants 

to the first 16 institutions listed above. Any amount appropriated 

in excess of $26,600,000 but less than $28,600,000 is used to make 

grants to Norfolk State University and Tennessee State University 

and any remaining appropriation is made available to each of the 

18 institutions based on a formula. Awards may be used for building endowments as well as the same purposes for which the 

strengthening HBCU grants may be used. 

Strengthening Alaska Native and Native Hawaiian-serving institutions 

The Committee recommends $6,500,000 for strengthening Alaska 

Native and Native Hawaiian-serving institutions, $5,404,000 below 

the fiscal year 2005 level and the same as the budget request. 

Strengthening tribally controlled colleges and universities 

The Committee recommends $23,808,000 for the strengthening 

tribally controlled colleges and universities program, the same as 

the budget request and the fiscal year 2005 level. 

International education and foreign languages studies 

Domestic programs 

The bill provides $92,466,000 for the domestic activities of the 

international education and foreign languages studies programs, 

the same as the fiscal year 2005 appropriation and the budget request. The program assists graduate and undergraduate foreign 

language and area studies programs and students at institutions of 

postsecondary education. 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. In 

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general, the Secretary has discretion to allocate funding among 

these various activities. 

Overseas programs 

The bill provides $12,737,000 for the overseas programs in international education and foreign language studies authorized under 

the Mutual Educational and Cultural Exchange Act of 1961, popularly known as the Fulbright-Hays Act. The appropriation is the 

same as the budget request and the fiscal year 2005 appropriation. 

Funding for these programs support group projects abroad, faculty 

research abroad, special bilateral projects, and doctoral dissertation 

research abroad. 

Institute for International Public Policy 

The bill provides $1,616,000 for the Institute for International 

Public Policy, the same as the budget request and the fiscal year 

2005 appropriation. This program provides a grant to an eligible 

recipient to operate the Institute through sub-grantees chosen 

among minority serving institutions. 

Fund for the improvement of postsecondary education 

The Committee recommends $49,211,000 for the fund for the improvement of postsecondary education (FIPSE), $27,000,000 above 

the budget request and $112,897,000 below the fiscal year 2005 

amount. FIPSE awards grants and contracts to a variety of postsecondary institutions and other organizations to improve the quality 

and delivery of postsecondary education.

Minority science and engineering improvement 

The bill provides $8,818,000 for the minority science and engineering improvement program (MSEIP), the same as the fiscal year 

2005 appropriation and the budget request. 

The MSEIP 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. 

Interest subsidy grants 

The bill does not include funding for interest subsidy grants authorized under section 121 of the Higher Education Act, the same 

amount requested in the budget and $1,488,000 below the fiscal 

year 2005 appropriation. This program provides loan subsidies to 

higher education institutions for facilities acquisition, construction 

and renovation loans taken prior to 1974. All loans will terminate 

by the fiscal year 2013. The authority to initiate new loan subsidy 

commitments was repealed in the 1992 amendments to the Higher 

Education Act. 

Tribally controlled postsecondary vocational and technical institutions 

The bill includes $7,440,000 for grants for tribally controlled 

postsecondary vocational and technical institutions, the same as 

the budget request and the fiscal year 2005 amount. This program 

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grams to ensure continuation and expansion of vocational training 

opportunities for Indian youth. 

TRIO 

The bill provides $836,543,000 for the TRIO programs, 

$467,153,000 above the budget request and the same as the fiscal 

year 2005 appropriation. The TRIO programs provide a variety of 

outreach and support services to encourage low-income, potential 

first-generation college students to enter and complete college. Discretionary grants of up to four or five years are awarded competitively to institutions of higher education and other agencies. At 

least two-thirds of the eligible participants in TRIO must be lowincome, first-generation college students. 

GEAR UP 

The bill includes $306,488,000 for the GEAR UP program, the 

same as last year’s level and $306,488,000 above the budget request. GEAR UP provides grants to states and partnerships of lowincome middle and high schools, institutions of higher education 

and community organizations to target entire grades of students 

and give them the skills and encouragement to successfully pursue 

postsecondary education. 

Byrd scholarships 

The bill does not include funding for the Byrd scholarships program, the same as the budget request and $40,672,000 below the 

fiscal year 2005 appropriation. The Byrd scholarship program provides formula grants to States to award $1,500 scholarships to students who demonstrate academic excellence in high school. 

Javits fellowships 

The Committee recommends $9,797,000 for the Javits fellowship 

program, the same as the budget request and the fiscal year 2005 

appropriation. Under the Javits program, institutions receive Federal support to make fellowship awards to students pursuing doctoral study in the arts, humanities, and social sciences. 

Graduate assistance in areas of national need program 

The Committee recommends $30,371,000 for the graduate assistance in areas of national need (GAANN) program, the same as the 

budget request and the fiscal year 2005 appropriation. The GAANN 

program awards grants to institutions of higher education to provide fellowships to economically disadvantaged students who have 

demonstrated academic excellence and who are pursuing graduate 

education in designated areas of national need. 

Teacher quality enhancement grants 

The Committee recommends $58,000,000 for teacher quality enhancement grants, $58,000,000 above the budget request and 

$10,337,000 below the fiscal year 2005 appropriation. Teacher quality enhancement grants have three components: state grants, partnership grants and recruitment grants. By statute, state and partnership grants each receive 45 percent of the appropriation, and recruitment grants receive 10 percent. 

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Under the state grant component, states apply to receive up to 

three years of funding to improve the quality of their teaching force 

through promoting reform activities such as teacher licensing and 

certification, accountability for high quality teacher preparation 

and professional development and recruiting teachers for high-need 

schools. States must match 50 percent of the federal award. 

Under the partnership component, partnerships apply to receive 

a five-year grant to strengthen the capacity of K–12 educators in 

designing and implementing effective teacher education programs, 

and by increasing collaboration among these practitioners and departments of arts and sciences and schools of education at institutions of higher education. Partnerships must match 25 percent of 

the federal grant in the first year, 35 percent in the second year, 

and 50 percent for the remaining years. 

The recruitment component supports the efforts to reduce shortages of qualified teachers in high-need school districts. States or 

partnerships may apply to receive these grants. 

The Committee believes that colleges of education play a key role 

in improving teacher quality. The Committee urges colleges receiving teacher quality enhancement grants to consider the recommendations made by the Teaching Commission, including recruiting stronger students from all major fields of study, requiring 

education majors to receive at least a minor in an academic subject 

in addition to education, using research-based practices and pedagogy and offering opportunities to learn and observe in a real world 

setting. 

Child care access means parents in school 

The Committee recommends $15,970,000 for child care access 

means parents in school program, the same as the budget request 

and the fiscal year 2005 appropriation. Under this program, institutions may receive discretionary grants of up to four years to support or establish a campus-based childcare program primarily serving the needs of low-income students enrolled at the institution. 

Priority is given to childcare programs that leverage significant 

local or institutional resources and utilize a sliding fee scale. 

Grants can only be used to supplement childcare services or start 

new programs. 

Community college access 

The bill does not include funding for a proposed community college access program, which was requested by the Administration at 

$125,000,000. This program would support competitive awards to 

States providing dual-enrollment programs through which high 

school students take college-level courses through community colleges and receive both high school and postsecondary credit. The 

Committee notes that this program has not been authorized. 

Demonstration projects to ensure quality higher education for students with disabilities 

The Committee does not recommend funding for demonstration 

projects in disabilities, the same as the budget request. The program was funded at $6,944,000 in fiscal year 2005. 

This program provides discretionary grants for three years to 

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185

ance and professional development activities for faculty and administrators in institutions of higher education in order to provide students with disabilities a high-quality postsecondary education. A 

number of models have now been developed and are being disseminated to other institutions. 

Underground railroad program 

The Committee does not recommend funding for the underground 

railroad program, which is the same as the budget request. This 

program was funded at $2,204,000 in fiscal year 2005. The underground railroad program provides grants to non-profit institutions 

to research, display, interpret and collect artifacts relating to the 

history of the underground railroad. 

GPRA data/HEA program evaluation 

The Committee recommends $980,000 for program evaluation 

and development of data required under the Government Performance and Results Act for Higher Education programs administered 

by the Department. This is the same as the fiscal year 2005 appropriation and the budget request. 

The Committee understands that for many higher education programs, baseline and performance indicator data are sparse, nonexistent or difficult to collect. Funding under this activity will support the Department in developing high-quality data as required 

under the Government Performance and Results Act. 

Olympic Scholarships 

The bill includes $980,000 for Olympic Scholarships, the same as 

the fiscal year 2005 level. The budget did not request funding for 

this program. This program provides financial assistance to athletes who are training at the U.S. Olympic Education Center or one 

of the U.S. Olympic Training Centers and who are pursuing a postsecondary education at an institution of higher education. 

Thurgood Marshall legal education opportunity program

The bill does not include funding for the Thurgood Marshall legal 

education opportunity program, the same as the budget request. 

The program was funded at $2,976,000 in fiscal year 2005. This 

program provides low-income, minority and disadvantaged college 

students with the information, preparation and financial assistance 

needed to gain access to and complete law school study. 

HOWARD UNIVERSITY

The bill provides $240,790,000 for Howard University, $2,000,000 

above the budget request and the fiscal year 2005 appropriation. 

The bill includes a minimum of $3,524,000 for the endowment, 

which is the same as the current level. 

Howard University is a ‘‘Research I’’ university located in the 

District of Columbia. Direct appropriations for Howard University 

are authorized by 20 U.S.C. 123, originally enacted in 1867. Howard University provides undergraduate liberal arts, graduate and 

professional instruction to approximately 11,000 students from all 

50 States. Masters degrees are offered in over 55 fields and Doctor 

of Philosophy degrees in 26 fields. 

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COLLEGE HOUSING AND ACADEMIC FACILITIES LOANS PROGRAM

The bill provides $573,000 for the Federal administration of the 

college housing and academic facilities loan (CHAFL) program, the 

Higher Educational Facilities Loans program and the College 

Housing Loans program, the same as the budget request and the 

fiscal year 2005 appropriation. 

HISTORICALLY BLACK COLLEGE AND UNIVERSITY CAPITAL AND

FINANCING PROGRAM

Federal administration 

The bill provides $210,000 for the administration of the historically black college and university capital financing program authorized under part D of title III of the Higher Education Act, the same 

as the fiscal year 2005 appropriation and the same as the budget 

request. The program is intended to make 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. 

Bond subsidies 

Under the HBCU capital program, a private, for-profit ‘‘designated bonding authority’’ issues construction bonds to raise capital for loans to historically black colleges and universities for construction projects. The Department provides insurance for these 

bonds, guaranteeing full payment of principal and interest to bond 

holders. Federally insured bonds and unpaid interest are limited by 

statute to $375,000,000. The letter of credit limitation establishes 

the total amount of bonds which can be issued by the designated 

bonding authority. The credit limitation must be explicitly stated 

in an appropriation Act according to the authorizing legislation. 

INSTITUTE OF EDUCATION SCIENCES

The bill includes $522,696,000 for the Institute of Education 

Sciences. This amount is $43,632,000 above the budget request, 

and $538,000 below the fiscal year 2005 level. This account supports education research, statistics, and assessment activities. 

Research 

This bill includes $164,194,000 for educational research, the 

same as the fiscal year 2005 level and the budget request. The Institute of Education Sciences 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 

This bill includes $90,931,000 for the activities of the National 

Center for Education Statistics, exclusive of the National Assessment of Educational Progress. This amount is the same as the 

budget request and the fiscal year 2005 level. 

Statistics activities are authorized under the Education Sciences 

Reform Act of 2002, title I of P.L. 107–279. The Center collects, 

analyzes, and reports statistics on all levels of education in the 

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United States. Activities are carried out directly and through 

grants and contracts. Major publications include ‘‘The Condition of 

Education’’ and ‘‘Digest of Education Statistics.’’ Other products include projections of enrollments, teacher supply and demand, and 

educational expenditures. Technical assistance to state and local 

education agencies and postsecondary institutions is provided. 

International comparisons are authorized. 

Regional educational laboratories 

The Committee has included $66,132,000 for the regional educational laboratories. This amount is the same as the fiscal year 

2005 level. The budget request did not include funding for this program. The Committee believes that the regional educational laboratories can play a key role in supporting the achievement of all children by focusing and aligning their work to help states and education practitioners implement the requirements contained in the 

No Child Left Behind Act (NCLB). This assistance should include 

product development, applied research, technical assistance and 

professional development. The Committee intends that each regional educational laboratory identify priority NCLB issues in their 

designated region and provide assistance with the implementation 

of NCLB. Particular focus should be placed on helping states and 

schools implement the provisions contained in the Highly Qualified 

Teacher regulations. 

IDEA National Activities: Research and innovation 

The bill includes $72,566,000 for research and innovation, 

$10,538,000 below the fiscal year 2005 level and the same as the 

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 bill includes $10,000,000 for special education studies and 

evaluations, the same as the budget request and $6,000,000 below 

the comparable fiscal year 2005 level. This program awards competitive grants, contracts and cooperative agreements to assess the 

implementation of the Individuals with Disabilities Education Act 

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. Funding for this activity 

was previously supported through funds set aside under the special 

education grants to states program. 

Statewide data systems 

The bill includes $24,800,000 for statewide data systems development, the same as the budget request and the fiscal year 2005 

level. This program awards grants, on a competitive basis, to State 

educational agencies to enable such agencies to design, develop, 

and implement statewide, longitudinal data systems to efficiently 

and accurately manage, analyze, disaggregate, and use individual 

student data, consistent with the No Child Left Behind Act. 

188

The Committee supports the design, development and implementation of longitudinal data systems that will enable States to use 

data to close achievement gaps. The Committee notes that much of 

this data is already being collected and is available for free on various websites, such as www.schoolmatters.com, and the Committee 

encourages the Department, states, school districts, researchers 

and the public to make use of available data to improve education 

and management of taxpayer resources. 

Assessment 

This bill includes $94,073,000 for the National Assessment of 

Educational Progress, $22,500,000 below the budget request, and 

the same as the fiscal year 2005 level. The Assessment is authorized under section 303 of the National Assessment of Educational 

Progress Authorization Act, and is the only nationally representative 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 Assessment is operated by 

contractors through competitive awards made by the National Center for Education Statistics; a National Assessment Governing 

Board formulates the policy guidelines for the program. Within the 

amounts provided, $5,088,000 is for the National Assessment Governing Board. 

The Committee is concerned that a key purpose of public education is being neglected: the civic mission of schools to educate our 

young people for democracy and to prepare them to be engaged citizens. The National Assessments of Educational Progress in civics 

and history are the best way we have to measure how well schools 

are doing in fulfilling this purpose. Therefore, the Committee requests that the National Assessment Governing Board, in consultation with the Commissioner, National Center for Education Statistics, prepare a report on the feasibility of the National Assessment 

of Educational Progress conducting state level assessments in the 

subjects of U.S. history and civics at grades 8 and 12 and, if feasible, the earliest schedule under which such assessments could be 

administered. The Governing Board shall, within 180 days of enactment of the FY 2006 appropriation, submit the feasibility report 

to the House and Senate Appropriations Committees, the House 

Education and the Workforce Committee, the Senate Health, Education, Labor and Pensions Committee, and the Secretary of Education.

DEPARTMENTAL MANAGEMENT

The bill includes $559,518,000 for departmental management 

(salaries and expenses) at the Department of Education. This 

amount is $3,536,000 above the fiscal year 2005 appropriation and 

$408,000 below the 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 operations of 

the Department as well as separate costs associated with the Office 

for Civil Rights and the Office of the Inspector General. 

189

The Committee continues to be pleased with the emphasis the 

Department’s senior management team has placed on complying 

with the Government Performance and Results Act. The Committee 

expects the Department to continue to develop and refine GPRA 

measures for all programs, focusing particularly on student 

achievement outcomes. 

The Committee urges the Department of Education to fully investigate whether Xavier University of Louisiana is entitled to approximately $1,142,465 as a result of errors by the Department of 

Education with respect to Federal Cash Transaction Reports (ED–

PMS–272) and the Grant Administrative and Payment System 

(GAPS) from the period of March 31, 1987 through June 30, 2002. 

If the results of an investigation determine that such errors were 

made by the Department of Education, the Committee urges the 

Department of Education to reimburse all funds owed to Xavier 

University as a result of such errors. 

Program administration 

The bill includes $418,992,000 for program administration. This 

amount is $288,000 below the fiscal year 2005 appropriation and 

the same as the budget request. These funds support the staff and 

other costs of administering programs and activities at the Department. Items include personnel compensation and 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. 

The Committee recognizes the invaluable role that the Communities Can program has served over the last five years and the important financial support for this endeavor arranged by the Federal 

Interagency Coordinating Council (FICC) through the Departments 

of Education and of Health and Human Services, among others. 

Communities Can efforts have proven valuable in ensuring the integration into their communities of children and youth with disabilities and their families by promoting models of coordinated services 

that have ensured effective utilization of scarce resources. The 

models have generated support from the private sector, including 

faith-based organizations, which has amplified the impact of public 

resources. In light of the dissolution of the FICC, the Committee 

is concerned that Communities Can be able to continue its work in 

promoting effective models of coordinated services for this population. Therefore, the Committee requests the Office of Special 

Education and Rehabilitative Services to provide it a plan of action 

for carrying forward this activity in the absence of the FICC. 

The Committee is aware that the Department of Education is 

taking steps to restructure the Rehabilitation Services Administration’s system for providing oversight and monitoring of the Vocational Rehabilitation program. The Committee is interested in ensuring that the Department have a replacement system and plan 

in place for accountability, monitoring and technical assistance of 

these programs prior to the dismantling of the current system. The 

Committee directs the Department to develop such a plan and discuss such a plan with state vocational Rehabilitation agencies and 

stakeholders in advance of further staffing reductions. 

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Office for Civil Rights 

The bill includes $91,526,000 for the salaries and expenses of the 

Office for Civil Rights. This amount is $2,151,000 above the fiscal 

year 2005 appropriation and the same as the budget request. This 

Office is responsible for enforcing laws that prohibit discrimination 

on the basis of race, color, national origin, sex, disability, membership in a patriotic society, and age in all programs and institutions 

that receive funds from the Department. These laws extend to 50 

State educational agencies, 16,000 local educational agencies, 3,500 

institutions of higher education, as well as to proprietary schools, 

State rehabilitation agencies, libraries, and other institutions receiving Federal funds. 

Office of the Inspector General 

The bill includes $49,000,000 for the Office of the Inspector General. This amount is $1,673,000 above the fiscal year 2005 appropriation and $408,000 below the 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 which prohibits 

funds under 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 which prohibits 

funds under 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 which prohibits 

funds under this Act from being used to prevent the implementation of programs of voluntary prayer and meditation in public 

schools. 

Sec. 304. The Committee continues a provision which allows up 

to 1 percent of any discretionary funds appropriated for the Department of Education to be transferred between appropriations accounts, provided that no appropriation is increased by more than 

3 percent by any such transfer. This provision requires the Secretary to notify the Appropriations Committees of both Houses of 

Congress at least 15 days in advance of a transfer. 

Sec. 305. The Committee includes a provision, pursuant to section 303 of H. Con. Res. 95, the concurrent resolution on the budget 

for fiscal year 2006, which provides $4,300,000,000 for the purpose 

of eliminating the estimated Pell grant shortfall. 

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TITLE IV—RELATED AGENCIES 

COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR

SEVERELY DISABLED

The bill provides $4,669,000 for the Committee for Purchase 

From People Who Are Blind or Severely Disabled, the same as the 

comparable fiscal year 2005 appropriation and the budget request. 

The Committee for Purchase From People Who Are Blind or Severely Disabled was established by the Wagner-O’Day Act of 1938 

as amended. Its primary objective is to increase the employment 

opportunities for people who are blind or have other severe disabilities and, whenever possible, to prepare them to engage in competitive employment. 

CORPORATION FOR NATIONAL AND COMMUNITY SERVICE

The Corporation for National and Community Service was established by the National and Community Service Trust Act of 1993 

to enhance opportunities for national and community service and 

provide national service educational awards. The Corporation 

makes grants to States, institutions of higher education, public and 

private nonprofit organizations, and others to create service opportunities for a wide variety of individuals through full-time national 

and community service programs. The Committee requests that the 

Chief Executive Officer of the Corporation be prepared to discuss 

the economic impact of its programs at the fiscal year 2007 appropriations hearing. 

DOMESTIC VOLUNTEER SERVICE PROGRAMS

The Committee recommends $357,962,000 for the Domestic Volunteer Service Programs that are administered by the Corporation 

for National and Community Service. This is $4,217,000 above the 

fiscal year 2005 appropriation and $2,000,000 below the budget request. Appropriations for these programs are not authorized in law 

for fiscal year 2006. 

VISTA 

The Committee recommends $96,428,000 for the Volunteers in 

Service to America (VISTA) program, this is $2,188,000 above the 

fiscal year 2005 level and the same as the budget request. The 

VISTA program supports individuals who recruit volunteers and 

organize community volunteer activities but who do not provide direct volunteer services. 

Teach for America 

The Committee recommends $2,000,000 for capacity building for 

Teach for America. This is $2,000,000 less than the budget request. 

National Senior Volunteer Corps 

The Committee recommends a total of $219,784,000 for the National Senior Volunteer Corps, $3,927,000 above the fiscal year 

2005 level and the same as the budget request. 

The Committee recommends $112,058,000 for the Foster Grandparents program, $634,000 above the fiscal year 2005 level and the 

192

same as the budget request. This program provides volunteer service opportunities for low-income people aged 60 and over. 

The Committee recognizes the valuable contributions of seniors 

participating in the Foster Grandparent Program [FGP]. In accordance with the Domestic Volunteer Service Act [DVSA], the Committee intends that one-third of the increase over the fiscal year 

2005 level shall be used to fund Program of National Significance 

[PNS] expansion grants to allow existing FGP programs to expand 

the number of volunteers serving in areas of critical need as identified by Congress in the DVSA. All remaining funds shall be used 

to fund an administrative cost increase for each Foster Grandparent Program nationwide. The amount to be allocated to individual grantees shall be calculated based on a percentage of the entire federal grant award in fiscal year 2005, including the amount 

specified for payment of non-taxable stipends to Foster Grandparent volunteers. The Corporation for National and Community 

Service (CNCS) shall comply with the directive that use of PNS 

funding increases in the FGP shall not be restricted to any particular activity. The Committee further directs that CNS shall not 

stipulate a minimum or maximum amount for PNS grant augmentation. 

In addition, the maximum dollars CNCS may use in FY 2006 for 

Communications and Training, Technical Assistance, and Recruitment and Retention activities shall not exceed the amount enacted 

for these two activities in FY 2005. 

Funds appropriated for FY 2006 may not be used to implement 

or support service collaboration agreements or any other changes 

in the administration and/or governance of national service programs prior to passage of a bill by the authorizing committee of jurisdiction specifying such changes. 

The CNCS shall comply with the directive that use of funding increases in the FGP, RSVP, SCP and VISTA not be restricted to any 

particular activity. In addition, none of these increases may be 

used to fund demonstration activities. 

The Committee recommends $47,438,000 for the Senior Companion program, $1,533,000 above the fiscal year 2005 appropriation and the same as the budget request. The program provides 

project grants to private, non-profit organizations and State and 

local public agencies to offer volunteer service opportunities to lowincome individuals aged 60 and over. These volunteers assist older 

adults with physical, mental or emotional impairments that put 

them at risk for institutionalization. 

The bill provides $60,288,000 for the Retired Senior Volunteer 

Program (RSVP), $1,760,000 above the fiscal year 2005 appropriation and the same as the budget request. This program provides 

part-time volunteer service opportunities for low-income individuals aged 55 and over to recruit volunteers and organize volunteer 

activities relating to a variety of social needs.

Program administration 

The Committee recommends $39,750,000 for program administration, $1,062,000 above the fiscal year 2005 appropriation and 

the same as the budget request. 

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NATIONAL AND COMMUNITY SERVICE PROGRAMS, OPERATING

EXPENSES

(INCLUDING TRANSFER OF FUNDS)

The Committee recommends $523,087,000 for National and Community Service Programs operating expenses, including the Trust. 

This is $18,430,000 less than the comparable fiscal year 2005 level 

and $5,000,000 less than the budget request. The Committee recommends $270,000,000 for AmeriCorps State and National grants 

(authorized under subtitle C) and education awards only grants 

(authorized under subtitle H), plus an additional $146,000,000 for 

the Trust, including $10,000,000 to be held in reserve, and 

$4,000,000 for the President’s Freedom Scholarships. 

The Committee recommendation includes the following program 

levels:

Learn and Serve .................................................................................... $40,000,000 

National Civilian Community Corps .................................................... 25,500,000 

Innovation and Demonstration ............................................................. 9,945,000 

Evaluation .............................................................................................. 4,000,000 

State Commissions ................................................................................ 12,642,000 

Points of Light Foundation ................................................................... 10,000,000 

America’s Promise ................................................................................. 5,000,000

SALARIES AND EXPENSES

The Committee recommends $27,000,000 for salaries and expenses associated with the administrative activities of the Corporation. This is $1,208,000 more than the comparable fiscal year 2005 

level and the same as the budget request. 

OFFICE OF INSPECTOR GENERAL

The Committee recommends $6,000,000 for Office of Inspector 

General, $48,000 more than the comparable fiscal year 2005 level 

and the same as the budget request. The Committee directs the Inspector General to continue to review the Corporation’s management of the National Service Trust. 

The Office of Inspector General is authorized by the Inspector 

General Act of 1978, as amended. This Office provides an independent assessment of all Corporation operations and programs, including those of the Volunteers in Service to America and the National Senior Service Corps, through audits, investigations, and 

other proactive projects. 

ADMINISTRATIVE PROVISIONS

The Committee recommendation includes a number of administrative provisions carried previous years: (1) language regarding 

qualified student loans eligible for education awards; (2) language 

regarding the availability of funds for the placement of volunteers 

with disabilities; (3) language directing the Inspector General to 

levy sanctions in accordance with standard Inspector General audit 

resolution procedures, which include, but are not limited to, debarment of any grantee found to be in violation of AmeriCorps’ program requirements, including using grant or program funds to 

lobby the Congress; (4) language which requires the Corporation to 

ensure that significant changes to program requirements or policy 

are made only through public notice and comment rulemaking; and 

194

(5) language prohibiting an officer or employee of the Corporation 

from disclosing any grant selection information to any person not 

authorized to receive such information. 

CORPORATION FOR PUBLIC BROADCASTING

The Committee has provided $400,000,000 in advance funding 

for fiscal year 2008 for the Corporation for Public Broadcasting 

(CPB). The Administration did not request any advance funding. 

The Committee has included authority for CPB to spend up to 

$30,000,000 in previously appropriated fiscal year 2006 funds for 

digital conversion activities. The Committee has also included authority for CPB to spend up to $52,000,000 in fiscal year 2006 

funds the Satellite Interconnection system. 

The Committee rescinds $100,000,000 in funds previously appropriated for fiscal year 2006. 

FEDERAL MEDIATION AND CONCILIATION SERVICE

The bill provides $42,331,000 for the Federal Mediation and Conciliation Service (FMCS), a decrease of $2,108,000 below the comparable fiscal year 2005 appropriation the same as the budget request. 

The FMCS attempts to prevent and minimize labor-management 

disputes having a significant impact on interstate commerce or national defense, except in the railroad and airline industries. The 

agency convenes boards of inquiry appointed by the President in 

emergency disputes and conducts dispute mediation, preventive 

mediation, and arbitration. In addition, the Service offers alternative dispute resolution services and training to other Federal 

agencies to reduce litigation costs and speed Federal administrative 

proceedings. 

The bill also includes provisions first enacted in the fiscal year 

1996 Appropriations Act granting the agency the authority to accept gifts and to charge fees for certain services. 

FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION

The bill provides $7,809,000 for the Federal Mine Safety and 

Health Review Commission, which is the same as the fiscal year 

2005 level and the same as the budget request. The Commission 

is responsible for reviewing the enforcement activities of the Secretary of Labor under the Federal Mine Safety and Health Act. The 

Commission’s administrative law judges hear and decide cases initiated by the Secretary of Labor, mine operators, or miners. The 

five-member Commission hears appeals from administrative law 

judge decisions, rules on petitions for discretionary review, and 

may direct, of its own initiative, review of cases that present unusual questions of law. 

INSTITUTE OF MUSEUM AND LIBRARY SERVICES

The Committee recommends $249,640,000 for the Institute of 

Museum and Library Services. This is $30,924,000 below the fiscal 

year 2005 level and $8,965,000 below the budget request. The Institute makes state formula grants for library services and discretionary national grants for joint library and museum projects. 

195

For Library Services, the Committee recommends $165,500,000 for State Grants and $3,500,000 for library services to Native 

Americans and Native Hawaiians. The Committee recommends 

$12,500,000 for national leadership grants. 

In honor of her career as a librarian and lifelong dedication to 

early learning, early reading, and literacy, the Committee has renamed the Librarians for the 21st Century program, the Laura 

Bush 21st Century Librarian Program. The Committee has included $24,000,000 for this program that recruits and educates librarians. This program is helping recruit new professionals for 

public, academic, research and school libraries; building the capacity of library schools through faculty and curriculum development; 

and updating the skills of current library workers. The Committee 

is particularly interested in the program’s work in enhancing 

school library media centers. Research has established the value of 

the school library media center to student achievement, but there 

is a great need to raise awareness among teachers and school administrators about the role that the library and librarian can play. 

School library media centers can contribute to improved student 

achievement by providing instructional materials aligned to the 

curriculum; by collaborating with teachers, administrators and parents; and by extending their hours of operation beyond the school 

day. The Committee encourages IMLS to establish a priority within 

the Laura Bush 21st Century Librarian Program to develop or enhance programs to promote collaboration between educators and librarians employed in educational institutions. 

For Museum Services, the Committee recommends $17,325,000 

for the Museums for America program, $992,000 for the 21st Museum Professionals program, and $446,000 for Museum Assessment 

programs. The Committee recommends $2,800,000 for Conservation 

Project Support; $815,000 for the Conservation Assessment Program; $8,000,000 for National Leadership Grants for Museums, 

and $845,000 for Native American and Native Hawaiian Museum 

Services. The Committee has included $1,000,000 and in first time 

funding for Museum Grants for African American History and Culture. 

The Committee recommends $11,917,000 for program administration, the same as the budget request.

MEDICARE PAYMENT ADVISORY COMMISSION

The Committee recommends $10,168,000 for the Medicare Payment Advisory Commission, an increase of $269,000 above the comparable fiscal year 2005 appropriation and the budget request. The 

Commission advises Congress on matters of physician and hospital 

reimbursement under the Medicare and Medicaid programs. 

NATIONAL COMMISSION ON LIBRARIES AND INFORMATION SCIENCE

The Committee recommends $993,000 for the National Commission on Libraries and Information Science. This is the same as the 

fiscal year 2005 level and the budget request. 

NATIONAL COUNCIL ON DISABILITY

The bill provides $2,800,000 for the National Council on Disability (NCD), a decrease of $544,000 below the comparable fiscal 

196

year 2005 appropriation and the same as the budget request. The 

Council monitors implementation of the Americans with Disabilities Act and makes recommendations to the President, the Congress, the Rehabilitation Services Administration, and the National 

Institute on Disability and Rehabilitation Research on public policy 

issues of concern to individuals with disabilities. 

NATIONAL LABOR RELATIONS BOARD

The bill provides $252,268,000 for the National Labor Relations 

Board (NLRB). This is $2,408,000 above the fiscal year 2005 level 

and the same as the budget request. The NLRB receives, investigates, and prosecutes unfair labor practice charges filed by businesses, labor unions, and individuals. It also schedules and conducts representation elections. The five-member Board considers 

cases in which an administrative law judge decisions are appealed. 

The Committee remains concerned about the involuntary expansion of the mandatory jurisdiction of the National Labor Relations 

Board (NLRB) and its ever increasing burden on small businesses. 

The Committee asks the administration to investigate the heavy 

caseload taken on by the NLRB and how the backlog might be reduced through an adjustment of the jurisdictional thresholds set in 

1959. The Committee urges NLRB to examine the scope of its original jurisdiction, and report to the Committee by March 1, 2006 on 

how its jurisdiction has increased since 1959 due to the absence of 

adjustments on the mandatory jurisdiction thresholds to account 

for inflation. Additionally, the Committee urges NLRB to report on 

the number of cases brought before NLRB annually, delineated by 

incremental thresholds of gross receipts and/or purchases, and bargaining unit size, with special attention paid to cases involving 

small businesses. Inasmuch as current NLRB reporting requirements may not capture this information in such detail, the Committee urges the NLRB to revise all necessary forms and regulations to capture such data on an individual basis (or, at a minimum, in an appropriate ‘‘banded’’ aggregate). 

NATIONAL MEDIATION BOARD

The bill provides $11,628,000 for the National Mediation Board 

(NMB), the same as the comparable fiscal year 2005 appropriation 

and the budget request. The NMB mediates labor disputes between 

employees and railroad and airline carriers subject to the Railway 

Labor Act. The Board also resolves representation disputes involving labor organizations seeking to represent railroad or airline employees. 

OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION

The bill provides $10,510,000 for the Occupational Safety and 

Health Review Commission, the same as the fiscal year 2005 level 

and the budget request. The Commission adjudicates contested citations issues by the Occupational Safety and Health Administration against employers for violations of safety and health standards. The Commission’s administrative law judges settle and decide 

cases at the initial level of review. The agency’s three appointed 

Commissioners also review cases, issue rulings on complicated 

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issues, and may direct review of any decision by an administrative 

law judge. 

RAILROAD RETIREMENT BOARD

DUAL BENEFITS ACCOUNT

The bill provides $97,000,000 for dual benefits, a decrease of 

$10,136,000 below the comparable fiscal year 2005 appropriation 

and the same as the budget request. These funds are used to pay 

dual benefits to those retirees receiving both railroad retirement 

and social security benefits. The bill 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 $7,000,000 may be derived in 

this manner. 

FEDERAL PAYMENT TO THE RAILROAD RETIREMENT ACCOUNT

The bill provides $150,000 for the interest earned on unnegotiated checks, the same as the budget request and the comparable 

amount provided for fiscal year 2005. 

LIMITATION ON ADMINISTRATION

The bill provides a consolidated limitation of $102,543,000 on the 

expenditure of railroad retirement and railroad unemployment 

trust funds for administrative expenses of the Railroad Retirement 

Board, the same as the comparable fiscal year 2005 appropriation 

and the budget request. The bill includes a provision from the fiscal 

year 1999 Appropriations Act prohibiting the transfer of resources 

formerly identified in a Memorandum of Understanding from the 

RRB to the Inspector General. 

The Railroad Retirement Board (RRB) administers comprehensive retirement-survivor and unemployment-sickness insurance 

benefit programs for railroad workers and their families. This account limits the amount of funds in the railroad retirement and 

railroad unemployment insurance trust funds that may be used by 

the RRB for administrative expenses. The Committee prohibits 

funds from the railroad retirement trust fund from being spent on 

any charges over and above the actual cost of administering the 

trust fund, including commercial rental rates. 

The bill includes language (Sec. 516) limiting the availability of 

funds to the Railroad Retirement Board to enter into an arrangement with a nongovernmental financial institution to serve as disbursing agent for benefits payable under the Railroad Retirement 

Act of 1974. 

The Committee is pleased with the management of the Board 

and reiterates its interest in quickly and comprehensively implementing the Government Performance and Results Act. 

LIMITATION ON THE OFFICE OF INSPECTOR GENERAL

The bill provides authority to expend $7,196,000 from the railroad retirement and railroad unemployment insurance trust funds 

for the Office of Inspector General, the same as the comparable fiscal year 2005 appropriation and the budget request. This account 

provides funding for the Inspector General to conduct and superVerDate jul 14 2003 07:43 Jun 22, 2005 Jkt 021909 PO 00000 Frm 00197 Fmt 6659 Sfmt 6602 E:\HR\OC\HR143.XXX HR143
198

vise audits and investigations of programs and operations of the 

Board. 

The Committee compliments the work of the Office of the Inspector General of the Railroad Retirement Board for their work in obtaining information on actual collections, offsets, and funds put to 

better use as required in House Report 105–635. This information 

is of great use to the Committee and the Committee understands 

the difficulty encountered by the OIG in obtaining it. The Committee expects that the Office of Inspector General will continue to 

report the information to it.

SOCIAL SECURITY ADMINISTRATION

PAYMENTS TO SOCIAL SECURITY TRUST FUNDS

The bill provides $20,470,000 for mandatory payments necessary 

to compensate the Old Age and Survivors Insurance (OASI) and 

Disability Insurance (DI) Trust Funds for special payments to certain uninsured persons (for which no payroll tax is received), costs 

incurred for administration of pension reform activities and interest lost on the value of benefit checks issued but not negotiated. 

This appropriation restores the trust funds to the position they 

would have been in had they not borne these costs properly 

charged to the general funds. 

SUPPLEMENTAL SECURITY INCOME PROGRAM

The Committee provides $29,533,174,000 for the Supplemental 

Security Income (SSI) program. The Committee also provides 

$11,110,000,000 in advance funding for the first quarter of fiscal 

year 2007. 

Beneficiary services 

In addition to Federal benefits, the Social Security Administration (SSA) administers a program of supplementary State benefits 

for those States that choose to participate. The funds are also used 

to reimburse the trust funds for the administrative costs of the program. The bill provides $52,000,000 for beneficiary services, the 

same as the budget request, within the total appropriation for SSI. 

This funding reimburses State vocational rehabilitation services 

agencies for successful rehabilitation of SSI recipients. 

Research and demonstration 

Within the appropriation for SSI, the bill provides $27,000,000 

for research and demonstration activities conducted under section 

1110 of the Social Security Act. 

Administration 

Within the appropriation for SSI, the Committee provides 

$2,897,000,000 for payment to the Social Security trust funds for 

the SSI Program’s share of SSA’s base administrative expenses. 

This is the same funding level as the budget request. 

LIMITATION ON ADMINISTRATIVE EXPENSES

The Committee provides a limitation on administrative expenses 

for the Social Security Administration (SSA) of $9,159,700,000 to 

be funded from the Social Security and Medicare trust funds. This 

199

is $554,799,000 more than the fiscal year 2005 comparable level 

and $108,700,000 less than the budget request. 

Social Security Advisory Board 

The Committee provides that not less than $2,000,000 within the 

limitation on administrative expenses shall be available for the Social Security Advisory Board, the same as both the fiscal year 2005 

level the budget request. 

User fees 

In addition to other amounts provided in the bill, the Committee provides an additional limitation of $120,000,000 for administrative 

activities funded from user fees. This is $5,000,000 less than the 

fiscal year 2005 level and the same as the request. 

OFFICE OF INSPECTOR GENERAL

(INCLUDING TRANSFER OF FUNDS)

The Committee provides $92,805,000 for the Office of the Inspec- tor General (OIG), $2,427,000 more than the fiscal year 2005 comparable level and $195,000 less than the budget request. The bill 

also provides authority to expend $66,805,000 from the Social Security trust funds for activities conducted by the Inspector General, 

$1,969,000 more than the fiscal year 2005 comparable level and 

$195,000 less than the budget request. 

TITLE V—GENERAL PROVISIONS 

Sec. 501. The Committee continues a provision to allow 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. 

Sec. 502. The Committee continues a provision to prohibit the obligation of funds beyond the current fiscal year unless expressly so 

provided. 

Sec. 503. The Committee continues a provision to prohibit appropriated funds to be used to support or defeat legislation pending 

before the Congress or any State legislature, except in presentation 

to the Congress or any State legislature itself. 

Sec. 504. The Committee continues a provision to limit 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 to prohibit funds 

to be used to carry out a needle distribution program. 

Sec. 506. The Committee continues a provision to require 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. 507. The Committee continues a provision to prohibit appropriated funds to be used for any abortion. 

Sec. 508. The Committee continues a provision to provide exceptions for Sec. 507 and adds a limitation prohibiting funds from the 

200

bill to be made available to a Federal, State or local government 

or program if they discriminate against institutional or individual 

health care entities if they do not provide, pay for, or refer for abortions. 

Sec. 509. The Committee continues a provision to prohibit the 

use of funds in the Act concerning research involving human embryos. However, this language should not be construed to limit federal support for research involving human embryonic stem cells 

listed on an NIH registry and carried out in accordance with policy 

outlined by the President. 

Sec. 510. The Committee continues a provision to prohibit the 

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. 511. The Committee continues a provision related to annual 

reports to the Secretary of Labor. 

Sec. 512. The Committee continues a provision to prohibit the 

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. 513. The Committee continues a provision that prohibits the 

transfer of funds from this Act except by authority provided in this 

Act or another appropriation Act. 

Sec. 514. The Committee includes a provision to limit funds in 

the bill for public libraries to those libraries that comply with the 

requirements of the Children’s Internet Protection Act. 

Sec. 515. The Committee includes a provision to limit technology 

funds in the bill for elementary and secondary schools to those 

schools that comply with the requirements of the Children’s Internet Protection Act. 

Sec. 516. The Committee includes language limiting the availability of funds to the Railroad Retirement Board to enter into an 

arrangement with a nongovernmental financial institution to serve 

as disbursing agent for benefits payable under the Railroad Retirement Act of 1974. 

Sec. 517. The Committee maintains a provision clarifying the 

procedures for reprogramming of funds. The Committee notes that 

this provision is consistent with reprogramming language included 

in other bills within the Committee’s jurisdiction. 

Sec. 518. The Committee includes a provision extending the 

availability of funds appropriated under section 1015 of P.L. 108–

173 for an additional year, allowing CMS and SSA more flexibility 

to implement the Medicare Prescription Drug, Improvement, and 

Modernization Act of 2003. 

CONSTITUTIONAL AUTHORITY

Clause 3(d)(1) of rule XIII of the Rules of the House of Representatives states that: 

Each report of a committee on a public bill or public joint resolution shall contain the following:

(1) A statement citing the specific powers granted to 

Congress in the Constitution to enact the law proposed by 

the bill or joint resolution.

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The Committee on Appropriations bases its authority to report 

this legislation on Clause 7 of Section 9 of Article I of the Constitution of the United States of America which states:

No money shall be drawn from the Treasury but in consequence of Appropriations made by law * * *.

Appropriations contained in this Act are made pursuant to this 

specific power granted by the Constitution. 

COMPARISON WITH BUDGET RESOLUTION

Clause 3(c)(2) of rule XIII of the Rules of the House of Representatives requires an explanation of compliance with section 

308(a)(1)(A) of the Congressional Budget Act of 1974 (Public Law 

93–344), as amended, which requires that the report accompanying 

a bill providing new budget authority contain a statement detailing 

how the authority compares with the report submitted under section 302 of the Act for the most recently agreed to concurrent resolution on the budget for the fiscal year. This information follows:

[In millions of dollars] 

302(b) allocation This bill 

Budget authority Outlays Budget authority Outlays 

Discretionary .................................................................................. 142,514 143,702 142,514 143,802

Mandatory ...................................................................................... 402,591 404,083 402,591 404,083

In accordance with the Congressional Budget Act of 1974 (Public 

Law 93–344), as amended, the following information was provided 

to the Committee by the Congressional Budget Office: 

FIVE-YEAR PROJECTIONS

In compliance with section 308(a)(1)(B) of the Congressional 

Budget Act of 1974 (Public Law 93–344), as amended, the following 

table contains five-year projections associated with the budget authority provided in the accompanying bill:

[In millions of dollars] 

Outlays: 

2006 .................................................................................................... 370,337

2007 .................................................................................................... 58,474

2008 .................................................................................................... 15,470

2009 .................................................................................................... 3,789

2010 and beyond ................................................................................ 542

FINANCIAL ASSISTANCE TO STATE AND LOCAL GOVERNMENTS

In accordance with section 308(a)(1)(C) of the Congressional 

Budget Act of 1974 (Public Law 93–344), as amended, the financial 

assistance to State and local governments is as follows:

[In millions of dollars] 

New budget authority ..................................................................................... 220,961

Fiscal Year 2006 outlays resulting therefrom ............................................... 159,308

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TRANSFER OF FUNDS

Pursuant to clause 3(f)(2), rule XIII of the Rules of the House of 

Representatives, the following table is submitted describing the 

transfers of funds provided in the accompanying bill. 

The table shows, by Department and agency, the appropriations 

affected by such transfers.

APPROPRIATION TRANSFERS RECOMMENDED IN THE BILL 

Account to which transfer is made Amount Account from which transfer is made Amount 

Department of Labor: .......................... Department of Labor 

Special Benfits .................................. (1) Postal Service ....................................... (1) 

Various Agencies 1 ............................. Energy Employee Occupational Illness 

Compensation Fund 1.

..........................

Employment Standards Administration—Salaries and Expenses.$33,050,000 Black Lung Disability Trust Fund ............. $33,050,000

Departmental Management—Salaries and Expenses.24,239,000 Black Lung Disability Trust Fund ............. 24,239,000

Office of Inspector General ............... 344,000 Black Lung Disability Trust Fund ............. 344,000

Department of Health and Human Services: Department of Health and Human Services: 

National Institutes of Health: National Institutes of Health 

Various Institutes and centers 

for AIDS.

up to 3% Various institutes and centers for AIDS ... up to 3%

Various institutes and centers 

for AIDS.

(2) Office of AIDS Research ............................ (2) 

Various institutes and centers up to 1% Various institutes and centers .................. up to 1%

Related Agencies: 

National Service Trust ....................... 146,000,000 Corp. for National and Community Service 146,000,000

National Service Trust ....................... (1) Corp. for National and Community Service (1) 

Social Security Administration:.

Office of Inspector General ...... 66,805,000 Federal Old-Age and Survivors Insurance 

Trust Fund and Federal Disability Insurance Trust Fund.

66,805,000

1 Such sums. 

2 Amount det’d to be AIDS. 

RESCISSIONS

Pursuant to clause 3(f)(2), rule XIII of the Rules of the House of 

Representatives, the following table is submitted describing the rescissions recommended in the accompanying bill.

Account Amount 

Department of Labor, National Emergency Grants ........................................................................................ ¥$20,000,000 

Department of Labor, Training and Employment Service .............................................................................. ¥5,000,000

Department of Labor, Training and Employment Service .............................................................................. ¥125,000,000

Department of Labor, Workers Compensation Programs ............................................................................... ¥120,000,000

Department of HHS, Health Professions Student Loans ................................................................................ ¥15,912,000

Corporation of Public Broadcasting, Fiscal Year 2006 Advance .................................................................. ¥100,000,000

CHANGES IN APPLICATION OF EXISTING LAW

Pursuant to clause 3, rule XIII of the Rules of the House of Representatives, the following statements are submitted describing the 

effect of provisions in the accompanying bill which may directly or 

indirectly change the application of existing law. 

In some instances the bill includes appropriations for certain ongoing programs which are not yet authorized for fiscal year 2006. 

The bill provides that appropriations shall remain available for 

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203

izing legislation does not presently authorize such extended availability. 

In various places in the bill, the Committee has earmarked funds 

within appropriation accounts in order to fund specific sections of 

a law. Whether these actions constitute a change in the application 

of existing law is subject to individual interpretation, but the Committee felt that this fact should be mentioned. 

In several instances, the bill provides advance appropriations for 

fiscal year 2007 or 2008 for programs for which such advances are 

not authorized by law.

TITLE I—DEPARTMENT OF LABOR 

TRAINING AND EMPLOYMENT SERVICES

Language prohibiting the use of funds from any other appropriation to provide meal services at or for Job Corps centers. 

STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE

OPERATIONS

Language allowing the use of funds for amortization payments to 

States which had independent retirement plans in their State employment service agencies prior to 1980. 

Language allowing the Labor Department to withhold from State 

allotments funds available for penalty mail under the WagnerPeyser Act. 

Language providing that funds in this Act for one-stop career 

centers and unemployment insurance national activities may be 

used for contracts, grants or agreements with non-State entities. 

Language providing that funds in this Act may be used by the 

States for integrated Employment Service and Unemployment Insurance automation efforts. 

EMPLOYMENT STANDARDS ADMINISTRATION

SALARIES AND EXPENSES

Language authorizing the Secretary of Labor to accept and spend 

all sums of money ordered to be paid to the Secretary, in accordance with the terms of a Consent Judgment in U.S. District Court 

for the Northern Mariana Islands. 

Language authorizing the Secretary of Labor to collect user fees 

for processing certain applications and issuing certain certificates 

and registrations under the Fair Labor Standards Act and the Migrant and Seasonal Agricultural Worker Protection Act. 

SPECIAL BENEFITS

Language providing funds may be used under the Federal Employees’ Compensation Act in which the Secretary of Labor may reimburse an employer, who is not the employer at the time of injury, for portions of the salary of a reemployed, disabled beneficiary. 

Language allowing the Secretary of Labor to transfer certain administrative funds from the Postal Service fund and certain other 

government corporations and agencies related to the administration of the Federal Employees’ Compensation Act. 

204

Language allowing the Secretary of Labor to require any person 

filing a claim for benefits under the Federal Employees’ Compensation Act or the Longshore and Harbor Workers’ Compensation Act 

to provide such identifying information as the Secretary may require, including a Social Security number. 

OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION

SALARIES AND EXPENSES

Language establishing a maximum amount available for grants 

to States under the Occupational Safety and Health Act, which 

grants shall be no less than 50 percent of the costs of State programs required to be incurred under plans approved by the Secretary under section 18 of the Act. 

Language authorizing the Occupational Safety and Health Administration to retain and spend up to $750,000 of training institute course tuition fees for training and education grants. 

Language allowing the Secretary of Labor to collect and retain 

fees for services provided to Nationally Recognized Testing Laboratories. 

Language prohibiting OSHA from obligating or expending any of 

these funds to enforce the annual fit test requirement of the General Industry Respiratory Protection Standard with respect to exposure to tuberculosis. 

MINE SAFETY AND HEALTH ADMINISTRATION

SALARIES AND EXPENSES

Language allowing the Mine Safety and Health Administration 

to collect up to $750,000 at the National Mine Health and Safety 

Academy for room, board, tuition, and the sale of training materials, otherwise authorized by law to be collected, to be available 

for mine safety and health education and training activities, notwithstanding 31 U.S.C. 3302. 

Language allowing the Mine Safety and Health Administration 

to accept land, buildings, equipment, and other contributions from 

public and private sources; to prosecute projects in cooperation 

with other agencies, Federal, State, or private; and to promote 

health and safety education and training in the mining community 

through cooperative programs with States, industry, and safety associations. 

Language allowing the Secretary of Labor to use any funds available to the Department to provide for the costs of mine rescue and 

survival operations in the event of major disasters. 

GENERAL PROVISIONS

Language is included deeming certain payments for workers 

compensation to be consistent with P.L. 107–17. 

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TITLE II—DEPARTMENT OF HEALTH AND HUMAN 

SERVICES 

HEALTH RESOURCES AND SERVICES ADMINISTRATION

HEALTH RESOURCES AND SERVICES

Language providing that $39,180,000 from general revenues, notwithstanding section 1820(j) of the Social Security Act, shall be 

available for carrying out the Medicare rural hospital flexibility 

grants program under section 1820 of such Act. 

Language providing that in addition to fees authorized by section 

427(b) of the Health Care Quality Improvement Act of 1986, fees 

shall be collected for the full disclosure of information under the 

Act sufficient to recover the full costs of operating the National 

Practitioner Data Bank, and shall remain available until expended 

to carry out that Act. 

Language providing that fees collected under the Health Care 

Fraud and Abuse Data Collection Program shall be sufficient to recover the full costs of operating the program, and shall remain 

available until expended to carry out that Act. 

Language providing that $26,000,000 of the funding provided for 

community health centers is to be allocated to high-poverty counties, notwithstanding current law. 

Language providing that all pregnancy counseling under the 

family planning program shall be nondirective.

Language making $25,000,000 available under section 241 of the 

Public Health Service Act to fund special programs for the care and 

treatment of individuals with HIV disease. 

Language identifying a specific amount for maternal and child 

health SPRANS activities, notwithstanding current law. 

CENTERS FOR DISEASE CONTROL AND PREVENTION

Language permitting the Centers for Disease Control and Prevention to purchase and insure official motor vehicles in foreign 

countries. 

Language providing the Centers for Disease Control and Prevention to purchase, hire, maintain and operate aircraft. 

Language providing that $30,000,000 is available until expended 

for equipment and construction and renovation of facilities. 

Language providing that $123,883,000 is available until September 30, 2006 for International HIV/AIDS. 

Language providing that collections from user fees may be credited to the Centers for Disease Control and Prevention appropriation. 

Language making specific amounts under section 241 of the Public Health Service Act available to carry out: National Immunization Surveys; National Center for health Statistics surveys; information systems standards development and architecture and applications-based research used at local public health levels; Public 

Health Research; and the National Occupational Research Agenda. 

Language allowing the Director of the Centers for Disease Control and Prevention to redirect certain funds appropriated under 

Public Law 101–502. 

206

Language providing that not to exceed $12,500,000 may be made 

available for grants under section 1509 of the Public Health Service 

Act to not more than 15 States, tribes, or tribal organizations. 

Language permitting the Centers for Disease Control and Prevention to proceed with property acquisition, including a long-term 

ground lease for construction on non-federal land, for construction 

of a replacement laboratory in the Ft. Collins, Colorado area. 

Language permitting the Centers for Disease Control and Prevention to exempt from any personnel ceiling applicable to the 

Agency both civilian and Commissioned Officers detailed to the 

States, municipalities, or other organizations under authority of 

section 214 of the Public Health Service Act for purposes related 

to homeland security during the period of detail or assignment. 

NATIONAL INSTITUTES OF HEALTH

NATIONAL LIBRARY OF MEDICINE

Language providing that the National Library of Medicine may 

enter into certain personal services contracts. 

Language making $8,200,000 available under section 241 of the 

Public Health Service Act to carry out National Information Center 

on Health Services Research and Health Care Technology and related health services. 

OFFICE OF THE DIRECTOR

Language providing that the National Institutes of Health is authorized to collect third party payments for the cost of the clinical 

services that are incurred in NIH research facilities and that such 

payments shall be credited to the NIH Management Fund and 

shall remain available for one fiscal year after they are deposited. 

Language providing the Director of NIH authority to transfer 

funds between appropriation accounts in this or any other Act. 

Language providing that a uniform percentage of the amounts 

appropriated to the Institutes and Centers may be transferred and 

utilized for the NIH Roadmap for Medical Research. 

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES

Language making specific amounts available under section 241 of 

the Public Health Service Act to fund technical assistance, National 

data, data collection and evaluation activities; $16,000,000 to carry 

out national surveys on drug abuse; and, $4,300,000 to evaluate 

substance abuse treatment programs. 

AGENCY FOR HEALTHCARE RESEARCH AND QUALITY

Language is included to permit the Agency for Healthcare Research and Quality to retain and expend amounts received from 

Freedom of Information Act fees, reimbursable and interagency 

agreements and the sale of data tapes. 

207

CENTERS FOR MEDICARE AND MEDICAID SERVICES

GRANTS TO STATES FOR MEDICAID

A provision that in the administration of title XIX of the Social 

Security Act, payments to a state for any quarter may be made 

with respect to a State plan or plan amendment in effect during 

any such quarter, if submitted in, or prior to, such quarter and approved in that or any such subsequent quarter. 

PAYMENTS TO THE HEALTH CARE TRUST FUNDS

Language providing indefinite authority for paying benefits if the 

annual appropriation is insufficient. 

PROGRAM MANAGEMENT

A provision that all funds collected in accordance with section 

353 of the Public Health Service Act, together with such sums as 

may be collected from authorized user fees, administrative fees collected relative to Medicare overpayment recovery activities, and the 

sale of data, shall be available for expenditure by the Center for 

Medicare and Medicaid Services. 

Language allowing fees charged in accordance with 31 U.S.C. 

9701 to be credited to the Centers for Medicare and Medicaid Services administrative account. 

Language providing that funds under this heading are available 

for the Healthy Start, Grow Smart program. 

ADMINISTRATION FOR CHILDREN AND FAMILIES

PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND

FAMILY SUPPORT PROGRAMS

Language providing that the sum of the amounts available to a 

State with respect to expenditures under title IV–A of the Social 

Security Act in fiscal year 1997 under this appropriation and under 

such title IV–A as amended by the Personal Responsibility and 

Work Opportunity Reconciliation Act of 1996 shall not exceed the 

limitations under section 116(b) of such Act. 

SOCIAL SERVICES BLOCK GRANT

Language providing that States may transfer up to 10 percent of 

Temporary Assistance for Needy Family funds to the Social Services Block Grant. 

CHILDREN AND FAMILIES SERVICES PROGRAMS

Language making $6,000,000 available under section 241 of the 

Public Health Service Act to carry out provisions of section 1110 of 

the Social Security Act. 

Language providing that unexpended Community Services Block 

Grant funds may be carried over to the next fiscal year by local 

grantees. 

Language making $4,500,000 available under section 241 of the 

Public Health Service Act to carry out evaluations of adolescent 

pregnancy prevention approaches. 

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OFFICE OF THE SECRETARY

GENERAL DEPARTMENTAL MANAGEMENT

Language making $39,552,000 available under section 241 of the 

Public Health Service Act to carry out national health or human 

services research and evaluation activities. 

Language providing $13,120,000 for prevention service demonstration grants under the Adolescent Family Life program, notwithstanding current law. 

HEALTH INFORMATION TECHNOLOGY INITIATIVE

Language making $16,900,000 available under section 241 of the 

Public Health Service Act to carry out health information technology network development activities. 

PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND

Language providing for the transfer of $8,589,000 from amounts 

appropriated to the Centers for Disease Control and Prevention for 

activities authorized by Section 319F–2(a) of the Public Health 

Service Act. 

TITLE III—DEPARTMENT OF EDUCATION 

IMPACT AID

Language ensuring that schools serving the children of military 

personnel continue to receive Impact Aid funds when the military 

parents who live on-base are deployed and the child continues to 

attend the same school and in cases in which an on-base military 

parent is killed while on active duty and the child continues to attend the same school. 

SCHOOL IMPROVEMENT PROGRAMS

Language allowing the Republic of the Marshall Islands and the 

Federated States of Micronesia to reserve up to five percent of their 

supplemental education grants for technical assistance, administration and oversight purposes. 

VOCATIONAL AND ADULT EDUCATION

Language stating that a portion of the amount provided for Adult 

Education State Grants shall be for integrated English literacy and 

civics education services to immigrants and other limited English 

proficient populations, and specifying the distribution of such 

funds. 

STUDENT FINANCIAL ASSISTANCE

Language providing that the maximum Pell grant a student may 

receive in the 2005–2006 academic year shall be $4,100. 

HIGHER EDUCATION

Language providing that funds are available to fund fellowships 

for academic year 2006–2007 under part A, subpart 1 of title VII 

of the Higher Education Act of 1965, under the terms and conditions of part A, subpart 1. 

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Language providing that notwithstanding any other provision of 

law, funds made available to carry out title VI of the Higher Education Act and section 102(b)(6) of the Mutual Educational and 

Cultural Exchange Act of 1961 may be used to support visits and 

study in foreign countries by individuals who are participating in 

advanced foreign language training and international studies in 

areas that are vital to United States national security and who 

plan to apply their language skills and knowledge of these countries in the fields of government, the professions, or international 

development. 

HOWARD UNIVERSITY

Language providing that Howard University shall use not less 

than $3,524,000 for the endowment program pursuant to the Howard University Endowment Act. 

TITLE IV—RELATED AGENCIES 

CORPORATION FOR NATIONAL AND COMMUNITY SERVICE

DOMESTIC VOLUNTEER SERVICE PROGRAMS, OPERATING EXPENSES

Language prohibiting certain funds from being used for stipends 

or other monetary incentives for volunteers or volunteer leaders 

whose incomes exceed 125 percent of the national poverty level. 

NATIONAL AND COMMUNITY SERVICE PROGRAMS, OPERATING

EXPENSES

Language allowing certain funds to be used for education awardonly grants. 

Language allowing certain additional funds to be transferred to 

the National Service Trust, upon a determination that it is necessary to support the activities of national service participants and 

after notice is transmitted to the Congress. 

Language prohibiting certain funds from being used to support 

salaries and related expenses (including travel) attributable to employees of the Corporation for National and Community Service. 

Language requiring certain funds to be provided in an manner 

that is consistent with the recommendations of peer review panels 

in order to ensure that priority is given to programs that demonstrate quality, innovation, replicability, and sustainability. 

Language allowing certain funds to support an endowment fund, 

and permitting certain investments of the endowment fund. 

Language prohibiting funds for national service programs run by 

certain other Federal agencies. 

Language requiring the Corporation for National and Community Service to increase significantly the level of matching funds 

and in-kind contributions provided by the private sector, and to reduce the total Federal costs per participant in all programs. 

Language allowing certain funds to be made available to provide 

assistant to State commissions on national and community service. 

Language allowing certain funds to be used for grant application 

reviews. 

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ADMINISTRATION PROVISIONS

Language allowing certain loans to be considered qualified student loans. 

Language allowing certain grantees to be eligible for grants targeted to individuals with disabilities. 

Language requiring the Inspector General of the Corporation for 

National and Community Service to conduct random audits of the 

grantees that administer activities under the AmeriCorps programs, to levy sanctions for violations, and to obtain reimbursements of misused funds from grantees committing substantial violations. 

Language requiring the Corporation for National and Community Service to make significant changes to program requirements 

or policies only through public notice and comment rulemaking. 

Language prohibiting personnel of the Corporation for National 

and Community Service from making unauthorized disclosures of 

covered grant selection information. 

FEDERAL MEDIATION AND CONCILIATION SERVICE

SALARIES AND EXPENSES

The bill includes language specifying that notwithstanding 31 

U.S.C. 3302, fees charged by the Federal Mediation and Conciliation Service, up to full-cost recovery, for special training activities 

and for arbitration services shall be credited to and merged with 

its administrative account, and shall remain available until expended; that fees for arbitration services shall be available only for 

education, training, and professional development of the agency 

workforce; and that the Director of the Service is authorized to accept on behalf of the United States gifts of services and real, personal, or other property in the aid of any projects or functions within the Director’s jurisdiction. 

NATIONAL LABOR RELATIONS BOARD

SALARIES AND EXPENSES

The bill includes a provision requiring that appropriations to the 

NLRB shall not be available to organize or assist in organizing agricultural laborers or used in connection with investigations, hearings, directives, or orders concerning bargaining units composed of 

agricultural laborers as referred to in 2(3) of the Act of July 5, 1935 

(29 U.S.C. 152), and as amended by the Labor-Management Relations Act, 1947, as amended, and as defined in 3(f) of the Act of 

June 25, 1938 (29 U.S.C. 203), and including in said definition employees engaged in the maintenance and operation of ditches, canals, reservoirs, and waterways, when maintained or operated on 

a mutual non-profit basis and at least 95 per centum of the water 

stored or supplied thereby is used for farming purposes. 

RAILROAD RETIREMENT BOARD

DUAL BENEFITS PAYMENTS ACCOUNT

The bill includes language providing that the total amount provided for railroad retirement dual benefits shall be credited to the 

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Dual Benefits Payments Account in 12 approximately equal 

amounts on the first day of each month in the fiscal year. 

LIMITATION ON ADMINISTRATION

The bill includes language providing that the Railroad Retirement Board shall determine the allocation of its administrative 

budget between the railroad retirement accounts and the railroad 

unemployment insurance administration fund. 

SOCIAL SECURITY ADMINISTRATION

LIMITATION ON ADMINISTRATIVE EXPENSES

Language providing that unobligated balances at the end of fiscal 

year 2006 shall remain available until expended for the agency’s 

information technology and telecommunications hardware and software infrastructure, including related equipment and non-payroll 

administrative expenses associated solely with this information 

technology and telecommunications infrastructure; language authorizing the use of up to $15,000 for official reception and representation expenses; and language providing that reimbursement 

to the trust funds under this heading for expenditures for official 

time for employees of the Social Security Administration pursuant 

to section 7131 of title 5, United States Code, and for facilities or 

support services for labor organizations pursuant to policies, regulations, or procedures referred to in 7135(b) of such title shall be 

made by the Secretary of the Treasury, with interest, from 

amounts in the general fund not otherwise appropriated, as soon 

as possible after such expenditures are made. 

Language providing that funds may be derived from administration fees collected pursuant to 1616(d) of the Social Security Act or 

212(b)(3) of Public Law 93–66 and that, to the extent that the 

amounts collected pursuant to such sections in fiscal year 2006 exceed $119,000,000, the amounts shall be available in fiscal year 

2007 only to the extent provided in advance in appropriations Acts. 

Language providing that funds may be derived from fees collected pursuant to section 303(c) of the Social Security Protection 

Act of Public Law 108–203 and shall remain available until expended. 

Language providing that unobligated funds previously appropriated for Federal-State partnerships shall be transferred to the 

Supplemental Security Income Program and remain available until 

expended. 

OFFICE OF INSPECTOR GENERAL

Language permitting the transfer of a certain amount of funds 

into this account from the SSA administrative account provided 

that the Appropriations Committees are promptly notified. 

GENERAL PROVISIONS

Sections 102, 201, 202, 203, 204, 205, 206, 207, 208, 209, 210, 

211, 212, 213, 214, 215, 216, 217, 218, 219, 301, 302, 303, 304, 501, 

504, 505, 507, 508, 509, 510, 511, 512, 513, 514, 516, 517, 518 and 

519 of the bill are general provisions, most of which have been carried in previous appropriations acts, which place limitations on the 

212

use of funds in the bill or authorize or require certain activities, 

and which might, under some circumstances, be construed as 

changing the application of existing law. 

DEFINITION OF PROGRAM, PROJECT, AND ACTIVITY

During fiscal year 2006 for purposes of the Balanced Budget and 

Emergency Deficit Control Act of 1985 (Public Law 99–177), as 

amended, the following information provides the definition of the 

term ‘‘program, project, and activity’’ for departments and agencies 

under the jurisdiction of the Labor, Health and Human Services, 

and Education and Related Agencies Subcommittee. The term ‘‘program, project, and activity’’ shall include the most specific level of 

budget items identified in the Departments of Labor, Health and 

Human Services, and Education, and Related Agencies Appropriations Act, 2006, the accompanying House and Senate Committee 

reports, the conference report and accompanying joint explanatory 

statement of the managers of the committee of conference. 

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.

APPROPRIATIONS NOT AUTHORIZED BY LAW

Pursuant to clause 3 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:

Agency/Program Last year of

authorization 

Authorization

level 

Appropriations in last 

year of authorization 

Appropriations in this 

bill 

DEPARTMENT OF LABOR

Employment and Training 

Administration—Training 

and Employment Services.

2003 ............................. Such Sums ................... $5,217,070,000 $5,121,792

DEPARTMENT OF HEALTH 

AND HUMAN SERVICES

HRSA:

Health Professions, except 

certain nursing programs.

2002 ............................. Such Sums ................... $295,111,000 $47,128,000

Healthy Start ......................... 1995 ............................. Such Sums ................... $102,543,000 $97,747,000

Newborn Hearing Screening .. 2002 ............................. Such Sums ................... $9,995,000 $10,000,000

Organ Transplantation .......... 1993 ............................. Such Sums ................... $24,990,000 $23,282,000

Bone Marrow Donor Registry 2003 ............................. Such Sums ................... $21,891,000 $25,416,000

Rural and Community Access 

to Emergency Devices.

2003 ............................. 25,000,000 ................... $12,500,000 $1,960,000

State Offices of Rural Health 2002 ............................. Such Sums ................... $7,996,000 $8,223,000

Family Planning .................... 1985 ............................. 158,400,000 ................. $142,500,000 $285,963,000

CDC:

Birth Defects ......................... 2002 ............................. Such Sums ................... $98,040,000 $127,179,000

Cancer Registries .................. 2003 ............................. Such Sums ................... $45,649,000 $48,584,000

Prostate Cancer .................... 2004 ............................. Such Sums ................... $15,452,000 $14,071,000

213

Agency/Program Last year of

authorization 

Authorization

level 

Appropriations in last 

year of authorization 

Appropriations in this 

bill 

Breast and Cervical Cancer 

Prevention.

2003 ............................. Such Sums ................... $199,371,000 $204,425,000

Wisewoman ........................... 2003 ............................. Such Sums ................... $12,500,000 $12,500,000

Prevention Centers ................ 2003 ............................. Such Sums ................... $26,830,000 $29,700,000

Health Statistics ................... 2003 ............................. Such Sums ................... $125,899,000 $109,021,000

Infectious Disease Control .... 2005 ............................. Such Sums ................... $225,589,000 $229,471,000

Diabetes ................................ 2005 ............................. Such Sums ................... $63,457,000 $64,960,000

Safe Motherhood/Infant 

Health Promotion.

2005 ............................. Such Sums ................... $44,738,000 $44,740,000

Childhood Obesity ................. 2005 ............................. Such Sums ................... $41,930,000 $41,930,000

Oral Health Promotion .......... 2005 ............................. Such Sums ................... $11,204,000 $12,000,000

Preventive Health Services 

Block Grant.

1998 ............................. Such Sums ................... $149,092,000 $100,000,000

HIV/AIDS Prevention .............. 2005 ............................. Such Sums ................... $662,267,000 $657,694,000

Sexually Transmitted Diseases Grants.1998 ............................. Such Sums ................... $112,117,000 $159,633,000

Tuberculosis Grants .............. 2002 ............................. Such Sums ................... $132,689,000 $138,811,000

Asthma Prevention ................ 2005 ............................. Such Sums ................... $32,422,000 $32,422,000

Lead Poisoning Prevention .... 2005 ............................. Such Sums ................... $36,474,000 $36,474,000

Injury Prevention and Control 2005 ............................. Such Sums ................... $138,237,000 $138,237,000

Loan Repayment ................... 2002 ............................. Such Sums ................... $500,000 $500,000

NIH:

National Institutes of 

Health—Research Training.

1996 ............................. Such Sums ................... $416,992,000 $0

National Cancer Institute ..... 1996 ............................. Such Sums ................... $2,248,000,000 $4,841,774,000

National Heart, Lung, and 

Blood Institute.

1996 ............................. Such Sums ................... $1,354,945,000 $2,951,270,000

National Institute on Aging .. 1996 ............................. Such Sums ................... $453,541,000 $1,057,203,000

National Institute on Alcohol 

Abuse and Alcoholism.

1994 ............................. Such Sums ................... $185,538,000 $440,333,000

National Institute on Drug 

Abuse.

1994 ............................. Such Sums ................... $424,315,000 $1,010,130,000

National Institute of Mental 

Health.

1994 ............................. Such Sums ................... $613,352,000 $1,417,692,000

National Institute of Biomedical Imaging and Bioengineering.

2003 ............................. Such Sums ................... $280,100,000 $299,808,000

National Library of Medicine 1996 ............................. Such Sums ................... $140,936,000 $318,091,000

SAMSHA:

Substitute Abuse and Mental 

Health Services Administration programs.

FY 2003 ....................... Such Sums ................... $3,158,068,000 $3,230,744,000

ACF:

Low Income Home Energy Assistance.FY 2004 ....................... 2,605,300,000 .............. $1,888,790,000 $1,984,799,000

Office of Refugee Resettlement, except: Unaccompanied Alien Children, 

Trafficking Victims and 

Torture Victims.

FY 2002 ....................... Such Sums ................... $439,894,000 $478,006,000

Trafficking Victims ................ FY 2005 ....................... 15,000,000 ................... up to $9,915,000 up to $9,915,000

Torture Victims ...................... FY 2005 ....................... 20,000,000 ................... $9,915,000 $9,915,000

Child Care Development 

Block Grant.

FY 2002 ....................... 1,000,000,000 .............. $2,099,994,000 $2,082,910,000

Head Start ............................. FY 2003 ....................... Such Sums ................... $6,815,570,000 $6,899,000,000

Voting Access for individuals 

with Disabilities.

FY 2005 ....................... 35,000,000 ................... $14,879,000 $14,879,000

Native American programs ... FY 2002 ....................... Such Sums ................... $45,946,000 $44,780,000

Community Services Block 

Grant programs.

FY 2003 ....................... Such Sums ................... $739,315,000 $389,672,000

AOA:

Aging Services Programs ...... FY 2005 ....................... Such Sums ................... $1,393,342,000 $1,376,217,000

214

Agency/Program Last year of

authorization 

Authorization

level 

Appropriations in last 

year of authorization 

Appropriations in this 

bill 

OFFICE OF THE SECRETARY

Adolescent Family Life (Title 

XX).

1985 ............................. 30,000,000 ................... $14,716,000 $30,742,000

DEPARTMENT OF EDUCATION

Education for the Disadvantaged—Migrant Education.FY 2003 ....................... Such Sums ................... $34,750,000 $34,269,000

Innovation and Improvement—Credit Enhancement for Charter School 

Facilities.

FY 2003 ....................... Such Sums ................... $24,838,000 $36,981,000

Special Education:

Grants to States Part B ........ FY 2002 ....................... Such Sums ................... $7,528,533,000 $10,739,746,000

Preschool Grants ................... FY 2002 ....................... Such Sums ................... $390,000,000 $384,597,000

Grants for Infants and Families.FY 2002 ....................... Such Sums ................... $417,000,000 $440,808,000

IDEA National Activities ........ FY 2002 ....................... Such Sums ................... $337,271,000 $248,632,000

Rehabilitation Services and 

Disability Research.

FY 2003 ....................... Such Sums ................... $3,013,305,000 $3,128,638,000

Special Institutions for Persons with Disabilities:

National Technical Institute 

for the Deaf.

FY 2003 ....................... Such Sums ................... $53,800,000 $56,137,000

Gallaudet University .............. FY 2003 ....................... Such Sums ................... $100,800,000 $107,657,000

Vocational and Adult Education.FY 2003 ....................... Such Sums ................... $2,121,690,000 $1,991,782,000

Student Financial Assistance FY 2004 ....................... Such Sums ................... $14,007,296,000 $15,281,752,000

Student Aid Administration .. FY 2004 ....................... Such Sums ................... $116,727,000 $124,084,000

Higher Education:

Aid for Institutional Development.FY 2004 ....................... Such Sums ................... $485,065,000 $505,519,000

International Education and 

Foreign Language.

FY 2004 ....................... Such Sums ................... $103,680,000 $106,819,000

Domestic Program ................ FY 2004 ....................... Such Sums ................... $89,211,000 $92,466,000

Institute for International 

Public Policy.

FY 2004 ....................... Such Sums ................... $1,629,000 $1,616,000

Fund for Improvement of 

Post Secondary Education.

FY 2004 ....................... Such Sums ................... $157,700,000 $59,211,000

Minority Science and Engineering Improvement.FY 2004 ....................... Such Sums ................... $8,889,000 $8,818,000

Tribally Controlled Post-Secondary Vocational and 

Technical Institutions.

FY 2004 ....................... $4,000,000 ................... $7,185,000 $7,440,000

Federal TRIO Programs ......... FY 2004 ....................... Such Sums ................... $832,559,000 $836,543,000

GEAR UP ................................ FY 2004 ....................... Such Sums ................... $298,230,000 $306,488,000

Javitts Fellowships ................ FY 2004 ....................... Such Sums ................... $9,876,000 $9,797,000

Graduate Assistance in Areas 

of National Need.

FY 2004 ....................... Such Sums ................... $30,616,000 $30,371,000

Teacher Quality Enhancement 

Grants.

FY 2004 ....................... Such Sums ................... $88,887,000 $58,000,000

Child Care Access Means 

Parents in School.

FY 2004 ....................... Such Sums ................... $16,098,000 $15,970,000

GPRA Data/HEA program 

evaluation.

FY 2004 ....................... Such Sums ................... $988,000 $980,000

B.J. Stupak Olympic Scholarships.FY 2004 ....................... Such Sums ................... $988,000 $980,000

Howard University—Endowment Program.FY 1985 ....................... $2,000,000 ................... $2,000,000 $3,524,000

Institute of Education 

Sciences—Research and 

Innovation in Special Education.

FY 2002 ....................... Such Sums ................... $78,380,000 $72,566,000

215

Agency/Program Last year of

authorization 

Authorization

level 

Appropriations in last 

year of authorization 

Appropriations in this 

bill 

RELATED AGENCIES

Corporation for National and 

Community Service.

FY 1996 ....................... Such Sums ................... $600,385,000 $918,949,000

Corporation for Public Broadcasting, Interconnection.FY 1993 ....................... $200,000,000 ............... $65,327,000 $52,000,000

Corporation for Public Broadcasting, Digitalization.FY 2001 ....................... $20,000 ........................ $20,000,000 $30,000,000

National Council on Disability.FY 2003 ....................... Such Sums ................... $2,858,000 $2,800,000

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 italics, 

existing law in which no change is proposed is shown in roman): 

SECTION 1015 OF THE MEDICARE PRESCRIPTION DRUG, 

IMPROVEMENT, AND MODERNIZATION ACT OF 2003

(Public Law 108–173) 

SEC. 1015. FUNDING START-UP ADMINISTRATIVE COSTS FOR MEDICARE REFORM. 

(a) * * *

(b) AVAILABILITY.—Amounts provided under subsection (a) shall 

remain available until September 30, ø2005¿ 2006. 

* * * * * * *

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(302)

* In computing the comparable level for FY 2005, we include about $1 billion in costs for administration of the new Medicare drug benefit that were covered in FY 2005 by a one-time special appropriation made in the authorizing legislation but which must be covered through regular discretionary appropriations in this bill starting in FY 2006. The figure used in the text 

refers to spending on programs, leaving aside rescissions, FY 2005 emergency designations, and 

other ‘‘scorekeeping adjustments’’. 

MINORITY VIEWS 

This bill is the clearest demonstration of what happens when 

Congress puts $140,000 tax cuts for those making more than a million dollars a year ahead of basic investments in education, 

healthcare, job training and job protection. 

As Majority Leader Tom DeLay pointed out two months ago during debate on the conference report on the FY 2006 budget resolution, 

This is the budget that the American people voted for 

when they returned a Republican House, a Republican 

Senate and a Republican White House last November.

The average American family wants Congress to focus on creating conditions that make it easier for them to get a good education for their kids; keep secure and decent paying jobs at home; 

and provide affordable healthcare so that everyone has access to a 

doctor. 

This bill is the most visible and recent evidence that this Congress isn’t doing that. 

Because the Republican Majority has already made a decision to 

borrow huge sums to provide super-sized, six-digit tax cuts to the 

most fortunate people in our society, they have to produce the kind 

of cuts we see in this bill. 

This spring, the Majority party in the House passed a budget 

resolution that provides $16 billion less than the amount necessary 

just to maintain current service levels for non-defense programs. At 

the same time, that budget resolution extended and expanded on 

the four years of successive tax cut bills that have reduced overall 

federal revenues to the lowest level since at least 1965, measured 

relative to the size of the economy. This bill implements that budget plan. 

On the budget resolution, the House Majority voted to cut an abstract category called ‘‘domestic discretionary spending’’. This bill, 

and other domestic appropriations bills, contains the very real cuts 

in specific programs that the House previously voted for in the abstract. 

In nominal dollar terms, this bill provides $1.6 billion less than 

the comparable FY 2005 level.* After adjusting for inflation and 

population growth, it represents a $5.7 billion cut in real purchasing power. As a result, this bill cuts ongoing services that 

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Americans rely on to have a decent quality of life, engaging fully 

in work, family and their communities. 

This bill is so inadequate it even cuts deeply into the President’s 

signature programs in training, healthcare and education. The bill 

cuts his Community College skills training initiative in half. It cuts 

the $300 million increase he proposed for Community Health Centers by two-thirds, and it completely eliminates his $1.5 billion 

High School reform initiative. 

We do not doubt that Chairman Regula and the Majority members of the Subcommittee tried to do the best they could with the 

budget figure they were given. The problem does not lie so much 

with how the Majority selected the particular education or health 

care or job training programs to be cut, as with the overall budget 

policy that mandates cuts in such high priority programs. 

WORKERS

• The bill disinvests in job training and help for the unem- ployed—cutting these programs by $346 million below the current 

level while 7.6 million Americans remain out of work. • It again cuts Adult Training Grants by another $31 million (3.4 percent) below the 2005 level to $866 million—a 9 percent cut 

below the $955 million provided in FY 1998 and the lowest funding 

level in 10 years. • It cuts the U.S. Employment Service, which provides essential information about job openings to people looking for work, by $116 

million (13.7 percent) below the current level and $67 million (8.4 

percent) below the FY 2001 level. The bill would eliminate job 

search assistance for 2.5 million people. • It further cuts critical services for at-risk youth—the very 

group the President says he and the First Lady are making a priority. Youth Training Grants serving high school drop outs are cut 

by $36 million (3.7 percent) below the current level to $950 million, 

eliminating training and work experience for 12,000 youth. The bill 

provides nearly 33 percent less funding for youth training than provided in FY 2001. • It even cuts Job Corps below its current funding level. Job 

Corps is one of the most successful job training programs ever— 

placing 85 percent of disadvantaged, young adults into jobs and college, and taking them off the street. • The bill eliminates the $50 million Youthful Offender initiative, eliminating skills training for 9,500 young people who have 

gotten in trouble with the law. 

• On the worker protection front, the Republican Majority has 

gutted the program that is supposed to act as a whistle blower on 

countries that compete for American jobs with child and slave 

labor. Eleven years after NAFTA, labor abuses continue in Mexico, 

China, and Central America. But, this bill takes the cop off the 

beat by cutting International Labor Affairs by 87 percent. 

HEALTH

On healthcare, the Committee bill—like the President’s budget— 

takes a step backward in efforts to maintain basic health services 

for the 45 million people without health insurance. In fact, it includes slightly less than proposed by the President for the Health 

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Resources and Services Administration, the HHS agency whose 

mission it is to improve access to health care. 

• The bill wipes out almost all of the HHS Title VII health professions training programs. In total, these programs see a reduction 

from $300 million to $47 million, a cut of 84 percent. Of 12 programs in this category, only two remain. Some of the grants being 

terminated help students from minority and disadvantaged backgrounds attend health professions schools to alleviate the shortage 

of doctors and dentists in low-income and minority communities. 

Others provide training opportunities for medical students and 

residents in rural and other under-served areas, to encourage them 

to go into practice in those areas. 

• It also eliminates the Healthy Communities Access Program, 

which tries to repair some of the holes in the health care safety net 

and help health centers and public hospitals and other providers 

build more effective local systems of care for the uninsured. 

• The bill cuts funding to help improve health care in rural 

areas by 41 percent. This includes a 73 percent cut in Rural Health 

Outreach grants, meaning no new grants and a big cut in ongoing 

projects. 

• It cuts the Maternal and Child Health Block Grant by $24 million—producing a 20 percent reduction in per-capita purchasing 

power relative to four years earlier. This program helps states provide prenatal care for mothers and preventive health services and 

medical treatment for children lacking other sources of health care, 

including children with disabilities and other special needs. 

• The bill reduces the increase requested by the President for 

Community Health Centers by two-thirds, from $304 million to 

$100 million. More than half of the remaining increase has already 

been committed by the Department of HHS to fund applications for 

new health center sites and services that have been approved but 

for which FY 2005 funds were not available. Under the bill, relatively small amounts will be available in FY 2006 to cover rising 

health care costs at existing centers or to fund additional applications for new or expanded health centers. 

• The measure eliminates the $100 million contribution to the 

Global Fund to Fight HIV/AIDS, Malaria and Tuberculosis, which 

had been included in the NIH budget for the past four years. 

• With just a couple of exceptions, most health care programs 

that aren’t cut by the bill have their funding frozen, with no increases to cover rising health care costs or caseloads or anything 

else. For example, the Ryan White AIDS programs—other than 

drug assistance—receive slightly less funding (in nominal dollars) 

than three years earlier, even though the number of patients with 

AIDS has been rising by more than 6 percent per year. 

As for research at the National Institutes of Health to try to find 

cures for diseases like Parkinson’s disease or Alzheimer’s, the Committee essentially adopted the President’s budget. It provided an 

increase of only 0.5 percent—the smallest percentage increase in 36 

years, and 2.6 percent short of what NIH estimates would be needed just to keep up with inflation in research costs. One result will 

be that NIH can support about 505 fewer research grants than just 

two years earlier. 

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For the programs of the Centers for Disease Control that help 

protect the public against infectious and other diseases, some of the 

largest cuts come in assistance to state and local health departments. In particular, the Preventive Health Block Grant is cut by 

$31 million or 24 percent, relative to the FY 2005 enacted level. 

These grants are used by states and localities for basic public 

health functions such as responding to disease outbreaks, immunizing children, and improving care for people with chronic diseases 

like diabetes and asthma. Further, grants that help health departments improve their preparedness against bio-terrorism and other 

public health emergencies are cut by $75 million. 

Most other CDC programs have their funding frozen. This includes prevention and control of HIV/AIDS, sexually transmitted 

diseases, tuberculosis, and most other infectious diseases, as well 

as environmental health. There is a welcome addition of $50 million for immunization against the flu, but no increase at all is provided for childhood immunization, despite rising vaccine costs. 

HUMAN SERVICES

In the human services area, the Committee cuts in half the Community Services Block Grant, a program aimed at helping the poorest people in our communities who often have no other place to 

turn. This is an improvement over the President’s plan to abolish 

the program entirely, but it still leaves more than 1,000 local community services agencies seriously short of resources to assist lowincome people. The purpose of this block grant is to provide flexible 

funds to meet whatever a local community considers their most important needs, whether it be for job training, emergency food aid, 

programs for low-income seniors, or home weatherization. 

The bill also cuts the Low-Income Energy Assistance Program (LIHEAP) by almost $200 million—even though there’s no reason 

to expect that we won’t have another winter of sky-high heating oil 

and natural gas prices. Over the past four years, the average cost 

of heating a home with oil has almost doubled, and the share of 

that cost covered by the average LIHEAP grant has fallen by half, 

from 49 percent to 25 percent. 

Further, the legislation includes an increase of just 0.7 percent 

for Head Start—less than what would be needed to keep up with 

rising costs for teacher salaries, heating, transportation for children and other necessary expenses. It freezes appropriations for 

the Child Care Block Grant—marking the fourth year in a row that 

this block grant has been either frozen or cut and leading to a 13 

percent reduction below FY 2002 in terms of inflation-adjusted per 

capita purchasing power. It provides only a one percent increase for 

seniors’ nutrition programs, such as Meals on Wheels, and no increase at all for other key programs at the Administration on 

Aging. 

EDUCATION

On the education front, the Republican Majority has essentially 

imposed the first freeze on education funding in a decade. At the 

same time, No Child Left Behind requires our schools to do more 

for a record 55 million school children. This bill, however, offers 

them little additional help. It takes a number of actions that shift 

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more of the burden of financing education to the local property tax, 

even as Federal mandates to those same communities grow. 

• It cuts No Child Left Behind by $806 million (3.3 percent) 

below the current level. Under this bill, the NCLB funding shortfall 

will be $13.2 billion next year and over $40 billion since enactment.

• The bill cuts the $603 million increase the Administration proposed for Title 1 to help low-income children improve their reading 

and math skills to only $100 million. The Administration’s request 

was already inadequate. However, under this bill, Title 1 funding 

will be $9.9 billion below NCLB’s funding promise for FY 2006. 

• The Republican Majority again breaks its funding promise on 

IDEA, the program that is aimed at helping local communities pay 

for the costs of educational services to disabled children mandated 

by Federal law. The bill is $3.9 billion below the Republican promise in the IDEA Improvement Act of 2004 to put special education 

funding on a glidepath to full funding. It even cuts the $508 million 

increase requested by the Administration to only $150 million. The 

entire idea of IDEA was to raise the federal share of special education costs to 40 percent over time. Under this bill, the federal 

share of special education costs will actually drop from 18.6 percent 

this year to 18.1 percent next year. 

• The bill freezes After School Centers, virtually for the fourth 

year in a row at $991 million even though only 38 percent of all 

after school applications nationwide could be funded last year. We 

are turning away children when more than 14 million kids are unsupervised after school each day. 

• It slashes Education Technology by $196 million (39.5 percent) 

on top of a $196 million cut last year. One in four states have no 

other dedicated technology funds to track NCLB student achievement data, improve teachers’ use of technology, and close the 

achievement gap through online learning. 

• It eliminates Comprehensive School Reform grants to 1,000 

high-poverty schools by eliminating the program. Rigorous independent evaluations have shown that comprehensive school reform 

models such as Success for All, America’s Choice, High Schools 

That Work, First Things First, and Talent Development are making a significant difference in helping schools implement integrated, schoolwide reform strategies. This bill turns its back on 

these schools. 

• The bill cuts investments in teachers. It freezes the main 

NCLB program to put qualified teachers in every classroom—

Teacher Quality State Grants—at $2.9 billion for the 3rd consecutive year of a freeze or cut. The bill denies 80 percent of the Administration’s $500 million request to provide an incentive for the best 

teachers to teach in the most challenging high-poverty schools. It 

cuts funds requested for math and science teachers by $79 million 

(29 percent). It even cuts teacher training in American history by 

$69 million (58 percent). 

• It freezes Impact Aid payments to 1,300 school districts for 

over 1 million military and other Federally-connected children, 

funding Impact Aid at approximately 35 percent below the maximum payments authorized for FY 2006. The bill also freezes flexible innovative education grants, English language training, civic 

307

education, State assessments, and rural education. Some of these 

programs have been frozen for four years in a row. • Although the Republican Majority promised low-income stu- dents a $100 increase in the maximum Pell Grant in the 2006 

Budget Resolution, this bill provides only half that. The $50 increase would offset only 2 percent of the additional $2,300 in fouryear public college costs since 2001. 

PUBLIC BROADCASTING

While we are pleased that the Committee adopted the Demo- cratic amendment to restore $400 million in fiscal year 2008 advance appropriations for the Corporation for Public Broadcasting, 

this bill still includes harmful cuts in Federal support for local television and radio stations, and for acclaimed children’s programs 

such as Sesame Street, Mr. Rogers, and Reading Rainbow. This bill rescinds $100 million or 25 percent of the funds Congress has already enacted for the Corporation for Public Broadcasting for FY 2006. In addition, out of this reduced appropriation, 

the bill asks public broadcasters to absorb up to $82 million for the 

mandatory costs of digital conversion and replacement of the public 

television satellite interconnection system. In all, the bill would cut 

federal assistance to stations by as much 46 percent below the 

prior FY 2006 enacted level. These cuts come at a time when commercial broadcasters are engaged in a race to the bottom to bolster 

ratings, while public broadcasting offers us refreshing, innovative, 

educational and in-depth alternative programming. 

CONCLUSION

What is at stake in this bill is not just the question of how much 

money will be provided. We are really facing the larger question of 

how well we will meet our obligations to the country’s future. The 

President wants to blow up Social Security’s guarantees as we 

know them and force Americans to count on their personal investments for their retirement. He has expended great time and energy 

to convince Americans they must invest for their future. 

The country needs to do the same thing. We have to count on our 

investments. However, this bill walks away from the investment 

we should be making in our human capital. One year of cuts might 

be tolerated. But, the LHHS bill is targeted for deeper and deeper 

cuts over time. One needs to look no further than No Child Left 

Behind. • Four years ago, we fell $4.2 billion short of the NCLB 

funding promise. • Three years ago, we fell $5.4 billion short. • Two years ago, the gap was $7.6 billion. • Last year, the gap grew to $9.8 billion. • Under this bill, the gap will exceed $13 billion. 

The same disinvestment is now occurring in programs such as 

job training, health professions training, child care, after school 

centers, and teacher training. And, this quiet erosion in these needed investments will get worse under the Majority’s long-term plan. 

This is a prescription for America walking away from our commitment to equal opportunity and a better quality of life for all 

Americans. The only guarantee we are providing them in this bill 

308

is that greater access to better jobs and higher wages, affordable 

healthcare and quality educational and lifetime opportunities will 

not be achieved. 

THE DEMOCRATIC ALTERNATIVE

The Democratic Amendment offered during Appropriations Committee consideration of this bill would have invested an additional 

$11.8 billion for priority job training, education and health programs, and fully offset these funds by reducing super-sized, sixdigit tax cuts that provide the greatest benefit to those who need 

it the least. It also included $11.8 billion for deficit reduction. 

Under the Democratic Amendment, the average tax cut of a person 

making more than a million dollars would have been reduced from 

about $140,000 to $36,500. Unfortunately, the Democratic Amendment was defeated on a party line vote of 29 to 35. The Democratic Amendment invested an additional $7.8 billion 

to provide real educational opportunity. The Amendment provided: • $3 billion more for Title 1 reading and math services for 

nearly 1 million additional low-income students; • $250 million more for teacher and school improvement, 

which would have resulted in 22,000 additional teachers receiving high-quality professional development and prevented 

1,000 high-poverty schools from losing ongoing comprehensive 

school reform grants; • $939 million more for after school centers, child care and 

Head Start centers to help working families obtain high-quality childcare, an early ‘‘headstart’’ on education, and afterschool learning opportunities for their children; • $1.56 billion more for special education to keep us on a 

glidepath toward full funding, instead of losing ground as this 

bill would do; and • A $450 increase in the maximum Pell Grant for the lowest 

income students. 

The Democratic Amendment invested an additional $738 million 

to provide more unemployed Americans with the job search assistance and training they need for the Jobs of the 21th Century. The 

Amendment: 

• Restored the $125 million cut from the President’s signature job training initiative so that workers can qualify for the 

high-skills jobs that employers in growth industries have found 

difficult to fill; 

• lnvested more in science, math and technology education 

programs today so that we will have a technologically proficient workforce tomorrow; and 

• Reversed the 87 percent cut in the Labor Department 

funding that helps countries improve their labor standards and 

eliminate abusive child labor. 

In terms of heath care and human services, the Democratic 

Amendment avoided most of the cuts made in the Committee bill 

and included additional funds for certain high priority investments. 

The Amendment: 

• Restored funding for the health professions programs, 

which help increase the number of minorities in medical and 

dental schools and encourage medical students to go into priVerDate jul 14 2003 07:43 Jun 22, 2005 Jkt 021909 PO 00000 Frm 00308 Fmt 6604 Sfmt 6602 E:\HR\OC\HR143.XXX HR143
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mary care and consider practice in rural and underserved 

areas; 

• Fully funded the President’s request for Community 

Health Centers, so that the many communities applying for 

funds to start or expand a health center have a better chance 

of actually receiving assistance; 

• Expanded programs to address the special health needs of 

rural areas, rather than cutting these programs 41 percent as 

the Committee’s bill does; 

• Restored funding for grants to state and local health departments to help combat infectious diseases and other health 

threats and improve preparedness against bioterrorist attack 

or natural epidemic; 

• Invested in biomedical research at NIH by providing a sufficient increase to keep up with inflation in research costs and 

to avoid the need to reduce the number of research grants supported; 

• Restored the $100 million contribution to the Global AIDS 

Fund; 

• Reversed cuts in the LlHEAP energy assistance program, 

in order to help low-income families and senior citizens avoid 

having to choose between heating and eating next winter; and 

• Raised funding for Community Services Block Grant to its 

FY 2002 level of $650 million to help local organizations operating in almost every county in the U.S. provide basic services 

to poor people.

One particular focus of the Democratic Amendment was increases in a series of programs that help young mothers and families in difficult circumstances care for infants and children, in part 

to reduce some of the economic pressures that might cause a 

woman to decide not to carry a pregnancy to term. We hear many 

expressions of concern for life. These concerns need to go beyond 

the rhetorical and attack the real life conditions that can lead a 

woman to make another choice. Lectures from politicians will not 

help unless we extend a hand to assist women to overcome economic pressures and other life challenges that sometimes make a 

pregnancy and the thought of another child seem overwhelming. 

Concern about life cannot end at the checkbook’s edge. 

That is why the Amendment—

• Added $175 million to the Maternal and Child Health 

Block Grant, to restore its purchasing power to the FY 2002 

level, and added $98 million to double the Healthy Start program; both of these programs support prenatal and infant 

health services and help young, low-income mothers learn to 

care for their babies and gain access to the services they need. 

• Added $300 million to Child Care grants, restoring purchasing power to FY 2002, to help low-income families secure 

safe and affordable child care. 

• Added $418 million to restore the purchasing power of the 

Community Services Block Grant, to help local communitybased agencies meet basic needs of low-income families, such 

as emergency assistance with food and other needs, parenting 

education, child care, and job training and placement. 

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• Added $126 million to double grants to states and tribes 

for family violence prevention programs and to provide shelter 

to victims of violence and their children. • Added $212 million to restore the purchasing power of 

adult job training grants to FY 2002 levels, to help parents acquire the skills needed to obtain well-paying jobs to support 

their families. 

This Amendment also would have reversed a number of harmful 

cuts that would result in costs passed down to state and local governments, already squeezed by a wide array of cuts in programs 

across the Federal government that provide important services to 

the public. 

What is at stake in this bill is not just the question of how much 

money will be provided for education, healthcare, or job training. 

We are really facing the larger question of who we are as a people 

and what kind of nation we want to be. The Democratic Amendment sought to move us in the right direction. 

DAVID R. OBEY. STENY HOYER. 

ROSA DELAURO. 

JESSE JACKSON, JR. LUCILLE ROYBAL-ALLARD.

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