22–423 PDF 

Calendar No. 163 

109TH CONGRESS REPORT " ! SENATE 1st Session 109–103 

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

JULY 14, 2005.—Ordered to be printed 

Mr. SPECTER, from the Committee on Appropriations, 

submitted the following 

R E P O R T 

[To accompany H.R. 3010] 

The Committee on Appropriations, to which was referred the bill 

(H.R. 3010) making appropriations for the Departments of Labor, 

Health and Human Services, and Education and related agencies 

for the fiscal year ending September 30, 2006, and for other purposes, reports the same to the Senate with an amendment and recommends that the bill as amended do pass. 

Amount of budget authority 

Total of bill as reported to the Senate ............. $604,436,313,000 

Amount of 2005 appropriations ........................ 501,344,991,000 

Amount of 2006 budget estimate ...................... 600,212,625,000 

Amount of House allowance .............................. 601,592,573,000 

Bill as recommended to Senate compared to— 

2005 appropriations .................................... ∂103,091,322,000 

2006 budget estimate ................................. ∂4,223,688,000 

House allowance ......................................... ∂2,843,740,000 
(2) 

C O N T E N T S 

Page 

Summary of Budget Estimates and Committee Recommendations .................... 4 

Overview and Bill Highlights ................................................................................. 4 

Highlights of the Bill ............................................................................................... 4 

Title I—Department of Labor: 

Employment and Training Administration .................................................... 7 

Employee Benefits Security Administration .................................................. 19 

Pension Benefit Guaranty Corporation .......................................................... 19 

Employment Standards Administration ......................................................... 20 

Occupational Safety and Health Administration ........................................... 23 

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

Bureau of Labor Statistics ............................................................................... 25 

Office of Disability Employment Policy .......................................................... 25 

Departmental Management ............................................................................. 26 

Veterans Employment and Training ............................................................... 29 

Office of the Inspector General ........................................................................ 30 

General Provisions ........................................................................................... 30 

Title II—Department of Health and Human Services: 

Health Resources and Services Administration ............................................. 32 

Centers for Disease Control and Prevention .................................................. 57 

NIH Preamble ................................................................................................... 88 

Substance Abuse and Mental Health Services Administration .................... 176 

Agency for Healthcare Research and Quality ................................................ 186 

Centers for Medicare and Medicaid Services ................................................. 188 

Administration for Children and Families ..................................................... 196 

Administration on Aging .................................................................................. 214 

Office of the Secretary ...................................................................................... 218 

Office of the Inspector General ........................................................................ 224 

General Provisions, Department of Health and Human Services ................ 225 

Title III—Department of Education: 

Education for the Disadvantaged .................................................................... 228 

Impact Aid ......................................................................................................... 235 

School Improvement Programs ........................................................................ 236 

Indian Education .............................................................................................. 243 

Innovation and Improvement .......................................................................... 244 

Safe Schools and Citizenship Education ......................................................... 253 

English Language Acquisiton .......................................................................... 256 

Special Education ............................................................................................. 257 

Rehabilitation Services and Disability Research ........................................... 261 

Special Institutions for Persons With Disabilities: 

American Printing House for the Blind ................................................... 267 

National Technical Institute for the Deaf ............................................... 267 

Gallaudet University ................................................................................. 268 

Vocational and Adult Education ..................................................................... 268 

Student Financial Assistance .......................................................................... 273 

Student Aid Administration ............................................................................ 275 

Higher Education ............................................................................................. 276 

Howard University ........................................................................................... 284 

College Housing and Academic Facilities Loans ............................................ 284 

Historically Black College and University Capital Financing Program ...... 284 

Institute of Education Science ......................................................................... 285 

Departmental Management: 

Program Administration ........................................................................... 288 

Office for Civil Rights ............................................................................... 289 

Office of the Inspector General ................................................................ 290 
Page

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Title III—Department of Education—Continued 

General Provisions ........................................................................................... 291 

Title IV—Related Agencies: 

Committee for Purchase from People who are Blind or Severely Disabled ............................................................................................................... 292 

Corporation for National and Community Service ........................................ 292 

Corporation for Public Broadcasting ............................................................... 297 

Federal Mediation and Conciliation Service .................................................. 298 

Federal Mine Safety and Health Review Commission .................................. 299 

Institute of Museum and Library Services ..................................................... 299 

Medicare Payment Advisory Commission ...................................................... 301 

National Commission on Libraries and Information Science ....................... 301 

National Council on Disability ........................................................................ 301 

National Labor Relations Board ...................................................................... 301 

National Mediation Board ............................................................................... 302 

Occupational Safety and Health Review Commission ................................... 303 

Railroad Retirement Board .............................................................................. 303 

Social Security Administration ........................................................................ 304 

Title V—General Provisions ................................................................................... 308 

Budgetary Impact of Bill ......................................................................................... 309 

Compliance With Paragraph 7, Rule XVI of the Standing Rules of the Senate .......................................................................................................................... 309 

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

Senate ................................................................................................................... 310 

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

Senate ................................................................................................................... 310 

Comparative Statement of New Budget Authority ............................................... 313 
(4) 

SUMMARY OF BUDGET ESTIMATES AND COMMITTEE 

RECOMMENDATIONS 

For fiscal year 2006, the Committee recommends total budget authority of $604,436,313,000 for the Departments of Labor, Health 

and Human Services, and Education, and Related Agencies. Of this 

amount, $141,653,000,000 is current year discretionary funding, including offsets. 

OVERVIEW AND BILL HIGHLIGHTS 

The Labor, HHS, and Education and Related Agencies bill constitutes the largest of the non-defense Federal appropriations bills 

being considered by Congress this year. It is the product of extensive deliberations, driven by the realization that no task before 

Congress is more important than safeguarding and improving the 

health and well-being of all Americans. This bill is made up of over 

300 programs, spanning three Federal Departments and numerous 

related agencies. But the bill is more than its component parts. 

Virtually every element of this bill reflects the traditional ideal of 

democracy: that every citizen deserves the right to a basic education and job skills training; protection from illness and want; and 

an equal opportunity to reach one’s highest potential. 

This bill at the same time provides a safety net of social protections for the needy while stimulating advances in human achievement and the life sciences. At its core, this bill embodies those defining principles by which any free society must be guided: compassion for the less fortunate; respect for family and loved ones; acceptance of personal responsibility for one’s actions; character development; and the avoidance of destructive behavior. 

HIGHLIGHTS OF THE BILL 

Job Training.—The Committee recommendation includes 

$5,250,806,000 for job training programs, an increase of 

$195,293,000 over the budget request, but $86,966,000 below the 

enacted 2005 level. 

Worker Protection.—The Committee bill includes $1,557,000,000 

to ensure the health and safety of workers, including $252,268,000 

for the National Labor Relations Board, $477,491,000 for the Occupational Safety and Health Administration and $280,490,000 for 

the Mine Safety and Health Administration. The recommendation 

is an increase of $32,000,000 over the 2005 level. 

Child Labor.—The Committee bill includes $93,248,000 for activities designed to end abusive child labor. This is $80,829,000 

above the budget request, but the same as the 2005 level. 

National Institutes of Health.—A total of $29,414,515,000 is recommended to fund biomedical research at the 27 Institutes and 

Centers that comprise the NIH. This represents an increase of 
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$1,050,000,000 over the fiscal year 2005 level and $904,731,000 

over the budget request. 

Health Centers.—The recommendation includes $1,839,311,000 

for health centers, $105,000,000 over the fiscal 2005 level. 

Medicare Modernization Act [MMA].—The Committee recommendation included $880,000,000, the full amount of the budget 

request, for MMA activities, consisting of $560,000,000 in the Program Administration account of the Centers for Medicare and Medicaid Services, and $320,000,000 for the Social Security Administration. 

Substance Abuse.—The Committee bill provides $3,260,783,000 

for substance abuse prevention and treatment programs. Included 

in this amount is $2,186,646,000 for substance abuse treatment, 

$202,289,000 for substance abuse prevention and $901,334,000 for 

mental health programs. 

Low-income Home Energy Assistance State Grants.—The Committee recommends $2,183,000,000 for heating and cooling assistance for low-income individuals and families, $183,000,000 above 

the budget request and $601,000 more than the 2005 level. 

Head Start.—The Committee recommendation includes 

$6,874,314,000 for the Head Start Program. This represents an increase of $31,200,000 over the 2005 level. 

Persons With Disabilities.—To promote independent living in home and community-based settings. This includes $47,164,000 for 

the Office of Disability Policy at the Department of Labor, 

$14,879,000 for Disabled Voter Services and $40,000,000 for Real 

Choice Systems Change Grants through the Center for Medicaid 

and Medicare Services. 

Education for the Disadvantaged.—The Committee has provided $12,839,571,000 in grants to enhance educational opportunities for 

disadvantaged children, an increase of $100,000,000 over the fiscal 

year 2005 level. 

Educator Professional Development.—The Committee recommends $2,916,605,000 for State grants to improve teacher quality and almost $3,600,000,000 in various programs administered by 

the Department of Education. 

English Language Acquisition.—The Committee recommends 

$675,765,000 for bilingual education. 

Student Financial Aid.—The Committee recommends 

$15,103,795,000 for student financial assistance, an increase of 

$838,046,000 over the fiscal year 2005 level. The amount provided 

for the Pell Grant Program will allow for a maximum grant award 

of $4,050. 

Higher Education Initiatives.—The Committee bill provides 

$2,104,508,000 for initiatives to provide greater opportunities for 

higher education, including $836,543,000 for Federal TRIO programs and $306,488,000 for GEAR UP. 

Education for Individuals With Disabilities.—The Committee bill 

provides $11,515,151,000 to help ensure that all children have access to a free and appropriate education, and that all infants and 

toddlers with disabilities have access to early intervention services. 

This represents an increase of $103,500,000 over the 2005 level. 

Rehabilitation Services.—The bill recommends $3,133,638,000 for 

rehabilitation services, an increase of $59,064,000 above the 
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amount provided in 2005. These funds are essential for families 

with disabilities seeking employment. The Committee restored 

funding for several important programs proposed for elimination, 

such as Supported Employment State Grants, Projects with Industry, Recreational programs and programs for migrant and seasonal 

farmworkers. 

Services for Older Americans.—For programs serving older Amer- icans, the Committee recommendation includes $3,170,461,000. 

This recommendation includes $219,784,000 for senior volunteer 

programs, $436,678,000 for community service employment for 

older Americans, $354,136,000 for supportive services and centers, 

$160,744,000 for family caregiver support programs and 

$718,697,000 for senior nutrition programs. For the medical research activities of the National Institute on Aging, the Committee 

recommends $1,090,600,000. The Committee recommendation also 

includes not less than $31,700,000 for the Medicare insurance 

counseling program. 

Corporation for Public Broadcasting.—The Committee bill recommends an advance appropriation for fiscal year 2008 of 

$400,000,000 for the Corporation for Public Broadcasting. In addition, the Committee bill includes $35,000,000 for conversion to digital broadcasting and $40,000,000 for the replacement project of the 

interconnection system in fiscal year 2006 funding. 

REPROGRAMMING AND TRANSFER AUTHORITY

The Committee has included bill language delineating permissible transfer authority in general provisions for each of the Departments of Labor, Health and Human Services, and Education, 

as well as specifying reprogramming authority in a general provision applying to all funds provided under this Act. 
(7) 

TITLE I—DEPARTMENT OF LABOR 

EMPLOYMENT AND TRAINING ADMINISTRATION

TRAINING AND EMPLOYMENT SERVICES

(INCLUDING RESCISSIONS)

Appropriations, 2005 ............................................................................. $5,337,772,000 

Budget estimate, 2006 ........................................................................... 5,055,513,000 

House allowance .................................................................................... 5,121,792,000 

Committee recommendation ................................................................. 5,250,806,000 

The Committee recommends $5,250,806,000 for this account in 

2006 which provides funding primarily for activities under the 

Workforce Investment Act [WIA]. This is $86,966,000 less than the 

2005 level, $129,014,000 more than the House allowance, and 

$195,293,000 over the administration request. 

Training and employment services is comprised of programs designed to enhance the employment and earnings of economically 

disadvantaged and dislocated workers, operated through a decentralized system of skill training and related services. This appropriation is generally forward-funded on a July-to-June cycle. Funds 

provided for fiscal year 2006 will support the program from July 

1, 2006 through June 30, 2007. 

Beginning with the fiscal year 2000 appropriation, budget constraints required that a portion of this account’s funding be advance appropriated, with obligations for a portion of Adult and Dislocated Worker Employment and Training Activities and Job Corps 

delayed until the following fiscal year. This practice will continue 

in this year’s appropriation. 

Pending reauthorization of the Workforce Investment Act the 

Committee is acting on a current law request, deferring without 

prejudice proposed legislative language under the jurisdiction of 

the authorizing committees. 

The Committee is aware of the High Growth Job Training Initiative created in 2002 to prepare workers for job opportunities in 

high growth and high demand sectors of the American economy. 

The Committee supports efforts to take a proactive approach to job 

training, tracking workforce trends and anticipating industry needs 

in communities hard-hit by recent economic downturns. The Committee has included $55,000,000 for this initiative, which shall be 

awarded based on a competitive process. 

The Committee notes that the budget request does not include 

funding for the personal re-employment account initiative, and expects that none of the funds provided for fiscal year 2006 will be 

utilized for this initiative unless specifically authorized by law. 

The Committee recommendation concurs with the House in retaining language from last year’s bill requiring that the Department take no action to amend, through regulatory or other admin-
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istrative action, the definition established in 20 CFR 677.220 for 

functions and activities under title I of the Workforce Investment 

Act until such time as legislation reauthorizing the Act is enacted. 

The Committee expects that, while the Workforce Investment Act 

is in the process of being altered and renewed, the Administration 

will refrain from unilateral changes to the administration, operation and financing of employment and training programs. 

Adult Employment and Training.—For Adult Employment and Training Activities, the Committee recommends $893,618,000, 

which is $27,882,000 more than the budget request and House allowance, and $3,000,000 less than the program year 2005 level. 

This program is formula-funded 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, which will be 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 Assistance.—For Dislocated Worker Assistance, the Committee recommends $1,476,064,000 the same as the 

program year 2005 level, $132,480,000 more than the budget request, and $70,800,000 more than the House allowance. Of the 

total, $1,193,264,000 is designated for State formula grants. This 

program is a State-operated effort which provides core services, intensive services, training, and supportive services to help permanently separated workers return to productive, unsubsidized employment. In addition, States use these funds for rapid response assistance to help workers affected by mass layoffs and plant closures. The recommendation includes $282,800,000 available to the 

Secretary for activities such as responding 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, including 

community college initiatives. 

The Committee bill continues language authorizing the use of 

funds under the dislocated workers program for projects that provide assistance to new entrants in the workforce and incumbent 

workers, as well as to provide assistance where there have been 

dislocations across multiple sectors or local areas of a State. 

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

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

The Committee was pleased to learn from the Secretary that the 

administration has established an interagency effort to address our 

Nation’s nursing shortage. The shortage is especially critical in 

rural America and within various ethnic minority populations, such 

as native Hawaiians. The Department is accordingly strongly urged 

to work with nursing programs serving such populations, and in 

particular, to ensure that summer employment opportunities exist 

for nursing students. 

The Committee is aware of the ever changing agricultural worker 

training needs in Hawaii and recommends continued funding for a 

collaborative and adaptive effort involving the Hawaiian Depart-
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ment of Labor and Industrial Relations and the Hawaiian Cooperative Extension Service to provide multiculturally-sensitive on-farm 

food safety training, agribusiness training, and production training 

in support of a rapidly expanding landscaping and grounds keeping 

industry. 

Community Based Job Training Initiative.—The Committee recommendation includes $125,000,000 to carry out the Community 

College/Community Based Job Training Grant initiative, compared 

to the $250,000,000 request. The House recommendation includes 

a rescission of $125,000,000 in funds provided in fiscal year 2005 

for this program, as well as a total of $125,000,000 for 2006. The 

Committee recommendation allocates $125,000,000 from National 

Emergency Grant funds available under section 132(a)(2)(A) of the 

Workforce Investment Act, and does not rescind funds provided in 

the fiscal year 2005 bill for this initiative. The Secretary is directed 

to initially use resources from the National Emergency Grants account for these awards that are designated for non-emergencies 

under sections 171(d) and 170(b) of the Workforce Investment Act. 

Community Based Job Training Grant awards will also be subject 

to the limitations of sections 171(c)(4)(A) through 171(c)(4)(C) of the 

Workforce Investment Act to ensure that these grants are awarded 

competitively. Funds used for this initiative should strengthen 

partnerships between workforce investment boards, community colleges, and employers, to train workers for high growth, high demand industries in the new economy. 

The Committee encourages the Employment and Training Administration to consider, in future solicitations for grant applications for the Community Based Job Training Initiative, including 

One Stop Career Centers, and in rural areas and other communities without community colleges, eligibility of alternative education and training providers to apply for these grants. 

Youth Training.—For Youth Training, the Committee rec- ommends $986,288,000, which is $36,288,000 more than the budget 

request and House allowance, and the same as the program year 

2005. The Committee recommendation does not address the administration’s legislative proposals for these activities. The purpose of 

Youth Training is to provide eligible youth with assistance in 

achieving academic and employment success through improving 

educational and skill competencies and providing connections to 

employers. Other activities include providing mentoring opportunities, opportunities for training, supportive services, summer employment opportunities that are directly linked to academic and occupational learning, incentives for recognition and achievement, 

and activities related to leadership development, citizenship, and 

community service. 

Job Corps.—For Job Corps, the Committee recommends 

$1,582,000,000. This is $64,981,000 more than the budget request, 

and $30,140,000 more than the 2005 comparable level. The Committee concurs with the House in not including the proposed 

$25,000,000 rescission of funds previously appropriated for construction and renovation activities. The Committee applauds Job 

Corps for establishing partnerships with national employers, and 

encourages Job Corps to continue to work with both large employers and small businesses to ensure that student training meets cur-
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rent labor market needs. Job Corps 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 voluntary 

and is open to economically disadvantaged young people in the 16– 

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. 

As a national training program, Job Corps is particularly well 

suited to help meet the needs of large, multi-state employers for 

skilled entry-level workers. 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 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 recommends a minimum of $10,000,000 of the program year 2005 Community College Initiative funding be dedicated 

to community colleges partnerships with Job Corps centers. The 

Committee expects 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. 

The Committee commends the work of the NJCA Foundation for 

Youth Opportunities [FYO] in its charitable and educational activities and programs that benefit youth, especially those at-risk. The 

FYO seeks to provide resources and research that helps non-profit, 
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for-profit, and Government agencies further education and training 

opportunities for disadvantaged youth. 

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. 

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 is committed to promoting and expanding costeffective Federal programs that have a proven record of success 

provide consistent and positive results and help address national 

labor shortages. Therefore, the Committee recommends 

$10,000,000 for second year funding for the incremental expansion 

of Job Corps. This in addition to the $10,000,000 provided in previously appropriated funds to begin the process of establishing additional Job Corps centers. In the selection process, priority should 

go to: States that currently do not have a Job Corps Center or who 

work in conjunction with an existing center serving the entire 

State or region; Sites that can be started in the short term as satellite Job Corps centers (residential or non-residential) and later be 

converted to stand alone facilities. 

The Committee recognizes Project CRAFT (Community, Restitution, and Apprenticeship-Focused Training), a program of the 

Home Builders Institute, the workforce development arm of the 

National Association of Home Builders, as a modern intervention 

technique in the rehabilitation and reduced recidivism of adjudicated youth. The Committee also acknowledges the importance of 

housing to our Nation’s economy and the role Project CRAFT plays 

in preparing young people to join the residential construction industry’s workforce. The Committee therefore encourages the Department to replicate Project CRAFT to bring its outcomes-oriented 

approach to adjudicated juveniles throughout the country in order 

to help them become members of this industry’s workforce and spur 

the Nation’s economy. 

The Committee recognizes that the Weber Basin and Clearfield, 

Utah Job Corps centers are among the highest ranked in the Nation. The Committee recognizes the State of Utah for its impressive 

contribution to the Job Corps program. 

Responsible Reintegration of Youthful Offenders.—The Committee recommendation includes $50,000,000, to continue funding 
12 

for the current Reintegration of Youthful Offenders Program. Neither the budget request in House allowance included funding for 

this program, which was funded at $49,600,000 in program year 

2005. The Reintegration of Youthful Offenders Program targets 

critical funding to help prepare and assist young offenders to return to their communities. The program also provides support, opportunities, education and training to youth who are court-involved 

and on probation, in aftercare, on parole, or who would benefit 

from alternatives to incarceration or diversion from formal judicial 

proceedings. 

Prisoner Re-entry.—The recommendation includes the 

$19,840,000 for the prisoner re-entry initiative, to extend assistance to a broader population of ex-offenders. This is the same as 

the enacted 2005 level and the House allowance, and $15,160,000 

below the request. 

Native Americans.—For Native Americans, the Committee recommends $54,238,000. This is the same as the budget request, the 

House allowance, and the enacted program year 2005 level. This 

program 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. 

Migrant and Seasonal Farmworkers.—For Migrant and Seasonal Farmworkers, the Committee recommends $80,557,000, compared 

to the 2005 enacted level of $75,759,000. Authorized by WIA, this 

program 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, 

year-round employment within and outside of the agriculture industry. 

There are at least 3 million hard-working migrant and seasonal 

farmworkers in America whose annual incomes are below $10,000. 

At a time when most State budgets are shrinking and many of the 

basic services provided by State and local governments are being 

cut back, the Committee recognizes the importance of sustaining a 

national commitment, dating from 1964, to help alleviate the 

chronic seasonal unemployment and underemployment that traps 

many farmworker families in a cycle of poverty across generations 

and that deprives many farmworker children of educational opportunities and real prospects for better jobs at higher wages. The 

Committee also recognizes that many State and local government 

officials will be reluctant to fund this training and related assistance for this vulnerable portion of our Nation’s workforce who migrate through many States every year, even though the work they 

perform is essential to the economic well-being of our Nation’s 

farmers, growers, and small businesses. 

The Committee recommendation of $80,557,000 for program year 

2006 activities authorized under Section 167 of the Workforce Investment Act is reflected in two separate line items on the table 

accompanying the Committee Report: ‘‘Migrant and Seasonal 

Farmworkers’’ and ‘‘National Activities/Other.’’ Under the Migrant 
13 

and Seasonal Farmworkers line item, the Committee recommends 

$80,053,000. The Committee recommendation includes bill language directing that $5,000,000 of this amount be used for migrant 

and seasonal farmworker housing grants, of which not less than 70 

percent shall be for permanent housing. The principal purpose of 

these funds is to continue the network of local farmworker housing 

organizations working on permanent housing solutions for migrant 

and seasonal farmworkers. The Committee encourages greater emphasis on the southeast region for farmworker housing grants. The 

recommendation also provides that the remaining amount of 

$75,053,000 be used for State service area grants, including funding grantees in those States impacted by formula reductions to at 

least the amount they were alloted in program year 2004, requiring 

$3,840,000. Within the National Activities/Other line item, the 

Committee recommendation includes $504,000 to be used for Section 167 training, technical assistance and related activities, including funds for migrant rest center activities. The Committee 

urges the Department to continue valuable technical assistance 

services provided by the Association of Farmworker Opportunity 

Programs. Finally, the Committee wishes to again advise the Department regarding the requirements of the Workforce Investment 

Act in selecting an eligible entity to receive a State service area 

grant under Section 167. Such an entity must have already demonstrated a capacity to administer effectively a diversified program 

of workforce training and related assistance for eligible migrant 

and seasonal farmworkers. 

National Programs.—This activity includes WIA-authorized programs in support of the workforce system including technical assistance and incentive grants, evaluations, pilots, demonstrations 

and research, and the Women in Apprenticeship Program. 

Technical Assistance.—The Committee recommends $3,458,000 

for the provision of technical assistance and staff development, an 

increase of $1,458,000 over the budget request and House allowance, but the same as the program year 2005 level. This includes 

$982,000 for technical assistance to employers and unions to assist 

them in training, placing, and retraining women in nontraditional 

jobs and occupations, as authorized under the Women in Apprenticeship and Non-Traditional Occupations Act of 1992, Public Law 

102–530; this amount is specified in bill language, to prevent its 

being diverted to other purposes. As described in the Migrant and 

Seasonal Farmworker section of this report, the recommendation 

also includes $504,000 for WIA Section 167 activities. 

Pilots, Demonstrations, and Research.—The Committee recommends $90,367,000, an increase of $60,367,000 over the budget 

request, and $16,367,000 over the House allowance for grants or 

contracts to conduct research, pilots or demonstrations that improve techniques or demonstrate the effectiveness of programs. 

In addition, the Committee recommends $6,944,000 to maintain 

the current level of for the Denali Commission as authorized in 

Public Law 108–7, for job training in connection with infrastructure building projects it funds in rural Alaska. Funding will allow 

unemployed and underemployed rural Alaskans to train for high 

paying jobs in their villages. 
14 

The Committee is deeply concerned about the ability of the 28 

million Americans who are deaf or hard-of-hearing to be informed 

of critical news and information in the post-9/11/01 environment. 

The Committee is aware that court reporting schools may not be 

able to meet the ‘‘unfunded mandate’’ set by the Telecommunications Act of 1996 to provide closed captioning of 100 percent of 

broadcast programming by January 2006. These compelling concerns justify continued Federal support to those schools to increase 

their capability to attract and train more real time writers and to 

work closely with the broadcasting industry to significantly increase the amount of programming that is closed captioned, that 

100 million Americans utilize closed captioning in some form and 

the shortage of providers need to be addressed immediately. 

The University of Hawaii Center on the Family is dedicated to 

understanding and promoting the factors that foster resiliency in 

families facing personal, social, and financial crises. The uniqueness of this program is the emphasis on the psychological and behavioral processes, family resilience and vulnerability, and includes 

Asian, Pacific Islander, and Caucasian families. The State’s diverse 

multicultural population adds to the reliability of the research conclusions. 

Evaluation.—The Committee recommends $7,936,000 to provide 

for the continuing evaluation of programs conducted under the 

Workforce Investment Act, as well as of federally-funded employment-related activities under other provisions of law. 

Rescission.—The Committee concurs with the House in recommending rescission of $20,000,000 in unobligated Health Care Tax 

Credit Funds and $5,000,000 in unobligated funds provided for 

emergency response activities, as requested by the administration. 

COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS

Appropriations, 2005 ............................................................................. $436,678,000 

Budget estimate, 2006 ........................................................................... 436,678,000 

House allowance .................................................................................... 436,678,000 

Committee recommendation ................................................................. 436,678,000 

The Committee recommends $436,678,000, the same as the budget request, the House allowance, and the program year 2005 comparable level for community service employment for older Americans. This program, authorized by title V of the Older Americans 

Act, provides part-time employment in community service activities 

for unemployed, low-income persons aged 55 and over. It is forward-funded from July to June, and the 2006 appropriation will 

support the program from July 1, 2006, through June 30, 2007. The 

Committee believes that within the title V community service employment for older Americans, special attention should be paid to 

providing community service jobs for older Americans with poor 

employment prospects, including individuals with a long-term detachment from the labor force, older displaced homemakers, aged 

minorities, limited English-speaking persons, and legal immigrants. 

The program provides a direct, efficient, and quick means to assist economically disadvantaged older workers because it has a 

proven effective network in every State and in practically every 

county. Administrative costs for the program are low, and the vast 
15 

majority of the money goes directly to low-income seniors as wages 

and fringe benefits. 

The program provides a wide range of vital community services 

that would not otherwise be available, particularly in low-income 

areas and in minority neighborhoods. Senior enrollees provide necessary and valuable services at Head Start centers, schools, hospitals, libraries, elderly nutrition sites, senior center, and elsewhere in the community. These services would not be available 

without the program. 

A large proportion of senior enrollees use their work experience 

and training to obtain employment in the private sector. This not 

only increases our Nation’s tax base, but it also enables more lowincome seniors to participate in the program. 

The Committee believes that the program should pay special attention to providing community service jobs for older Americans 

with poor employment prospects, including individuals with a longterm detachment from the labor force, older displaced homemakers, 

aged minorities, limited English-speaking persons, and legal immigrants. 

FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES

Appropriations, 2005 ............................................................................. $1,057,300,000 

Budget estimate, 2006 ........................................................................... 966,400,000 

House allowance .................................................................................... 966,400,000 

Committee recommendation ................................................................. 966,400,000 

The Committee recommends $966,400,000 the same as the budget estimate and House allowance for fiscal year 2006, and a decrease of $90,900,000 below the fiscal year 2005 appropriation for 

Federal Unemployment Benefits and Allowances. Trade adjustment 

benefit payments are expected to decline from $750,000,000 in fiscal year 2005 to $655,000,000 in fiscal year 2006, while trade training in fiscal year 2006 will remain at the 2005 level of 

$259,400,000 with an estimated 80,000 participants. Wage insurance costs are expected to increase form $48,000,000 in fiscal year 

2005 to $52,000,000 in fiscal year 2006. 

The Committee expects the Department to provide funds to the 

State of Alaska to mitigate negative effects on Alaskan fishermen 

and other Alaskan displaced workers stemming from passage of 

trade legislation in 2002. Funds should be provided on a flexible 

basis to cover costs of job training and placement programs, among 

other uses. 

The Trade Adjustment Assistance Reform Act of 2002 that 

amended the Trade Act of 1974 was signed into law on August 6, 

2002 (Public Law 107–210). This Act consolidated the previous 

Trade Adjustment Assistance [TAA] and NAFTA Transitional Adjustment Assistance [NAFTA–TAA] programs, into a single, enhanced TAA program with expanded eligibility, services, and benefits. Additionally, the Act provides a program of Alternative Trade 

Adjustment Assistance for Older Workers. 
16 

STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE

OPERATIONS

Appropriations, 2005 ............................................................................. $3,636,709,000 

Budget estimate, 2006 ........................................................................... 3,470,366,000 

House allowance .................................................................................... 3,470,366,000 

Committee recommendation ................................................................. 3,499,779,000 

The Committee recommends $3,499,779,000 for this account. 

This is $29,413,000 above the budget request as well as the House 

allowance and $136,930,000 above the 2005 comparable level. Included in the total availability is $3,366,954,000 authorized to be 

drawn from the ‘‘Employment Security Administration’’ account of 

the unemployment trust fund, and $132,825,000 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 which administer Federal 

and State unemployment compensation laws and operate the public 

employment service. 

For unemployment insurance [UI] services, the bill provides $2,610,000,000. This includes $2,600,000,000 for State Operations, 

and $10,000,000 for UI national activities, which is directed to activities that benefit the State/Federal unemployment insurance 

program. The bill provides for a contingency reserve amount should 

the unemployment workload exceed an average weekly insured 

claims volume of 2.8 million. This contingency amount would fund 

the administrative costs of unemployment insurance workload over 

the level of 2.8 million insured unemployed per week at a rate of 

$28,600,000 per 100,000 insured unemployed, with a pro rata 

amount granted for amounts of less than 100,000 insured unemployed. 

The Committee has provided funds requested by the administration from the Unemployment Insurance Trust Fund for conducting 

in person reemployment and eligibility assessments of UI beneficiaries and preventing and detecting fraudulent claims. The Committee notes that the Social Security Act requires the use of merit 

based staff in the administration of the UI program and expects 

that States will use State merit staffed UI personnel to perform 

these functions. 

For the Employment Service allotments to States, the Committee recommends $746,302,000 which includes $23,114,000 in general 

funds together with an authorization to spend $723,188,000 from 

the ‘‘Employment Security Administration’’ account of the unemployment trust fund. This compares to the budget request and 

House allowance of $696,000,000 and the enacted level of 

$780,592,000 for allotments to States. Due to tight budget constraints, the Committee recommendation does not include Reemployment Services Grants, funded in 2005 at $34,291,000, but restores the additional $50,302,000 reduction proposed by the administration for Employment Service Grants to States. These funds are 

available for the program year of July 1, 2006 through June 30, 

2007. 

The recommendation also includes $33,766,000 for Employment 

Service national activities, a decrease of $31,210,000 from the fiscal 

year 2005 level. This recommendation reflects the transfer of the 

foreign labor certification program to the Employment and Train-
17 

ing Administration Program Administration account, as requested 

by the administration. The recommendation maintains the 2005 

enacted level of $17,856,000 for the work opportunity tax credit 

program. The recommendation also includes $90,000,000 for One-Stop Career Centers, compared to the budget request and House allowance 

of $87,974,000 and 2005 enacted level of $97,974,000. The Committee recommendation includes funding for America’s Labor Market Information System, including core employment statistics, universal access for customers, improving efficiency in labor market 

transactions, and measuring and displaying WIA performance information. 

The recommendation includes the budget request level of $19,711,000 for the Work Incentives Grants program, 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

Appropriations, 2005 ............................................................................. $517,000,000 

Budget estimate, 2006 ........................................................................... 465,000,000 

House allowance .................................................................................... 465,000,000 

Committee recommendation ................................................................. 465,000,000 

The Committee recommends $465,000,000, the same as the budget estimate and House allowance for fiscal year 2006, and 

$52,000,000 less than the fiscal year 2005 level. 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. The bill anticipates that fiscal year 2006 advances will be made to the Black 

Lung Disability Trust Fund. The requested amount is required to 

provide for loan interest payments on Black Lung Trust Fund borrowed amounts. 

The separate appropriations provided by the Committee for all 

other accounts eligible to borrow from this account in fiscal year 

2006 are expected to be sufficient. Should the need arise, due to 

unanticipated changes in the economic situation, laws, or for other 

legitimate reasons, advances will be made to the appropriate accounts to the extent funds are available. Funds advanced to the 

Black Lung Disability Trust Fund are now repayable with interest 

to the general fund of the Treasury. 

PROGRAM ADMINISTRATION

Appropriations, 2005 ............................................................................. $170,101,000 

Budget estimate, 2006 ........................................................................... 206,111,000 

House allowance .................................................................................... 206,111,000 

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

The Committee recommendation includes $117,123,000 in general funds for this account, as well as authority to expend 

$82,877,000 from the ‘‘Employment Security Administration’’ ac-
18 

count of the unemployment trust fund, for a total of $200,000,000. 

This level provides sufficient resources to cover built-in cost increases. 

General funds in this account provide the Federal staff to administer employment and training programs under the Workforce Investment Act, the Older Americans Act, the Trade Act of 1974, the 

Denali Commission Act, the Women in Apprenticeship and NonTraditional Occupations Act of 1992, 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, as amended. Federal 

staff costs related to the Wagner-Peyser Act in this account are 

split 97 percent to 3 percent between unemployment trust funds 

and general revenue, respectively. 

The Committee believes that the public workforce system is 

strengthened by the effective participation of all of the stakeholders 

in the system and urges that the Department use a portion of its 

discretionary funds to support that participation through grants 

and contracts to intergovernmental, business, labor, and community-based organizations dedicated to training and technical assistance in support of Workforce Investment Boards and their members. 

The Committee is concerned that there are limited opportunities 

for Native Hawaiian administrators in health care organizations 

and encourages effective training programs to prepare Native Hawaiians with the expertise to excel in these areas. 

The Committee instructs that, for the purposes of the temporary 

visa programs, the Department of Labor shall treat loggers as agricultural workers and not as non-agricultural workers. Presently, 

the Department classifies loggers as non-agricultural; however, 

since June 1987, it has imposed upon them the same worker protections and labor standards as H–2A agricultural workers. Employers wishing to hire logger aliens must already provide transportation, housing, and meals, and must make the same benefits 

available to U.S. workers based on Department policy that predates the 1986 immigration reforms. The provision applies strictly 

to loggers, and shall not affect any other H–2B workers. 

WORKERS COMPENSATION PROGRAMS

(RESCISSION)

Appropriations, 2002 ............................................................................. $175,000,000 

Appropriations, 2005 ............................................................................. ........................... 

Budget estimate, 2005 ........................................................................... ¥120,000,000 

House allowance .................................................................................... ¥120,000,000 

Committee recommendation ................................................................. ¥120,000,000 

The Committee concurs with the budget request and House allowance in rescinding $120,000,000 in unobligated emergency response funds. 

The Committee is aware of the long-term health concerns of first 

responders in the wake of the September 11 tragedy. The Nation 

owes a debt to these workers, who reacted with courage and bravery in a moment of chaos. The Committee is concerned that the 

needs of the first responders be well documented and funds be dispersed in a manner that quickly and efficiently serves the needs of 
19 

these brave men and women. For that reason, the Committee has 

included bill language which retroactively authorizes $44,000,000 

in spending on behalf of victims and first responders. 

EMPLOYEE BENEFITS SECURITY ADMINISTRATION

SALARIES AND EXPENSES

Appropriations, 2005 ............................................................................. $131,213,000 

Budget estimate, 2006 ........................................................................... 137,000,000 

House allowance .................................................................................... 137,000,000 

Committee recommendation ................................................................. 134,900,000 

The Committee recommendation provides $134,900,000 for this 

account which is $3,687,000 above the 2005 comparable level. This 

provides sufficient resources to cover built-in cost increases. 

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. ESBA is also responsible for enforcement of sections 8477 

and 8478 of the Federal Employees’ Retirement Security Act of 

1986 [FERSA]. In accordance with the requirements of FERSA, the 

Secretary of Labor has promulgated regulations and prohibited 

transactions class exemptions under the fiduciary responsibility 

and fiduciary bonding provisions of the law governing the Thrift 

Savings Plan for Federal employees. In addition, the Secretary of 

Labor has, pursuant to the requirement of section 8477(g)(1) of 

FERSA, established a program to carry out audits to determine the 

level of compliance with the fiduciary responsibility provisions of 

FERSA applicable to Thrift Savings Plan fiduciaries. ESBA provides funding for the enforcement and compliance; policy, regulation, and public services; and program oversight activities. 

PENSION BENEFIT GUARANTY CORPORATION

The Corporation’s estimated obligations for fiscal year 2006 include single employer benefit payments of $5,102,000,000, multiemployer financial assistance of $90,000,000 and administrative expenses of $296,978,000. Administrative expenses are comprised of 

three activities: (1) pension insurance activities, $41,599,000; (2) 

operational support, $93,749,000; and (3) pension plan termination 

expenses, $161,630,000. Such expenditures will be financed by permanent authority. 

The Pension Benefit Guaranty Corporation is a wholly owned 

Government corporation established by the Employee Retirement 

Income Security Act of 1974. The law places it within the Department of Labor and makes the Secretary of Labor the Chair of its 

Board of Directors. The Corporation receives its income primarily 

from insurance premiums collected from covered pension plans, assets of terminated pension plans, collection of employer liabilities 

imposed by the Act, and investment earnings. It is also authorized 

to borrow up to $100,000,000 from the Treasury. The primary purpose of the Corporation is to guarantee the payment of pension 

plan benefits to participants if covered defined benefit plans fail or 

go out of existence. 

The 2006 budget does not recommend a discretionary limit on administrative expenditures [LAE] for PBGC. The PBGC’s budget re-
20 

flects—in a way that is more accountable to the Committee—the 

level of administrative expenditures that the Committee believes is 

appropriate to PBGC’s changing responsibilities to protect the pensions it insures. PBGC’s dollar benefit levels and workload change 

from year to year as specific pension plans fail. Most of its workload involves terminating failed pension plans, so that pension benefits can be paid. The workload of plan termination especially fluctuates from year to year as large plans (or a spate of small ones) 

terminate, and then as the terminations are completed. The language provides the PBGC the flexibility to respond when dictated 

by increased workload and increased benefit payments, while increasing accountability to the Committee by requiring approval by 

the Office of Management and Budget and the Committees on Appropriations. 

The single-employer program protects about 34.6 million participants in about 29,600 defined benefit pension plans. The multi-employer insurance program protects about 9.8 million participants in 

more than 1,600 plans. 

EMPLOYMENT STANDARDS ADMINISTRATION

SALARIES AND EXPENSES

Appropriations, 2005 ............................................................................. $400,847,000 

Budget estimate, 2006 ........................................................................... 416,332,000 

House allowance .................................................................................... 416,332,000 

Committee recommendation ................................................................. 412,616,000 

The Committee recommendation includes $412,616,000 for this 

account. The bill contains authority to expend $2,048,000 from the 

special fund established by the Longshore and Harbor Workers’ 

Compensation Act; the remainder of $410,568,000 are general 

funds. In addition, an amount of $33,050,000 is available by transfer from the black lung disability trust fund. 

This recommendation provides sufficient funding to offset The 

impact of inflation, and includes resources for a portion of requested program increases, to implement a program of union advisory services. The $15,891,000 request for Program Direction has 

been reduced to $15,375,000, an increase of $123,000 over the 2005 

level to cover built-in costs; an addition of $2,000,000 is described 

in the following paragraph. 

The recommendation includes $2,000,000 to make available personnel and other resources to facilitate the expeditious startup of 

a system to resolve claims of victims for bodily injury caused by asbestos exposure. This may include contracts with individuals or entities having relevant experience to assist in jump starting the program, as described in S. 852, the Fair Act of 2005. Activities to 

shorten the lead-time for implementation of asbestos activities encompass procedures for the processing of claims, including procedures for the expediting of exigent health claims, and planning for 

promulgation of regulations. 

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’ Com-
21 

pensation Act [FECA], the Longshore and Harbor Workers’ Compensation Act, and the Federal Mine Safety and Health Act (black 

lung). 

SPECIAL BENEFITS

Appropriations, 2005 ............................................................................. $233,000,000 

Budget estimate, 2006 ........................................................................... 237,000,000 

House allowance .................................................................................... 237,000,000 

Committee recommendation ................................................................. 237,000,000 

The Committee recommends $237,000,000, the same as the budg- et estimate for fiscal year 2006, and $4,000,000 more than fiscal 

year 2005. This appropriation primarily provides benefits under the 

Federal Employees’ Compensation Act [FECA]. The payments are 

prescribed by law. In fiscal year 2006, an estimated 155,000 injured Federal workers or their survivors will file claims; 55,000 will 

receive long-term wage replacement benefits for job-related injuries, diseases, or deaths. 

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

account numbers by individuals filing claims under the Federal 

Employees’ Compensation Act or the Longshore and Harbor Workers’ Compensation Act and its extensions. 

The Committee recommends continuation of appropriation language that provides authority to use the FECA fund to reimburse 

a new employer for a portion of the salary of a newly reemployed 

injured Federal worker. The FECA funds will be used to reimburse 

new employers during the first 3 years of employment not to exceed 75 percent of salary in the worker’s first year, declining thereafter. 

The Committee again includes appropriation language that retains the drawdown date of August 15. The drawdown authority 

enables the Agency to meet any immediate shortage of funds without requesting supplemental appropriations. The August 15 drawdown date allows flexibility for continuation of benefit payments 

without interruption. 

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

Postal Service, the Tennessee Valley Authority, and other entities 

are required to pay to cover their fair share of the costs of administering the claims filed by their employees under FECA. The Committee concurs with requested bill language to allow use of fair 

share collections to fund capital investment projects and specific 

initiatives to strengthen compensation fund control and oversight. 

SPECIAL BENEFITS FOR DISABLED COAL MINERS

Appropriations, 2005 ............................................................................. $275,997,000 

Budget estimate, 2006 ........................................................................... 232,250,000 

House allowance .................................................................................... 232,250,000 

Committee recommendation ................................................................. 232,250,000 

The Black Lung Consolidation of Administrative Responsibility 

Act was enacted on November 2, 2002. The Act amends the Black 

Lung Benefits Act to transfer part B black lung benefits responsibility from the Commissioner of Social Security to the Secretary of 
22 

Labor, thus consolidating all black lung benefit responsibility 

under the Secretary. Part B benefits are based on claims filed on 

or before December 31, 1973. The Secretary of Labor already responsible for the part C claims filed after December 31, 1973. In 

fiscal year 2006, an estimated 46,100 beneficiaries (5,100 miners 

and 41,000 survivors) will receive benefits. 

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

fiscal year 2006 for special benefits for disabled coal miners. This 

is in addition to the $81,000,000 appropriated last year as an advance for the first quarter of fiscal year 2006. The recommendation 

is the same as the administration request and House allowance. 

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. 

By law, increases in black lung benefit payments are tied directly 

to Federal pay increases. The year-to-year decrease in this account 

reflects a declining beneficiary population. 

The Committee recommends an advance appropriation of 

$74,000,000 for the first quarter of fiscal year 2007, the same as 

the administration request. These funds will ensure uninterrupted 

benefit payments to coal miners, their widows, and dependents. 

ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION

PROGRAM

Appropriations, 2005 ............................................................................. $40,321,000 

Budget estimate, 2006 ........................................................................... 96,081,000 

House allowance .................................................................................... 96,081,000 

Committee recommendation ................................................................. 96,081,000 

The Committee recommends $96,081,000, the same as the budget 

estimate for fiscal year 2005, and $55,760,000 more than 2005. 

The mission of the Energy Employees Occupational Illness Compensation Program is to deliver benefits to eligible employees and 

former employees of the Department of Energy, its contractors and 

subcontractors or to certain survivors of such individuals, as provided in the Energy Employees Occupational Illness Compensation 

Program Act. The mission also includes delivering benefits to certain beneficiaries of the Radiation Exposure Compensation Act. 

Benefit costs of $760,515,000 are anticipated in fiscal year 2006. 

The Department of Labor’s Office of Workers’ Compensation Programs within the Employment Standards Administration is responsible for adjudicating and administering claims filed by employees 

or former employees (or their survivors) under the Act. The program went into effect on July 31, 2001. 

In 2006, the volume of incoming claims under Part B of the Energy Employees Occupational Illness Compensation Program is estimated to remain stable at about 16,500 claims from Department 

of Energy [DOE] employees or survivors, and private companies 

under contract with DOE, who suffer from a radiation-related cancer, beryllium-related disease, or chronic silicosis as a result of 

their work in producing or testing nuclear weapons. 
23 

BLACK LUNG DISABILITY TRUST FUND

Appropriations, 2005 ............................................................................. $1,061,969,000 

Budget estimate, 2006 ........................................................................... 1,068,000,000 

House allowance .................................................................................... 1,068,000,000 

Committee recommendation ................................................................. 1,068,000,000 

The Committee recommends $1,068,000,000 for this account in 

2006, an increase of $6,031,000 above the fiscal year 2005 level, 

and the same as the budget request and House allowance. The appropriation language changed beginning in fiscal year 2003 for the 

Black Lung Disability Trust Fund to provide such sums as may be 

necessary to pay for benefits. This change eliminated the need for 

drawdowns from the subsequent year appropriation in order to 

meet current year compensation, interest, and other benefit payments. 

The total amount available for fiscal year 2006 will provide $314,011,000 for benefits payments, and $57,989,000 for administrative expenses for the Department of Labor. Also, included is 

$696,000,000 for interest payments on advances. 

The trust fund pays all black lung compensation/medical and 

survivor benefit expenses when no responsible mine operation can 

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

are incurred in administering the benefits program and operating 

the trust fund. 

It is estimated that 41,400 people will be receiving black lung 

benefits financed through the end of the fiscal year 2006, compared 

to an estimated 44,500 receiving benefits in fiscal year 2005. 

The basic financing for the trust fund comes from a coal excise 

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

from reimbursement from the Advances to the Unemployment 

Trust Fund and Other Funds as well as 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

Appropriations, 2005 ............................................................................. $464,158,000 

Budget estimate, 2006 ........................................................................... 466,981,000 

House allowance .................................................................................... 477,199,000 

Committee recommendation ................................................................. 477,491,000 

The Committee recommendation includes $477,491,000 for this 

account. This is an increase of $10,510,000 over the budget request 

and an increase of $13,333,000 above the 2005 comparable level. 

This Agency is responsible for enforcing the Occupational Safety 

and Health Act of 1970 in the Nation’s workplaces. 

This recommendation provides sufficient funding to offset the impact of inflation, as well as additional resources to expand outreach 

to non-English speaking workers and small businesses. 

In addition, the Committee has included language to allow 

OSHA to retain up to $750,000 per fiscal year of training institute 
24 

course tuition fees to be utilized for occupational safety and health 

training and education grants in the private sector. 

The Committee retains language carried in last year’s bill effectively exempting farms employing 10 or fewer people from the provisions of the Act except those farms having a temporary labor 

camp. The Committee also retains language exempting small firms 

in industry classifications having a lost workday injury rate less 

than the national average from general schedule safety inspections. 

These provisions have been in the bill for many years. 

The Committee believes that OSHA’s worker safety and health 

training and education programs, including the grant program that 

supports such training, are a critical part of a comprehensive approach to worker protection. The Committee is concerned that 

OSHA has again cut funding to help establish ongoing worker safety and health training programs and has therefore restored the 

Susan Harwood training grant program to $10,510,000. Bill language specifies that no less than $3,200,000 shall be used to maintain the existing institutional competency building training grants, 

provided that grantees demonstrate satisfactory performance. 

The Committee has provided $53,896,000, the budget request 

level, for the State consultation grant program and expects that 

this program will continue to be targeted to provide compliance assistance to small businesses. 

The Committee continues to be pleased with OSHA’s efforts in 

placing high priority on the voluntary protection programs [VPP] 

and other voluntary cooperative programs. The Committee expects 

OSHA to continue to place high priority on the VPP. Cooperative 

voluntary programs, especially the VPP, are an important part of 

OSHA’s ability to assure worker safety and health and should be 

administered in conjunction with an effective strong enforcement 

program. 

The Committee also intends that the Office of Regulatory Analysis continue to be funded as close as possible to its present level. 

MINE SAFETY AND HEALTH ADMINISTRATION

SALARIES AND EXPENSES

Appropriations, 2005 ............................................................................. $279,136,000 

Budget estimate, 2006 ........................................................................... 280,490,000 

House allowance .................................................................................... 280,490,000 

Committee recommendation ................................................................. 280,490,000 

The Committee recommendation includes $280,490,000 for this 

account, an increase of $1,354,000 over the 2005 enacted level, and 

the same as the budget request and House allowance. 

This recommendation provides sufficient funding to offset the impact of inflation, as well as additional resources for enforcement 

and compliance assistance. It deletes one-time funding of projects 

contained in the 2005 enacted level. 

The Committee recommendation also includes bill language providing up to $2,000,000 for mine rescue and recovery activities, the 

same as the fiscal year 2005 comparable level. It also retains the 

provision 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 a major disaster. 
25 

This Agency insures the safety and health of the Nation’s miners 

by conducting inspections and special investigations of mine operations, promulgating mandatory safety and health standards, cooperating with the States in developing effective State programs, 

and improving training in conjunction with States and the mining 

industry. 

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

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

Bill language also allows MSHA to retain up to $1,000,000 from 

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

for such activities. 

BUREAU OF LABOR STATISTICS

SALARIES AND EXPENSES

Appropriations, 2005 ............................................................................. $529,003,000 

Budget estimate, 2006 ........................................................................... 542,523,000 

House allowance .................................................................................... 542,523,000 

Committee recommendation ................................................................. 542,523,000 

The Committee includes $542,523,000 for this account, 

$13,520,000 more than the 2005 comparable level. This includes 

$77,845,000 from the ‘‘Employment Security Administration’’ account of the unemployment trust fund, and $464,678,000 in Federal funds. This funding level will cover the Agency’s built-in increases, and includes funds to continue the Mass Layoff Statistics 

Program. 

The Bureau of Labor Statistics is the principal fact finding Agency in the Federal Government in the broad field of labor economics. 

The Committee urges the Bureau of Labor Statistics to revamp 

its website to make it more user friendly. 

OFFICE OF DISABILITY EMPLOYMENT POLICY

Appropriations, 2005 ............................................................................. $47,164,000 

Budget estimate, 2006 ........................................................................... 27,934,000 

House allowance .................................................................................... 27,934,000 

Committee recommendation ................................................................. 47,164,000 

The Committee recommends $47,164,000 for this account in 

2006. This is $19,230,000 more than the President’s request and 

the same as 2005. The Committee intends that at least 80 percent 

of these funds shall be used for demonstration and technical assistance grants to develop innovative and effective practices to increase 

the employment of youth and adults with disabilities. 

Congress created the Office of Disability Employment Policy 

[ODEP] in the Department of Labor’s fiscal year 2001 appropriation. Programs and staff of the former President’s Committee on 

Employment of People with Disabilities [PCEPD] have been integrated into this office. 

The Committee is aware of the outstanding success of national 

non-profits working to increase self-employment among people with 

disabilities. Self-employment can provide income, assets and other 

elements of self-sufficiency to people with disabilities that are hard 
26 

to place in traditional work environments because of the flexibility 

inherent in self-employment. In addition to the direct benefit to the 

business owner and the savings to the Social Security Disability Income program resulting from self-employment, preliminary data 

suggests that business owners with disabilities are far more likely 

to hire other people with disabilities as the business expands. 

Within the funds provided for the Office of Disability Employment Policy, the Committee has included $5,000,000 for a national 

initiative focusing on self-employment as an option for persons with 

disabilities. As the centerpiece of this new initiative, the Committee has included $3,000,000 to assist State Job Training Institutions, WIA One Stops, SBA Small Business Development Centers, 

the Vocational Rehabilitation and Employment Services of the Department of Veterans Affairs, State, and Tribal Vocational Rehabilitation Agencies, and other related programs in implementing effective and accessible practices for achieving sustainable self employment outcomes for individuals with disabilities. Practices 

should include but not be limited to providing public education, 

training, technical assistance and accessible online and print resources with the purpose of advancing self employment opportunities for Americans with disabilities. The Committee directs that, in 

making the national technical assistance grant, priority be given to 

national non-profits with experience in delivering direct consumer 

services as well as training to public and private agencies. The remainder of the funds in the initiative should be used to undertake 

a thorough analysis of the structures currently in place that either 

promote or impede the expansion of business ownership in the disability community. 

The Committee recommends that the Office of Disability Employment Policy continue the existing, structured, internship program 

for undergraduate college students with disabilities, at no less than 

current appropriation levels. The Committee continues to believe 

that this innovative, structured internship program will provide 

important opportunities for undergraduate students with disabilities to pursue academic and career development opportunities 

within the Department of Labor and other Federal agencies. 

DEPARTMENTAL MANAGEMENT

SALARIES AND EXPENSES

Appropriations, 2005 ............................................................................. $320,688,000 

Budget estimate, 2006 ........................................................................... 244,423,000 

House allowance .................................................................................... 239,783,000 

Committee recommendation ................................................................. 320,561,000 

The Committee recommendation includes $320,561,000 for this 

account, which is $76,138,000 more than the budget request and 

$127,000 less than the 2005 comparable level. In addition, an 

amount of $24,239,000 is available by transfer from the black lung 

disability trust fund, which is the same as the budget request and 

the House allowance. 

The primary goal of the Department of Labor is to protect and 

promote the interests of American workers. The departmental management appropriation finances staff responsible for formulating 

and overseeing the implementation of departmental policy and 
27 

management activities in support of that goal. In addition, this appropriation includes a variety of operating programs and activities 

that are not involved in departmental management functions, but 

for which other salaries and expenses appropriations are not suitable. 

The Committee recommendation includes $26,720,000 for Executive Direction, the same as the fiscal year 2005 comparable level. 

The Committee recommendation includes $9,764,000 for the 

Women’s Bureau. The Committee encourages the Women’s Bureau 

to support effective programs such as ‘‘Women Work!’’, to provide 

technical assistance and training on programming for women in 

transition to reenter the workforce. 

The Committee is pleased with efforts to investigate the impact 

of the nursing shortage on the overall health care labor market 

across the country, particularly in rural areas, such as Hawaii. The 

Committee urges the Department to work with HRSA in creating 

solutions to remedy the ongoing shortage and report on these efforts. 

The University of Hawaii Center on the Family is dedicated to 

understanding and promoting the factors that foster resiliency in 

families facing personal, social, and financial crises. The uniqueness of this program is the emphasis on the psychological and behavioral processes, family resilience and vulnerability, and includes 

Asians, Pacific Islanders and Caucasians families. The State’s diverse multicultural population adds to the reliability of the research conclusions. 

The Committee is disappointed that the Department of Labor 

has once again put forward a budget for the coming year that drastically reduces funding for International Labor Affairs Bureau 

[ILAB], in particular, those initiatives working with the International Labor Organization [ILO] to combat abusive and exploitative child labor. 

The Committee is aware that the administration is aggressively 

pursing multiple trade agreements that will depend upon the 

United States’ ability to provide technical assistance on labor 

standards, including but not limited to the eradication of child 

labor. ILAB is the division of the U.S. Government with the mission and authority to provide that assistance. A budget request 

that eliminates all funding for multilateral and bilateral technical 

assistance, elimination of child labor, permanent reporting capacity 

and HIV/AIDS in the Workplace promotes a lack of confidence in 

the United States’ trade efforts. 

The Committee commends the Department of Labor on its report 

‘‘Investing In Every Child’’ which found that the average economic 

benefit of eliminating child labor around the world exceeds the cost 

of those efforts by a ratio of 6.7 to 1. The study also found that 

each year of additional education beyond the age of 14 yields an 

11 percent increase in that individual’s earning power resulting in 

just over $5,000,000,000,000 in global benefits. The Committee 

views the investment made by the United States and the programs 

run by the Department of Labor to eliminate child labor as a proven method for improving the economic infrastructure of developing 

nations and providing a market for U.S. goods. 
28 

Given the aggressive trade agenda and the recent commitment to 

capacity building in developing nations as a form of aid, the Committee is mystified by the Department’s now annual effort to eliminate these programs, this year proposing an astounding 86 percent 

reduction. 

Therefore, the Committee recommendation includes $93,248,000 

for the Bureau of International Labor Affairs. Of this amount, the 

Committee’s recommendation includes $45,000,000 for the U.S. 

contribution to sustain and to extend to more countries in waiting 

the successful efforts of the ILO’s International Program for the 

Elimination of Child Labor [IPEC]. Also included is $37,000,000 for 

bilateral assistance to expand upon the program initiated by the 

Department in fiscal year 2001 to help ensure access to basic education for the growing number of children removed from the worst 

forms of child labor in impoverished nations where abusive and exploitative child labor is most acute. The Committee expects the Department of Labor to work with the governments of host countries 

to eliminate school fees that create a barrier to education. 

The Committee notes and welcomes ILAB’s technical assistance 

programs that promote the goals of the Harkin-Engel protocol, as 

well as ILAB’s ongoing efforts to implement Executive Order 13126 

and its reporting under the Trade and Development Act of 2000. 

To complement these efforts, the Committee directs that $4,500,000 

of the basic education funds be used to provide critical oversight of 

both the public and private investment in the protocol. The Committee expects that at a minimum, this will include an annual public report to both the Congress and the Department. The report 

should cite progress made on key points of the Protocol and Joint 

Statement including: development of a child labor monitoring system by industry, the effective elimination of the worst forms of 

child labor and forced labor in the supply chain, and the development of an industry-wide, public, transparent certification system. 

The Committee directs that funds be awarded with priority given 

to academic institutions with expertise in agriculture and the U.N. 

Norms on Business and Human Rights. 

The Committee deems it very important that ILAB deepen and 

improve its permanent capacity to compile and report to the Congress annually on the extent to which each foreign country that has 

trade and investment agreements with the United States enforces 

internationally-recognized worker rights. This report is required 

under multiple U.S. laws and promotes core labor standards as embodied in the ILO Declaration on Fundamental Principles and 

Rights at Work as adopted and reaffirmed in 1998. The Committee 

is aware that currently this report only tracks the progress of countries that are designated as beneficiaries under the U.S. Generalized System of Preferences [GSP]. The GSP program grants dutyfree treatment to specified products imported from developing countries and territories. As the United States’ negotiates separate Free 

Trade Agreements with GSP beneficiaries, the DOL stops tracking 

their progress in the elimination of abusive and exploitative child 

labor. Therefore, the Committee directs the Secretary to include in 

the 2006 report, all former GSP recipients that have achieved a 

Free Trade Agreement with the United States over the preceding 

2 years. The Committee has provided $1,000,000 for the compila-
29 

tion of this report, which shall be transmitted to the Congress no 

later than September 1, 2006. 

The Committee is disturbed by recent reports that the Department is treating commodities that were purchased with grant 

funds as a sub-grant and requiring re-payment in ways that undermine the original purpose of the grants. The Committee notes that 

the U.S. Government has sensible procedures in place for the distribution of commodities that retain value after the end of the 

grant. Therefore, the Committee directs that the Department adhere to the OMB standards for grant-making, including those 

standards that pertain to the disbursement of goods. These standards should be applied to all ongoing grants, as well as any new 

grants. 

For other ILAB programs, including 125 FTE for Federal Admin- istration, the Committee recommends $10,248,000. 

Acknowledging the need to upgrade the information technology 

capability in the Department of Labor, the Committee recommends 

$29,760,000 for the information technology fund, and $1,700,000 

for management cross cut activities. The total provided includes 

support for cross-cutting investments such as common office automation suite implementation, architecture requirements, equipment, software, and related needs, as well as human resource management. In addition, $6,230,000 is recommended for a separate 

Working Capital Fund appropriation, for implementation of a new 

core accounting system for the Department of Labor. 

The Committee retains bill language intended to ensure that decisions on appeals of Longshore and Harborworker Compensation 

Act claims are reached in a timely manner. 

VETERANS EMPLOYMENT AND TRAINING

Appropriations, 2005 ............................................................................. $222,833,000 

Budget estimate, 2006 ........................................................................... 224,334,000 

House allowance .................................................................................... 229,334,000 

Committee recommendation ................................................................. 224,334,000 

The Committee recommendation includes $224,334,000 for this 

account, including $194,834,000 in general revenue funding and 

$29,500,000 to be expended from the ‘‘Employment Security Administration’’ account of the unemployment trust fund. This is 

$1,315,000 more than the 2005 comparable level. For State grants the bill provides $162,415,000, which includes 

funding for the Disabled Veterans Outreach Program and the Local 

Veterans Employment Representative Program. 

For Federal administration, the Committee recommends 

$30,435,000, the same as the budget request and the House allowance. The Committee supports the concept of the Transition Assistance Program administered jointly with the Department of Defense 

which assists soon-to-be-discharged service members in 

transitioning into the civilian work force and includes funding to 

maintain this effective program. 

Individuals leaving the military may be 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 Committee expects the Secretary of Labor to ensure that a module on 
30 

homelessness prevention is added to the Transition Assistance Program 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. 

The Committee recommendation includes $1,984,000, the same 

as the budget request, for the National Veterans Training Institute 

[NVTI]. This Institute provides training to the Federal and State 

staff involved in the direct delivery of employment and training related services to veterans. 

The Committee recommendation includes $22,000,000 for the 

Homeless Veterans Program, the same as the budget request. Also 

included is $7,500,000 for the Veterans Workforce Investment Program, 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 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. 

OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2005 ............................................................................. $68,995,000 

Budget estimate, 2006 ........................................................................... 70,819,000 

House allowance .................................................................................... 70,819,000 

Committee recommendation ................................................................. 72,819,000 

The bill includes $72,819,000 for this account, $3,824,000 above 

the 2005 comparable level. The bill includes $67,211,000 in general 

funds and authority to transfer $5,608,000 from the ‘‘Employment 

Security Administration’’ account of the unemployment trust fund. 

In addition, an amount of $344,000 is available by transfer from 

the black lung disability trust fund. This level provides sufficient 

resources to cover built-in cost increases, as well as augmenting 

program accountability activities and expanding the labor racketeering program. 

The Office of the Inspector General [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 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. 

GENERAL PROVISIONS

General provision bill language is included to: 
31 

Provide for modified general transfer authority (sec. 101). 

Prohibit funding for the procurement of goods and services utilizing forced or indentured child labor in industries and host countries already identified by the Labor Department in accordance 

with Executive Order 13126 (sec. 102). 

Authorize funds to be appropriated for job training for workers 

involved in construction projects funded through the Denali Commission (sec. 103). 

Provide that certain payments made by the New York Workers’ 

Compensation Board in response to terrorist attacks shall be 

deemed to have been made for workers compensation programs 

(sec. 104). 

Require the Department of Labor to submit its fiscal year 2007 

congressional budget justifications in the same format and level of 

detail used by the Department of Education in its fiscal year 2006 

congressional budget justification (sec. 105). 
(32) 

TITLE II—DEPARTMENT OF HEALTH AND HUMAN 

SERVICES 

HEALTH RESOURCES AND SERVICES ADMINISTRATION

HEALTH RESOURCES AND SERVICES

Appropriations, 2005 ............................................................................. $6,828,012,000 

Budget estimate, 2006 ........................................................................... 5,991,144,000 

House allowance .................................................................................... 6,468,437,000 

Committee recommendation ................................................................. 7,423,434,000 

The Committee provides a program level of $7,423,434,000 for 

the Health Resources and Services Administration [HRSA]. The 

Committee recommendation includes $7,398,434,000 in budget authority and an additional $25,000,000 via transfers available under 

section 241 of the Public Health Services Act. The fiscal year 2005 

comparable program level was $6,828,012,000, the administration 

request program level was $5,991,144,000, and the House provided 

$6,468,437,000. 

Health Resources and Services Administration activities support 

programs to provide health care services for mothers and infants; 

the underserved, elderly, homeless; migrant farm workers; and disadvantaged minorities. This appropriation supports cooperative 

programs in community health, AIDS care, health provider training, and health care delivery systems and facilities. 

The Committee recognizes the unique needs of frontier and rural 

populations and applauds the Department for establishing competitive grants specifically aimed at programs with those designations. 

The Committee likewise recognizes the limited accessibility of island communities, whether rural or urban, and urges the Department to include an island designation to promote programs in 

areas geographically isolated from the mainland and neighbor islands. Criteria for island designation includes a clinic, federally 

qualified health center, or hospital located on a land mass surrounded by water and greater than 2,000 miles from the United 

States mainland. 

BUREAU OF PRIMARY HEALTH CARE

COMMUNITY HEALTH CENTERS

The Committee provides $1,839,311,000 for the community 

health centers. The fiscal year 2005 comparable program level was 

$1,734,311,000, the administration request program level was 

$2,037,871,000, and the House provided $1,834,311,000. This group 

of programs includes community health centers, migrant health 

centers, health care for the homeless, and public housing health 

service grants. Within the amount provided, $20,000,000 has been allocated to 

offset the rising cost of health care at existing centers, and 
33 

$5,000,000 has been allocated to resolve specific financial situations 

beyond the control of the local health center, such as unusual increases in the number of uninsured patients seeking care. 

The Committee includes bill language 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 administration 

request and in fiscal year 2005. Bill language has also been included clarifying that these funds are available until expended. The 

Committee has included bill language allowing costs associated 

with the health centers tort liability relief to be paid from the fund. 

The Committee intends that the fund be used to pay judgments 

and settlements, occasional witness fees and expenses, and the administrative costs of the program, which includes the cost of evaluating claims, defending claims, and conducting settlement activities. The Committee is aware of legislation that would extend 

FTCA coverage to volunteer physicians and non-grantee health 

centers (commonly referred to as ‘‘look-alikes’’). While both proposals would extend FTCA coverage to additional providers, the 

Committee expects the amount provided to be adequate to cover 

any increased costs in fiscal year 2006. 

The Committee does not provide additional funds for loan guarantee authority under section 330(d) of the Public Health Service 

Act. The Committee notes that $105,000,000 in loan guarantee authority from the $160,000,000 appropriated in fiscal years 1997 and 

1998 continues to remain available for guarantees of both loan 

principal and interest. 

The Committee is concerned by the small number of health centers that have been able to utilize the loan guarantee program despite sufficient funding being available since fiscal year 1997. The 

Committee urges HRSA to increase the percentages at which loan 

guarantees are provided for managed care plans, networks, and facilities to the highest authorized levels in order to enhance the 

number of health centers participating in the program. 

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. However, HRSA 

should limit the use of this mechanism in a manner consistent with 

expected budget requests. 

The Committee is concerned that HHS requires health centers 

and other facilities to have a HPSA priority score of 14 or above 

in order to obtain a J–1 Visa physician placement and that this additional criterion has severely limited access to J–1 physicians in 

underserved communities. The Committee encourages HRSA to 

consider using an alternative methodology for entities eligible for 

Federal J–1 Visa physician placements. 

The Committee recognizes an important role of the consolidated 

health centers is caring for people living with or at risk of hepatitis 

C. The committee encourages the Bureau of Primary Care to provide leadership and training to its grantees on hepatitis C prevention, medical management and treatment. 

The Committee recognizes the cultural differences inherent in 

addressing family violence prevention among minority populations, 
34 

such as Native Hawaiians. Additionally, many victims of domestic 

violence seek care through safety net providers in community 

health centers rather than present to costly emergency departments. The Committee encourages the Department to fund demonstration projects that combine integrated family violence prevention models focused on minority populations with primary care delivery. 

The Committee commends the efforts of health centers to deliver 

culturally and linguistically appropriate care and encourages the 

Secretary to work with health centers to better enable them to provide, to the maximum extent feasible, culturally competent and linguistically appropriate services. The Committee also urges that attention be given to strategies to increase the numbers and diversity 

of health professionals at community health centers. 

The Committee recognizes that Nurse-Managed Health Centers 

[NMHCs] serve a dual function in strengthening the health care 

safety net by providing health care to populations in underserved 

areas and by providing the clinical experiences to nursing students 

that are mandatory for professional development. Recognizing that 

NMHCs are frequently the only source of health care to their patients and that a lack of clinical education sites for nurses is a contributing factor to the nationwide nursing shortage, the Committee 

encourages HRSA to provide alternative means to secure cost-based 

reimbursement for NMHCs, by providing that reimbursement or by 

granting university-based CHCs. In addition, the Committee encourages HRSA to research the effectiveness of nurse-managed 

health centers as a national model to reduce health disparities. 

The Committee encourages the Bureau of Primary Health Care 

to consider establishing a grant program within its community 

health center program that would support the establishment and/ 

or expansion of nurse practice arrangements commonly referred to 

as nurse-managed health centers that provide the medically underserved with access to primary care services and promote career advancement among nursing personnel in a variety of training settings. 

The Committee is concerned that Federal community health center funds are often not available to small, remote communities in 

Alaska, Hawaii, and other similar States because the population 

base is too small. Many of these communities have no health service providers and are forced to travel long distances by boat or 

plane even in emergency situations. The Committee supports efforts now underway to increase community health center funding 

to address the growing number of uninsured persons in this country. The Committee recommends that HRSA examine its regulations and applications procedures to ensure they do not unduly 

burden small communities and are appropriately flexible to meet 

the needs of these communities. The Committee applauds the agency for its initiatives such as the ‘‘Alaska Frontier Health Plan’’ and 

encourages the Agency to continue and expand its efforts with this 

program. 

Native Hawaiian Health Care 

The Committee again includes the legal citation in the bill for 

the Native Hawaiian Health Care Program. The Committee has in-
35 

cluded sufficient funding so that health care activities funded 

under the Native Hawaiian Health Care Program can be supported 

under the broader community health centers line. The Committee 

expects that not less than $14,100,000 be provided for these activities in fiscal year 2006. 

Free Clinics Medical Malpractice Coverage 

The Committee provides $99,000 in funding for payments of 

claims under the Federal Tort Claims Act to be made available for 

free clinic health professionals as authorized by U.S.C. Title 42, 

Section 233(o) of the Public Health Service Act. The fiscal year 

2005 comparable level was $99,000 and neither the administration 

nor the House provided any funding for this program. This appropriation continues to extend Federal Tort Claims Act coverage to 

medical volunteers in free clinics in order to expand access to 

health care services to low-income individuals in medically underserved areas. 

Radiation and Exposure Screening and Education Program 

The Committee provides $1,958,000 for the Radiation Exposure 

Compensation Act. The fiscal year 2005 comparable level was 

$1,958,000, the administration request was $1,936,000 and the 

House provided $1,900,000. 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. 

Health Care Access for the Uninsured/Community Access Program 

The Committee provides $60,000,000 for the Community Access Program. The fiscal year 2005 comparable level was $82,993,000 

and the administration did not request fund for this program in fiscal year 2006. This program is designed to increase the capacity 

and effectiveness of community health care institutions and providers who serve patients, regardless of their ability to pay. 

Community Health Centers have the potential to serve as a valuable resource in biomedical and behavioral research aimed at reducing health status disparities among minority and medically underserved populations. The Committee is pleased that HRSA, 

through the H–CAP program, has prioritized the establishment of 

demonstration projects between Community Health Centers and 

minority health professions schools for the purpose of health status 

disparities research and data collection. Such demonstration 

projects were authorized in the ‘‘Health Care Safety Net Amendments of 2002.’’ 

National Hansen’s Disease Program 

The Committee has included $17,066,000 for the National Hansen’s Disease Program. The fiscal year 2005 comparable level was 

$17,251,000 and the administration request was $16,066,000 in fiscal year 2006. This program offers Hansen’s Disease treatment in 

Baton Rouge at the Center, at other contract supported locations 

in Baton Rouge, and in grant supported outpatient regional clinics. 

These programs provide treatment to about 3,000 of the 6,000 Hansen’s disease sufferers in the United States. 
36 

National Hansen’s Disease Program Buildings and Facilities 

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

The fiscal year 2005 comparable level was $247,000 and the administration request was $222,000. This funding provides for the repair and maintenance of buildings at the Gillis W. Long Hansen’s 

Disease Center. 

Payment to Hawaii for Hansen’s Disease Treatment 

The Committee provides $2,017,000 for Hansen’s disease services. The fiscal year 2005 comparable level was $2,017,000 and the 

administration requested $2,016,000. 

Black Lung Clinics 

The Committee provides $5,975,000 for black lung clinics. The 

fiscal year 2005 comparable level was $5,951,000 and the administration requested $5,912,000. This program funds clinics that treat 

respiratory and pulmonary diseases of active and retired coal miners. These clinics reduce the incidence of high-cost inpatient treatment for these conditions. 

BUREAU OF HEALTH PROFESSIONS

National Health Service Corps: Field Placements 

The Committee provides $40,705,000 for field placement activities. The fiscal year 2005 comparable level was $45,068,000 and 

the administration request was $40,705,000. The funds provided 

for this program are used to support the activities of National 

Health Service Corps obligors and volunteers in the field, including 

travel and transportation costs of assignees, training and education, recruitment of volunteers, and retention activities. Salary 

costs of most new assignees are paid by the employing entity. 

The Committee is pleased by the increasing proportion of NHSC 

assignees being placed at Community, Migrant, Homeless, and 

Public Housing Health Centers. The Committee encourages HRSA 

to further expand this effort to ensure that the health center expansion effort has access to a sufficient level of health professionals 

through the NHSC. 

The Committee is concerned by reports that the current HPSA 

scoring process used by HRSA to place physicians disadvantages 

many health centers located in medically underserved areas of the 

country. The Committee urges HRSA to reconsider the decision to 

score FQHCs under the newly authorized automatic designation 

process based on data and criteria that virtually eliminate all such 

FQHCs from eligibility for the placement of NHSC scholars, Ready 

Responders, and HHS’ J–1 Visa waiver program. 

National Health Service Corps: Recruitment 

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

The fiscal year 2005 comparable level was $86,380,000 and the administration request was $86,091,000. This program provides major 

benefits to students (full-cost scholarships or sizable loan repayment) in exchange for an agreement to serve as a primary care provider in a high priority federally designated health professional 
37 

shortage area. These funds should support multi-year, rather than 

single-year, commitments. 

The Committee believes that the inclusion of Optometrists in the 

National Health Service Corps’ [NHSC] Student Loan Repayment 

Program will result in the expanded accessibility of eye care in 

communities where it is most needed. Accordingly, the Committee 

urges the Health Resources and Services Administration 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. 

HEALTH PROFESSIONS

The Committee provides $454,393,000 for all HRSA health professions programs. The fiscal year 2005 comparable level was 

$450,213,000 and the administration requested $160,534,000 in fiscal year 2006. 

The Committee recognizes that physicians trained in combined 

Internal Medicine-Pediatrics [Med-Peds] residency training programs are particularly well suited to care for patients with chronic 

medical illnesses who transition from pediatric to adult-centered 

care. These physicians receive intensive training in the care of children with chronic illnesses as well as primary care for adults. The 

Committee believes that Med-Peds physicians may fill the emerging need of caring for these patients. The Committee encourages 

HRSA to consider developing model demonstration projects on 

transition care. The goal would be to address the healthcare needs 

of this underserved population and to train future physicians to 

provide care for them. 

The Committee understands that 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 the Job Corps success in training students with the skills 

they need to fill critical shortages through major national employer 

partners. The Committee encourages HRSA to consider making Job 

Corps Centers eligible for HRSA funding for allied health training 

programs. 

The Committee commends HRSA for its continuing 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 American College of Chest Physicians and 

the members of the Critical Care Workforce Partnership. The Committee requests HRSA provide a copy of this report to the Committee by July 1, 2006. The Committee continues to encourage 

HRSA to address the critical care workforce shortage issue and use 

the pulmonary/critical care specialty as a model for developing and 

testing policy approaches to address workforce shortage issues. 
38 

Training for Diversity 

Centers of Excellence 

The Committee provides $33,609,000 for the Centers of Excellence program. The fiscal year 2005 comparable level was 

$33,609,000 and the administration did not request any funds for 

this program in fiscal year 2006. This program was established to 

fund institutions that train a significant portion of the Nation’s minority health professionals. Funds are used for the recruitment and 

retention of students, faculty training, and the development of 

plans to achieve institutional improvements. The institutions that 

are designated as centers of excellence are private institutions 

whose mission is to train disadvantaged minority students for service in underserved areas. Located in poor communities and usually 

with little State funding, they serve the health care needs of their 

patients often without remuneration. 

The Committee is pleased that HRSA has re-focused the Minority Centers of Excellence program on providing support to historically minority health professions institutions. The Committee recognizes the important role of this program in supporting faculty 

and other academic programs at minority institutions. 

Health Careers Opportunity Program 

The Committee provides $35,647,000 for the Health Careers Opportunity Program. The fiscal year 2005 comparable level was 

$35,647,000 and the administration did not request any funds for 

this program in fiscal year 2006. This program provides funds to 

medical and other health professions schools for recruitment of disadvantaged students and pre-professional school preparations. 

The Committee is concerned about the reduced level of support 

provided to minority health professions schools through the H–COP 

program in recent fiscal years. For fiscal year 2006, the Committee 

urges HRSA to give priority consideration to awarding grants to 

those institutions with a historic mission of training minorities in 

the health professions. HRSA should report to the Committee within 6 weeks of enactment of this Act with the steps it has taken to 

address this issue. 

Faculty Loan Repayment 

The Committee provides $1,302,000 for the Faculty Loan Repayment program. The fiscal year 2005 comparable level was 

$1,302,000 and the administration did not request any funds for 

this program in fiscal year 2006. This program provides for the repayment of education loans for individuals from disadvantaged 

backgrounds who are health professions students or graduates, and 

who have agreed to serve for not less than 2 years as a faculty 

member of a health professions school. 

Scholarships for Disadvantaged Students 

The Committee provides $47,128,000 for the Scholarships for 

Disadvantaged Students program. The fiscal year 2005 comparable 

level was $47,128,000 and the administration requested $9,381,000 

for this program in fiscal year 2006. This program provides grants 

to health professions schools for student scholarships to individuals 
39 

who are from disadvantaged backgrounds and are enrolled as fulltime students in such schools. The Committee continues to intend 

that all health professions disciplines made eligible by statute be 

able to participate in the scholarships program. 

Training in Primary Care Medicine and Dentistry 

The Committee provides $90,000,000 for Training in Primary 

Care Medicine and Dentistry programs. The fiscal year 2005 comparable level was $88,816,000 and the administration did not request funding for this program in fiscal year 2006. 

Family Medicine Training 

Family medicine activities support grants for graduate training 

in family medicine, grants for pre-doctoral training in family medicine, grants for faculty development in family medicine, and grants 

for the establishment of departments of family medicine. The Committee reiterates its support for this program and recognizes its importance in increasing the number of primary care physicians in 

underserved areas. 

General Internal Medicine and Pediatrics Training 

This program provides funds to public and private nonprofit hospitals and schools of medicine and osteopathic medicine to support 

residencies in internal medicine and pediatrics. Grants may also 

include support for faculty. 

Physician Assistants 

This program supports planning, development, and operation of 

physician assistant training programs. 

General Dentistry and Pediatric Dental Residencies 

This program assists dental schools and postgraduate dental 

training institutions to meet the costs of planning, developing, and 

operating residency training and advanced education programs in 

general practice of dentistry and funds innovative models for 

postdoctoral general dentistry and pediatric dentistry. 

Interdisciplinary, Community-based Linkages 

Area Health Education Centers 

The Committee provides $28,971,000 for the Area Health Education Centers program. The fiscal year 2005 comparable level was 

$28,971,000 and the administration did not request any funds for 

this program in fiscal year 2006. This program links university 

health science centers with community health service delivery systems to provide training sites for students, faculty, and practitioners. The program supports three types of projects: Core grants 

to plan and implement programs; special initiative funding for 

schools that have previously received Area Health Education Centers [AHEC] grants; and model programs to extend AHEC programs with 50 percent Federal funding. 
40 

Health Education and Training Centers 

The Committee provides $3,819,000 for the Health Education 

and Training Centers program. The fiscal year 2005 comparable 

level was $3,819,000 and the administration did not request any 

funds for this program in fiscal year 2006. These centers provide 

training to improve the supply, distribution, and quality of personnel providing health services in the State of Florida or along the 

border between the United States and Mexico and in other urban 

and rural areas with populations with serious unmet health care 

needs. 

Allied Health and Other Disciplines 

The Committee provides $11,753,000 for the Allied Health and 

Other Disciplines programs. The fiscal year 2005 comparable level 

was $11,753,000 and the administration did not request any funds 

for this program in fiscal year 2006. The Committee intends that 

these funds be used to support existing programs at not less than 

last year’s level. These programs seek to improve access, diversity, 

and distribution of allied health practitioners to areas of need. The 

program improves access to comprehensive and culturally competent health care services for underserved populations. 

The Committee is concerned about the emerging shortage of occupational therapists needed to work with baby boom retirees and 

encourages HRSA to give priority consideration to projects for 

schools that address these manpower shortages by both training 

faculty and students for entry level service. 

The Committee is aware that dental disease disproportionately 

affects our Nation’s most vulnerable populations, including many in 

rural America. New ways of bringing oral health care to rural and 

underserved populations are needed. The Committee encourages 

HRSA to explore alternative methods of delivering preventive and 

restorative oral health services in rural America. Specifically, the 

Committee encourages HRSA to explore development of an advanced dental hygiene practitioner who would be a graduate of an 

accredited dental hygiene program and complete an advanced educational curriculum, which prepares the dental hygienist to provide 

diagnostic, preventive, restorative and therapeutic services directly 

to the public in rural and underserved areas. 

The Committee notes that since 1999 HRSA has not provided a 

focus, through a request for proposals or other program initiatives, 

on pediatric occupational therapy. In view of the importance of this 

health profession to children with disabilities, the Committee encourages HRSA to identify a competitive category specifically for 

pediatric occupational therapy training grants in 2006. 

Geriatric Education Centers and Training 

The Committee provides $29,548,000 for the Geriatrics Education 

Centers and Training programs. The fiscal year 2005 comparable 

level was $31,548,000 and the administration did not request any 

funds for this program in fiscal year 2006. This program supports 

grants to health professions schools to establish geriatric education 

centers and to support geriatric training projects. These centers 

and geriatric training programs play a vital role in enhancing the 
41 

skill-base of health care professionals to care for our Nation’s growing elderly population. 

Quentin N. Burdick Program for Rural Health Interdisciplinary Training 

The Committee provides $6,076,000 for these programs. The fiscal year 2005 comparable level was $6,076,000 and the administration did not request any funds for this program in fiscal year 2006. 

This program addresses shortages of health professionals in rural 

areas through interdisciplinary training projects that prepare students from various disciplines to practice together, and offers clinical training experiences in rural health and mental health care 

settings to expose students to rural practice. 

Podiatric Primary Care Training 

This program provides grants to hospitals and schools of 

podiatric medicine for residency training in primary care. In addition to providing grants to hospitals and schools of podiatric medicine for residency training in primary care, the program also permits HRSA to study and explore ways to more effectively administer postdoctoral training in an ever changing health care environment. 

Chiropractic Demonstration Grants 

This program provides grants to colleges and universities of 

chiropractic to carry out demonstration projects in which chiropractors and physicians collaborate to identify and provide effective 

treatment of spinal and lower back conditions. The Committee continues to support the chiropractic research and demonstration 

grant program, originally authorized under section 782 of Public 

Law 102–408, and funded by the Committee in previous years. The 

Committee recommends that the chiropractic-medical school demonstration grant program be continued. 

Workforce Information and Analysis 

The Committee provides $712,000 for these programs. The fiscal 

year 2005 comparable level was $716,000 and the administration 

requested $712,000. 

Health Professions Data and Analysis 

This program supports the collection and analysis of data on the 

labor supply in various health professions and on future workforce 

configurations. 

Research on Certain Health Professions Issues 

This program supports research on the extent to which debt has 

a detrimental effect on students entering primary care specialties; 

the effects of federally funded education programs for minorities attending and completing health professions schools; and the effectiveness of State investigations in protecting the health of the public. 
42 

Public Health Workforce Development 

With the continued need for public health training throughout 

the country, the Committee believes these programs serve an important role in maintaining the country’s public health infrastructure. 

Public Health, Preventive Medicine, and Dental Public 

Health Programs 

The Committee provides $9,097,000 for these programs. The fis- cal year 2005 comparable level was $9,097,000 and the administration did not request any funds for this program in fiscal year 2006. 

This program supports awards to schools of medicine, osteopathic 

medicine, public health, and dentistry for support of residency 

training programs in preventive medicine and dental public health; 

and for financial assistance to trainees enrolled in such programs. 

Health Administration Programs 

The Committee provides $1,070,000 for the Health Administration programs. The fiscal year 2005 comparable level was 

$1,070,000 and the administration did not request any funds for 

this program in fiscal year 2006. These programs provide grants to 

public or nonprofit private educational entities, including schools of 

social work, but not schools of public health, to expand and improve graduate programs in health administration, hospital administration, and health policy analysis and planning; and assists educational institutions to prepare students for employment with public or nonprofit private agencies. 

Although the majority of Native Hawaiians receive services in 

federally qualified community health centers, there is only one Native Hawaiian health care administrator working in these centers. 

The Committee is concerned that limited mentoring and training 

opportunities exist for Native Hawaiian administrators in health 

care organizations. The Committee urges that a portion of money 

appropriated for Native Hawaiian Health Care Act programs be 

used to prepare Native Hawaiians with the expertise to excel in administrative health care positions. 

Nursing Workforce Development Programs 

The Committee provides $155,661,000 for the Nursing Workforce 

Development programs. The fiscal year 2005 comparable level was 

$150,661,000 and the administration requested $149,991,000 for 

these programs in fiscal year 2005. The Committee recognizes that 

the current nursing shortage has reached a crisis state across 

America. The situation only promises to worsen due to a lack of 

young nurses in the profession, an aging existing workforce, and inadequate availability of nursing faculty to prepare future nurses. 

The Committee urges HRSA to support programs aimed at increasing nursing faculty and encouraging a diverse population’s entry 

into nursing. 

Advanced Education Nursing 

The Committee provides $58,160,000 for the Advanced Education 

Nursing programs. The fiscal year 2005 comparable level was 

$58,160,000 and the administration requested $42,806,000 for this 
43 

program in fiscal year 2006. This program funds nursing schools to 

prepare nurses at the master’s degree or higher level for teaching, 

administration, or service in other professional nursing specialties. 

The Committee understands that advanced practice nurses provide high quality, cost-effective care in whatever geographic locations they practice and that often they are a patient’s only option 

for care. The Committee requests the Administrator to report to 

the Committee within 6 weeks of enactment of this Act on the 

number of advanced practice nurse candidates that receive 

traineeships and the number that then work in rural, isolated or 

underserved areas across the United States. 

Nurse Education, Practice, and Retention 

The Committee provides $40,468,000 for the Nurse Education, 

Practice, and Retention Programs. The fiscal year 2005 comparable 

level was $36,468,000 and the administration requested 

$46,325,000 for this program in fiscal year 2006. The goal of this 

program is to improve the quality of nursing practice. Activities 

under this program will initiate new projects that will change the 

educational mix of the nursing workforce and empower the workforce to meet the demands of the current health care system. 

Nursing Workforce Diversity 

The Committee provides $17,270,000 for the Nursing Workforce 

Diversity program. The fiscal year 2005 comparable level was 

$16,270,000 and the administration requested $21,244,000 for this 

program in fiscal year 2006. The goal of this program is to improve 

the diversity of the nursing workforce through increased educational opportunities for individuals from disadvantaged backgrounds. The Committee urges the Division of Nursing to develop 

and increase cultural competence in nursing and to increase the 

number of underrepresented racial and ethnic minorities in all 

areas of nursing education and practice to enhance nurses’ ability 

to provide quality health care services to the increasingly diverse 

community it serves. 

Nurse Loan Repayment and Scholarship Program 

The Committee provides $31,482,000 for the Nurse Loan Repayment and Scholarship programs. The fiscal year 2005 comparable 

level was $31,482,000 and the administration requested 

$31,369,000 for this program in fiscal year 2006. This program offers student loan repayment to nurses in exchange for an agreement to serve not less than 2 years in an Indian Health Service 

health center, Native Hawaiian health center, public hospital, community or migrant health center, or rural health clinic. 

Nurse Faculty Loan Program 

The Committee provides $4,831,000 for the Nursing Faculty 

Loan program. The fiscal year 2005 comparable level was 

$4,831,000 and the administration requested $4,821,000 for this 

program in fiscal year 2006. This program supports the development of a student loan fund in schools of nursing to increase the 

number of qualified nursing faculty. 
44 

Comprehensive Geriatric Education 

The Committee provides $3,450,000 for Comprehensive Geriatric 

Education grants. The fiscal year 2005 comparable level was 

$3,450,000 and the administration requested $3,426,000 for this 

program in fiscal year 2006. These grants prepare nursing personnel to care for the aging population. 

Children’s Hospitals Graduate Medical Education Program 

The Committee has provided $300,000,000 for the Children’s 

Hospitals Graduate Medical Education [GME] program. The fiscal 

year 2005 comparable level was $300,730,000 and the administration requested $200,000,000 for this program in fiscal year 2006. 

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). Children’s hospitals are statutorily defined under Medicare as those whose inpatients are predominantly under the age of 18. The funds in this 

program are 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. 

National Practitioner Data Bank 

The Committee provides $15,700,000 for the national practitioner 

data bank. The fiscal year 2005 comparable level was $15,700,000 

and the administration request was $15,700,000. The Committee 

and the administration assume that full funding will be provided 

entirely through the collection of user fees and will cover the full 

cost of operating the data bank. Bill language is included to ensure 

that user fees are collected to cover all costs of processing requests 

and providing such information to data bank users. 

Health Care Integrity and Protection Data Bank 

The Committee provides $4,000,000 for the health care integrity 

and protection data bank. The fiscal year 2005 comparable level 

was $4,000,000 and the administration request was $4,000,000. 

The Committee and the administration assume that full funding 

will be provided entirely through the collection of user fees and will 

cover the full cost of operating the data bank. The data bank is intended to collect, maintain, and report on certain actions taken 

against health care providers, suppliers, and practitioners. 

MATERNAL AND CHILD HEALTH BUREAU

Maternal and Child Health Block Grant 

The Committee provides $710,000,000 for the maternal and child 

health [MCH] block grant. The fiscal year 2005 comparable level 

was $723,928,000 and the administration request was 

$723,928,000. 

The Maternal and Child Health Block Grant program provides a 

flexible source of funding that allows States to target their most ur-
45 

gent maternal and child health needs through development of community-based networks of preventive and primary care that coordinate and integrate public and private sector resources and programs for pregnant women, mothers, infants, children, and adolescents. The program supports a broad range of activities including 

prenatal care, well child services and immunizations, reducing infant mortality, preventing injury and violence, expanding access to 

oral health care, addressing racial and ethnic disparities and providing comprehensive care for children, adolescents, and families 

through clinics, home visits and school-based health programs. 

The MCH block grant funds are provided to States to support 

health care for mothers and children. According to statute, 85 percent of appropriated funds up to $600,000,000 are distributed to 

States and 15 percent are set aside for special projects of regional 

and national significance [SPRANS]. Also according to statute, 

12.75 percent of funds over $600,000,000 are to be used for community-integrated service systems [CISS] programs. The remaining 

funds over $600,000,000 are distributed on the same 85/15 percent 

split as the basic block grant. 

The Committee has included bill language identifying $121,396,250 for the SPRANS set-aside. Within that total, the 

Committee intends that $4,000,000 be used to continue the sickle 

cell newborn screening program and its locally based outreach and 

counseling efforts; $5,000,000 be used to continue the oral health 

demonstration programs and activities in the States; $2,000,000 be 

used for mental health programs and activities in the States; 

$3,000,000 be used for epilepsy demonstration projects; $1,000,000 

be used for a fetal alcohol syndrome demonstration program; and 

$2,000,000 be used for newborn and child screening for heritable 

disorders as authorized in title XXVI of the Children’s Health Act 

of 2000. 

The Committee has provided $5,000,000 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 eligible 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 also provides $2,000,000 for mental health programs and activities in the States. The Committee expects that the 

programs will include mental health grants for prevention and 

early intervention services for children and youth ages 0 to 24 

years and for women’s mental health as it relates to their role in 

the family, particularly for women diagnosed with postpartum depression [PPD]. One out of every ten new mothers suffers from 

PPD, a treatable condition that presents a range of emotional and 

physical changes. Unfortunately, half of these women never get 

help. The Committee encourages the Bureau to utilize this funding 

to focus on low-income women and mothers of children with low 

birth weight. The Committee recommends that funding be used on 

science-based programs or models such as the Starting Early Starting Smart Program that was funded by the Substance Abuse and 
46 

Mental Health Service Administration [SAMHSA] and the Casey 

Family Programs to specifically target early intervention and prevention. 

The Committee has provided $3,000,000 for the continuation of 

epilepsy demonstration programs 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. Of the amount provided, the Committee 

recommends 30 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. In implementing this program, the Committee encourages HRSA to partner with a national 

organization whose mission is to improve the lives of children and 

adults affected by seizure through research, education, advocacy 

and service. 

The Committee has included $1,000,000 to continue the demonstration program on fetal alcohol syndrome begun in last year’s 

appropriation. Each year, 40,000 children are born with fetal alcohol spectrum disorders [FASD], the leading known cause of mental 

retardation and birth defects. The demonstration program should 

continue to coordinate services between the National Organization 

on Fetal Alcohol Syndrome and community health centers to improve the prevention, identification, and support of individuals with 

fetal alcohol syndrome. In addition, funds have been included to engage and include maternal child health sites in this successful 

demonstration. 

Newborn screening is a public health activity used for early identification of infants affected by certain genetic, metabolic, hormonal 

and or functional conditions for which there are effective treatments or interventions. Screening detects disorders in newborns 

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

and other serious illnesses. 

The Committee again provides $2,000,000 within the SPRANS 

amount for the heritable disorders program authorized in title 

XXVI of the Children’s Health Act. This program is designed to 

strengthen States’ newborn screening programs and improve 

States’ ability to develop, evaluate, and acquire innovative testing 

technologies, and establish and improve programs to provide 

screening, counseling, testing and special services for newborns and 

children at risk for heritable disorders. The Committee urges 

HRSA to include additional conditions, such as biliary atresia, 

Fragile X, and abnormally elevated levels of bilirubin, in this evaluation of testing programs with the goal of implementing cost-effective public health screening programs for these and other disorders. The Committee requests a report by July 15, 2006 on the 

steps taken to validate a screening tool for Fragile X and to launch 

a screening program across the country. Given the potential of 

Fragile X screening as a viable prototype for newborn and infant 

screening, the Committee encourages HRSA to allocate funding 

from the heritable disorders screening program toward screening 

and epidemiological research activities related to Fragile X. 

The Committee is aware of the extreme disparities that exist 

among State newborn screening programs for metabolic and ge-
47 

netic disorders. Parents and healthcare providers responsible for 

the care of newborns should be able to provide the best chance at 

a healthy start on life. For this reason, the Committee strongly 

urges HRSA to include as a requirement for funding a provision 

that parents be informed in writing of the availability of additional 

tests that may not be required under State law. 

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

Grant has provided to comprehensive thalassemia treatment centers under the SPRANS program. The Committee strongly encourages MCHB to continue this program, expand it to include additional centers around the country, and to coordinate closely its activities with the Cooley’s Anemia Foundation. 

The most crucial need for individuals suffering from Chronic Fatigue Syndrome is for effective, compassionate medical care. 

Through its demonstration grants program, HRSA has piloted effective ways of delivering health care services to those with emerging illnesses. The Committee encourages HRSA to provide demonstration grants to develop model CFS clinical centers with the 

goal of delivering effective, multidisciplinary clinical care to persons with CFS. 

The Committee recognizes the critical role of hemophilia treatment centers 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 

urges HRSA to continue its support of this model disease management network. 

The Committee is aware that many school-age children with vision problems significant enough to affect their learning are not 

screened for vision problems prior to entering school. In an effort 

to stimulate a national effort to reduce the occurrence of vision loss 

and its accompanying disabilities, the Committee encourages 

HRSA to consider developing a National Core Performance Measure for children’s vision. 

Sickle Cell Anemia Demonstration Program 

The Committee provides $500,000 for the sickle cell anemia demonstration program. The fiscal year 2005 comparable level was 

$198,000 and the administration did not request funding for this 

program in fiscal year 2006. 

Traumatic Brain Injury Program 

The Committee provides $9,297,000 for the traumatic brain injury program. The fiscal year 2005 comparable level was 

$9,297,000 and the administration did not request funding for this 

program in fiscal year 2006. The program supports implementation 

and planning grants to States for coordination and improvement of 

services to individuals and families with traumatic brain injuries 

as well as protection and advocacy. Such services can include: prehospital care, emergency department care, hospital care, rehabilitation, transitional services, education, employment, and long-term 

support. The Committee includes $3,000,000 for protection and ad-
48 

vocacy services, as authorized under section 1305 of Public Law 

106–310. 

Healthy Start Initiative 

The Committee provides $104,000,000 for the healthy start infant mortality initiative. The fiscal year 2005 comparable level was 

$102,543,000 and the administration request was $97,747,000. 

The healthy start initiative was developed to respond to persistently high rates of infant mortality in this Nation. The initiative 

was expanded in fiscal year 1994 by a special projects program, 

which supported an additional seven urban and rural communities 

to implement infant mortality reduction strategies and interventions. The Children’s Health Act of 2000 fully authorized this initiative as an independent program. 

The Committee urges HRSA to give preference to current and 

former grantees with expiring or recently expired project periods. 

This should include grantees whose grant applications were approved but not funded during fiscal year 2005. 

Universal Newborn Hearing Screening and Early Intervention 

The Committee provides $9,792,000 for universal newborn hearing screening and early intervention activities. The fiscal year 2005 

comparable level was $9,792,000 and the administration did not request funds for this program in fiscal year 2006. 

The Committee has included sufficient funding to continue the 

initiative begun several years ago to provide grants to States to establish universal newborn hearing screening and early intervention 

programs. The Committee is pleased by the success of the initiative 

and the substantial response from States. 

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 $20,000,000 for emergency medical services for children. The fiscal year 2005 comparable level was 

$19,830,000 and the administration did not request funding for this 

program in fiscal year 2006. The program supports demonstration 

grants for the delivery of emergency medical services to acutely ill 

and seriously injured children. 

The Committee notes 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 20 

years of achievement 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 center activities. The fiscal year 2005 comparable level was $23,499,000 and 
49 

the administration requested $23,301,000 for this program in fiscal 

year 2006. The funds provided support activities authorized in the 

Poison Control Center Enforcement and Enhancement Act as well 

as the development and assessment of uniform patient management guidelines. 

HIV/AIDS BUREAU

ACQUIRED IMMUNE DEFICIENCY SYNDROME

Ryan White AIDS Programs 

The Committee provides $2,083,296,000 for Ryan White AIDS programs. The recommendation includes $25,000,000 in transfers 

available under section 241 of the Public Health Service Act. The 

fiscal year 2005 comparable level was $2,073,296,000 and the administration request was $2,083,296,000. 

Next to the Medicaid program, the Ryan White CARE Act (the 

CARE Act) is the largest Federal investment in the care and treatment of people living with HIV/AIDS in the United States. The 

CARE Act provides a wide range of community-based services, including primary and home health care, case management, substance abuse treatment, mental health services, and nutritional 

services. 

Within the total provided, the Committee intends 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 

continue with at least the level of funding provided in fiscal year 

2005. 

The Committee is concerned that at least 30 percent of persons 

living with HIV are co-infected with hepatitis C, and that hepatitis 

C related complications are emerging as the leading cause of death 

among persons living with HIV/AIDS. The Committee requests 

that HRSA provide both more guidance to grantees on providing 

services to co-infected individuals, and more education and training 

to medical providers on treating persons co-infected with HIV and 

HCV. 

Emergency Assistance—Title I 

The Committee provides $610,094,000 for emergency assistance 

grants to eligible metropolitan areas disproportionately affected by 

the HIV/AIDS epidemic. These funds are provided to metropolitan 

areas meeting certain criteria. Half of the funds are awarded by 

formula and the other half are awarded through supplemental competitive grants. 

Comprehensive Care Programs—Title II 

The Committee provides $1,131,836,000 for HIV health care and 

support services. These funds are awarded to States to support 

HIV service delivery consortia, the provision of home and community-based care services for individuals with HIV disease, continuation of health insurance coverage for low-income persons with HIV 

disease and support for State AIDS drug assistance programs 

[ADAP]. 
50 

The Committee continues to be encouraged by the progress of 

anti-retroviral therapy in reducing the mortality rates associated 

with HIV infection and in enhancing the quality of life of patients 

on medication. The Committee has approved bill language for 

$797,521,000 for AIDS medications. 

The Committee is concerned that Title II base award amounts 

have been reduced by $14,000,000 over the past 2 fiscal years, 

thereby reducing the ability of State and territory health departments to provide comprehensive health care services to all those 

living with HIV/AIDS in need. The Committee recognizes the 

unique role that State health departments play in coordinating 

HIV/AIDS care and treatment programs within their State, regardless of funding source. The Committee encourages HRSA, in collaboration with state health departments, to seek meaningful 

measures by which coordination between all Ryan White CARE Act 

grantees and other Federal HIV/AIDS programs can occur within 

States and territories, with inclusion of State representatives in 

HRSA’s monitoring visits of Title III and IV grantees, as well as 

notification to states of new grantees within their jurisdictions. 

The Committee recognizes the importance of ADAP in making it 

possible for low-income Americans to access and afford the drugs 

to treat HIV/AIDS. Today, more than 150,000 Americans depend on 

ADAP to preserve and extend their lives. Unfortunately, dozens of 

States find themselves unable to keep up with the demand for patients in need of coverage under ADAP, and many states have been 

forced to take drastic action to offset funding shortfalls. The Committee encourages HRSA to explore methods of redistributing unobligated funds to help address the ADAP crisis. 

Early Intervention Program—Title III–B 

The Committee provides $195,578,000 for early intervention 

grants. These funds are awarded competitively to primary health 

care providers to enhance health care services available to people 

at risk of HIV and AIDS. Funds are used for comprehensive primary care, including counseling, testing, diagnostic, and therapeutic services. 

Women, Infants, Children, and Youth—Title IV 

The Committee provides $72,519,000 for title IV pediatric AIDS. 

Funds are awarded to community health centers, family planning 

agencies, comprehensive hemophilia diagnostic and treatment centers, federally qualified health centers under section 1905(1)(2)(B) 

of the Social Security Act, county and municipal health departments and other nonprofit community-based programs that provide 

comprehensive primary health care services to populations with or 

at risk for HIV disease. 

Title IV of the CARE Act provides a program of grants for coordinated services and access to research for women, infants, children 

and youth. Title IV grantees may engage in a broad range of activities to reduce mother-to-child transmission, including voluntary 

testing of pregnant women and treatment to reduce mother-to-child 

transmission. In addition, title IV grantees are required to provide 

individuals with information and education on opportunities to participate in HIV/AIDS clinical research. 
51 

The Committee expects HRSA to maximize available funds under 

this part to existing grantees. The Committee is concerned that instructions to HRSA regarding the analysis of data pertaining to administrative costs in title IV have still not been followed, making 

it almost impossible for HRSA to impose a cap in fiscal year 2006. 

The Committee strongly urges HRSA to collaborate with grantees 

under this title to produce necessary tools for the accurate collection of expense data. Unless HRSA can produce data regarding administrative expenses with a precise definition to ensure accuracy 

and comparability, the Agency will be unable to impose a limitation 

on such expenses without harming the ability of grantees to provide services for women, children, youth and families infected with 

HIV. 

The Committee is aware of the efforts of title IV grantees to care 

for youth infected with HIV and urges HRSA to disseminate the effective practices and models of care developed by title IV grantees 

across all Ryan White CARE Act providers. 

Technical assistance may be provided to title IV grantees using 

up to 2 percent of the funds appropriated under this section. Within this amount sufficient funds exist to maintain agreements to 

provide technical assistance to title IV grantees and to conduct policy analysis and research. 

AIDS Education and Training Centers 

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

training centers [AETC’s]. AIDS education and training centers 

train health care practitioners, faculty, and students who care for 

AIDS patients outside of the traditional health professions education venues, and support curriculum development on diagnosis 

and treatment of HIV infection for health professions schools and 

training organizations. The targeted education efforts by AETC’s 

are needed to ensure the cost-effective use of the significant expenditures in Ryan White programs and the AIDS drugs assistance 

program. The Agency is urged to fully utilize the AETC’s to ensure 

the quality of medical care and to ensure, as much as possible, that 

no individual with HIV receives suboptimal therapy due to the lack 

of health care provider information. 

AIDS Dental Services 

The Committee provides $13,218,000 for AIDS Dental Services. 

This program provides grants to dental schools, dental hygiene 

schools, and postdoctoral dental education programs to assist with 

the cost of providing unreimbursed oral health care to patients 

with HIV disease. 

Telehealth 

The Committee provides $3,888,000 for telehealth activities. The 

fiscal year 2005 comparable level was $3,916,000 and the administration request was $3,888,000. The telehealth program funded 

through the Office for the Advancement of Telehealth promotes the 

effective use of technologies to improve access to health services for 

people who are isolated from healthcare and distance education for 

health professionals. 
52 

SPECIAL PROGRAMS BUREAU

Organ Donation and Transplantation 

The Committee provides $24,413,000 for organ transplant activi- ties. The fiscal year 2005 comparable level was $24,413,000 and 

the administration request was $23,282,000. These funds support 

a scientific registry of organ transplant recipients and the National 

Organ Procurement and Transplantation Network to match donors 

and potential recipients of organs. A portion of the appropriated 

funds may be used for education of the public and health professionals about organ donations and transplants, and to support 

agency staff providing clearinghouse and technical assistance functions. 

The Committee notes that Public Law 108–216, the Organ Donation Recovery and Improvement Act of 2004 has provided new program authorizations and urges efforts to implement the new law. 

Funding provided by the Committee may be used to implement the 

provisions of the new law and the Committee notes that the new 

provisions may have a direct impact on increasing the rate of successful transplantations. 

The Committee is concerned that pregnant women and their families are unaware of the benefits of umbilical cord blood in treating 

many congenital and genetic diseases. The Committee encourages 

HRSA to consider adding umbilical cord blood to organ and tissue 

donation education programs operated by HRSA to provide education on all options for umbilical cord blood storage including public donation and private banking. 

The Committee is encouraged by the continuing success of the 

Organ Donation Collaborative Project and has included funds for 

its continuation. This project is focused on the Nation’s largest hospitals and has adopted the goal of helping these hospitals achieve 

organ donation rates of 75 percent or higher, which will result in 

at least 6,000 additional organs available for transplantation. The 

Committee notes that this project has made important progress toward this goal over the last year and urges its continuation. The 

Committee also urges the agency to facilitate the adoption of a national system of simultaneous referrals of available organs as opposed to the current system of sequential or serial referrals. 

National Cord Blood Stem Cell Bank Program 

The Committee has provided $9,859,000 for the National Cord 

Blood Stem Cell Bank Network. The fiscal year 2005 comparable 

level was $9,859,000 and the administration did not request funds 

for this activity in fiscal year 2006. 

The Committee continues to be supportive of the effort to build 

the Nation’s supply of cord blood stem cells available for therapy 

and research. The Committee notes that the Institute of Medicine 

study required by House Report 108–401 has been completed and 

submitted to the Committee and HRSA. The Committee expects 

HRSA to begin implementation of this program as soon as possible. 

National Bone Marrow Donor Program 

The Committee provides $22,916,000 for the National Bone Marrow Donor Registry. The fiscal year 2005 comparable level was 
53 

$25,416,000 and the administration request was $22,916,000. The 

National Bone Marrow Donor Registry is a network, operated 

under contract, which helps patients suffering from leukemia or 

other blood diseases find matching volunteer unrelated bone marrow donors for transplants. The program also conducts research on 

the effectiveness of unrelated marrow transplants and related 

treatments. 

Trauma Care 

The Committee provides $3,418,000 for trauma/emergency medical services. The fiscal year 2005 comparable level was $3,418,000 

and the administration did not request funds for this program in 

fiscal year 2006. This program is intended to improve the Nation’s 

overall emergency medical systems, which are constantly activated 

to respond to a wide range of natural and man-made disasters. 

State Planning Grants for Health Care Access 

The Committee has not provided funding for State Planning 

Grants for Health Care Access in fiscal year 2006. The fiscal year 

2005 comparable level was $10,910,000 and the administration did 

not request funding for this activity in fiscal year 2006. 

RURAL HEALTH PROGRAMS

Rural Health Policy Development Program 

The Committee provides $8,825,000 for the Rural Health Policy 

Development Program. The fiscal year 2005 comparable level was 

$8,825,000 and the administration request was $8,528,000. The 

funds provide support for the Office of Rural Health Policy to be 

the focal point for the Department’s efforts to improve the delivery 

of health services to rural communities and populations. Funds are 

used for rural health research centers, the National Advisory Committee on Rural Health, and a reference and information service. 

Rural Health Care Services Outreach Grants 

The Committee provides $39,278,000 for health outreach grants. 

The fiscal year 2005 comparable level was $39,278,000 and the administration request was $10,767,000. This program supports 

projects that demonstrate new and innovative models of outreach 

in rural areas such as integration and coordination of health services. 

The Committee understands that many primary care clinics in 

isolated, remote locations are providing extended stay services and 

are not staffed or receiving appropriate compensation to provide 

this service. The Committee encourages HRSA to continue its support for a demonstration project authorized in the Medicare Modernization Act to evaluate the effectiveness of a new type of provider, the ‘‘Frontier Extended Stay Clinic,’’ to provide expanded 

services in remote and isolated primary care clinics to meet the 

needs of seriously ill or injured patients who cannot be transferred 

quickly to acute care referral centers, and patients who require 

monitoring and observation for a limited time. 

Mississippi’s Delta is a community in which residents disproportionately experience disease risk factors and children are signifi-
54 

cantly mentally and physically developmentally behind. The Committee recognizes that communities such as this show positive behavioral change when community-based programs and infrastructure are in place. The Committee believes that collaborative programs offering health education, coordination of health services 

and health-related research offer the best hope for breaking the 

cycle of poor health in underprivileged areas such as the Mississippi Delta. Therefore, the Committee recommends the continued funding of these activities as already initiated and undertaken 

by the coordinated efforts of the Mississippi Delta Health Alliance, 

which is a collaboration involving Delta State University, Mississippi State University, the University of Mississippi Medical 

Center, and the Mississippi State Department of Health. 

Rural and Community Access to Emergency Devices 

The Committee provides $8,927,000 for rural and community access to emergency devices. The fiscal year 2005 comparable level 

was $8,927,000 and the administration request was $1,960,000. 

This provides funding for both the rural program under section 413 

of the Public Health Service Act and the community access demonstration under section 313. These programs provide grants to expand placement of automatic external defibrillators [AEDs] and to 

ensure that first responders and emergency medical personnel are 

appropriately trained. 

Rural Hospital Flexibility Grants 

The Committee provides $64,180,000 for rural hospital flexibility grants. The fiscal year 2005 comparable level was $39,180,000 and 

the administration did not request funds for this program in fiscal 

year 2006. 

Under this program, eligible rural hospitals may convert themselves into limited service facilities termed Critical Access Hospitals. Such entities are then eligible to receive cost-based payments from Medicare. The grant component of the program assists 

States with the development and implementation of State rural 

health plans, conversion assistance, and associated activities. 

Of the amount provided, the Committee includes $15,000,000 to 

continue the Small Rural Hospital Improvement Grant Program, as 

authorized by section 1820(g)(3) of the Social Security Act and Public Law 107–116 and outlined in House Report 107–342. 

The Committee has included $25,000,000 for a Rural Health, 

Education, and Workforce Infrastructure Demonstration Program 

which shall solicit and fund proposals from local governments, hospitals, universities, and rural public health-related entities and organizations for research development, educational programs, job 

training, and construction of public health-related facilities. 

State Offices of Rural Health 

The Committee provides $8,321,000 for the State Offices of Rural 

Health. The fiscal year 2005 comparable level was $8,321,000 and 

the administration request was $8,223,000. The State Office of 

Rural Health program helps the States strengthen rural heath care 

delivery systems by allowing them to better coordinate care and 

improve support and outreach in rural areas. The Committee be-
55 

lieves that continued funds for this purpose are critical to improving access and quality health care services throughout rural communities. 

Rural Emergency Medical Services 

The Committee has provided $500,000 for the Rural EMS Training and Assistance Grants program. The comparable fiscal year 

2005 level was $496,000 and the administration did not request 

funding for this program in fiscal year 2006. 

Native and Rural Alaskan Health Care 

The Committee provides $39,680,000 for the Denali Commission. The fiscal year 2005 comparable level was $39,680,000 and the administration did not request funding for this program in fiscal year 

2006. These funds support construction and renovation of health 

clinics, hospitals and social service facilities in rural Alaska, as authorized by Public Law 106–113, to help remote communities in 

Alaska develop critically needed health and social service infrastructure for which no other funding sources are available, thereby 

providing health and social services to Alaskans in remote rural 

communities as they are in other communities throughout the 

country. The Committee expects the Denali Commission to allocate 

funds to a mix of rural hospital, clinic, long-term care and social 

service facilities, rather than focusing exclusively on clinic funding. 

Terrorism Preparedness 

The Committee provides $510,500,000 for bioterrorism prepared- ness related activities at HRSA. Within this total, $483,000,000 is 

provided for hospital preparedness grants and $27,500,000 is provided for education and curriculum development. 

The Committee intends that, at the discretion of the Secretary of 

Health and Human Services, funds provided for the hospital preparedness grants may be used for deployable mass casualty units 

(as requested in the Strategic National Stockpile), credentialing integration (as requested in the Office of the Secretary), and training 

a medical reserve corps (as requested in the Office of the Secretary). These deployable mass casualty units could provide key 

hospital surge capacity in the event of a terrorist attack or natural 

disaster. HRSA should continue to work with the Department and 

other HHS agencies to coordinate their terrorism preparedness activities. 

Within the total provided for hospital preparedness grants, the 

Committee approves the request for $25,000,000 to create a medical surge capacity national demonstration at Washington Hospital 

Center. The funding will increase emergency care capacity for the 

Nation’s Capital, and serve as a national demonstration center for 

advanced mass casualty emergency facility design, training, and 

care. 

The Committee is concerned about the current HRSA strategy for 

providing training to health care professionals on bioterrorism preparedness. Many expert analyses, including several presented at 

the Secretary’s Council on Public Health Preparedness, have 

stressed the need for a consistent, national curriculum for bioterrorism preparedness training. The Committee is troubled that, in-
56 

stead of adopting a consistent, national approach to training, 

HRSA has instead chosen to issue 19 separate grants for continuing education on bioterrorism training, and a further 12 grants 

for curriculum development. The Committee believes that this approach risks producing a fragmented and uncoordinated bioterrorism preparedness training program instead of the integrated 

and coordinated program that is needed. The Committee instructs 

HRSA to seek ways to improve the coordination and consistency of 

its bioterrorism training program, and to report to the Committee 

on recommendations for achieving a consistent, national strategy 

for bioterrorism preparedness training no later than 6 weeks after 

the date of enactment of this Act. 

Family Planning 

The Committee provides $285,963,000 for the title X family planning program. The fiscal year 2005 comparable level was 

$285,963,000 and the administration request was $285,963,000. 

Title X grants support primary health care services at more than 

4,600 clinics nationwide. About 85 percent of family planning clients are women at or below 150 percent of poverty level. Title X 

of the Public Health Service Act, which established the family planning program, authorizes the provision of a broad range of acceptable and effective family planning methods and preventive health 

services. This includes FDA-approved methods of contraception. 

The Committee believes that the authority for making grants 

under title X must remain unchanged. 

The Committee is aware of the findings of a recent HHS Inspector General’s report, which documents efforts by the Office of Population Affairs to inform and periodically remind title X grantees of 

their responsibilities regarding State child abuse and sexual abuse 

reporting requirements. The report notes that OPA includes State 

reporting requirements in its reviews and site visits of grantees, 

and cites an extensive amount of effort and training that goes on 

within the program to ensure that clinicians are conversant with 

State reporting requirements, and trained to both recognize signs 

of sexual coercion and sexual violence and follow appropriate procedures when dealing with such cases. 

Health Care-related Facilities and Activities 

The Committee provides $480,751,000 for the construction and 

renovation (including equipment) of health care-related facilities 

and other health care-related activities. The fiscal year 2005 comparable level was $482,729,000 and the administration did not request funds for this program in fiscal year 2006. This account 

makes funds available to public and private entities for the construction and renovation of health care-related facilities and other 

health care-related activities. 

Program Management 

The Committee provides $143,992,000 for program management 

activities for fiscal year 2006. The fiscal year 2005 comparable level 

was $147,080,000 and the administration request was 

$145,992,000. 
57 

Section 340B of the Public Health Service Act created the 340B 

Drug Discount Program to lower drug prices for over 10,000 public 

health grantees including community health centers and public 

hospitals. The Committee notes that the program is growing rapidly due the growth in the number of Community Health Centers 

and an expansion of the number of rural and small hospitals eligible to be recognized as disproportionate share hospitals, contained 

in the Medicare Modernization Act. The Committee is deeply concerned that the Department lacks the oversight capability to ensure that safety-net organizations participating in the program receive the full statutory discounts. The Committee agrees with the 

Inspector General that participating entities must have the ability 

to independently verify that they are receiving the mandated discounts, and strongly urges HRSA to develop a mechanism by which 

this verification can take place. 

HEALTH EDUCATION ASSISTANCE LOANS

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

loans guaranteed before 1992. The fiscal year 2005 comparable 

level was $4,000,000 and the administration request was 

$4,000,000. For administration of the HEAL Program including the 

Office of Default Reduction, the Committee provides $2,916,000. 

The fiscal year 2004 comparable level was $3,244,000 and the administration request was $2,916,000. 

The HEAL Program insures loans to students in the health professions. The Budget Enforcement Act of 1990, changed the accounting of the HEAL Program. One account is used to pay obligations arising from loans guaranteed prior to 1992. A second account 

was created to pay obligations and collect premiums on loans guaranteed in 1992 and after. Administration of the HEAL Program is 

separate from administration of other HRSA programs. 

NATIONAL VACCINE INJURY COMPENSATION PROGRAM

The Committee provides that $74,484,000 be released from the 

vaccine injury compensation trust fund in fiscal year 2006, of which 

$3,600,000 is for administrative costs. The total fiscal year 2005 

comparable level was $69,151,000 and the total administration request was $73,716,000. 

The National Vaccine Injury Compensation Program provides 

compensation for individuals with vaccine-associated injuries or 

deaths. Funds are awarded to reimburse medical expenses, lost 

earnings, pain and suffering, legal expenses, and a death benefit. 

The vaccine injury compensation trust fund is funded by excise 

taxes on certain childhood vaccines. 

CENTERS FOR DISEASE CONTROL AND PREVENTION

DISEASE CONTROL, RESEARCH, AND TRAINING

Appropriations, 2005 ............................................................................. $4,775,810,000 

Budget estimate, 2006 ........................................................................... 4,306,063,000 

House allowance .................................................................................... 6,105,586,000 

Committee recommendation ................................................................. 6,254,215,000 

The Committee provides a program level of $6,254,215,000 for 

the Centers for Disease Control and Prevention [CDC]. The Com-
58 

mittee recommendation includes $5,989,115,000 in budget authority and an additional $265,100,000 via transfers available under 

section 241 of the Public Health Services Act. The fiscal year 2005 

comparable program level was $4,775,810,000 and the administration requested program level was $4,306,063,000. 

The activities of the CDC focus on several major priorities: provide core public health functions; respond to urgent health threats; 

monitor the Nation’s health using sound scientific methods; build 

the Nation’s health infrastructure to insure our national security 

against bioterrorist threats; promote women’s health; and provide 

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

that are conducive to good health. 

INFECTIOUS DISEASES

The Committee recommends $1,709,361,000 for infectious disease 

related programs at the CDC. The fiscal year 2005 comparable 

level was $1,679,889,000 and the administration requested a comparable level of $1,709,758,000 for fiscal year 2006. The Committee 

recommendation includes $12,794,000 in transfers available under 

section 241 of the Public Health Services Act. 

The Coordinating Center for Infectious Diseases includes the National Center for Infectious Diseases, the National Center for STD, 

TB, and HIV Prevention, and the National Immunization Program. 

Infectious Diseases Control 

The Committee has provided $3,848,000 above the comparable 

amount for fiscal year 2005 to expand infectious diseases control 

activities. The Committee intends that all infectious diseases control activities be funded at least at the level of the administration’s 

request and that the additional funds be used to address emerging 

issues as determined by CDC. 

These activities focus on: national surveillance of infectious disease; applied research to develop new or improved diagnoses; prevention and control strategies; working with State and local departments and private health care providers to transfer application of 

infectious disease prevention technologies; and strengthening the 

capability to respond to outbreaks of new or reemerging disease. 

Disease outbreaks endanger U.S. citizens at home and abroad, 

threaten U.S. Armed Forces overseas, and exacerbate social and 

political instability. Outbreaks can interfere with the global marketplace, affecting tourism, trade, and foreign investment. CDC’s 

strategies to combat infectious diseases invest in and build upon 

both the public health system that was established over a century 

ago to increase the preparedness to address the emergence of dangerous new threats. 

Chronic Fatigue.—With near-completion of the restoration of 

$12,900,000 to the Chronic Fatigue Syndrome [CFS] research program in response to a report from the Inspector General dated May 

12, 1999, the Committee commends CDC for developing a comprehensive CFS program. The Committee encourages CDC to provide sufficient resources to sustain efforts to identify biomarkers 

for CFS, educate health care providers about the diagnosis and 

treatment of CFS, and better inform the public about it to aid early 
59 

detection and improve patient care. The Committee requests a report by May 1, 2006 providing a detailed accounting of how the 

$12,900,000 in restored funding has been used. 

Collaboration With Asia.—The Committee recognizes that strong 

collaborative ties with Asian countries are among the mechanisms 

which may contribute to the stability of the Asia/Pacific region. The 

multiethnic and multicultural population of Hawaii and its geographic location provide an ideal pathway for a CDC supported initiative with a focus on emerging infectious and chronic disease 

problems in Asia. The Committee also recognizes this has the potential for providing frontline protection for the United States 

mainland from emerging diseases, as well as assisting Asian countries with treatment for such diseases. The Committee encourages 

CDC to explore collaboration and joint funding of projects with 

Asian governments, such as Korea, to study immigrants in Hawaii 

as a mechanism for addressing both infectious and chronic disease 

burden and treatment in the Pacific. 

Hepatitis.—The Committee is concerned that more than 75 percent of the 4 million people with hepatitis C are unaware of their 

condition. The Committee encourages CDC to collaborate with national voluntary health organizations to raise awareness of appropriate screening and medical follow up of target populations. The 

Committee is also aware of increasing rates of hepatitis A and B 

infections among select adult populations, as well as the alarming 

rate of individuals co-infected with both hepatitis C and HIV. The 

Committee encourages CDC to help increase hepatitis screening 

initiatives in the States. In addition, The Committee encourages 

CDC to consider focusing 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. 

Liver Wellness.—The Committee continues to be concerned about 

the prevalence of hepatitis and encourages CDC to consider working with voluntary health organizations and professional societies 

to promote liver wellness with increased attention toward education and prevention. 

Meningococcal Disease.—Meningococcal disease is one of the few 

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

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 meningococcal education and adolescent immunization programs through partnerships with associations, such as the National Meningitis Association, 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. 

Prevention Epicenter Program.—The Committee applauds CDC’s 

support for the Prevention Epicenter Program and encourages CDC 

to continue and expand this program to address patient safety 

issues. 
60 

Sepsis.—The Committee is aware that sepsis, an overwhelming 

systemic response to infection that leads to organ dysfunction and 

death, kills more that 215,000 Americans every year. The Committee understands that new treatments have been developed 

which significantly improve prognosis when sepsis is diagnosed in 

a timely fashion. In addition, new guidelines have been developed 

to aid health care professionals in identifying the syndrome. Unfortunately, too few medical personnel know how to properly diagnose 

sepsis. To improve patient outcomes, the Committee encourages 

CDC to develop a sepsis education program to train infectious disease physicians, emergency room doctors, and critical care nurses 

in the proper identification of sepsis. 

HIV, STD, and TB Prevention 

Recognizing the intersection among these diseases, and the need 

for a focal point for leadership and accountability, CDC combines 

HIV, STD, and TB activities to provide leadership in preventing 

and controlling human immunodeficiency virus infection, other sexually transmitted diseases [STDs], and tuberculosis. CDC works in 

collaboration with partners at community, State, national, and 

international levels, applying multi-disciplinary programs of research, surveillance, technical assistance, and evaluation. These 

diseases are not yet vaccine preventable and must be controlled 

and prevented by identifying, diagnosing, and treating infected persons; provision of confidential, culturally competent counseling to 

identify and reach those who have been exposed to infection and 

who may not know it; and individual and population level health 

promotion to reduce high risk behaviors. 

Within the total provided, $637,000 above the comparable 

amount for fiscal year 2005 has been provided for tuberculosis-related activities. All other activities are funded at the level of the 

administration’s request. 

HIV/AIDS Prevention.—CDC’s HIV/AIDS prevention programs 

are working in every State and territory to prevent new infections, 

link people who are already infected to medical care, and translate 

scientific research findings into practical prevention programs 

available to every person at risk. CDC will continue to adapt these 

prevention programs to meet new and different needs. 

Infertility Prevention.—The Committee notes that CDC is 

charged legislatively with instituting programs to help prevent infertility. CDC’s current program activities in this matter are undertaken by the division of HIV/STD/TB and are limited to the prevention of venereal diseases. The Committee understands that there 

are numerous additional 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 this program and provide greater support to public 

education on the risks to fertility. 

Oral Fluid Rapid HIV Tests.—The Committee is supportive of 

CDC’s use of the oral fluid rapid HIV test in its HIV/AIDS activities. The Committee strongly encourages CDC to move forward as 
61 

quickly as possible with the purchase of additional tests to sustain 

and expand these successful efforts. 

Tuberculosis.—The Committee is pleased with the efforts of the 

tuberculosis control program, which has reduced the number of 

new tuberculosis cases for the past 10 years. However, the number 

of new tuberculosis cases in foreign-born individuals in the United 

States remains a concern. Although tuberculosis rates have been 

falling, the Committee is aware that similar low rates have been 

achieved in the past only to see a reemergence of the disease due 

to inadequate control efforts. In the end, any savings achieved during that period were more than used to again gain control of the 

incidence of the disease. The Committee has provided $637,000 

over the fiscal year 2005 level to expand tuberculosis control efforts 

to prevent a similar reemergence. 

The Committee understands that TB is an enormous health crisis in the developing world, killing 2 million people every year. In 

recent years, several new vaccine candidates for TB have been developed and have shown promising results when tested in animals. 

The Committee strongly encourages CDC to continue and, if possible, expand the existing TB vaccine research cooperative agreement. 

The Committee is aware that refugees entering the United 

States with TB pose a serious public health threat. In particular, 

multidrug resistant TB cases pose the deadliest and costliest risk. 

The Committee recognizes that over the past year an outbreak of 

TB has occurred among Hmong refugees from Thailand who have 

resettled in the United States, mainly in California, Minnesota and 

Wisconsin. In California alone, local health departments have detected 25 TB cases among 3,400 Hmong refugees from Thailand in 

the last 10 months, four of which are multidrug resistant. The 

Committee urges CDC to make resources available to States facing 

TB outbreaks among their refugee population. 

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. 

Immunization 

The Committee recommends $510,706,000 for the program authorized under section 317 of the Public Health Service Act. The 

fiscal year 2005 comparable level was $480,794,000 and the administration requested $515,920,000 for fiscal year 2006. The Committee recommendation includes $12,794,000 in transfers available 

under section 241 of the Public Health Service Act. Within the total 

provided, all activities are funded at the level requested by the administration. The Committee has transferred $5,214,000 from Immunization to Global Health to continue to support global vaccination efforts. This is a technical change and should not result in any 

programmatic decrease in Immunization activities. 
62 

The Omnibus Reconciliation Act of 1993 established a vaccine 

purchase and distribution system that provides, free of charge, all 

pediatric vaccines recommended for routine use by the Advisory 

Committee on Immunization Practices to all Medicaid-eligible children, uninsured children, underinsured, and native Americans 

through program-registered providers. 

Despite great success in lowering disease levels and raising immunization coverage rates, much remains to be done to ensure the 

protection of children and adults worldwide. Approximately 1 million 2-year-old children in the United States have not received one 

or more of the more established, recommended vaccines. New vaccines, although greatly beneficial to public health, complicate an already complex immunization schedule and make it increasingly difficult to ensure complete immunization. One of our Nation’s greatest challenges is extending our success in childhood immunization 

to the adult population. The burden due to the occurrence of vaccine-preventable diseases in adults in the United States is staggering. As many as 50,000 U.S. adults die of influenza, pneumococcal infections and hepatitis B. CDC is addressing these obstacles 

to the greatest extent possible and continues to provide leadership 

to reduce disability and death resulting from diseases that can be 

prevented through vaccination. 

The Committee encourages CDC to increase section 317 grant 

support for infrastructure development and purchase of vaccines 

for the State of Alaska’s universal immunization program. It has 

been brought to the Committee’s attention that infrastructure costs 

of delivering vaccines to children in Alaska are substantially higher 

than in other areas of the country, because of the many small, remote communities which must be served primarily by air. The 

Committee encourages the agency to give careful consideration to 

Alaska’s request for sufficient funding for the purchase of vaccines 

needed for 90 percent of Alaskan children and to provide infrastructure support needed to deliver these vaccines at the community level, including development of a statewide immunization registry to ensure that all children in Alaska are immunized. The 

Committee notes that failure to immunize children in remote areas 

of Alaska results in deaths each year from exposure to open sewage 

lagoons and contaminated water. 

Vaccine Tracking.—The Committee is pleased by CDC’s development of the Surveillance, Preparedness, Awareness and Response 

System and has included sufficient resources to provide the same 

level of support of these activities as in fiscal year 2005. In light 

of vaccine shortages that have occurred over the past several flu 

seasons, the Committee understands that this system could serve 

as a valuable surveillance and tracking system for private and public sector inventory levels of vaccine. 

HEALTH PROMOTION

The Coordinating Center for Health Promotion includes the National Center for Chronic Disease Prevention and Health Promotion and the National Center for Birth Defects and Developmental Disabilities. 

The Committee recommends $974,080,000 for Health Promotion 

related activities at the CDC. The fiscal year 2005 comparable level 
63 

was $1,021,709,000 and the administration requested 

$964,421,000. 

The Committee recognizes the important role national non-governmental health organizations play in increasing the awareness of 

chronic disease prevention and birth defects and development disabilities issues. Therefore, the Committee has included $2,421,000 

to allow for the award of projects to support the dissemination of 

information on the condition or disease and effective public health 

interventions or to conduct public and professional health awareness and education efforts. Using a competitive review process, 

each project should be awarded for a 3-year project period and 

should not exceed $1,000,000 per year. 

CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION

Within the total provided, the following amounts are provided for 

the specified activities above the comparable amount for fiscal year 

2005: $300,000 to expand Heart Disease and Stroke related activities; $300,000 to expand Diabetes related activities; $404,000 to expand Cancer Prevention and Control activities; $3,000,000 to expand Tobacco related activities; $50,000 to expand oral health related activities; $310,000 to expand Prevention Center activities; 

$100,000 to expand the Racial and Ethnic Approach to Community 

Health Program; and $84,000 to expand Primary Immune Deficiency Syndrome-related activites. All other activities are funded at 

the level of the administration’s request or as specified below. 

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, and various neurological conditions 

such as epilepsy. These and other chronic diseases now account for 

nearly 70 percent of all health care costs, as well as 70 percent of 

all deaths annually. A few modifiable risk factors bring suffering 

and early death to millions of Americans. Three such factors—tobacco use, poor nutrition, and lack of physical activity—are major 

contributors to our Nation’s leading causes of death. 

Alzheimer’s Disease and Healthy Aging.—The Committee understands that 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. Epidemiological studies reveal that individuals taking anti-inflammatory 

drugs to treat conditions such as arthritis have a lower-than-expected occurrence of Alzheimer’s. Other studies appear to link 

known risk factors for diabetes and heart disease and risk factors 

for Alzheimer’s and dementia. CDC, in cooperation with the Alzheimer’s Association, is launching 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. In light of the threat Alzheimer’s presents as well 

as growing public interest in learning how to remain brain-healthy, 

the Committee recommends $1,700,000 to continue this important 

initiative. 

Amyotrophic Lateral Sclerosis.—The Committee understands 

that a national Amyotrophic Lateral Sclerosis [ALS] registry may 

enable unprecedented progress in understanding ALS. Although 
64 

several sources of ALS patient information currently exist in varying forms around the world, this information is not as comprehensive as required for the needed research. The Committee provides 

$1,000,000 for pilot programs to begin to gather data for a nationwide ALS registry that will estimate the incidence and prevalence 

of the disease, promote a better understanding of the epidemiology 

of the disease, and provide data that will be useful for research on 

improving disease management and developing standards of care. 

CDC should, to the extent practicable, identify and coordinate with 

existing data, surveillance systems and registries, such as statebased ALS registries, the Department of Veterans Affairs ALS registry and the National Institute for Neurological Disorders and 

Stroke repository. 

Autoimmune Diseases.—The Committee encourages CDC to provide resources for the awareness and prevention of autoimmune 

diseases. 

Breast and Cervical Cancer.—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, Asian Pacific Islander, 

and African American populations. As part of this initiative, the 

Committee is very interested in the innovative approaches, such as 

that of the Men Against Breast Cancer Partners In Survival Program, which focuses on the role of the male support-giver as an integral component of the early detection, patient care and survivorship of breast cancer. 

Cancer Prevention and Control.—The Committee is strongly supportive of the CDC cancer programs focused on awareness, education and early detection and has included a significant increase 

for these programs. 

The growth of cancer prevention and control programs within 

State health agencies has resulted in the recognition that improved 

coordination of cancer control activities is essential to maximizing 

resources and achieving desired cancer prevention and control outcomes. The Committee commends CDC for its work with health 

agencies to enhance the number and quality of cancer-related programs that are available to the U.S. population and to develop an 

integrated and coordinated approach to reduce the cancer burden 

through prevention, early detection, treatment, and rehabilitation. 

Within the amounts provided, the following amounts are provided for the specified activities above the comparable amount for 

fiscal year 2005: $136,000 to expand comprehensive cancer activities and $200,000 to expand activities related to the Geraldine Ferraro Cancer Education Program. All other activities are funded at 

the level of the administration’s request. 

Cancer Survivorship Resource Center.—The Committee supports 

the ongoing partnership between CDC and the Lance Armstrong 

Foundation to address the needs of the approximately 10 million 

cancer survivors and their families and friends. The Committee has 

included sufficient resources to provide at least the same level of 

support for LiveStrong, the National Cancer Survivorship Resource 

Center, as was provided in fiscal year 2005. 

Chronic Kidney Disease.—The Committee previously has expressed concern regarding the need to expand public health strate-
65 

gies to combat chronic kidney disease [CKD] given that many individuals are diagnosed too late to initiate treatment regimens that 

could reduce morbidity and mortality. Twenty million Americans 

have CKD, and another 20 million are at risk of developing the disease. Individuals with diabetes or hypertension have especially 

high vulnerability. Kidney disease is the 9th leading cause of death 

in the United States, and death by cardiovascular disease is 10 to 

30 times higher in kidney dialysis patients than in the general population. Further, the number of individuals with end stage renal 

disease [ESRD], irreversible kidney failure requiring either dialysis 

or a transplant to remain alive, is expected to increase from 

372,000 patients in 2000 to over 660,000 by 2010. Therefore, the 

Committee has included an increase of $1,800,000 for CKD to develop capacity and infrastructure at CDC for a kidney disease surveillance, epidemiology, and health outcomes program; award 

grants to support several State-based demonstration projects for 

CKD prevention and control; and under the leadership of a national voluntary health organization and in collaboration with 

CDC, 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. 

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 10 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. 

Colorectal Cancer.—The Committee understands that colorectal 

cancer is the third most commonly diagnosed cancer among both 

men and woman in the United States, and the second leading 

cause of cancer related deaths. When colorectal cancer is detected 

and treated early, survival is greatly enhanced. However, despite 

the availability of proven screening tests, only 37 percent of 

colorectal cancers are diagnosed while the disease in still in a localized stage. 

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. 

Delta Health Initiative.—The Mississippi Delta Region experiences some of the Nation’s highest rates of chronic diseases, such 

as diabetes, hypertension, obesity, heart disease and stroke. The 

Committee recognizes the efforts of the Delta Health Alliance in 

health education, coordination of health services and health-related 

research in the Mississippi Delta. The Committee believes that 

such collaborative, community-based programs offer the best hope 

for breaking the cycle of poor health in underprivileged areas such 
66 

as the Mississippi Delta. The Committee recommends that the 

CDC collaborate with the Delta Health Alliance in addressing the 

chronic health issues of the Mississippi Delta. 

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 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 encourages CDC to 

take advantage of the opportunity to also collect information about 

the standard of care available to people with diabetes nationwide. 

Samples from this study may represent a valuable scientific resource, and the Committee encourages CDC to consider making 

these samples and information available to the research community. 

The Committee encourages the CDC to continue and expand its 

efforts to standardize the measurement of C-peptide as a surrogate 

marker for pancreatic beta cell function. The development and validation of reliable, standard assays for C-peptide have the potential 

to significantly accelerate regulatory approval of new therapies to 

prevent or reverse autoimmune diabetes. 

Diabetes and Obesity in Minority Populations.—The Committee 

is concerned by the toll that the twin epidemics of diabetes and 

obesity are taking on the health of minorities. An effective culturally-sensitive response is urgently needed to address this escalating epidemic. The Committee encourages CDC to fund initiatives 

of national and community organizations that have the capacity to 

carry out coordinated health promotion programs that will focus on 

diabetes and obesity in minority communities. The Committee encourages CDC to seek out organizations directed by and serving individuals from communities with disproportionate diabetes and 

obesity rates. 

The high incidence of diabetes among Native American, Native 

Alaskan, and Native Hawaiian populations persists. The Committee is pleased with the CDC’s efforts to target this population, 

in particular, to assist the leadership of Native Hawaiian and Pacific Basin Islander communities. It is important to incorporate traditional healing concepts and to develop partnerships with community health centers. The Committee encourages CDC to build on all 

its historical efforts in this regard. 

Epilepsy.—The Committee supports the CDC epilepsy program, 

which is making progress in research, epidemiology and surveillance, early detection, improved treatment, public education and 

expansion of interventions to support people with epilepsy and 

their families in their communities. The Committee applauds 

CDC’s partnership with the Epilepsy Foundation in developing the 

recommendations of Living Well with Epilepsy II. Sufficient funding has been provided to continue this partnership and to implement ongoing epilepsy public health programs. 

Genomic Medicine.—The Committee is aware that steps need to 

be taken today to prepare the public health system for the coming 

widespread use of genetic technologies in healthcare. Failing to do 

so may exacerbate existing health disparities and seriously limit 
67 

progress generated by the Human Genome Project. The Committee 

urges 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. 

Geraldine Ferraro Cancer Education Program.—In fiscal year 

2004, Congress provided funding to initiate the Geraldine Ferraro 

Cancer Education Program, as authorized by the Hematological 

Cancer Research Investment and Education Act of 2002. The Committee is pleased that CDC has established a cooperative agreement program with national health organizations to develop strategies to provide information and education for patients, their family 

members, friends, and caregivers with respect to hematologic cancers. The Committee expects CDC to increase efforts to address 

hematologic cancer survivorship issues and improve quality of national hematologic data. With the additional funds provided, the 

Committee strongly encourages CDC to support activities related to 

the development of interactive web based education for health care 

providers on the signs, symptoms and current treatment of blood 

cancer by comprehensive cancer centers. 

Glaucoma and Other Vision Disorders.—Age-related threats to 

sight, including age-related macular degeneration, glaucoma, cataracts and diabetic retinopathy are expected to nearly double by the 

year 2030 with the aging of the baby-boomer generation. Recognizing this emerging public health threat, the Committee is aware 

of the demonstrated success of vision screening programs in preventing blindness and vision impairments among many of the more 

than 30 million adults that suffer from eye-related disorders. 

The Committee is encouraged by the CDC’s exploration of strategies to implement a national initiative to combat the effects of eyerelated disorders, especially glaucoma. The Committee has included 

sufficient resources to maintain at least the fiscal year 2005 level 

for vision screening and education programs in partnership with 

national voluntary health agencies and for CDC to continue to develop a national surveillance system to monitor trends over time 

and assess the economic costs of vision loss especially related to 

glaucoma. In addition, the Committee has again included sufficient 

resources to maintain at least the fiscal year 2005 level of funding 

for a model project that is testing and evaluating the efficacy of 

glaucoma screening using mobile units. 

Heart Disease and Stroke.—The Committee understands that 

CDC is establishing a Heart Disease and Stroke Division to consolidate and elevate its efforts to prevent and control heart disease, 

stroke and other cardiovascular diseases. The Committee supports 

the goal of establishing a Heart Disease and Stroke Prevention program in each State. The Committee encourages CDC to maintain 

support for these activities in fiscal year 2006 within the funds provided. 

Inflammatory Bowel Disease.—The Committee understands that 

an estimated 1 million people in the United States may suffer from 

Crohn’s disease or ulcerative colitis, collectively known as inflammatory bowel disease [IBD]. 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 
68 

and Colitis Foundation of America. The Committee encourages the 

CDC to continue this important initiative and has provided sufficient resources to do so. 

Interstitial Cystitis.—The Committee is pleased by the establishment of a cooperative agreement between the CDC and the Interstitial Cystitis Association and has included funds to continue the 

public and professional education initiative regarding interstitial 

cystitis. 

Lung Disease.—The Committee encourages the CDC to consider 

supporting efforts to validate the importance of spirometry 

screenings in early detection of lung disease. Such efforts include 

further research and development of projects to facilitate the translation of new scientific knowledge into spirometry public health 

screening programs. The Committee urges the CDC to coordinate 

with the National Heart, Lung and Blood Institute in translating 

the results of these efforts into guidance for public health programs, including vital signs and screening programs. 

Lupus.—The Committee recognizes that lupus is a serious, complex, debilitating chronic autoimmune disease that can cause inflammation and tissue damage to virtually any organ system in the 

body and impacts between 1.5 and 2 million individuals. The Committee is concerned by the lack of reliable epidemiological data on 

the incidence and prevalence of all forms of lupus among various 

ethnic and racial groups. The Committee encourages CDC to consider modifying the National Lupus Patient Registry to create a 

common data entry and management system across all study sites, 

to collaborate with a consortium of academic health centers with an 

expertise in lupus epidemiology, and to ensure that study sites represent different geographic regions of the United States that have 

a sufficient number of individuals of all racial and ethnic backgrounds disproportionately affected by Lupus, including Hispanics, 

Asians, Native Americans, and African Americans. 

Mind-Body Research.—The Committee continues to support 

mind-body research and has provided sufficient funding to continue 

these efforts in the same form and at the same level as in fiscal 

year 2005. 

National Information Center on Vision Loss.—The Committee encourages CDC to create a National Information Center on Vision 

Loss to address the need for access to appropriate public health information to improve the well being and prevent further disability 

and disease among persons who are blind or visually impaired. The 

Committee encourages CDC to partner with a national nonprofit 

organization that has regional offices throughout the United States 

and is recognized for its dedication and leadership in providing information to persons who are blind. 

Nutrition, Physical Activity and Obesity.—Obesity is rampant in 

the United States. Between 1980 and 1994, the prevalence of obesity in the United States has increased by 100 percent in children 

and adolescents. More than 20 percent of the adult population is 

30 pounds or more overweight and 10 to 15 percent of children and 

adolescents are overweight. Risk factors associated with obesity— 

physical inactivity and unhealthy eating—account for at least 

300,000 preventable deaths each year and increase the risk for 

many chronic diseases like diabetes, heart disease and cancer. The 
69 

Committee is aware that the CDC’s own statistics show that Native Americans, including Native Alaskans and Native Hawaiians 

suffer higher rates of obesity than other Americans. The Committee has included sufficient resources to provide the same level 

of support provided in fiscal year 2005 for Nutrition, Physical Activity, and Obesity related activities. 

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 where 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 encourages CDC to design and develop mechanisms for fasttracked translation of research into reasoned guidance for the 

American public. 

To prevent unhealthy weight gain and maintain healthy weight 

among children and adolescents, CDC is encouraged to work with 

the U.S. Department of Education to issue a report with recommendations about reintroducing physical education into the 

school day. 

Oral Health.—The Committee recognizes that to effectively reduce disparities in oral disease will require improvements at the 

State and local levels. The Committee has provided additional 

funding to States to strengthen their capacities to assess the prevalence of oral diseases, to target interventions, such as additional 

water fluoridation and school-linked sealant programs, and resources to the underserved, and to evaluate changes in policies, 

programs and disease burden. The Committee encourages the CDC 

to advance efforts to reduce the disparities and health burden from 

oral cancers that are closely linked to chronic diseases such as diabetes and heart disease. 

The Committee is concerned about the rising obesity rate among 

American’s youth. Some eating habits can adversely affect not only 

body weight but also oral health. The Committee has provided 

$50,000 above the fiscal year 2005 level for the CDC Division of 

Oral Health to develop an instructional video for school age children on the harmful effects of excessive consumption of soft drinks. 

The Committee understands that the dental community has already developed some instructional materials and urges CDC to 

work with the American Dental Association in producing the video. 

Osteoporosis and Bone Health Action Plan.—The Committee is 

aware of the Surgeon General’s report on Bone Health and 

Osteoporosis. The Surgeon General calls for a national action plan 

for bone health. The Committee encourages CDC to collaborate 

with a leading national voluntary health organization focused on 

osteoporosis and bone health to confer with other relevant Federal 

agencies and public and private stakeholders to develop a National 

Action Plan on Bone Health and Osteoporosis. 
70 

Prevention Centers.—The Committee encourages the continued 

support of center activities aimed at improving knowledge about 

the effective models for health promotion programs for persons 

with disabilities. 

The Committee continues to support within the prevention center 

program a Tobacco Prevention Research Network to increase the 

knowledge base on the most effective strategies for preventing and 

reducing youth tobacco use, as well as on the social, physiological, 

and cultural reasons for tobacco use among children. 

Primary Immunodeficiency Diseases.—Congress has made funds 

available for CDC to support the national physician education and 

public awareness campaign developed by the Jeffrey Modell Foundation. The Foundation program has generated more than 

$35,000,000 in donated media coverage, resulted in substantial increases in the number of diagnosed patients, and is a model of public-private cooperation. The campaign has featured public service 

announcements, physician symposia, publications, and the development of website and educational materials, as well as mailings to 

physicians, school nurses, daycare centers, and others. The campaign was expanded to reach the underserved African-American 

population in fiscal year 2005, and the Committee has provided 

$84,000 above the fiscal year 2005 level to further expand the program to Hispanic communities in fiscal year 2006. 

Prostatitis.—The Committee understands that up to 10 percent of 

the male population worldwide may benefit from better methods to 

diagnose and prevent prostatitis. The Committee encourages CDC 

to consider expanding its investigation of the etiology of prostatitis. 

Psoriasis.—The Committee urges CDC to consider working with 

a national organization to develop a surveillance program to ascertain and monitor psoriasis and psoriatic arthritis prevalence and 

comorbidities. 

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. PH causes deadly deterioration of the heart and lungs and is 

a secondary condition in many other serious disorders such as 

scleroderma and lupus. Because early detection of PH is critical to 

a patient’s survival and quality of life, the Committee encourages 

CDC to consider supporting a cooperative agreement with the pulmonary hypertension community to foster greater awareness of the 

disease. 

Reorganization.—The Committee understands that the CDC is 

considering the reorganization of programs under the Coordinating 

Center on Health Promotion, particularly programs under the National Center on Chronic Disease Prevention and Health Promotion. The Committee encourages the Director to work closely 

with external partners to adopt changes that will streamline administrative functions, improve and strengthen collaboration 

among programs, and increase public awareness of these serious 

illnesses. 

REACH Initiative.—The Committee recognizes the strengths that 

national/multi-geographical minority organizations may be able to 

provide to the REACH Initiative. Such organizations could have 

the capacity to influence communities through pre-existing coali-
71 

tions and collaborative relationships. Such organizations may also 

be able to provide key support to local organizations that may lack 

the infrastructure needed to fully implement the 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. 

Sleep Disorders.—The Committee continues to be concerned 

about the prevalence of sleep disorders and recognizes the need for 

enhanced public and professional awareness on sleep and sleep disorders. The Committee encourages CDC to consider working with 

other agencies and voluntary health organizations to support the 

development of a sleep education and public awareness initiative. 

Steps to a Healthier United States.—The Committee applauds the 

Department’s continued commitment to tackling the problems of 

obesity, diabetes, and asthma. The Committee agrees that these 

are three of the most critical chronic conditions afflicting Americans. The Committee is concerned that existing programs that address these problems have not yet been implemented in all of the 

States. The Committee has provided sufficient resources to continue this initiative and existing programs within CDC that are 

aimed at obesity, diabetes, and asthma. The Committee strongly 

urges CDC to coordinate the efforts of these programs such that 

the best possible outcome is achieved using these funds. 

Thrombosis.—The Committee understands that thrombosis is a 

serious public health problem and that there is a great need to increase public awareness of thrombosis and thrombophilia among 

the public and the medical community. Information on the basic 

epidemiology of thrombosis and thrombophilia remains to be collected. The Committee encourages CDC to expand its efforts by 

partnering with a volunteer health organization to expand its outreach and education programs regarding thrombosis and 

thrombophilia. 

Tobacco Use.—The Committee recognizes the effectiveness of 

State and national counter-marketing campaigns in reducing youth 

tobacco use and the diminishing resources at the State and national levels for such efforts. The Committee has provided increased funding for tobacco activities to support counter marketing 

programs targeting areas with the highest rates of youth tobacco 

use. 

Vision Screening.—The Committee commends CDC for its partnership with a leading voluntary health association dedicated to 

fighting blindness and saving sight, improving education and early 

detection of potentially blinding eye diseases. 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 has provided sufficient resources to continue 

this partnership with the same association. 

Birth Defects, Developmental Disabilities, Disability and Health 

Within the total provided, the following amounts are provided for 

the specified activities above the comparable amount for fiscal year 
72 

2005: $200,000 to expand autism surveillance, awareness, and education activities; $75,000 to expand the National Spina Bifida Program; $73,000 to expand surveillance and epidemiological efforts of 

Duchenne and Becker muscular dystrophies; $48,000 to expand 

support for the Special Olympics Healthy Athletes Initiative and 

$500,000 to expand the activities of the Christopher and Dana 

Reeve Paralysis Resource Center; all other sub-activities are funded at the level of the administration’s request. In addition, the 

Committee has provided $936,000 over the fiscal year 2005 level 

for undesignated birth defect-related activities. 

Autism.—The Committee is aware of the progress that has been 

made with the autism programs at CDC. 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, $100,000 in new funding 

is available to fund the Center’s 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 an additional $100,000 for 

the Center to expand its work on this initiative. 

Centers for Birth Defects Research and Prevention.—The Committee encourages CDC to consider expanding the promising research being conducted by the regional Centers for Birth Defects 

Research and Prevention and maintain assistance to States to implement and expand community-based birth defects tracking systems, programs to prevent birth defects, and activities to improve 

access to health services for children with birth defects. 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. 

CHADD Resource Center.—The Committee is aware that some 

estimates indicate that as many as 7 percent of school-age children 

have Attention-Deficit/Hyperactivity-Disorder [AD/HD] and more 

than two-thirds of these children will continue to experience symptoms through adulthood. The Committee has been informed that 

only half of all children with AD/HD receive necessary treatment 

with lower diagnostic and treatment rates among girls, minorities 

and children in foster care. The Committee continues to support 

the National Resource Center on AD/HD and has provided sufficient resources to provide the same level of support as was provided in fiscal year 2005. 

Christopher and Dana Reeve Paralysis Resource Center.—The 

Committee understands the growing demand for information, resources, and public health services by individuals with paralysis. 

The Committee has included $500,000 above the fiscal year 2005 

level for the Paralysis Resource Center and the associated rehabilitation therapy program. The Committee encourages CDC to evaluate the public health effectiveness of the paralysis programs and 

explore the feasibility of health care system-wide implementation of 

new rehabilitation 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 
73 

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. The Committee expects CDC to direct an increasing amount of the funds 

available to education and awareness, patient recruitment and 

other related services. 

Craniofacial Malformation.—The Committee has continued funding for CDC’s initiatives to help families of children with 

craniofacial malformations. The Committee commends CDC for 

their work with the National Foundation for Facial Reconstruction 

and has provided funds to continue the Foundation’s efforts with 

Arkansas, Iowa, and New York and possibly other States to collect 

data on the prevalence of these malformations, the ability of families to access services, and the long-term outcomes associated with 

craniofacial malformation. Funds are also available to analyze and 

disseminate this information to families and health care professionals and to define and categorize established standards of optimal care. 

Diamond Blackfan Anemia.—The Committee has provided sufficient funds to continue CDC’s public health outreach and surveillance program for Diamond Blackfan Anemia [DBA]. These funds 

should continue to be used to (a) educate clinicians and blood disorder treatment centers about DBA and how to diagnose it and (b) 

collaborate with a Clinical Care Center, which already has significant experience in treating DBA patients, to create a critical mass 

of DBA expertise where DBA patients may be referred. 

Disabilities Prevention.—The Committee continues to strongly 

support the CDC disabilities prevention program, which provides 

support to States and academic centers to reduce the incidence and 

severity of disabilities, especially developmental and secondary disabilities. 

Down Syndrome.—The Committee understands that CDC is performing 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 expects to have preliminary results by the end of 

fiscal year 2005. A second study will document the onset and 

course of secondary and related developmental and mental disorders in individuals with Down syndrome. The Committee has 

provided sufficient resources to further develop this studies in fiscal year 2006. 

Duchenne and Becker Muscular Dystrophy.—The Committee has 

provided $6,000,000 to continue and expand surveillance, epidemiological, and education efforts for Duchenne and Becker muscular 

dystrophy. The Committee is pleased that the CDC and the Parent 

Project Muscular Dystrophy have established a coordinated education and outreach initiative and has provided sufficient resources 

to continue this initiative at least at the fiscal year 2005 level. The 

Committee requests that CDC develop and submit to the Committee a 5-year strategic plan for the Duchenne and Becker Muscular Dystrophy program by May 1, 2006. 

Fetal Alcohol Spectrum Disorders.—The Committee is concerned 

by the prevalence of Fetal Alcohol Spectrum Disorders [FASD] in 
74 

the United States and notes that drinking during pregnancy is the 

Nation’s leading known preventable cause of mental retardation 

and birth defects. FASD affects 1 in 100 live births or as many as 

40,000 infants each year, and an individual with fetal alcohol syndrome can incur a lifetime health cost of over $800,000. To publicize and promote awareness of this critical updated public health 

information, the Committee has provided sufficient resources to 

continue these activities. 

Fetal Deaths.—CDC has reported that fetal deaths at 20 weeks 

gestation or greater account for nearly as many deaths as those 

that occur to infants during the first year of life. In fiscal year 

2005, the Committee included funding to implement a demonstration project with several States to link existing birth defect surveillance systems and fetal death registries and to use that data to 

help develop strategies to reduce fetal deaths. The Committee is 

aware that the first year of the demonstration project was highly 

successful. A review of the public health burden of fetal deaths, 

identification of data gaps related to surveillance and risk factors, 

and a plan to expand broader birth defects surveillance to include 

surveillance of fetal deaths were produced. The Committee supports continued funding of the project at the same level in fiscal 

year 2006 to develop a detailed protocol for the surveillance project, 

which should include identifying possible data sources, developing 

and testing data collection instruments and standard methods for 

surveillance of fetal deaths, and pilot testing and evaluating the 

surveillance project. 

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 resources to continue these activities. 

Genomic Medicine.—The Committee is aware that steps need to 

be taken today to prepare the public health system for the coming 

widespread use of genetic technologies in healthcare. Failing to do 

so may exacerbate existing health disparities and seriously limit 

progress generated by the Human Genome Project. 

Hemophilia.—The Committee supports CDC’s continued efforts 

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 encourages 

CDC to consider enhancing its support of the network to ensure 

continued access to this comprehensive chronic care model for all 

persons with bleeding and clotting disorders. 

The Committee recognizes the important work of all voluntary 

organizations concerned with hemophilia, and encourages CDC to 

take steps to ensure that additional patient-based organizations 

can participate in its hemophilia grant program on an annual 

basis. 

Hereditary Hemorrhagic Telangiectasia.—The Committee is 

aware of interest in the establishment of a Hereditary Hemorrhagic 

Telangiectasia [HHT] National Resource Center through a partner-
75 

ship 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 appropriate consideration to supporting it within the funds provided. 

Human Genome Project.—The Committee urges 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. 

Limb Loss Information Center.—The Committee understands 

that more than 1.5 million Americans are living with limb loss due 

to diabetes, heart disease, trauma, and cancer. A key challenge facing individuals with limb loss is gaining access to necessary health 

and rehabilitative services. The Committee commends CDC for its 

collaborations with voluntary organizations, such as the Amputee 

Coalition of America, to identify strategies to remove these barriers. The Committee continues to support the CDC’s resource and 

information center, which assists 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 encourages 

CDC to continue its support of the existing Center at no less than 

the fiscal year 2005 level. 

Special Olympics Healthy Athletes Initiative.—To address the 

unmet health needs among its athletes, Special Olympics created 

the Healthy Athletes Program, which provides Special Olympics 

athletes access to an array of health assessment, education, preventive health services and supplies, and referral for follow-up care 

where needed. These services are provided to athletes without cost 

in conjunction with competitions at local, State, national, and international levels. The Committee has included $48,000 above the fiscal year 2005 level for this program. 

Spina Bifida.—The Committee recognizes that Spina Bifida is 

the leading permanently disabling birth defect in the United 

States. While Spina Bifida and related neural tube defects are 

highly preventable through proper nutrition, including appropriate 

folic acid consumption, and its secondary effects can be mitigated 

through appropriate and proactive medical care and management, 

such efforts have not been adequately supported or coordinated to 

result in significant reductions in these costly conditions. Also, 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. 

HEALTH INFORMATION AND SERVICE

The Coordinating Center for Health Information and Services includes the National Center for Health Statistics [NCHS], a new 

National Center for Health Marketing, and a new National Center 

for Public Health Informatics. 

The Committee recommends a program level of $223,799,000 for 

Health Information and Service related activities at the CDC. This 

recommendation includes $134,235,000 in transfers available under 

section 241 of the Public Health Service Act. The fiscal year 2005 

comparable program level was $228,673,000 and the administration requested $223,799,000. 
76 

Health Statistics 

CDC’s statistics give context and perspective on which we can 

base important public health decisions. By aggregating the experience of individuals, CDC gains a collective understanding of health, 

collective experience with the health care system, and our problems 

and public health challenges. NCHS data are used to create a basis 

for comparisons between population groups or geographic areas, as 

well as an understanding of how trends in health change and develop over time. 

The NCHS is the Nation’s preeminent source of health statistics 

and therefore provides the foundation for assessing National health 

trends and developing sound programs and policies to protect and 

enhance the Nation’s health. The Committee is concerned with the 

adequacy and overall coordination of the various Federal programs 

that collect, analyze, and report the health statistics necessary for 

policy development and public health interventions. During this period of rapid advance in health and welfare policy, medical practice, 

and biomedical knowledge, the Committee is committed to ensuring 

that timely and relevant health statistics are available to guide policy decisions. The Committee has provided additional funds for the 

NCHS to strengthen its data collection infrastructure. 

Eating Disorders.—The Committee is concerned about the growing incidence and health consequences of eating disorders among 

the population. The extent of the problem while estimated by several long-term outcome studies as being high remains unknown. 

The Committee urges the CDC to research the incidence and morbidity and mortality rates of eating disorders, including anorexia 

nervosa, bulimia nervosa, binge eating disorder, and eating disorders not otherwise specified across age, race, and sex. 

ENVIRONMENTAL HEALTH AND INJURY PREVENTION

The Coordinating Center for Environmental Health and Injury 

Prevention includes the National Center for Environmental Health, 

the Agency for Toxic Substances and Disease Registry, and the National Center for Injury Prevention and Control. 

The Committee recommends $288,982,000 for environmental 

health and injury prevention related activities at the CDC. The fiscal year 2005 comparable level was $285,721,000 and the administration requested $284,820,000 for fiscal year 2006. 

Environmental Health 

Within the total provided, $400,000 above the fiscal year 2005 

level is to expand the Health Tracking Network. All other activities 

are funded at the level of the administration’s request. 

Many of the public health successes that were achieved in the 

20th century can be traced to innovations in environmental health 

practices. However, emerging pathogens and environmental toxins 

continue to pose risks to our health and significant challenges to 

public health. The task of protecting people’s health from hazards 

in their environment requires a broad set of tools. First among 

these tools are surveillance and data collection to determine which 

substances in the environment are getting into people and to what 

degree. It also must be determined whether or not these substances 
77 

are harmful to humans, and at what level of exposure. Many scientists estimate that about two-thirds of all cancers result from environmental exposure, but much better data are needed to improve 

this estimate and determine which exposures cause cancer and 

other diseases. 

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 encouraged to partner with 

voluntary health organizations 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. The Committee 

continues to support the CDC environmental health laboratory’s efforts to provide exposure information about environmental chemicals. The Committee understands that for most chemicals it is currently difficult to interpret biomonitoring information in a health 

risk context. Therefore, the Committee encourages CDC to develop 

the necessary methods to better 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 continue to 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. Further development of this device will help 

ensure its application in community health settings. 

Environmental Health Laboratory.—The CDC environmental 

health laboratory performs assessments for State investigations of 

diseases (such as cancer and birth defects) and investigations of 

chemical exposures, such as dioxin, pesticides, mercury and cadmium. CDC is also working with States to improve public health 

laboratories that assess State level biomonitoring needs. CDC 

works closely with academic institutions, other Federal agencies, 

and other partners to measure human exposure to toxic substances 

and the adverse effects of that exposure. 

Health Tracking Network.—The Committee has provided 

$400,000 over the fiscal year 2005 level to continue and expand the 

development of a Health Tracking Network, which seeks to develop 

a surveillance system that can integrate environmental hazards 

data with human exposure and health effects data that have possible links to the environment. With health tracking, public health 

officials can better target preventive services, health care providers 

can offer better health care, and the public will be able to develop 
78 

a clear understanding of what is occurring in their communities 

and how overall health can be improved. 

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. The Committee has included sufficient resources to continue support of the network at no less than the fiscal year 2005 level. These funds will be used 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. 

Volcanic Emission and Asthma.—The problem of asthma in Hawaii remains a serious health threat and challenge, especially 

among the medically underserved. In particular, the problem of volcanic emissions in Hawaii contributes to this and other respiratory 

problems. The Committee encourages CDC to consider potential 

interventions that may be helpful. 

Injury Prevention and Control 

CDC is the lead Federal Agency for injury prevention and control. Programs are designed to prevent premature death and disability and reduce human suffering and medical costs caused by: 

fires and burns; poisoning; drowning; violence; lack of bicycle helmet use; lack of seatbelt and proper baby seat use; and other injuries. The national injury control program at CDC encompasses nonoccupational injury and applied research in acute care and rehabilitation of the injured. Funds are utilized for both intramural and 

extramural research as well as assisting State and local health 

agencies in implementing injury prevention programs. The Committee recognizes the vital role CDC serves as a focal point for all 

Federal injury control activities. 

Within the total provided, the Committee has provided 

$2,500,000 over the fiscal year 2005 level for Youth Violence Prevention base funding; sufficient resources to support the National 

Violent Death Reporting System at the fiscal year 2005 level; and 

undesignated funding of $780,000 to the National Center for Injury 

Prevention and Control. Sufficient funds have been included to continue or increase support for all existing Injury Control Research 

Centers. 

National Violent Death Reporting System.—The Committee is 

supportive of the National Violent Death Reporting System, which 

is a State-based system that collects data from medical examiners, 

coroners, police, crime labs, and death certificates to understand 

the circumstances surrounding violent deaths. The information can 

be used to develop, inform, and evaluate violence prevention programs. The Committee has provided sufficient resources to continue this program with at least the fiscal year 2005 level of funding. The Committee urges the CDC to continue to work with private health and education agencies as well as State agencies in the 

development and implementation of an injury reporting system. 
79 

Suicide Prevention.—The Committee is aware that suicide remains the third leading cause of death among adolescents aged 10– 

19. Research has determined that those adolescents most at risk 

often suffer from mental disorders, including depressive disorders 

and substance abuse. Other risk factors, which interact with mental disorders to increase risk for adolescent suicide, may include 

family discord, school-related problems, obesity, contact with the 

juvenile justice system and exposure to the suicide of others. The 

Committee encourages CDC to consider the extent to which mental 

health screenings incorporated into ongoing prevention efforts regarding obesity, STDs and self-injury may serve to identify youth 

at risk. The Committee requests that CDC report on its findings 

to the Committee by May 1, 2006. 

The Committee encourages CDC to consider supporting the evaluation of suicide prevention planning, programs, and communication efforts to change knowledge and attitudes and to reduce suicide and suicidal behavior. These evaluation efforts would support 

communities to identify promising and effective suicide prevention 

strategies that follow the public health model and build community 

resilience. 

Violence Against Women.—The Committee urges CDC to increase 

research on the psychological sequelae of violence against women 

and expand research on special populations and their risk for violence including adolescents, older women, ethnic minorities, women 

with disabilities, and other affected populations. 

Youth Violence.—The Committee has included $2,500,000 above 

the fiscal year 2005 level for CDC’s youth violence prevention activities. The Committee notes that the level of youth violence in cities around the Nation is troubling. The city of Philadelphia, in particular, has experienced a spike in youth violence. The Committee 

encourages CDC to use some of the increase to address the growing 

number and seriousness of violent acts committed by youth in 

urban areas such as Philadelphia. 

OCCUPATIONAL SAFETY AND HEALTH

The Committee recommends $257,121,000 for occupational safety 

and health programs. The fiscal year 2005 level was $286,041,000 

and the administration requested $285,930,000 for fiscal year 2006. 

The Committee recommendation includes $87,071,000 in transfers 

available under section 241 of the Public Health Service Act. Sufficient funds have been included to maintain staffing levels at the 

Morgantown facility. 

The CDC’s National Institute for Occupational Safety and Health 

[NIOSH] is the only Federal Agency responsible for conducting research and making recommendations for the prevention of work-related illness and injury. The NIOSH mission spans the spectrum 

of activities necessary for the prevention of work-related illness, injury, disability, and death by gathering information, conducting scientific biomedical research (both applied and basic), and translating the knowledge gained into products and services that impact 

workers in settings from corporate offices to construction sites to 

coal mines. 

The Committee recognizes NIOSH as one of the Agency’s 5 coordinating centers. Given its unique statutory requirements, this is 
80 

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 participation 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. 

In fiscal year 2005, the Committee separated actual program 

costs from the administration of those programs by reallocating all 

administrative costs (except those of NIOSH) to a new account: 

Business Services Support. This enabled CDC to more easily interpret Congress’ intent with funding increases meant for either programs or administration of those programs. In fiscal year 2006, the 

Committee recommends reallocating $34,800,000 from the NIOSH 

line item to the Business Services and Support line item. This reallocation is equal to the administrative costs associated with 

NIOSH in fiscal years 2004 and 2005 and will end the need for continued central business services assessments, except those that are 

assessed across the entire Department of Health & Human Services. A reprogramming request will be required for any additional 

CDC assessment on the NIOSH budget line. All comparisons to fiscal year 2005 levels and the budget request have been adjusted to 

reflect this reallocation. 

The Committee recognizes that NIOSH, as the only Federal 

Agency for occupational safety and health research and prevention, 

provides national and international leadership to prevent work-related illness, injury, and death by gathering information, conducting scientific research, and translating the knowledge gained 

into products and services. Examples include the recently launched 

Research to Practice [r2p] initiative, which continues to gain momentum, and the next decade of the National Occupational Research Agenda [NORA–2]. The Committee applauds the goal of r2p, 

which is to reduce or eliminate occupational disease and injury by 

helping to ensure an increased impact of NIOSH-funded research 

in the workplace. The Committee notes that NIOSH is now consulting with partners and stakeholders to plan for NORA–2, which 

will be a review of the decade for the 21 priority research areas, 

examining the state of the science, noting key changes, identifying 

NORA contributions, discussing gaps and lessons learned, and 

making recommendations for the future. 

Construction Safety and Health.—The Committee once again is 

very pleased with the progress that NIOSH has made in its program directed at occupational illnesses and injuries in the building 

and construction industry and has included funding to continue 

this important worker safety initiative. 

Education and Research Centers.—The Committee recognizes the 

important role Education and Research Centers [ERCs] play in preventive health research and the training of occupational safety and 

health professionals, and includes an increase of $500,000 for ERCs 

over the amount appropriated for ERCs in fiscal year 2005. 

Energy Employees Occupational Illnesses.—Not later than 6 

months after enactment of this Act, NIOSH should provide a report 

to the Committee which: (1) identifies the cancer types which are 

not included in the list of 22 ‘‘specified cancers’’ under the Energy 

Employees Occupational Illness Compensation Program Act (42 
81 

U.S.C. 7384 et seq.) but for which exposure to internal or external 

ionizing radiation of any type can be shown to cause or contribute 

to the development of a cancer; (2) recommend the cancer types to 

be added to the list of specified cancers for individuals covered in 

the Special Exposure Cohort, with a justification for including such 

cancers and a ranking in order of priority based on radiosensitivity; 

(3) for each Special Exposure Cohort in effect on the date of submission of this report to Congress, identify the number of cases by 

facility for which there is a Special Exposure Cohort for each cancer type listed in item (2). The Secretaries of Labor and Health and 

Human Services are encouraged to amend their respective implementing regulations to include the list of cancers covered in the 

above referenced report for purposes of defining specified cancers 

for members of special exposure cohorts. 

Farm Health and Safety.—The Committee has included funding 

to continue the farm health and safety initiative. This important 

initiative, begun in fiscal year 1990, has a primary focus of reducing the incidence of fatal and nonfatal injuries and occupational 

diseases among the millions of agricultural workers and their families in the United States. The Committee is particularly pleased 

with the research being undertaken by the Agricultural Research 

Centers. 

Miners’ Choice Health Screening Program.—The Committee is 

concerned that sufficient resources were not allocated to implement 

the Miners’ Choice Health Screening Program in fiscal year 2005. 

The Committee urges NIOSH to implement this program in fiscal 

year 2006. This program was initiated to encourage all miners to 

obtain free and confidential chest x-rays to obtain more data on the 

prevalence of Coal Workers’ Pneumonconiosis in support of development of new respirable coal dust rules. The Committee is strongly supportive of these efforts and urges NIOSH to work to improve 

this health screening program thereby helping to protect the health 

and safety our Nation’s miners. 

Mining Research Program.—The Committee has provided sufficient resources to maintain the fiscal year 2005 level of funding for 

NIOSH’s Mining Research Program. 

National Occupational Research Agenda.—The Committee recommendation includes sufficient resources to maintain funding at 

the fiscal year 2005 level for CDC’s National Occupational Research Agenda [NORA]. The Committee believes that NORA is a 

critical scientific research program that protects employees and employers from the high personal and financial costs of work site 

health and safety losses. Industries such as agriculture, construction, health care, and mining benefit from the scientific research 

supported by NORA. The program’s research agenda focuses on 

prevention of disease and injury resulting from infectious diseases, 

cancer, asthma, hearing loss, musculoskeletal disorders, traumatic 

injuries, and allergic reactions, among others. The Committee continues to strongly support NORA and encourages expansion of its 

research program to cover additional causes of work place health 

and safety problems. 

National Mesothelioma Registry.—The Committee has provided 

$1,000,000 for the establishment of a National Mesothelioma Registry to collect data regarding symptoms, pathology, evaluation, 
82 

treatment, outcomes, and quality of life and a Tissue Bank to include the pre- and post-treatment blood (serum and blood cells) 

specimens as well as tissue specimens from biopsies and surgery. 

The Committee intends that not less than $500,000 of this amount 

should be allocated for the collection and maintenance of tissue 

specimens. 

National Personal Protective Technologies Laboratory.—The Committee provides sufficient resources to maintain the fiscal year 

2005 level of funding for the NIOSH National Personal Protective 

Technologies Laboratory to expedite research and development in, 

and certification of, protective equipment, such as powered air purifying respirators, and combined self-contained breathing apparatus/ 

escape sets. 

GLOBAL HEALTH

The Committee recommends $313,227,000 for global health related activities at the CDC in fiscal year 2006. The fiscal year 2005 

comparable level was $308,863,000 and the administration requested $306,079,000 for fiscal year 2006. The Office of Global 

Health will lead and coordinate CDC’s global programs to promote 

health and prevent disease in the United States and abroad, including ensuring rapid detection and response to emerging health 

threats. Within the total provided, all of the programs, except the 

global immunization program and the global malaria program, 

have been funded at the level requested by the administration. 

Global HIV/AIDS.—CDC works with governments in 25 countries in Africa, Asia and Latin America and the Caribbean focusing 

on primary prevention of HIV/AIDS; care and treatment of tuberculosis and other opportunistic infections, palliative care and appropriate use of antiretroviral medications; and infrastructure and 

capacity development. 

The Committee notes that funding for continuation of the International Mother and Child HIV Prevention Initiative [MTCT] has 

been requested in the budget for the Department of State under 

the jurisdiction of the Foreign Operations Appropriations Subcommittee. Therefore, the Committee does not provide any funding 

for the program in the CDC, however, the Committee remains supportive of this critical program. The Committee encourages CDC to 

ensure that funds provided to the MTCT program, the CDC GAP 

initiative, and the Global Fund for HIV/AIDS, Tuberculosis, and 

Malaria are used in a coordinated and complementary fashion. 

Global Disease Detection.—The Committee commends CDC for its 

role in strengthening the capacity of the public health community, 

both at home and abroad, to respond to global threats, such as 

SARS, monkeypox, West Nile virus, pandemic flu and bioterrorism. 

CDC’s Global Disease Detection System is integral to these efforts. 

This system is designed to provide worldwide technical support to 

ensure rapid and accurate diagnoses of emerging infectious disease 

events, and to provide a secure link between clinicians and laboratories and CDC and the World Health Organization to ensure realtime reporting of emerging threats. The Global Disease Detection 

System also will support sentinel sites in key regions around the 

globe to ensure prompt disease detection and referral to a regional 

laboratory service. These capacities are critical to mitigate the con-
83 

sequences of a catastrophic public health event, whether the cause 

is an intentional act of terrorism or the natural emergence of a 

deadly infectious virus, like SARS. The Committee has provided 

$12,077,000 over the fiscal year 2005 level for these efforts. 

Global Immunization Activities.—The Committee includes 

$144,455,000 for global immunization activities, including 

$101,254,000 for polio vaccine, surveillance, and program operations for the highly successful, yet unfinished polio eradication efforts; and $43,201,000 for the purchase of measles vaccine for measles mortality reduction and regional measles elimination initiatives and to expand epidemiologic, laboratory, and programmatic/ 

operational support to WHO and its member countries. 

The increased funding levels in Global Health and decreases in 

Immunization capture the proper alignment of programmatic costs 

within CDC under the new budget structure and will be directed 

to support programmatic activities to eradicate polio and eliminate 

measles worldwide. They do not represent a decrease in support of 

the immunization program. 

The Committee appreciates CDC’s contribution to global immunization efforts to eradicate polio and eliminate measles worldwide. 

Federal dollars help leverage private dollars in both the Polio 

Eradication Campaign and the Measles Initiative, partnerships 

among international agencies, NGOs and CDC. Polio eradication is 

close to completion; however, polio is still endemic in six countries. 

Any ground lost in maintaining ‘‘immunization days,’’ surveillance 

and labs is disastrous. Immunization is respected in these developing countries to the point that they cause temporary ceasefires 

in countries at war. 

The Committee notes that the fiscal year 2006 appropriation recommended here assumes full funding of the Congressional intent 

in the fiscal year 2005 appropriation. Accordingly, funds requested 

in Immunization and Business Services support related to Global 

Immunization Activities have been provided here. 

PUBLIC HEALTH RESEARCH

Public Health Research.—The Committee has provided 

$31,000,000 in transfers available under section 241 of the Public 

Health Service Act to fund the Public Health Research program. 

The fiscal year 2005 comparable level was $31,000,000 and the administration requested $31,000,000 for this program in fiscal year 

2006. The Committee is strongly supportive of public health and 

prevention research, which bridge the gap between medical research discoveries and behaviors that people adopt by identifying 

the best strategies for detecting new diseases, assessing the health 

status of populations, motivating healthy lifestyles, communicating 

effective health promotion messages, and acquiring and disseminating information in times of crisis. 

Alternative Therapies.—As more and more Americans use alternative and complementary therapies to maintain and improve their 

health, there is a growing need for better consumer information 

about these therapies. The Committee encourages CDC to consider 

expanding their efforts in this area. Practice-based assessments 

and the identification and study of promising and heavily used 

complementary and alternative therapies and practices should be 
84 

undertaken and results published. The Committee urges CDC to 

collaborate with the National Center for Complementary and Alternative Medicine [NCCAM] to assure that its efforts complement efforts by NCCAM. 

Food Marketing.—The Committee commends the CDC for its role 

and participation in the Food Marketing and the Diets and Health 

of Children and Youth study done in partnership with the Institute 

of Medicine through the Food and Nutrition Board and the Board 

on Children, Youth, and Families. The Committee encourages CDC 

to continue its efforts to identify the causes of obesity, particularly 

the science-based effects of food marketing on the diets and health 

of children and youth in the United States. 

Poor Diet and Inactivity.—Hundreds of thousands of people die 

prematurely each year from heart attack, stroke, and diabetes, and 

scientists agree that poor diet, physical inactivity, and being obese 

puts one at greater risk for those conditions. The Committee is concerned that the recent controversy regarding the estimates of the 

number of deaths due to obesity has resulted in public confusion 

and ignores other diet and physical inactivity disease rates, related 

deaths and health care costs. 

The Committee urges the CDC to conduct a study to estimate the 

number of premature deaths, diseases, and costs due to poor diet 

and physical inactivity. The study should include diet- and inactivity-related deaths, diseases, and costs due to heart disease, cancer, stroke, diabetes, and other diseases and those due to a range 

of dietary factors. The number of diet- and inactivity-related 

deaths, diseases, and costs should be compared to other leading 

causes including tobacco, alcohol, infectious diseases, etc. 

PUBLIC HEALTH IMPROVEMENT AND LEADERSHIP

The Committee provides $269,055,000 for public health improvement and leadership activities at the CDC. The fiscal year 2005 

comparable level was $266,842,000 and the administration requested a comparable program level of $206,541,000 for fiscal year 

2006. 

Leadership and Management 

The Committee provides $178,672,000 for leadership and management costs at the CDC in fiscal year 2006. The fiscal year 2005 

comparable level was $178,541,000 and the administration requested a comparable level of $178,672,000 for fiscal year 2006. 

Director’s Discretionary Fund.—The Committee has provided 

$10,000,000 for a Director’s Discretionary Fund. This fund will 

allow the Director to quickly respond to emerging public health 

issues and threats not contemplated at the time of enactment of 

the appropriations. 

Epidemic Services and Response.—CDC’s epidemic services and 

response program provides resources and scientific expertise for operating and evaluating surveillance systems; developing and refining research methods and strategies to the benefit of public health 

practice; training public health professionals who are prepared to 

respond to public health emergencies, outbreaks and other assistance requests; and communicating with multi-faceted audiences accurate public health information and effective messages. The Com-
85 

mittee recognizes that CDC maintains a keen appreciation for the 

fact that local outbreaks of illness can develop rapidly into 

epidemics, that previously unidentified health problems can appear 

at any time, that contaminated food or defective products may appear in the community without warning, and that the threat of bioterrorism is present in many areas of the world. When CDC participates in an investigation, all of the resources of the Agency are 

at the disposal of the affected area, including its state-of-the-art 

laboratories. 

Leadership and Management Savings.—The Committee strongly 

believes that as large a portion as possible of CDC funding should 

go to programs and initiatives that improve the health and safety 

of Americans. To facilitate this goal, any savings in leadership and 

management may be reallocated to the Director’s Discretionary 

Fund upon notification of the Committee. 

PREVENTATIVE HEALTH AND HEALTH SERVICES BLOCK GRANT

The Committee has provided $100,000,000 for the Preventative 

Health & Health Services Block grant. The fiscal year 2005 comparable level was $118,526,000 and the administration requested 

no funding for this program in fiscal year 2006. 

The block grant provides funding for primary prevention activities and health services that address urgent health problems in 

local communities. This flexible source of funding can be used to 

target concerns where other funds do not exist or where they are 

inadequate to address the extent of the health problem. The grants 

are made to the 50 States, the District of Columbia, two American 

Indian tribes, and eight U.S. territories. 

BUILDINGS AND FACILITIES

The Committee has provided $225,000,000 for the planning, design, and construction of new facilities, repair and renovation of existing CDC facilities, and data security and storage. The fiscal year 

2005 comparable level was $269,708,000 and the administration requested $30,000,000 for fiscal year 2006. 

The Committee recommendation includes $200,000,000 for the 

continuation of CDC’s Buildings and Facilities Master Plan in Atlanta, Georgia and $25,000,000 to complete construction of CDC’s 

Division of Vector Borne Infectious Diseases Laboratory in Fort 

Collins, Colorado. 

The Committee has again provided bill language to allow CDC 

to enter into a single contract or related contracts for the full scope 

of development and construction of facilities and instructs CDC to 

utilize this authority, when necessary, in constructing the Atlanta 

and Fort Collins facilities. 

BUSINESS SERVICES AND SUPPORT

The Committee provides $296,119,000 for business services support functions at the CDC. The fiscal year 2005 comparable level 

was $278,838,000 and the administration requested a comparable 

level of $263,715,000 for fiscal year 2006. These funds will be used 

to support CDC-wide support functions. 
86 

The recommendation includes $34,800,000 within Business Services and Support that was provided in fiscal year 2005, and in the 

administration request, in NIOSH. The reason for this is to provide 

the NIOSH share of CDC central services and support within this 

activity and to eliminate the need for additional taps and assessments. 

The Committee strongly believes that as large a portion as possible of CDC funding should go to programs and initiatives that improve the health and safety of Americans. To facilitate this goal, 

any savings in business services support may be reallocated to the 

Director’s Discretionary Fund upon notification of the Committee. 

TERRORISM

The Committee provides $1,566,471,000 for CDC terrorism preparedness activities. The comparable fiscal year 2005 level was 

$1,622,757,000 and the administration requested $1,616,723,000 

for these activities in fiscal year 2006. Although these funds have 

been provided in the Public Health and Social Services Emergency 

Fund [PHSSEF] in past appropriations, they have always been 

managed by CDC. The Committee expects that CDC will continue 

to closely coordinate its terrorism preparedness activities with 

those of the Department and other HHS Agencies. Within the funds provided, $735,391,000 is for Upgrading State 

and Local Capacity through grants and cooperative agreements; 

$29,425,000 is for the Centers for Public Health Preparedness; 

$5,424,000 is for the Advanced Practice Centers; $26,899,000 is for 

other State and Local Capacity; $137,972,000 is for upgrading CDC 

Capacity; $10,000,000 is for anthrax vaccine studies; $79,361,000 is 

for the Biosurveillance Initiative; and $542,000,000 is for the Strategic National Stockpile. 

Blood Safety.—The Committee understands that the American 

Red Cross [ARC] supplies blood to approximately one-half the Nation’s hospitals, operates the only blood system with the capacity 

to deliver blood anywhere and anytime it is needed, and is the only 

non-governmental organization with mandated primary agency responsibilities under the National Response Plan [NRP]. Among its 

NRP obligations, the ARC serves as a support agency to HHS for 

the provision of blood and blood products. The Committee is aware 

that the ARC has initiated a Biomedical Technology Assurance Initiative to protect its capacity to manage national blood supplies 

against cyber- and bio-security threats. The Committee supports 

this effort and encourages CDC to consider providing support to the 

Initiative from within the funds made available for biosurvelliance, 

capacity enhancement and stockpile activities. 

Clinician Update Service.—The conferees are aware of the Clinician Update Service, which the CDC has begun with World Medical 

Leaders to disseminate news, information, and alerts to physicians 

who are on the front lines in the effort to recognize biological, 

chemical, and radiological events. The Committee encourages CDC 

to consider supporting the completion of Phase II of the project. 

Modified Vaccinia Ankara.—The Committee is concerned that individuals with weak immune systems, an estimated 20 percent of 

the U.S. population, cannot take the existing animal-derived and 

cell-derived smallpox vaccines currently stored in the Strategic Na-
87 

tional Stockpile for emergency purposes. Funds have already been 

appropriated under the Project Bioshield Act for the planned stockpiling of the Modified Vaccinia Ankara [MVA] Smallpox Vaccine for 

immuno-compromised Americans. The Committee supports plans to 

purchase the new vaccine. 

Pandemic Influenza.—The Committee notes that several outside 

organizations, including the Trust for America’s Health, have made 

recommendations regarding pandemic preparedness. The Committee encourages CDC to consult with outside experts in its preparations for, and response to, a potential pandemic. 

The Committee is aware that the Department is developing a 

pandemic influenza response plan. The Committee recognizes that 

local public health departments, working with their States, play essential roles in responding to influenza outbreaks, including monitoring of local vaccine availability, distribution and redistribution 

of vaccines and antiviral medications to high priority populations, 

implementation of necessary epidemic containment measures, and 

communication to the public. Therefore, Committee encourages the 

Department to assure that all aspects of Federal pandemic influenza planning are consistent with operational realities at the local 

level and will have the intended public health results when implemented locally. The Committee further urges the Department to 

assure that Federal pandemic flu planning avoid duplication and 

inconsistency with other Federal directives concerning public 

health preparedness. 

State and Local Capacity.—The Committee continues to recognize that bioterrorism events will occur at the local level and will 

require local capacity, preparedness and initial response. It is the 

Committee’s intent that significant funding for State and local public health infrastructure be used to improve local public health capacity and meet the needs determined by local public health agencies. The Committee notes that HHS’ cooperative agreement guidance now includes explicit requirements for local concurrence with 

State spending plans for public health emergency preparedness and 

urges CDC to monitor and enforce these requirements. 

The Committee also recognizes that HHS has incorporated the 

National Response Plan into the cooperative agreement guidance 

and established new CDC Preparedness Goals. The Committee 

urges the Department to assure that the performance metrics for 

the CDC Preparedness Goals, by which local health department 

preparedness will be measured, are fully consistent with all requirements in the Target Capabilities being developed under 

Homeland Security Presidential Directive 8 by the Department of 

Homeland Security. 

Funds for bioterrorism prevention and response are distributed 

through grants to 50 States and four metropolitan areas. The Committee strongly recommends that these funds be distributed based 

on a formula that includes factors for risk of a terrorist event. Risk 

is challenging to quantify, but the Committee suggests that CDC, 

in coordination with the Secretary of Health and Human Services, 

consider the following and other factors: (1) Site of headquarters or 

major offices of multinational organizations; (2) site of major financial markets; (3) site of previous incidents of international terrorism; (4) some measure of population density versus just popu-
88 

lation; (5) internationally recognized icons; (6) percent of national 

daily mass transit riders; (7) proximity to a major port, including 

major port ranked on number of cargo containers arriving at the 

port per year. 

Strategic National Stockpile.—The Committee appreciates that 

planning and exercising plans for distribution of the Strategic National Stockpile is an integral aspect of overall local bioterrorism 

preparedness. The Committee urges CDC to assure that requirements for and evaluation of State and local activities with respect 

to the stockpile, including the Cities Readiness Initiative, are fully 

integrated into and consistent with requirements of the guidance 

for overall bioterrorism preparedness. 

NIH PREAMBLE

No task before this country is more important than safeguarding 

and improving the health of all Americans. For protecting the 

public’s health, together with educating our citizenry, represent the 

mainspring of our economic and social progress. Without question, 

the Nation’s strength can be no greater than the health and vitality of its population. Beyond its human toll, needless suffering and 

death erode productivity, undermine our leadership role on the 

global stage, weaken our defenses and threaten to bankrupt Federal, State, and family budgets. 

History has shown that it is imperative to maintain our longterm commitment to medical research regardless of short-term economic conditions. Since World War II, the life span of the average 

American has risen steadily, from 65 to nearly 77 years. While no 

single entity nor action can be credited for that success, one organization has played a significant role—the National Institutes of 

Health. The Nation’s investment in NIH has yielded a myriad of 

scientific achievements that are helping to save lives, prevent illness and improve the quality of life. From drugs to control high 

blood pressure, lower cholesterol and prevent blood clots to the development of a vaccine that eliminates the leading cause of mental 

retardation in infants, NIH has played a significant role. But that 

role has broadened and taken on even greater immediacy, as NIH 

has taken the lead in protecting our Nation against bioterrorism 

and other public health emergencies including anthrax, plague, tularemia and West Nile virus. With these and other threats looming, 

now is not the time for retrenchment; rather, it is the time to exploit fully any opportunity that could lead to improved health. 

The Committee also encourages new initiatives to reshape the 

conduct of research such as the ‘‘NIH Roadmap for Medical Research,’’ an approach that would bring together multiple institutes 

and scientific disciplines to tackle a handful of public health concerns. Similarly, the Committee strongly urges NIH to focus greater effort and resources on transforming basic science discoveries 

into preventive measures, improved diagnostics, drugs and treatments. The backbone of clinical research in this country, the Nation’s academic health centers, should be nurtured and new, innovative ways should be found to re-energize this enterprise. 

To these ends, the Committee recommends $29,414,515,000 for 

the NIH. This amount is $1,050,000,000 above the fiscal year 2005 

appropriation and $904,731,000 over the budget request. 
89 

Biomedical Research and Development Price Index.—The Committee is once again disappointed that the budget request would require NIH to break its funding commitments to existing grantees. 

Forcing grantees to reduce the scope of research that is already underway would establish an unfortunate precedent and could erode 

confidence in NIH. As a result, this reduction would have caused 

a disproportionate impact on more junior researchers and trainees, 

who need continued encouragement to pursue careers in research. 

Therefore, the Committee has included sufficient funding to enable 

NIH to fully pay the committed levels on its grants. The Committee 

is also disappointed that the budget request’s proposed average 

cost assumptions would keep NIH from purchasing the same 

amount of research as in fiscal year 2005 with its new research 

project grants [RPGs], when biomedical inflation, as measured by 

the Department of Commerce’s Biomedical Research and Development Price Index [BRDPI], is taken into account. The funding level 

recommended by the Committee will permit the average cost of 

new and competing RPGs to rise by the BRDPI inflator, or 3.2 percent, instead of being held flat, as proposed in the budget request. 

Human Embryonic Stem Cell Research.—The Committee continues to be concerned that the current administration policy relating to human embryonic stem cell research is so narrow that it is 

stifling the pace of stem cell research. The Committee strongly believes that embryonic stem cell research holds enormous potential 

for the treatment of cardiovascular disease, Parkinson’s, spinal 

cord injury and a vast array of other diseases and injuries. After 

convening 16 in-depth hearings on the subject, the Committee believes that with the proper safeguards in place, this field of investigation ought to be widened. While it originally appeared that 78 

embryonic stem cell lines would be available for research under the 

Federal policy, now, nearly 4 years after the President’s announcement on August 9, 2001, only 22 lines are available to researchers. 

Moreover, scientists have told the Committee that all available 

stem cell lines were grown with mouse feeder cells, making their 

therapeutic use for humans uncertain. The Committee strongly 

urges the administration to modify the current embryonic stem cell 

policy so that it provides this area of research the greatest opportunity to lead to the treatments and cures for which we are all hoping. 

The Committee also strongly urges that the NIH explore all avenues of stem cell research including adult stem cells and alternative methods of establishing human embryonic stem cell lines 

that do not involve the destruction of an embryo. 

The Committee is also deeply concerned with the slow pace of 

implementation of the current stem cell policy. The Committee was 

informed by NIH this year that anticipated spending on human 

embryonic stem cell research is just $24,300,000. The Committee 

strongly urges the NIH to commit a substantial amount of resources to all methods of human embryonic stem cell research. 
90 

NATIONAL CANCER INSTITUTE

Appropriations, 2005 ............................................................................. $4,825,259,000 

Budget estimate, 2006 ........................................................................... 4,841,774,000 

House allowance .................................................................................... 4,841,774,000 

Committee recommendation ................................................................. 4,960,828,000 

The Committee recommends an appropriation of $4,960,828,000 

for the National Cancer Institute [NCI]. The budget request was 

$4,841,774,000. The fiscal year 2005 appropriation was 

$4,825,259,000. The comparable amounts for the budget estimate 

include funds to be transferred from the Office of AIDS Research. 

Mission.—The NCI conducts and supports basic and applied cancer research in prevention, early detection, diagnosis, treatment, 

and rehabilitation. The Institute provides training support for research scientists, clinicians, and educators, and maintains a national network of cancer centers, clinical cooperative groups, community clinical oncology programs, cancer prevention and control 

initiatives, and outreach programs to rapidly translate basic research findings into clinical practice. 

Blood Cancers.—The Committee acknowledges some notable advances in the treatment of blood cancers, including leukemia, 

lymphoma, and multiple myeloma. These include several new 

drugs that have been approved and introduced to the market in the 

last 3 years, products of a strong public-private partnership. Despite new treatments, these cancers represent a serious health crisis. Almost 115,000 Americans will be diagnosed with these cancers 

in 2005, and nearly 55,000 will die from them. Moreover, the 5- 

year survival rates for these cancers lag behind the 64 percent 5- 

year survival rate for all cancers; the rate for multiple myeloma is 

only 32 percent, and for non-Hodgkin’s lymphoma it stands at 59 

percent. The Commmittee encourages the Institute to strengthen 

its support for translational and clinical blood cancer research. The 

blood cancers strike individuals of all ages, races, and each gender, 

and serve as valuable prototypes for the development of therapies 

for all types of malignant disorders. The Committee urges the institute to explore all mechanisms to support blood cancer research to 

improve treatment options and rapidly move discoveries from the 

laboratory bench to the patient’s bedside. 

Bone Marrow Failure Diseases.—The Committee encourages NCI 

to expand its research efforts into bone marrow failure diseases, including aplastic anemia, myelodysplastic disorders [MDS], and paroxysmal nocturnal hemoglobinuria [PNH]. Each year, between 

20,000 and 30,000 Americans are diagnosed with these diseases. In 

some cases, MDS, the most prevalent of these diseases, can 

progress over time to become acute leukemia. More research is 

critically needed to understand the causes of these diseases, develop effective treatments and cures, and prevent the progression 

of certain cases into leukemia. Furthermore, cancer patients who 

undergo chemotherapy often develop bone marrow failure diseases. 

The Committee encourages NCI to gain a better understanding of 

the link between chemotherapy and these diseases, and to explore 

the development of alternatives means of treating cancer without 

causing the subsequent development of bone marrow failure diseases. 
91 

Brain Tumors.—The Committee believes that increased attention 

should be given by NCI and NINDS to brain tumor research. The 

Committee encourages NCI to fund at least five Specialized Programs of Research Excellence in Brain Tumors [SPORE] grants in 

the upcoming fiscal year, with particular emphasis on those proposals which include both basic research and clinical treatment applications. 

Breast Cancer.—Breast cancer’s toll continues to threaten the 

lives and the quality of life of thousands of women across all walks 

of life. In addition to ongoing research activities underway at the 

National Cancer Institute, the Committee strongly urges the NCI 

to give increased attention to areas of research that focus on helping women to more fully restore and improve their quality of life 

after treatment, including further breast cancer research on 

lymphadema, stress, nutrition, exercise, weight, and the environment. 

The Committee remains concerned about missed opportunities in 

breast cancer screening, detection, prevention, control, and early diagnosis including those in mammogram detection, reading and 

analysis. The Committee strongly urges the 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. 

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. Once 

established, 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. 

Cancer Centers and Minorities.—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 provide continued support for comprehensive cancer centers at minority institutions focused on research, treatment, and prevention of cancer in African 

American, Native Hawaiian, and other minority communities. 

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; the development of novel targets 

for better prognosis; and effective therapeutic targeting. Designing 

new strategies to make the bone microenvironment hostile to invading tumor cells is of high clinical relevance. The Committee also 

urges NCI to expand research on osteosarcoma to improve survival 

and quality of life and to prevent metastatic osteosarcoma in children and teenagers who develop this cancer. 

Chronic Lymphocytic Leukemia [CLL].—This incurable disease is 

the most common form of adult leukemia in the United States. The 

Committee once again urges the NCI to increase research into 
92 

CLL, including improved therapies and their rapid movement from 

the laboratory to the bedside. The Committee strongly urges the 

NCI to give favorable consideration to continuing and expanding 

the scope of research activities funded through the CLL Research 

Consortium as it works to defeat this devastating blood disorder. 

Complementary and Alternative Cancer Therapies.—The Committee expects NCI to continue and expand its collaborative efforts 

with NCCAM to support research on promising complementary and 

alternative cancer therapies as well as on their integration with 

traditional therapies. 

DES.—The Committee continues to support increased efforts to 

study and educate the public and health professionals about the 

impact of exposure to the synthetic hormone diethylstilbestrol 

[DES]. The Committee expects NCI to continue to consult with organizations representing individuals impacted by DES as it carries 

out DES research and education efforts. 

Gynecologic Cancers.—In the last 5 years, approximately 130,000 

women in the United States have lost their lives to gynecologic cancer. The Committee commends the NCI for creating a cervical cancer and endometrial cancer SPORE, bringing the total number of 

gynecologic cancers SPORES to six, and expects that the NCI will 

expand the number of centers in the future. Unfortunately, 70 percent of ovarian cancer patients continue to be diagnosed in advanced stages when 5-year survival rates remain less then 25 percent. The Committee encourages continued research by the four 

ovarian SPORES that will lead to a better understanding of prevention and the development of a screening tool offering women 

earlier diagnosis when this cancer is more curable. The Committee 

also supports the expansion of NCI’s collaboration with the NICHD 

for faculty development of gynecologic oncologists. 

Health Cognition.—The Committee encourages NCI’s Division of 

Cancer Control and Population Sciences to continue to build innovative collaborations such as the Health Cognition Group. The activities of this group of researchers are designed to plumb knowledge from basic research on how people process and use health information and synthesize it with the development and evaluation 

of theory-based interventions to promote healthy behavior. Although these efforts are directed primarily to behaviors relevant to 

cancer, they will also serve the broader goal of developing theoretical frameworks that can be applied across a range of behavioral 

domains and conditions. 

Health Communication.—The Committee acknowledges NCI’s Division of Cancer Control and Population Sciences for developing 

HINTS, the first-ever survey to collect nationally representative information on the American public’s need for, access to, and use of 

cancer information. Such a database is useful to practicing physicians, public health departments and policymakers, among others. 

HINTS provides an invaluable snapshot of how adults use the 

many information resources around them to lead healthier lives 

and to reduce the burden of cancer in America. 

Hemophilia Cohort Study.—The Committee understands that 

NCI has made plans to discontinue research funding support of the 

Multi-Center Hemophilia Cohort Study. This cohort offers a database for improving the understanding of HCV and has served as 
93 

the basis of significant peer-reviewed findings. The Committee 

strongly urges the 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 May 

1, 2006 on possible future research opportunities using the cohort 

samples. 

Imaging Systems Technologies.—The Committee is encouraged by 

progress made by the NCI following its August 1999 conference on 

biomedical imaging, and it urges the NCI to continue to take a 

leadership role with the Centers for Medicare and Medicaid Services and the Food and Drug Administration to avoid duplicative reviews of new imaging technologies which may prevent their benefits from reaching patients on a timely basis. The Committee is 

aware of the great potential for improved patient care and disease 

management represented by molecular imaging technologies, especially positron emission tomography [PET] through its ability to 

image the biology of many kinds of cancer and other diseases. The 

Committee continues to support the NCI’s increased emphasis on 

examining the molecular basis of disease through imaging technologies such as PET and MicroPET. The Committee also continues 

to encourage the large-scale testing of women for breast cancer and 

men for prostate cancer to demonstrate and quantify the increased 

diagnostic and staging capabilities of PET relative to conventional 

diagnostic and staging technologies, including mammography. 

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 substantial 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. 

Lung Cancer.—Lung cancer remains a major public health issue 

and is the leading cause of cancer death among women and minority populations. The death rate is expected to escalate as the population ages. The Committee is encouraged by the success of new 

targeted drug therapies demonstrated in recent clinical trials in 

stage 4 patients. The Committee encourages the NCI to work with 

the thoracic surgical community to initiate new clinical trials that 

involve patients at an early stage of the disease when surgery is 

a treatment option. The trials should test the effectiveness of these 

new drugs as adjuvant therapy to improve the outcome of established thoracic surgical therapy for lung cancer. 

Lymphoma.—The Committee strongly urges that the NCI take 

bold action to address lymphoma as a public health problem and 

to capitalize on important research advances to date. While new 

treatments have become available for patients, more and improved 

treatment options are needed. The Committee strongly encourages 

the NCI to boost its investment in translational and clinical 
94 

lymphoma research. The Committee commends the NCI and the 

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 encourages the NCI to 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 also encourages 

that resources be used for research related to long-term survivors 

of both non-Hodgkin’s lymphoma and Hodgkin’s lymphoma. The 

Committee strongly supports the recommendation of the Leukemia, 

Lymphoma, and Myeloma Progress Review Group [LLM PRG] that 

resources be invested in identifying the populations of patients that 

are at high risk of adverse outcomes from their treatment for 

lymphoma. 

Mesothelioma Research.—The Committee is concerned with the 

pace of mesothelimoma research. This aggressive disease invades 

the lining of the lungs, heart, or stomach resulting in death in 4 

to 14 months. To address these concerns, the Committee strongly 

encourages the NCI to establish up to 10 mesothelioma centers, increase research, including clinical trials, detection and prevention 

methods, palliation of disease symptoms and pain management. 

The Committee requests that the NCI issue a report, by June 1, 

2006 on steps taken to address mesothelioma research. 

Multidisciplinary Research.—The NCI is commended for its innovative support of multidisciplinary training programs to enhance 

the scientific workforce. The Committee encourages NCI to explore 

new opportunities with the Office of Behavioral and Social Sciences 

Research to increase the number of scientists who can bridge the 

realms of behavioral and social science research and public health 

or biomedical research. 

Nanosystems Biology.—The Committee encourages NCI and the 

Office of the NIH Director to support a collaborative effort to bring 

nanotechnology, systems biology and molecular imaging together to 

examine the molecular basis of cancer. Initial efforts have shown 

that cancers such as breast cancer are not a single disease, but 

may encompass many different diseases, when examined at the 

molecular level. Many clinical trials of new drugs are now considered to fail if only 10 percent of patients benefit, yet the 10 percent 

may represent a specific type of the disease, where the drug may 

be 100 percent effective. Bringing these three disciplines together 

may allow researchers to identify specific sub-types of cancer and 

to better target new interventions. Successful results of such an effort could lead to a molecular classification of many types of cancer 

and to targeted molecular treatments for molecular-specific diseases. 

Native Hawaiians.—The Committee remains concerned about the 

high incidence of breast, colon, and lung cancer among the Native 

Hawaiian population. The Committee commends the NCI for its 
95 

progress toward understanding and addressing the needs of the 

Hawaiian and Pacific Basin populations through its cooperative 

agreement with Papa Ola Lokahi and looks forward to a report of 

the prioritized health needs identified by those assessments. 

Neurofibromatosis. The Committee commends NCI for conducting 

clinical trials of NF1 patients. The Committee is concerned about 

recent large drops in funding for NF research, and recognizing NF’s 

connection to many of the most common forms of human cancer, 

the Committee encourages NCI to substantially increase 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 trials 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 both extramurally and intramurally, 

and to develop new drugs for NF which could then apply to the 

general population because of NF’s connection to most 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. 

Ovarian Cancer.—Congress remains concerned that mortality 

rates associated with ovarian cancer have not seen the decreases 

that other cancer sites have experienced in the past 5 years. As the 

deadliest of all gynecologic cancers, ovarian cancer takes the lives 

of three-quarters of all women diagnosed with it within 5 years. 

Congress commends the National Cancer Institute 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 Specialized Programs of Research 

Excellence [SPOREs] program. As such, Congress strongly encourages NCI to sustain and strengthen its commitment to and investment in ovarian cancer and maintain the SPOREs initiatives directed toward ovarian cancer in fiscal year 2006. 

Pancreatic Cancer.—Pancreatic cancer is the country’s fourth 

leading cause of cancer death, killing over 32,000 individuals this 

year. Its 99 percent mortality rate is the highest of all cancers, and 

the average life expectancy after diagnosis with metastatic disease 

is just 3 to 6 months. The Committee is pleased that the NCI is 

moving forward to implement the recommendations outlined in the 

2001 report by the Pancreatic Cancer Progress Review Group 

[PRG] and that the Institute is funding three pancreatic cancer 

SPORE grants. However, the Committee is concerned that the current level of funding for pancreatic cancer research does not allow 

for the implementation of the PRG report and that only one of the 

three SPORE grants is fully funded. In addition, the Committee 

strongly urges the NCI to maintain or increase the number of pancreatic SPOREs as it undertakes a review of its translational research activities. Finally, the Committee notes that the NCI’s September 2004 report titled ‘‘Pancreatic Cancer Research’’ includes a 

single, overall budget figure for implementing the immediate and 
96 

short-term strategies of the Institute’s strategic plan to address the 

PRG’s recommendations, with no details about how the money 

would be used. Therefore, the Committee requests the NCI to develop a professional judgment budget that specifically details the 

cost of fully implementing the pancreatic cancer PRG and provide 

this professional judgment budget to the Committee by May 1, 

2006. 

Prostate Cancer.—The Committee commends the NCI for the considerable investment in prostate cancer, the leading cause of noncutaneous cancer death among men, and encourages NCI to continue to support research to improve the accuracy of screening and 

early detection of prostate cancer. 

Radio Waves.—The Committee urges the NCI to support research using radio waves that could prove promising in reducing 

cancerous tumors. While current radio frequency ablation requires 

placing electrodes directly into the tumor, this new non-invasive 

technique would target only the cancer cells while avoiding healthy 

tissue. 

Social Work.—The Committee encourages NCI to coordinate with 

the Centers for Disease Control and Prevention to conduct further 

research on the outcome of social work interventions to meet patient and family psychosocial needs in hospitals and cancer treatment centers. 

SPORE Program.—The Specialized Programs of Research Excellence [SPORE] Program at the NCI was established to support efforts to move laboratory findings into clinical practice to benefit patients in the near term. The Committee understands that the program has resulted in the translation of some exciting research into 

cancer clinical trials for vaccines, chemoprevention and dietary 

interventions. The results to date from SPORE funding include 

multi-center clinical trials, biomarker studies, prevention studies, 

genetic registries, data sharing, and tissue banking projects, all 

with critical patient focus. The Committee strongly encourages the 

NCI to continue to keep this translational goal at its forefront. The 

Committee further understands that the SPORE program has been 

extremely successful in rapidly moving science to practices that 

benefit patients; funded research that requires a team approach to 

cancer; supports collaboration across basic science, population 

science and clinical investigation; and provides a rapid translation 

from the laboratory to patient care. The Committee further urges 

that the translational research momentum, developed under the 

SPORE program, be maintained by the NCI. 

Tuberous Sclerosis Complex.—Tuberous sclerosis complex, or 

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. The Committee is encouraged that NCI is participating in a Trans-NIH Tuberous Sclerosis Coordinating Committee, and urges NCI’s continued involvement in this process. The Committee also urges NCI to collaborate 

with NIDDK on a conference on nutrient sensing and insulin-signaling in cells with inclusion of TSC research. 
97 

War on Cancer.—The Committee applauds the Director of the 

National Cancer Institute for setting a bold goal to eliminate suffering and death due to cancer by 2015. To assist Congress in establishing priorities, the Committee requests the Director to report 

to the Committee, by June 1, 2006, an outline of the progress made 

since the war on cancer was declared in 1971 and detail the specific steps that must be taken to achieve this goal by 2010. 

NATIONAL HEART, LUNG, AND BLOOD INSTITUTE

Appropriations, 2005 ............................................................................. $2,941,201,000 

Budget estimate, 2006 ........................................................................... 2,951,270,000 

House allowance .................................................................................... 2,951,270,000 

Committee recommendation ................................................................. 3,023,381,000 

The Committee recommendation includes $3,023,381,000 for the 

National Heart, Lung, and Blood Institute [NHLBI]. The fiscal year 

2005 appropriation was $2,941,201,000 and the budget request was 

$2,951,270,000. The comparable amounts for the budget estimate 

include funds to be transferred from the Office of AIDS Research. 

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, populationbased, and health education research. 

Advanced Imaging Technology for Heart Disease and Stroke.— The Committee is aware that heart perfusion PET scans using Rubidium-82 are considered the ‘‘gold standard’’ for determining the 

extent of muscle damage to the heart following a heart attack. The 

Committee encourages the NHLBI to expand its research efforts 

into the role of biological imaging and PET in delivering more accurate information to determine appropriate treatment for heart disease patients. 

Behavioral Research Grants.—For many years NIH has required 

that any proposed research project grant with a budget over 

$500,000 in direct costs be subject to additional review and scrutiny. The Committee is interested to know whether at NHLBI this 

additional layer of review may differentially impact large behavioral science research grants. The Committee requests a report 

from NHLBI of all requests to fund research grants over $500,000, 

and whether they were approved, comparing behavioral grants to 

others in the pool, during fiscal years 2000–2004. The report should 

be transmitted no later than May 1, 2006. 

Bleeding and Clotting Disorders.—The Committee commends 

NHLBI for its leadership in advancing research on bleeding and 

clotting disorders and their complications. The Committee encourages NHBLI to maintain its work in this area and applauds the Institute for its efforts, in cooperation with the National Hemophilia 

Foundation, to support research on improved and novel therapies 

for these disorders. 

Bone Marrow Failure Diseases.—The Committee encourages 

NHLBI to expand its research efforts into bone marrow failure diseases, including aplastic anemia, myelodysplastic disorders [MDS], 

and paroxysmal nocturnal hemoglobinuria [PNH]. Each year, in 

some cases, MDS, the most prevalent of these diseases, can 

progress over time to become acute leukemia. More research is 
98 

critically needed to understand the causes of these diseases, to develop effective treatments and cures, and to prevent the progression of certain cases into leukemia. 

Cardiothoracic Surgery.—The Committee recognizes the contributions of cardiothoracic surgery to the improvement in cardiac 

health in this country and looks forward to the advances that will 

come from further clinical research in the field. The Committee is 

encouraged by the steps the Institute is taking to establish a network for cardiothoracic surgical investigations, and urges rapid implementation of this plan with sufficient funding to continue the 

progress being made in the treatment of heart disease. 

Cardiovascular Diseases.—The Committee continues to strongly 

urge the Institute to place the highest priority on research for 

heart disease, stroke and other cardiovascular diseases. Therefore, 

the Committee urges the NHLBI to expand its research portfolio 

and increase its resources into the causes, cure, prevention and 

treatment of cardiovascular diseases. The Committee remains concerned that funding over the years for cardiovascular disease research has not kept pace with the scientific opportunities available, 

the number of Americans afflicted with cardiovascular diseases, or 

their economic toll. The Committee urges NHLBI to expand existing studies and to invest in promising initiatives. 

Cardiovascular Disease, Hypertension, and Kidney Disease.—The 

Committee is aware that chronic kidney dysfunction is an important risk factor for the development of cardiovascular disease. Additionally, hypertension, or high blood pressure, is the second leading cause of end-stage renal disease [ESRD], accounting for 23.6 

percent of ESRD patients. ESRD and kidney dysfunction together 

affect millions of Americans and is especially prevalent among elderly persons, African-Americans and patients with diabetes. Given 

the significant morbidity and mortality associated with cardiovascular disease among patients with kidney disease, the Committee recognizes the urgency to examine the relationship between 

cardiovascular disease and kidney disease. The Committee encourages NHBLI and NIDDK to work together to develop appropriate 

basic and clinical research initiatives addressing the pathogenesis 

of cardiovascular events in patients with kidney disease, while exploring therapeutic and preventive interventions. The Committee 

also encourages NHBLI to work with the renal community to support ongoing educational programs directed to health professionals, 

patients and the public to raise the awareness of the relationship 

between cardiovascular disease, hypertension and kidney disease. 

Cardiovascular Disease With Juvenile Diabetes.—The Committee 

commends NIDDK and NHLBI for their efforts in developing new 

opportunities for studies on the pathogenesis of cardiovascular disease complications among patients with juvenile diabetes, and to 

evaluate opportunities for intervention studies to reduce CVD complications among patients with juvenile diabetes. The Committee 

encourages the Institutes to closely monitor research progress in 

this field and to continue to promote the clinical translation of research findings into new therapies. 

Chronic Obstructive Pulmonary Disease [COPD] National Education and Prevention Program.—The Committee is pleased that 

NHLBI held a preliminary workshop to formulate strategies to-
99 

ward 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 the 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, including working with national lung organizations such 

as the American Thoracic Society and the American Lung Association to develop a national education campaign for providers and the 

public about COPD. 

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 of 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 the Institute to continue it and support 

the research projects undertaken by it. 

Diamond-Blackfan Anemia.—The Committee is pleased that 

NHLBI has awarded grants for research initiatives to investigate 

the rare bone marrow deficiency disorder, Diamond Blackfan Anemia [DBA]. The Committee understands that breakthroughs in this 

disorder may lead to important strides in research especially relating to blood cell formation (recovery from cancer chemotherapy), 

cancer predisposition, gene discovery, and the effectiveness of 

steroids and blood transfusions as treatment options for all bone 

marrow failure syndromes. The Committee commends NHLBI for 

its attention to this disorder. 

Down Syndrome.—The Committee encourages NHLBI to review 

the causes of congenital heart disease in children with Down Syndrome. Studies should also be encouraged in analyzing the increased risk of leukemia in persons with Down Syndrome. 

Duchenne Muscular Dystrophy.—The Committee is pleased that 

NLHBI has enhanced its research and related activities surrounding cardiac complications associated with DMD and urges the 

Institute to continue to expand and enhance this work going forward. The Committee urges NHLBI to become more involved with 

NIH Muscular Dystrophy activities by joining the Muscular Dystrophy Coordinating Committee. 

Heart Failure Clinical Research Network.—The Committee is 

concerned that in spite of advances in treatment, both the number 

of newly diagnosed cases and the number of Americans suffering 

from heart failure continues to grow, while the long-term prognosis 

for patients still remains poor. The Committee urges the NHLBI to 

initiate a planned research network to conduct clinical studies 

using burgeoning new approaches to improve outcomes for heart 

failure patients, and 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. 

Hemoglobinopathies.—Sickle cell anemia and thalassemia are inherited blood disorders caused by mutations in the genes for the 
100 

hemoglobin molecule, the protein in red blood cells that carries oxygen to all parts of the body. These conditions cause many problems 

including moderate to severe anemia, chronic pain, iron overload 

with its associated diabetes, liver and heart failure, enlarged 

spleen, bone weakness, pulmonary hypertension, and stroke. The 

Committee recognizes NHLBI’s continued commitment to invest in 

basic and clinical research in sickle cell anemia and thalassemia, 

and encourages NHLBI to sponsor a conference of experts to develop a report focused on the science and management issues that 

are common to these hemoglobinopathies. The Committee supports 

a cooperative effort to identify areas of scientific collaboration and 

promising new research directions in sickle cell anemia and thalassemia. 

Hemophilia.—The Committee commends the NHLBI for its leadership in advancing research on bleeding and clotting disorders and 

the complications of these disorders. The Committee encourages 

the NHBLI to maintain its work in this area and support research 

on improved and novel therapies. 

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. To advance the development of substitutes for natural blood 

vessels, the Committee urges the NHLBI to continue to invest in 

research to address this matter. 

Lung Cancer.—Chronic Obstructive Pulmonary Disease [COPD] 

is the fourth leading cause of death in the United States. Lung cancer is the leading cancer killer in both men and women and in 

2005. The Committee understands that COPD may be a predictor 

of future onset of lung cancer. With 24 million people having decreased lung function, and in the face of an ever-aging population, 

the need to develop better treatment and prevention strategies to 

address this linkage will only increase over the coming decade. The 

Committee encourages NHLBI to collaborate more extensively with 

NCI to develop appropriate research initiatives that can be undertaken cooperatively, and encourages NHLBI to sponsor a workshop 

on COPD as it relates to lung cancer with input from the lung community. 

Marfan Syndrome.—The Committee commends the NHLBI for 

its support of research on this life-threatening, degenerative genetic disorder, which is characterized by aortic aneurysms and dissections, painful orthopedic issues, pulmonary issues and ocular 

manifestations that can result in blindness. Years of basic research 

are ready to be translated into a clinical trial for a drug therapy 

that may potentially prevent aneurysm development, which may 

benefit not only the Marfan population but thousands of people 

who are afflicted with genetically triggered aneurysms and others 

with similar connective tissue disorders. The Committee urges the 

NHLBI to support this effort through all available mechanisms, as 

deemed 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, minimize brain damage and 
101 

loss of function from stroke. The Committee urges the NHLBI and 

the National Institute of Neurological Disorders and Stroke to initiate a planned 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. 

Primary Immunodeficiency Diseases.—The Committee understands that NHLBI has begun to work with the Jeffrey Modell 

Foundation as part of its national physician education and public 

awareness campaign for primary immunodeficiency diseases, including co-sponsorship of physician conferences at the NIH. The Institute also has supported the Foundation’s 10 Warning Signs Poster distribution, which is widely utilized by healthcare professionals 

in the Nation and globally. 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. 

Pulmonary Fibrosis.—The Committee urges the NHLBI to increase funding for lung research, particularly in the area of pulmonary fibrosis, a disease that is terminal and for which there is 

currently no effective treatment. 

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. For fiscal 

year 2006, the Committee encourages the Institute to increase 

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. 

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 commends the NHLBI for funding 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 systemic scleroderma. The Committee also commends 

NHLBI for its increasing 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 for 

the continued development of safe, effective treatments where few 

exist for some and none for others and to identify the causes of the 

complications of scleroderma that include pulmonary fibrosis, pulmonary hypertension, myocardial fibrosis, cardiac arrhythmias, 

pericarditis, and Raynaud’s Phenomenon. 

Sleep Disorders.—The Committee continues to urge the National 

Center on Sleep Disorders Research to partner with other Federal 

agencies, such as the Centers for Disease Control and Prevention, 

as well as voluntary health organizations, such as the National 

Sleep Foundation, to develop a sleep education and public aware-
102 

ness initiative to serve as an ongoing, inclusive mechanism for public and professional awareness on sleep and sleep disorders. 

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 the NHLBI to initiate a planned new 

SCCOR program to conduct interdependent clinical and multidisciplinary basic research projects on the molecular and cellular mechanisms of vascular injury, repair, and remodeling. This program 

would promote patient-oriented research to improve prevention, detection, and treatment of vascular diseases, such as heart attack 

and stroke. The SCCOR would provide resources to enable new 

clinical investigators to develop skills and research capabilities to 

conduct relevant research in this area. 

Thrombosis and Thrombophilia.—The Committee is very concerned about the basic science of thrombosis and thrombophilia, 

major causes of death and disability in this country. The Committee strongly urges the Institute to expand its support for basic 

research into their underlying causes in order to improve diagnosis 

and treatment for these conditions. The Committee also strongly 

urges the Institute to support this research and urges collaboration 

with the thrombophilia centers funded by CDC. 

Vascular Biology.—The Committee is very supportive of the Institute’s research initiatives and encourages NHLBI to continue to 

advance the field of vascular biology, the study of blood and blood 

vessels and their interactions. Vascular biology research provides 

the foundation for understanding the underlying causes of atherosclerosis, angiogenesis, inflammation, and thrombosis. Venous and 

arterial thrombosis, blood clots that can lead to heart attacks, 

strokes, or respiratory dysfunction, are a particularly important 

and understudied area of vascular biology. Much remains to be 

learned about the basic mechanisms of pathologic thrombosis, but 

research has determined that age is one of the most important risk 

factors. The Committee encourages NHLBI, in collaboration with 

NIA, to develop a research agenda on thrombosis and its impact on 

the elderly, to improve the diagnosis and treatment of this potentially fatal complication of many diseases. 

NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH

Appropriations, 2005 ............................................................................. $391,829,000 

Budget estimate, 2006 ........................................................................... 393,269,000 

House allowance .................................................................................... 393,269,000 

Committee recommendation ................................................................. 405,269,000 

The Committee recommendation includes $405,269,000 for the 

National Institute of Dental and Craniofacial Research [NIDCR]. 

The fiscal year 2005 appropriation was $391,829,000 and the budget requested $393,269,000. The comparable amounts for the budget 

estimate include funds to be transferred from the Office of AIDS 

Research. 

Mission.—The NIDCR supports research and research training to 

improve the oral health of Americans. The Institute emphasizes 

ways to prevent disease in high-risk groups, including the elderly, 

minority populations, and individuals with medical conditions and 

medications that compromise oral health. The research agenda in-
103 

cludes studies of craniofacial genes and birth defects; bone and 

joint diseases; AIDS, other infections, and immunity; oral cancer; 

chronic pain; epidemiology; biomaterials; and diagnostic systems. 

Dental Abnormalities.—NIDCR is encouraged 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 predominantly strikes women. Scleroderma is disfiguring and life-threatening, and effective treatments are lacking. Scleroderma is often 

associated with a number of dental and craniofacial complications. 

The most major and common problems are 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 cause or causes of the serious complications of 

scleroderma. 

Temporomandibular Joint Disorders [TMJ].—The Committee 

agrees with and is encouraged by recent public statements by NIH 

officials that because of past and current investments in research 

and patient registries, the field is now ready to support a substantial new research investment in this complex set of disorders. The 

Committee therefore strongly urges that NIDCR take its appropriate leadership role in a substantially expanded effort to complete the research needs and opportunities agenda outlined in the 

June 2005 NIH TMJ Report to Congress. As noted previously, the 

Committee expects NIDCR to continue to collaborate and coordinate with all relevant ICs. 

Because patient advocacy groups are often the best sources of information about affected populations and have established mechanisms for communicating with them, the Committee urges NIDCR 

to regularly consult with the TMJ Association and other relevant 

groups as it develops and operates its patient registry activities. In 

addition, the Committee urges NIDCR to fund an effort to categorize and analyze the symptoms of people with TMJ disorders 

that are collected in a patient advocacy group database, in an effort 

to enhance future TMJ research agendas. 

NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY

DISEASES

Appropriations, 2005 ............................................................................. $1,713,584,000 

Budget estimate, 2006 ........................................................................... 1,722,146,000 

House allowance .................................................................................... 1,722,146,000 

Committee recommendation ................................................................. 1,767,919,000 

The Committee recommends an appropriation of $1,767,919,000 

for the National Institute of Diabetes and Digestive and Kidney 

Diseases [NIDDK]. The fiscal year 2005 appropriation was 

$1,713,584,000 and the administration’s request is $1,722,146,000. 
104 

The comparable amounts for the budget estimates include funds to 

be transferred from the Office of AIDS Research. 

Mission.—The NIDDK provides leadership for a national program in three major disease categories: diabetes, endocrinology, 

and metabolic diseases; digestive diseases and nutrition; and kidney, urologic, and hematologic diseases. The NIDDK plans, conducts, fosters, and 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. 

Cooley’s Anemia.—The Committee continues to support the high 

quality research being conducted by the 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 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 the 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. 

Diamond-Blackfan Anemia.—The Committee is pleased that 

NIDDK will be hosting a workshop to understand the state of the 

science of Diamond-Blackfan Anemia [DBA] as it relates to research important to NIDDK, including red cell formation, 

ribosomal proteins, DBA animal models, gene therapy, mechanisms 

of iron overload and the development of treatment options for patients with iron overload. The Committee strongly encourages 

NIDDK to develop grant opportunities to support DBA research 

initiatives in these areas. 

Digestive Diseases.—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 suffering, mortality, and economic burden. 

The Committee commends NIDDK on the success of its Digestive 

Disease Centers program in addressing a wide range of disorders 

that result in tremendous human suffering and economic cost. The 

Committee continues to encourage NIDDK to expand this important program with an increased emphasis on irritable bowel syndrome. 

Diabetes in Native Hawaiians.—The Committee commends the 

NIDDK for its focused research on diabetes in Native American, 

Native Alaskan, and Native Hawaiian populations. The Committee 

is pleased with the innovative multicultural diabetes prevention 

campaign tailored specifically for native populations and the collaboration with CDC in the SEARCH epidemiological study. Addi-
105 

tionally, the Committee requests an update in the fiscal year 2007 

appropriations justification on recommendations resulting from the 

NIDDK and IHS conference scheduled to convene in 2005, and 

looks forward to similar conferences addressing prevention and 

treatment strategies in Native Hawaiian communities. 

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 

urges 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. The Committee notes that the recently published new USDA nutrition guidelines regarding alcohol consumption may not be appropriate for individuals with fatty liver disease, 

and therefore urges NIDDK to focus research on this matter to 

support a clarification of the USDA guidelines. 

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 urges NIDDK to expand its 

research activities on Fragile X and to coordinate these efforts with 

other Institutes working on related activities, including NIMH and 

NICHD. 

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 in January 2005, 

and urges NIDDK to issue 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. 

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 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 conference, and 

urges that this conference be convened as soon as possible. 

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 six drugs currently in early human trials. 

In addition to developing new drugs, the Committee urges NIDDK 

to encourage 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 percent treatment effectiveness 
106 

rate for hepatitis C within 10 years. The Committee encourages 

NIDDK to work with the National Hemophilia Foundation in developing and advancing research initiatives for addressing HCV 

within the bleeding disorders community. 

Hematology.—The Committee is aware of the high-quality hematology research in iron metabolism, gene regulation, and stem cell 

plasticity currently funded by the Institute. The Committee encourages NIDDK to set priorities for future research in these and new 

areas that significantly impact a broad array of blood disorders, 

such as erythroid differentiation, oxidant injury, and metabolomics. 

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 is pleased that NIDDK is contributing to the development of standardized approaches to measure 

incontinence and urges NIDDK to continue collaborating with 

NICHD on the incontinence state-of-the-science conference and on 

appropriate follow-up to this conference. 

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 increase funding for research focused on: (1) the 

cellular, molecular and genetic structure of IBD; (2) identification 

of the genes that determine susceptibility or resistance to IBD in 

various patient subgroups; and (3) translation of basic research 

findings into patient clinical trials as outlined in the research agenda developed by the scientific community titled ‘‘Challenges in Inflammatory Bowel Disease.’’ The Committee also encourages 

NIDDK to continue to strengthen its partnership with the IBD 

community and increase funding for its successful Digestive Disease Centers program with an emphasis on IBD. 

Integration of Type 1 Diabetes Research.—The Committee urges 

the NIH to facilitate the effective integration of the various research programs funded by the special funding for Type 1 Diabetes 

Research. 

Interstitial Cystitis.—The Committee notes that RFAs have been 

very helpful in stimulating scientific interest in interstitial cystitis 

[IC]. Therefore, the Committee urges the NIDDK to continue using 

this funding mechanism when investing in IC-specific basic science 

research, particularly in the area of urinary markers. The Committee also encourages the NIDDK to sponsor a scientific symposium on IC in 2006 to follow up on the very successful 2003 symposium. The Committee also urges the NIDDK to hold a separate 

meeting of leading international opinion leaders involved in IC research to seek clarity on the definition of IC. The absence of a uniform definition that accurately captures the condition and the affected population is negatively impacting patients in terms of diagnosis and treatment as well as researchers in terms of literature 

review and their research activities. The Committee was encouraged to learn that the NIDDK is launching an IC awareness campaign, and it hopes the NIDDK will continue to work closely with 
107 

the IC patient community on both developing the content and executing the campaign. 

Irritable Bowel Syndrome.—The Committee is pleased that 

NIDDK is formulating an action plan for digestive diseases and 

that irritable bowel syndrome [IBS] will be a focus area of this 

overall plan. However, given the increasing frequency of IBS and 

the Committee’s long-standing interest in this condition, the Committee strongly urges the NIDDK to complete this digestive disease 

plan as quickly as possible. 

Kidney Disease.—Kidney disease is a rapidly growing health 

problem in the United States, where an estimated 15 million people have lost 50 percent of their kidney function and another 20 

million more Americans are at increased risk of developing kidney 

disease. The marked increase in the end-stage renal disease 

[ESRD] population is fueled by the large number of patients with 

diabetes. Diabetes is the most common cause of kidney disease and 

accounts for 34 percent of patients on dialysis. Chronic kidney disease has emerged as a major contributing factor to cardiovascular 

disease. The Committee therefore encourages NIDDK to assign priority to expand the kidney disease research infrastructure through 

a robust program of kidney research core centers to promulgate collaborative research on a local, regional and national level. In addition, the Committee recommends expanded support for investigator-initiated research projects in five priority areas of greatest 

clinical importance: acute renal failure, diabetic nephropathy, hypertension, transplantation, and uremic cardiovascular toxicity. Research grant applications in these areas should be encouraged with 

appropriate program announcements and requests for proposals. 

Continued funding of grants to support development of investigator-initiated clinical and basic studies in these areas of high priority is essential. The Committee wishes to commend NIDDK for 

moving forward with the Clinical Trials Cooperative Group and 

supports collaboration with the renal community to seek new strategies and energize clinical investigation in the above mentioned 

areas. 

Liver Disease Research Action Plan.—The Committee is pleased 

to note that NIDDK, working with the leading scientific experts in 

the field, has published a comprehensive Liver Disease Research 

Action Plan to guide future research activities. The Plan is organized into 16 chapters and identifies numerous areas of research 

important to virtually every aspect of liver disease. The Committee 

urges that steps be taken to implement the plan immediately and 

submit a report to the Committee prior to next year’s hearings detailing what has been accomplished to that point, as well as future 

plans, with a specific timeline, for implementation of the balance 

of the plan. 

Mucopolysaccharidosis [MPS].—The Committee recognizes the 

efforts of the 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 broadbased 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 
108 

substrates that are stored, and potential therapeutic approaches 

continue to be of significant interest to the Committee. The Committee commends the NIDDK on its collaborations with NINDS, 

NICHD, NCRR, and ORD in advancing broad-based MPS-related 

research. 

Osteoporosis.—NIDDK is encouraged 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 critical research questions highlighted in the Surgeon 

General’s Report on Bone Health and Osteoporosis. 

Paget’s Disease.—NIDDK is urged 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. 

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 children 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 urges 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. 

Pediatric Liver Disease.—The Committee is pleased that the 

NIDDK has taken steps to increase research on biliary atresia, the 

most common cause of liver transplantation in children, by creating 

10 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. 

Polycystic Kidney Disease.—The Committee is pleased to learn of 

the first clinical drug trial for PKD in humans and the development of additional, innovative PKD therapies. This progress directly benefits more than 600,000 Americans suffering from PKD 

and could potentially save billions of Medicare and Medicaid dollars for renal replacement therapy and free up thousands of spots 

on the kidney transplant waiting list. These discoveries have produced a cohesive, interdisciplinary body of scientific work benefiting PKD research; engendered a broad range of alternative 

model research systems and reagents shared worldwide among 

PKD investigators; and drawn a host of talented investigators from 

other disciplines into the PKD field. The Committee urges NIDDK 

to pursue fulfillment of its PKD Strategic Plan by facilitating PKD 

clinical trials, expanding studies of pathophysiology and cellular 

pathobiology, expanding the PKD research infrastructure, and enhancing resources to create a supportive environment for PKD in-
109 

vestigators to develop new interventional strategies and pursue 

long-range planning. 

Primary Biliary Cirrhosis [PBC].—PBC is a rare, chronic and 

progressive liver disease that causes irreversible destruction of the 

bile ducts. The cause of PBC is still unknown, but current studies 

suggest it may involve autoimmunity, infection, or genetic predisposition, and does seem to appear more often in certain families. 

Women are affected 10 times more than men, and PBC is usually 

diagnosed in patients between the ages of 35 to 60 years. The Committee encourages NIDDK to further study this rare disease to determine among other things, why women are predominantly affected and whether there are successful treatment options other 

than liver transplantation. 

Prostatitis.—The Committee encourages the Institute to provide 

more diverse medical specialties to supplement and build upon the 

insufficient treatment options and the background of basic information now available for prostatitis. The genetic and molecular epidemiology, the management of pelvic pain, the infectious origins and 

the symptoms of prostatitis that are identical to symptoms of prostate cancer need special attention. 

The Committee applauds the work the Chronic Prostatitis Collaborative Research Network [CPCRN] has undertaken. The genetic and other possibilities linking prostate diseases is virtually 

unexplored. The Committee encourage microscopic studies of the 

prostatic fluid and tissue by infectious disease specialists, pathologists, immunologists and others. The Committee further encourages the NIDDK to increase research, public awareness, and public 

education to erase the stigma attached to this affliction that attacks young men. 

Scleroderma.—The Committee encourages the NIDDK to support 

scleroderma-relevant research. Scleroderma is a chronic and progressive disease that predominantly strikes women. It is estimated 

that 90 percent of patients with systemic sclerosis have gastrointestinal [GI] involvement and that of that number 50 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 

20 percent of those with systemic sclerosis often within the first 5 

years after diagnosis. More research is needed in order to develop 

safe and effective treatments and to identify the cause or causes of 

the complications of scleroderma. 

TEDDY.—The Committee commends the NIDDK for launching 

TEDDY, a long-term study to identify the environmental causes of 

autoimmune diabetes. The Committee urges the NIDDK to communicate details of the study to the research community, to provide 

access to study materials and data, and to develop mechanisms to 

integrate new technologies into the study design. 

TrialNet.—The Committee commends the NIDDK for its support 

of the Type 1 Diabetes TrialNet, which has launched a natural history study and a clinical intervention trial for juvenile diabetes. 

The Committee encourages the NIDDK to continue its efforts to 

translate basic and preclinical research on juvenile diabetes into a 

pipeline of new therapeutic strategies that can be evaluated 
110 

through the TrialNet clinical trials network. The Committee urges 

the NIDDK to develop biomarkers for the evaluation of efficacy and 

the efficient operation of clinical trials and to develop more efficient 

approaches to subject recruitment for clinical trials. 

Tuberous Sclerosis Complex.—Tuberous sclerosis complex, or 

TSC, is a genetic disorder that triggers uncontrollable tumor 

growth in multiple organs of the body including the kidneys, where 

patients are at risk for polycystic kidney disease, cancer or, most 

commonly, benign growths know as angiomyolipoma that can result in kidney failure. The Committee is encouraged that NIDDK 

is participating in a Trans-NIH Tuberous Sclerosis Coordinating 

Committee, and urges NIDDK’s continued involvement in this process. The Committee also urges NIDDK to collaborate with NCI on 

a conference on nutrient sensing and insulin-signaling in cells with 

inclusion of TSC research. 

NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

Appropriations, 2005 ............................................................................. $1,539,448,000 

Budget estimate, 2006 ........................................................................... 1,550,260,000 

House allowance .................................................................................... 1,550,260,000 

Committee recommendation ................................................................. 1,591,924,000 

The Committee recommends an appropriation of $1,591,924,000 

for the National Institute of Neurological Disorders and Stroke 

[NINDS]. The fiscal year 2005 appropriation was $1,539,448,000 

and the budget request is $1,550,260,000. The comparable amounts 

for the budget estimates include funds to be transferred from the 

Office of AIDS Research. 

Mission.—The NINDS conducts and supports a broad range of 

research and research training on the normal function of the brain, 

spinal cord, and peripheral nerves, and on neurological and neuromuscular disorders. Neurological research includes epidemiology 

studies to identify risk factors for disease; laboratory studies to examine the structure and function of nerve cells; and brain imaging 

studies to understand how the brain is affected by disease and how 

it operates to carry out tasks such as learning and memory. New 

approaches for the diagnosis, treatment, and prevention of brain 

disorders are evaluated in studies with patients and those at risk 

for brain disorders. 

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 

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. 

Amyotrophic Lateral Sclerosis [ALS].—The Committee is pleased 

by the increased number of NINDS research programs on ALS, including participation in the NIH partnership of 14 Institutes to accelerate neuroscience research, the NIH Blueprint for Neuroscience 
111 

Research, plus new interdisciplinary collaborations with other organizations and appropriate NIH Institutes, particularly NIEHS. The 

Committee commends NINDS on its multiple initiatives involving 

high-throughput screening and assay development to identify compounds with activity in neurodegenerative disorders, including 

ALS. The Committee is gratified by the development of 

translational research and the clinical trials programs at NINDS 

and by the public’s new opportunities to benefit from better access 

to and dissemination of information. The Committee is also pleased 

by the series of scientific workshops held since 2003 with the Department of Veterans Affairs [VA], the Department of Defense 

[DOD], and with leading scientists from academic centers throughout the Nation. The Committee encourages NINDS to continue and 

to grow its collaborative initiatives with voluntary health associations, other NIH Institutes, the DOD and the VA in the effort to 

advance ALS research and identify treatments and a cure for the 

disease. 

Ataxia Telangiectasia [A–T].—A–T is a genetic disease that attacks in early childhood. It progressively affects coordination and 

severely compromises the immune system. Children with A–T are 

highly likely to develop cancer, and rarely live beyond their teens. 

The Committee encourages the NINDS to work with the NCI and 

other appropriate Institutes to support research aimed at understanding the underlying causes of A–T, with the goal of translating 

this basic research into treatments for the disease. 

Basic Behavioral and Social Sciences Research.—The Committee 

encourages NINDS to participate in trans-institute initiatives organized by OBSSR or another institute to strengthen basic behavioral 

research and enhance opportunities for behavioral science research 

training. 

Batten Disease.—The Committee strongly urges the Institute to 

increase funding for Batten Disease research by actively soliciting 

grant applications and taking aggressive steps to assure that a vigorous research program is established. The Committee expects to 

be informed of the steps taken to increase research on Batten disease. 

Brain Tumors.—The Committee continues to believe that additional attention should be given by NINDS to identifying causes of 

and treatments for brain tumors and encourages NINDS to continue working with NCI to carry out the recommendations of the 

Report of the Brain Tumor Progress Review Group. 

Charcot-Marie-Tooth Disease.—The Committee continues to be 

concerned about NIH support for research on Charcot-Marie-Tooth 

[CMT] disease. The Committee welcomes the upcoming NINDS 

workshop on peripheral neuropathies, but remains unclear as to 

the degree this workshop will focus on CMT. The Committee urges 

the NIH to include a significant focus on CMT in the upcoming 

workshop with a goal of producing outcomes which will be directly 

relevant to CMT research and lead to a relevant program announcement or request for applications on CMT. The Committee 

encourages that relevant Institutes and Centers will participate in 

the workshop. In addition, the Committee requests NIH incorporate CMT research into its Blueprint for the Neurosciences initiative. 
112 

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. In addition, NINDS is encouraged to develop strategies to understand the 

incidence and impact on cognition of obstructive sleep apnea and 

other disorders of sleep. The NINDS is also encouraged to work 

with the NIA to develop strategies to investigate the biology of agerelated 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. 

Duchenne Muscular Dystrophy.—The Committee remains concerned with the amount of time taken by the NIH to comply with 

requirements of the MD Care Act, which became law in December 

2001. However, the Committee is pleased NIH has funded one additional Wellstone Muscular Dystrophy Cooperative Research Center and is working to fund two more for a full complement of six. 

The Committee further encourages the Institute to provide adequate funding and resources for each center. The Committee further requests that NINDS coordinate with NIAMS on timelines for 

translational research, the consensus conference and the strategic 

plan. 

Epilepsy.—The Committee seeks intensified efforts by the 

NINDS 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 March 2000 

and encourages the Institute to address important research issues 

raised at the ‘‘Living Well with Epilepsy II’’ conference held in July 

2003. The Committee encourages NINDS to continue to dedicate 

resources for carrying out its benchmark priorities, to develop 

plans and goals for the anti-epileptic drug development program, 

and to report to the Committee on its activities to further these important areas of research. 

Fragile X.—The Committee urges the 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. 

Fragile X-associated Tremor/Ataxia Syndrome [FXTAS].— 

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. 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 childbearing age the opportunity to pursue genetic counseling. NINDS, 

in collaboration with the National Institute on Aging, is urged to 

commit additional resources and expand research into FXTAS, including working with the other NIH institutes as well as the Centers for Disease Control and Prevention in the development of ge-
113 

netic counseling protocols for families affected by both Fragile X 

and FXTAS. 

Learning Disabilities.—The Committee commends NINDS for the 

work conducted to explore the neurological aspects of learning disabilities. The Committee looks forward to learning the results of 

this work and encourages the Institute to continue to coordinate 

with other Institutes working on related activities. 

Mucopolysaccharidosis [MPS].—The Committee commends 

NINDS efforts to collaborate with the Lysosomal Storage Disorder 

Research Consortium [LSDRC] in the development and release of 

the July 2004 program announcement titled ‘‘CNS Therapy Development for Lysosomal Storage Disorders’’ and the stated intent 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, including study of the blood brain barrier as an impediment to treatment, and use all available mechanisms to further stimulate and enhance efforts to better understand and treat 

MPS disorders. 

Neurofibromatosis.—The Committee encourages NINDS to aggressively expand 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 

therefore 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 calls upon NINDS to continue to coordinate its efforts with the other institutes at NIH as well as 

other government agencies. 

Neuroprosthetics.—The Committee strongly supports research on 

neuroprosthetics, such as the Brain Machine Interface (or Human 

Assisted Neurological Device) project. This research offers great 

promise in restoring movement in individuals suffering from a variety of neurological disorders, including paralysis, stroke and 

wound-related trauma, and should be expanded. 

PET Imaging and Alzheimer’s Disease.—The Committee urges 

the NINDS, in collaboration with the NIA and NIMH, to expand 

its research into early diagnosis of Alzheimer’s using PET imaging 

of the brain, and to share its results with the Centers for Medicare 

and Medicaid Services. 

Parkinson’s 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 Committee urges NINDS to continue 

support for the Udall Centers. The Committee further encourages 

the Director to create an additional Coordinating Udall Center to 

further focus and manage the interdisciplinary efforts of the Udall 

Centers. 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 set-
114 

ting. The Committee commends the NINDS for participating in a 

community-wide examination of private and public Parkinson’s disease research funding through the Parkinson’s Community Research Advisory Council. The Committee strongly encourages 

NINDS to continue to participate in this effort. The Committee 

commends the Director for implementing the Neuroscience Blueprint, which creates new opportunities for collaborative, directed 

research across institutes and through public-private partnerships. 

As the NINDS develops Blueprint initiatives for this and future 

years, the Committee encourages continued collaborations including additional intramural activities between NINDS, NIMH, and 

NIA to enhance understanding of neurodegenerative diseases, particularly Parkinson’s disease. 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 which will lead to better treatments or a cure for this devastating and costly disease. In particular, the Committee urges continued research on biomarkers, for early detection of Parkinson’s, 

and neuroprotective compounds, to slow or stop the disease until 

cures can be found. As the results of neuroprotection trials become 

known, the Committee urges the Director to provide funding for 

Phase III clinical trials of all the neuroprotection compounds found 

to be effective, including combinations of them. As Parkinson’s is 

affecting men and women at progressively younger ages, causing 

many to have to stop working within a few years of their diagnosis, 

early diagnosis and identification of neuroprotective compounds are 

critical. 

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 persons, 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 strongly urges 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. 

Picks Disease.—The Committee urges the NINDS to initiate 

funding for drug discovery efforts that focus on specific targets relevant to treating the mechanisms underlying brain degeneration 

due to frontotemporal dementia [FTD]. The Committee further encourages the NINDS to conduct multicenter treatment trials for 

symptomatic management of Pick’s disease and other FTDs. The 

Committee encourages the Institute to 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. 
115 

Rett Syndrome.—The Committee remains concerned at the level 

of funding dedicated toward research into the genetic cause of Rett 

syndrome, an incurable childhood neurological disorder that is the 

leading cause of severe neurologic impairment in females and the 

only autism spectrum disorder that is known to have a genetic 

cause. While once considered rare, increased diagnosis suggests 

that the prevalence of Rett syndrome may be much greater than 

the current estimated incidence of 1 in every 10,000 females. The 

discovery of the specific genetic cause of Rett syndrome could help 

elucidate a host of other disorders, including autism, schizophrenia, 

Parkinson’s, anxiety and autonomic nervous system disorders. Accordingly, the Committee strongly urges NIH to dedicate enhanced 

resources to research on the genetic cause of Rett syndrome. The 

Committee also encourages NIH to coordinate with private organizations supporting research initiatives in this area in order to ensure the most efficient use of resources. 

Spinal Muscular Atrophy.—The Committee understands that the 

severity of SMA, 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 strongly urges NIH/NINDS to continue to 

commit the resources to ensure a timely completion of the project 

mission—to identify and complete preclinical research and development of candidate therapeutics for treating SMA by 2007. To maximize program efficiency, it is also critical 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 encourages NINDS to aggressively expand its SMA basic, 

translational and clinical research portfolio. 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. The Committee strongly urges NINDS to successfully and 

expeditiously execute the SMA Therapeutics Development Program 

for the benefit of patients of SMA and countless other diseases. The 

Committee requests that NIH report back to the Committee, no 

later than June 1, 2006 with a progress report on all aspects of 

SMA research. 

Stroke.—The Committee continues to place a high priority on 

stroke research and strongly encourages the NINDS to increase resources for basic, clinical and translational research and related activities into stroke. The Committee remains concerned that funding 

for stroke research over the years has not kept pace with the scientific opportunities, the number of Americans afflicted with 

stroke, and the economic toll of this disease. Therefore, the Committee encourages the NINDS to aggressively expand its stroke 

education program, to implement the long-range strategic plan for 

stroke research and to continue searching for novel approaches to 

improve stroke diagnosis, treatment, rehabilitation and prevention. 

The Committee supports implementation of the Stroke Progress 

Review Group Report and expects prior to the fiscal year 2007 
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hearings a written update, including specific activities and initiatives in this regard. 

Tuberous Sclerosis Complex.—Tuberous sclerosis complex, or 

TSC, is a genetic disorder that triggers uncontrollable tumor 

growth in multiple organs of the body, including the brain, heart, 

kidneys, lungs, liver, eyes and/or skin. Individuals with TSC— 

many of whom are infants and young children—face a lifetime of 

suffering with kidney failure, seizures, behavioral disorders, autism 

and mental retardation. The Committee is encouraged that NINDS 

has organized a Trans-NIH Tuberous Sclerosis Coordinating Committee, and urges NINDS to continue to take a leadership role in 

convening meetings of this Committee, facilitating communication 

between the participating institutes, and encouraging funding of 

TSC-related research. The Committee also encourages NINDS to 

host a pre-clinical translational research workshop on TSC and to 

include TSC in the NINDS Pilot Therapeutic Network [NPTUNE]. 

Vulvodynia.—The recently published findings of NIH-supported 

research indicates that millions of women suffer from chronic pelvic 

and genitourinary pain conditions such as vulvodynia. Therefore, 

the Committee calls on NINDS to expand its support of research 

in this area, in coordination with NICHD, ORWH, the NIH Pain 

Consortium and other ICs, with a focus on etiology and multi-center therapeutic trials. 

NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES

Appropriations, 2005 ............................................................................. $4,402,840,000 

Budget estimate, 2006 ........................................................................... 4,459,395,000 

House allowance .................................................................................... 4,359,395,000 

Committee recommendation ................................................................. 4,547,136,000 

The Committee recommends an appropriation of $4,547,136,000 

for the National Institute of Allergy and Infectious Diseases 

[NIAID]. The budget request was $4,459,395,000. The fiscal year 

2005 appropriation was $4,402,840,000. Included in these funds is 

$100,000,000 to be transferred to the Global Fund to Fight HIV/ 

AIDS, Malaria, and Tuberculosis. Also included is bill language 

permitting up to $30,000,000 for extramural facilities construction 

grants. The comparable amounts for the budget estimate include 

funds to be transferred from the Office of AIDS Research. 

Mission.—The NIAID is the lead NIH Institute charged with developing vaccines and supporting research on allergies, acquired 

immunodeficiency syndrome [AIDS], sexually transmitted diseases, 

tuberculosis, tropical diseases, and other infectious diseases—including those likely to be used as agents of bioterrorism. To accomplish this mission, the NIAID supports and conducts basic and clinical research and research training programs in infectious diseases, 

whether they are naturally occurring or the result of a bioterrorist 

attack, and in diseases caused by, or associated with, disorders of 

the immune system. 

Anaphylaxis.—In recent years, the Committee has encouraged 

the NIAID to expand research in the areas of food and drug allergy. The Committee was pleased to learn of the Institute’s cosponsorship of a symposium on the definition and management of 

anaphylaxis, a particularly severe reaction often resulting from allergic responses to food or medications. A recent published report 
117 

of the meeting emphasized the need for expanded research to improve methods for diagnosing, treating, and preventing the condition. The Committee urges the NIAID to work with interested organizations to develop a comprehensive research agenda on anaphylaxis. The Committee requests a report by May 1, 2006, on how it 

plans to stimulate research in this area. 

Asthma.—The Committee is very pleased with NIAID’s leadership regarding asthma research and management. The Committee 

urges NIAID to continue to improve its focus and effort on asthma 

management, especially as it relates to children. The Committee 

also urges the 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, including agents used 

for immunization may play a role in the development of asthma. 

The Committee urges the Institute to expand research into the role 

that infections and vaccines play in the development of asthma. 

Atopic Dermatitis.—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 efforts 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 

an update in the fiscal year 2007 appropriations justification on efforts that have been made to foster investigator-initiated research 

in this area. 

Autoimmune Diseases.—The Committee applauds the formation 

of two cooperative research groups, the Autoimmune Centers of Excellence and the Cooperative Study Group for Autoimmune Disease 

Prevention, which support multidisciplinary research to understand and treat autoimmune diseases. The Committee urges NIAID 

to continue its support for the prevention centers and to encourage 

the participation of the wider research community in this initiative. 

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. 

Coinfection Research.—The Committee is concerned that there is 

growing evidence of liver toxicity of highly active antiretroviral 

therapy [HAART] in those with chronic viral hepatitis and in particular those with decompensated liver disease awaiting liver transplantation. There also appears to be an emerging problem of liver 

cancer in co-infected patients (HCV and/or HBV with HIV). The 

Committee encourages NIAID to initiate significant research initiatives in both of these areas. 

Dystonia.—The Committee continues to support the expansion of 

research and treatment developments regarding the neurological 

movement disorder dystonia, given that dystonia is the third most 
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common movement disorder after tremor and Parkinson’s disease. 

The Committee encourages NINDS to support additional research 

on both focal and generalized dystonia, and commends NINDS for 

its study of the DYT1 gene and encourages expansion in this area 

of research. The Committee is pleased with progress made in expanding the dystonia research portfolio resulting from the joint 

dystonia research program announcement [PA], and urges NINDS 

to consider options for continued progress once the program announcement expires in August 2005. 

Hemophilia.—The Committee urges NIAID to continue its efforts 

to develop and advance research initiatives for addressing 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. 

Hepatitis.—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. 

Hepatitis C 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 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 urges 

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 and for adequately 

testing vaccine candidates and antiviral drugs. 

Immune Tolerance.—The Committee is encouraged by the 

progress of the Immune Tolerance Network in launching clinical 

trials of protocols to induce immune tolerance in patients with 

Type 1 diabetes. These trials have the potential to prevent the recurrence of autoimmunity in patients with long-standing diabetes 

who have undergone islet transplantation and halt the autoimmune attack in recently diagnosed Type 1 diabetes patients. The 

Committee encourages the NIAID to continue its strong support of 

this clinical network and to expand its clinical studies promoting 

the translation of promising basic discoveries. 

Immune Surveillance Cell Proteomes.—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 their limited ability to diagnose individuals who have 

been exposed to these agents and do not show illness. Recent 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. Therefore, the Committee strongly 

supports research on immune surveillance cell proteomes (e.g. 

monocytes, neutrophils, dendritic cells, B cells and NK cells) and 

their response to chemical and biological pathogens. The Com-
119 

mittee also urges the NIAID to fund the development of a searchable electronic database for biological proteomes, the proteomics of 

immune surveillance cell interaction with pathogens (biological and 

chemical), and proteins derived from the immune surveillance cells 

themselves, as well as their interaction with pathogens. 

Inflammatory Bowel Disease.—The Committee continues to note 

with interest a scientific research agenda for Crohn’s disease and 

ulcerative colitis (collectively known as inflammatory bowel disease) titled ‘‘Challenges in Inflammatory Bowel Disease [IBD].’’ 

This report identifies strong linkages between the functions of the 

immune system and IBD. The Committee encourages the Institute 

to expand its research partnerships with the IBD community in fiscal year 2006 and increase funding for research focused on: (1) the 

immunology of IBD and (2) the interaction of genetics and environmental factors in the development of the disease. 

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 hold great promise for the most immediate results and 

the Committee encourages NIAID to pursue these lines of inquiry. 

Lupus.—The Committee recognizes that Lupus is a serious, complex, debilitating chronic autoimmune disease that causes inflammation and tissue damage to virtually any organ system in the 

body and impacts between 1.5 and 2 million individuals. The Committee strongly urges the National Institute of Allergy and Infectious Diseases to expand and intensify research and related activities with respect to Lupus. 

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 Institute has created a 

research consortium comprised of the leading experts in PI. Because of the importance of these diseases to public health and the 

impact they have on the economics of health care in this country, 

the Committee believes that it is critical that the consortium be 

managed efficiently, from both a scientific and an economic perspective. The Committee requests that NIAID report to it by May 

1, 2006 on the management of the consortium, as well as its plans 

for future research in this field. 

Psoriasis.—Psoriasis is a common, chronic, immune-mediated 

skin disease. The Committee urges NIAID to support additional research on psoriasis and psoriatic arthritis pathogenesis, research to 

develop diagnostic tests for psoriatic arthritis and clinical research 

to identify new safe and effective therapies for these diseases. 

Scleroderma.—The Committee commends the NIAID for its growing commitment to understanding the cause and to finding improved treatments for scleroderma, a chronic and progressive disease that predominantly strikes women. Scleroderma is disfiguring 
120 

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 (stem cells that are taken from the 

blood of the patient) versus high dose cytoxan for the treatment of 

progressive systemic scleroderma. The Committee encourages the 

NIAID to continue this commitment through expanded inclusion of 

scleroderma in the Autoimmune Centers of Excellence and for continued dialogue with the Institutes that are part of the Autoimmune Disease Coordinating Committee. 

Transplantation Research.—The Committee is aware that while 

1-year organ transplantation survival has improved remarkably 

over the last 15 years, there has been little success in reversing the 

decline in long-term graft and patient survival. Therefore, the Committee urges NIAID to convene an expert conference during fiscal 

year 2006, in collaboration with NIDDK and NHLBI, to develop a 

5-year Transplantation Research Action Plan identifying the most 

urgently needed research to facilitate an increase in the success of 

organ transplantation. The expert conference is also urged to focus 

on promising new technologies in pre-transplant organ care and 

post-transplant patient therapies. The Committee requests a report 

by May 1, 2006 on the results of this conference including a transNIH breakdown of resources committed to this category of research. The Committee also urges 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. 

Tuberculosis.—The World Health Organization [WHO] estimates 

that nearly one-third of the world’s population will become infected 

with tuberculosis [TB]; and by 2020, 70 million people will die 

worldwide 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 

expand efforts to develop new drugs, including multi-drug resistant 

drugs to treat TB. 

NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES

Appropriations, 2005 ............................................................................. $1,944,067,000 

Budget estimate, 2006 ........................................................................... 1,955,170,000 

House allowance .................................................................................... 1,955,170,000 

Committee recommendation ................................................................. 2,002,622,000 

The Committee recommendation includes $2,002,622,000 for the 

National Institute of General Medical Sciences [NIGMS]. The fiscal 

year 2004 appropriation was $1,955,170,000 and the administration’s request is $1,944,067,000. The comparable amounts for the 

budget estimate include funds to be transferred from the Office of 

AIDS Research. 

Mission.—NIGMS supports research and research training in the 

basic biomedical sciences. Institute grantees, working in such fields 

as cell biology, biophysics, genetics, developmental biology, pharmacology, physiology, biological chemistry, bioinformatics, and computational biology, study normal biological processes to better understand what goes wrong when disease occurs. In this way, 
121 

NIGMS supplies the new knowledge, theories, and technologies 

that can then be applied to the disease-targeted studies supported 

by other NIH components. NIGMS-supported basic research advances also regularly find applications in the biotechnology and 

pharmaceutical industries. The Institute’s training programs help 

provide the scientists needed by industry and academia to maintain United States leadership in biomedical science. 

Basic Behavioral Research.—The Committee notes the lack of a 

positive response to Congressional requests that the NIH establish 

a basic behavioral research and training program within the National Institute of General Medical Sciences as authorized within 

the statutory language establishing the Institute. The Committee 

notes that this recommendation was also made to the Director of 

NIH by a special task force created by the NIH to review this matter. The Committee believes that this research will support important advances in understanding the wide range of fundamental behavioral topics relevant to a variety of diseases and health conditions. The Committee strongly urges the NIGMS to consider establishing a basic behavioral research and training program as part of 

its portfolio, especially in the areas of learning, memory, and cognition; behavioral neuroscience; behavioral genetics; the biological 

basis of behavior; behavior change; stress; psychophysiology; social 

psychology; methodology and evaluation; and experimental psychology. 

Basic Research on Pre-disease Pathways.—The Committee is 

pleased that NIGMS, NIMH, NCI and OBSSR are collaborating to 

identify scientific opportunities and areas of basic behavioral research that should be supported by NIH. The Committee requests 

a report of the recommendations from the working group and the 

NIGMS’s plan for implementation of the recommendations by May 

1, 2006. 

Basic Behavioral Research in Roadmap.—The Committee requests that NIGMS study the feasibility of developing one or more 

funding initiatives specific to basic behavioral and social sciences 

research, which is significantly underrepresented in the New Pathways to Discovery segment. 

Minorities in Research.—The Committee commends NIGMS and 

its Division of Minority Opportunities in Research for their success 

in increasing the number and capabilities of ethnic minority students in the educational pipeline for biomedical research careers in 

psychology and other biomedical sciences and for mentoring them 

as they make the transition to graduate school. The Committee 

notes the role of behavior in racial and ethnic health disparities 

and that six of the ten leading causes of death are behaviorally 

based. The biomedical field involves a wide range of psychological 

research that addresses critical health and behavior concerns, such 

as HIV/AIDS, stress, cardiovascular disease, diabetes, cancer, substance abuse, and mental disorders, which have disproportionately 

negative effects on the health and lifespan of ethnic minorities. 

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 
122 

Committee encourages NIGMS to continue to support these important initiatives, and is particularly pleased that NIGMS has supported biomedical career opportunity programs for high school and 

undergraduate college students in conjunction with historically 

black health professions schools. The Committee urges continued, 

long-term support of this program. 

NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT

Appropriations, 2005 ............................................................................. $1,270,321,000 

Budget estimate, 2006 ........................................................................... 1,277,544,000 

House allowance .................................................................................... 1,277,544,000 

Committee recommendation ................................................................. 1,310,989,000 

The Committee recommends an appropriation of $1,310,989,000 

for the National Institute of Child Health and Human Development 

[NICHD]. The fiscal year 2005 appropriation was $1,270,321,000 

and the administration’s request is $1,277,544,000. The comparable 

amounts for the budget estimate include funds to be transferred 

from the Office of AIDS Research. 

Mission.—The NICHD is that component of the NIH responsible 

for conducting and supporting research on maternal and child 

health, the population sciences, and medical rehabilitation. Research encompassed by these areas targets infant mortality; genetic diseases, including birth defects; mental retardation; gynecological health and contraceptive development and evaluation; pediatric, maternal, and adolescent AIDS; developmental biology; vaccine development; demographic and behavioral research; and restoration or enhancement of function in individuals experiencing 

physical disability due to injury, disease, or birth defect. 

Autism.—The Committee is aware of the important research into 

the genetic basis of autism spectrum disorders and of its support 

for the Baby SIBS study on the incidence of autism among children 

in the same families. Accordingly, the Committee encourages the 

Institute to expand its support and funding for the Baby SIBS 

study, and encourages the Institute to expand its work with and 

support for similar public-private partnerships. 

Behavioral Science.—The Committee emphasizes its strong support for the broad portfolio of behavioral research at NICHD and 

supports its efforts to determine the biological, behavioral, and social factors that affect cognitive, social, and personality development of children in a variety of settings. The Committee encourages the institute to maintain its support for research and training 

in behavioral science as it engages in its priority setting process. 

Childhood Diseases on the Growing Skeleton.—NICHD is urged 

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. The Institute is encouraged to expand the Osteogenesis Imperfecta Clinic 

and osteogenesis imperfecta research, especially in genetic therapies, animal models, drug treatment and rehabilitation. To the extent feasible, NICHD is encouraged to work with NIAMS to study 

the rare disorders osteopetrosis and juvenile Paget’s disease. 

Childhood Obesity.—The Committee continues to be concerned 

about rising rates of childhood obesity and would like to see additional clinical trials that focus on the effectiveness of behavioral 
123 

interventions. The Committee recognizes the critical importance of 

prevention efforts in this area and supports continued initiatives to 

promote healthy behaviors in children and adolescents, and research to prevent health risk behaviors that contribute to this 

growing public health challenge. 

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 strongly encourages the Institute to assure adequate support for demographic 

training and for critical databases such as National Longitudinal 

Study of Adolescent Health and Fragile Families. NICHD-supported studies like these yield objective information about population trends and provide unbiased, accurate data to inform policy, 

programs, and practices to improve the health and productivity of 

the American people. 

Down Syndrome.—The Committee commends NICHD for increasing support for production of an experimental mouse model for 

Down Syndrome, the Ts65Dn mouse which allowed for the first 

time a pre-clinical model to test possible drugs or other treatments. 

The Committee encourages the NICHD 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. The Committee further encourages the Institute to 

ursue clinicl trials for Down Syndrome. 

Drug Safety for Children.—The Committee recognizes the importance of ensuring that drugs are safe and effective for use by children and are appropriately labeled for pediatric use. The Committee supports continued implementation of the Best Pharmaceuticals for Children Act of 2003, 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 fiscal year 2004, six studies were initiated and five additional studies are planned for fiscal year 2005. 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 that NIH provide an update during its annual appropriations testimony that shall include the role 

of other Federal agencies in implementing the Best Pharmaceuticals for Children Act of 2003; 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 form completed studies; the patent status of the drug studies; 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 many be considered for the priority list. 

Epilepsy.—Epilepsy often begins in childhood and can have potentially devastating effects when seizures are not controlled. This 
124 

disease has a severe impact on cognition and, even in its mildest 

forms, lifelong effects on employment and other quality of life 

measures. Recurring seizures are also a heavy burden for children 

with autism, brain tumors, cerebral palsy, mental retardation, tuberous sclerosis and a variety of genetic syndromes. The Committee 

urges the Institute to make research in epilepsy a priority, with 

particular emphasis on developmental effects, and to coordinate research efforts with the NINDS. 

Family Formation.—Families constitute the key environment for 

children’s development, and parents are crucial to children’s health 

and academic outcomes. The Committee encourages research on effective ways to promote and sustain healthy family formations, particularly for low-income families and families of color. Additional 

research is encouraged on the immediate and long-term impact of 

chronic and acute exposures to violence on child health and development. The institute is encouraged to include research related to 

family, community and cultural factors that serve as risk or protective factors and promote resilience from exposure to violence in the 

home, communities, and schools. 

Fragile X.—Title II of the Children’s Health Act of 2000 authorized the establishment of at least three Fragile X research centers. 

The Committee is pleased that the NICHD has funded three Centers, and urges the NICHD to increase the funding for existing centers of excellence by the end of fiscal year 2006, with the goal of 

enhancing the Centers and recruiting new researchers to the Fragile X field. The Committee also encourages the NICHD to coordinate its Fragile X research efforts internally, by partnering with 

others, and by relating Fragile X research with that in other developmental disorders, such as autism research. 

Genomics and Proteomics Research.—The Committee is pleased 

that NICHD has launched a major new 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. 

Human Infertility.—The Committee understands that the 

NICHD is planning to merge its National Cooperative Program for 

Infertility Research with its Specialized Cooperative Centers Program in Reproduction Research to form the Specialized Cooperative 

Centers Program in Reproduction and Infertility Research. The 

Committee understands that the merger of these center programs 

will allow a greater focus on human infertility research by permitting more efficient translation of knowledge from non-human animal models to humans. This will ensure the rapid development of 

novel approaches for the diagnosis, treatment and amelioration of 

such reproductive diseases and disorders as polycystic ovarian syndrome, endometriosis, hypogonadotropic hypogoandism and idiopathic male infertility. 

Infertility and Contraceptive Research.—The Committee notes 

that infertility is a disease which affects over 6 million people in 

the United States and is concerned that the number appears to be 
125 

growing as age, lifestyle, and environmental factors increasingly 

impact reproductive health outcomes. The Committee urges that 

additional research be undertaken to improve reproductive health 

intervention outcomes, as this research will not only increase the 

efficacy and effectiveness of reproductive health interventions but 

will significantly lower costs by reducing the number of interventions necessary to achieve a successful outcome. 

Learning Disabilities.—The Committee is pleased that NICHD 

continues to place a high priority on learning disabilities research. 

The efforts to address the special needs of children affected by a 

learning disability and improve literacy are showing promising results. The Committee encourages NICHD to continue to focus on 

reading disability and mathematics development research. Additionally, the Committee urges NICHD to lead a cooperative effort 

to collaborate on research efforts with other Institutes working on 

related activities. The Committee encourages cooperation in areas 

where work can be shared across Institutes on behalf of individuals 

with learning disabilities. 

Learning and School Readiness.—The Committee continues to 

support NICHD’s commitment to research in reading, learning disabilities and math and science cognition. The Committee is encouraged that NICHD has made progress on developing comprehensive, 

culturally neutral and developmentally appropriate assessments 

and instruments to measure cognitive, social and emotional skills 

for pre-school aged children that are necessary for school readiness. 

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 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 the NICHD 

is proceeding with a competing renewal of the MFMU’s in 2006 and 

encourages a sustained research investment in this program to facilitate resolution of these problems and promote the birth of 

healthy infants. 

National Children’s Study.—The Committee is pleased with 

NICHD efforts to launch the National Children’s Study, which 

would be the largest study of children ever undertaken in the 

United States and 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. The Committee urges that the National Children’s Study include an adequate sample of children to enable examination of the health and 

development outcomes of children conceived with the assistance of 

reproductive health technologies. 

The Committee further urges the NICHD to coordinate the involvement of the Department, the lead Federal partners—CDC, 

EPA and NIEHS—and other interested institutes, agencies and 

non-Federal partners conducting research on children’s environmental health and development, such that this study is ready for 

the field by no later than 2007. 

National Cooperative Program for Infertility Research.—The 

Committee understands that the NICHD is planning to merge its 
126 

National Cooperative Program for Infertility Research with its Specialized Cooperative Centers Program in Reproduction Research to 

form the Specialized Cooperative Centers Program in Reproduction 

and Infertility Research. The Committee understands that this 

merger will allow a greater focus on human infertility research and 

a more efficient translation of knowledge from non-human animal 

models to humans to ensure rapid development of novel approaches 

for the diagnosis, treatment and amelioration of such reproductive 

diseases and disorders as polycystic ovarian syndrome, endometriosis, hypogonadotropic, hypogoandism, and idiopathic male infertility. The Committee looks forward to hearing more about the 

progress towards this merger. 

Neurofibromatosis.—Learning disabilities occur with high frequency (30–65 percent) in children with NF and in approximately 

5 percent of the entire world’s population. 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. 

Therefore the Committee encourages NICHD to issue RFAs for NF 

research and aggressively pursue and expand funding of clinical 

trials for NF patients in the area of learning disabilities. The Committee is mindful that finding a treatment and cure for learning 

disabilities will not only benefit children, but also reduce costs of 

special education. 

Pediatric Kidney Disease.—The National Children’s Study provides a unique opportunity to identify 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 urges NICHD to support research toward understanding the physiologic mechanisms responsible for these risks 

to further prevent the development of kidney diseases and the 

antecedents of cardiovascular disease. 

Prader-Willi Syndrome.—Prader-Willi Syndrome is the most 

common known genetic cause of life threatening obesity in children. 

The Committee strongly encourages the NICHD to place a high priority on Prader-Willi Syndrome research to study childhood obesity. 

Furthermore, the NICHD is urged to incorporate Prader-Willi Syndrome into the planning process for The National Children’s Study. 

Preterm Birth.—Last year, the National Center for Health Statistics reported the first increase in the U.S. infant mortality rate 

since 1958; 61 percent of this increase is attributed to an increase 

in the birth of premature and low birth weight babies. An analysis 

of Agency for Healthcare Research and Quality data conducted by 

the March of Dimes Perinatal Data Center estimated that the total 

national hospital bill for premature babies was $15,500,000,000 in 

2002. The financial burden of prematurity is expected to continue 

to worsen until prevention of preterm births is better understood 

and clinical interventions are developed. The Committee is 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. 

Primary Immunodeficiency Diseases.—The Committee continues 

to be impressed with the dedication of financial and personnel resources by NICHD to the physician education and public awareness 

program conducted by the Jeffrey Modell Foundation to reach ear-
127 

liest diagnosis of this class of about 140 diseases. With regard to 

research on PI, the Committee is strongly encouraged by the Institute’s commitment to develop newborn screening procedures for PI, 

particularly X-linked SCID, utilizing microarray technologies. The 

Committee believes that NICHD should move ahead aggressively 

with this initiative, in partnership with the Foundation and private 

industry. 

Spinal Muscular Atrophy [SMA].—SMA is the leading genetic 

killer of infants and toddlers, and is the most prevalent genetic 

motor neuron disease. The severity of the disease, its relatively 

high incidence, and the possibility of imminent treatments have led 

NINDS to initiate the SMA Project. The Committee believes that 

the treatment of SMA, and the SMA Project at NINDS, is strategically consistent with the mission of the NICHD, with the NIH 

Roadmap initiative and its specific emphasis on cross-institute research integration. The Committee is concerned that, to date, the 

NICHD has not made any progress toward working collaboratively 

with NINDS to support and expand the SMA Project. The Committee strongly urges NICHD to do so expeditiously and to report 

back to the Committee no later than May 1, 2006. 

Vulvodynia.—The Committee commends NICHD for its commitment to chronic pain conditions including vulvodynia. This condition has profound impacts on the health and quality of life for millions of women. As a result of efforts funded by NICHD, the number of high-quality researchers interested in research on vulvodynia 

has increased. NICHD is strongly encouraged to reissue its request 

for applications in this area and to fund high-quality applications, 

with a particular emphasis on etiology and multi-center therapeutic trials. 

NATIONAL EYE INSTITUTE

Appropriations, 2005 ............................................................................. $669,070,000 

Budget estimate, 2006 ........................................................................... 673,491,000 

House allowance .................................................................................... 673,491,000 

Committee recommendation ................................................................. 693,559,000 

The Committee recommends an appropriation of $693,559,000 for 

the National Eye Institute [NEI]. The budget request was 

$673,491,000and the fiscal year 2005 appropriation was 

$$669,070,000. The comparable amounts for the budget estimate 

include funds to be transferred from the Office of AIDS Research. 

Mission.—The NEI is the Nation’s Federal resource for the conduct and support of laboratory 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. 

Basic Behavioral and Social Sciences Research.—Committee encourages NEI to participate in trans-institute initiatives organized 

by OBSSR or another institute to strengthen basic behavioral research and enhance opportunities for behavioral science research 

training. 
128 

Ocular Albinism.—The Committee recognizes recent advances in 

the treatment of ocular albinism by using gene therapy. The Committee encourages the National Eye Institute to favorably consider 

research grant proposals that seek to expand upon these important 

findings. 

NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES

Appropriations, 2005 ............................................................................. $644,505,000 

Budget estimate, 2006 ........................................................................... 647,608,000 

House allowance .................................................................................... 647,608,000 

Committee recommendation ................................................................. 667,372,000 

The Committee recommends an appropriation of $667,372,000 for 

the National Institute of Environmental Health Sciences [NIEHS]. 

The budget request was $647,608,000 and the fiscal year 2005 appropriation was $644,505,000. The comparable amounts for the 

budget estimate include funds to be transferred from the Office of 

AIDS Research. 

Mission.—The mission of the NIEHS is to define how environmental exposures affect health; how individuals differ in their susceptibility to these effects; and how these susceptibilities change 

with time. This knowledge, coupled with prevention and communication programs, can lead to a reduction in environmentally associated diseases and dysfunctions. 

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-center, 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. 

Basic Behavioral and Social Sciences Research.—The Committee 

encourages NIEHS to participate in trans-institute initiatives organized by OBSSR or another institute to strengthen basic behavioral 

or social science research, and to enhance opportunities for behavioral and social science research training. 

Breast Cancer.—The Committee believes that it is essential to 

support research on environmental factors that may be related to 

the etiology of breast cancer. The Committee recognizes the important first step the Institute has taken with its recently awarded 

grants to four research centers to begin to study the prenatal-toadult environmental exposures that may predispose a woman to 

breast cancer. However, the recent awards are only a small down 

payment in terms of dollars, process, and focus on the comprehensive and collaborative research that is needed. The need for more 

funding and a comprehensive research strategy, as outlined by the 

Breast Cancer and Environmental Research Act, is clear. The Committee understands that the Institute will establish an advisory 

board to make recommendations to the Director with regard to the 

development of the research centers. The Committee is pleased 

that the board will include representatives from the breast cancer 

community who have had the disease. The Committee asks that 

the director provide an update in the fiscal year 2007 appropriations justification on the progress of the centers. 
129 

Built Environment.—The Committee is pleased with the research 

that NIEHS is supporting on environmental factors, including built 

environment, and their relationship to the rising prevalence of obesity among youth and adults. The Committee urges NIEHS to continue work in this area, including transportation choices and their 

impact on public health outcomes. 

Environmental Health and Nursing.—The Committee is pleased 

with the coordination efforts of the NIEHS, NINR, CDC, HRSA 

and EPA to address the recommendations outlined in the 2002 

Roundtable Report and the IOM Report, ‘‘Nursing, Health and Environment.’’ The Committee encourages the establishment of a 

nursing research fellowship in environmental health issues. 

Interagency Coordinating Committee for the Validation of Alternative Methods [ICCVAM].—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 the NIEHS to 

strengthen the resources for the National Toxicology Program’s 

Interagency Center for the Evaluation of Alternative Toxicological 

Methods [NICEATM] for ICCVAM for methods validation reviews 

in fiscal year 2006. The Committee is encouraged by the National 

Toxicology Program’s [NTP] Road Map and Vision for NTP’s toxicology program in the 21st century and encourages NIEHS to move 

rapidly to implement the programs, especially those directly aimed 

at strengthening the scientific basis for many alternative methods 

(such as Quantitative Structure-Activity Relationships), mechanistic screens, high throughput assays, and toxicogenomics. 

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 concerning increasingly 

younger persons at risk. 

Pacific Center for Environmental Health.—The Committee commends the NIEHS for its prompt attention to the concerns of the 

citizens of Hawaii related to volcanic emissions, food and waterborne illnesses, fish contamination by pesticides and heavy metals, 

and pesticide residue in food and water. The Committee urges 

NIEHS to pursue an Environmental Health Sciences Center in Hawaii to research and address these environmental concerns and to 

seek workable solutions to improve the health of Pacific Islanders. 

Perchlorate.—The Committee encourages the Institute to support 

clinical, mechanistic, and epidemiological studies that focus on establishing a better understanding of the long-term health effects of 

perchlorate exposure on humans and determining with greater certainty what perchlorate exposures are safe for the most vulnerable 

populations. The Committee encourages the NIEHS to give priority 

in the following areas: (1) clinical studies on humans or primates 

designed to provide information on the effects of long-term exposures to low doses of perchlorate; (2) the design and implementa-
130 

tion of innovative epidemiological studies that assess the possible 

health effects of perchlorate exposure on the most vulnerable populations, including pregnant women and their fetuses and newborns, 

and involve appropriate control populations; and/or (3) in vitro 

studies of the perchlorate influence on placental and breast iodide 

transport using human tissues and animals studies, and the effects 

of perchlorate on development independent of effects on iodide 

transport. 

Risk Sciences.—The Committee encourages NIEHS to establish a 

competitive, peer-reviewed extramural program to conduct research 

in risk sciences, including methodologies for assessment, management, analysis, and communication of risks from exposure to environmental chemicals. 

NATIONAL INSTITUTE ON AGING

Appropriations, 2005 ............................................................................. $1,051,990,000 

Budget estimate, 2006 ........................................................................... 1,057,203,000 

House allowance .................................................................................... 1,057,203,000 

Committee recommendation ................................................................. 1,090,600,000 

The Committee recommendation includes $1,090,600,000 for the 

National Institute on Aging [NIA]. The budget request was 

$1,057,203,000 and the fiscal year 2005 appropriation was 

$1,057,203,000. The comparable amounts for the budget estimate 

include funds to be transferred from the Office of AIDS Research. 

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. Research in aging over the last two decades 

demonstrates that aging should not be equated with inevitable decline and disease. 

Age-related Bone Health.—The Committee is aware that the costs 

of age-related bone loss top $17,000,000,000 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. 

Alzheimer’s Disease.—The most common cause of dementia, Alzheimer’s disease has become one of the most serious threats to the 

Nation’s health and economic well-being. Today, an estimated 4.5 

million Americans—1 in 10 persons over age 65 and nearly half of 

those over 85—suffer from Alzheimer’s disease. That toll will rise 

to 5.1 million by 2010 and 7.7 million by 2030 unless scientists find 

ways to stop or slow the progression of the disease process. And unless answers are found soon, Alzheimer’s disease will wreak havoc, 

not only on family budgets but public funds as well. Over the next 

decade, Medicare spending on beneficiaries with Alzheimer’s will 

more than triple, to $189,000,000,000, while Medicaid spending 

over the same period will rise to $27,000,000,000. In light of these 

social and economic imperatives, the Committee was troubled to 

learn that NIA’s investment in Alzheimer research actually declined in fiscal year 2004 from the previous year. Given the enormous human and financial toll this disease is exacting on society, 

the Committee strongly urges NIH to expand its investment in Alz-
131 

heimer research toward an overall goal of $1,000,000,000. NIA 

should continue to assign the highest priority to this effort. 

Bone Marrow Failure Diseases.—Every year, between 20,000 and 

30,000 Americans are diagnosed with bone marrow failure diseases, which include aplastic anemia, myelodysplastic disorders 

[MDS], and paroxysmal nocturnal hemoglobinuria [PNH]. The 

highest incidence of these diseases occurs with people age 60 or 

older, and the number of cases of these diseases will increase each 

year as the American population continues to age. The Committee 

urges NIA to collaborate with NHLBI and NCI on research aimed 

at gaining a better understanding of the causes of these diseases 

and effective treatments and cures. 

Claude D. Pepper Older American Independence Centers.—The 

Committee continues to strongly support these successful centers, 

which focus on developing innovative and cost-effective ways to enhance the independence of older Americans, and on developing toplevel experts in geriatrics. 

Demographic and Economic Research.—The Committee commends NIA for supporting the Centers on the Demography of Aging 

program and expanding its program to include four new centers in 

2004 and for supporting the economic and demographic components 

of the Roybal Centers for Applied Gerontology program. The Committee encourages the Institute to sustain the economic viability of 

these centers programs in their quest to conduct essential economic 

and demographic population research as the United States and 

world age rapidly. The Committee encourages NIA to provide the 

scientific knowledge on population aging issues, especially by fully 

supporting the Health and Retirement Survey and National LongTerm 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. 

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. The Committee 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, the 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. 

Epilepsy.—As the population ages, the Committee is concerned 

about the rapidly growing incidence of epilepsy in senior citizens. 

Age-related epilepsy caused by stroke, cardiovascular disease, brain 

tumors and Alzheimer’s disease severely impacts the well-being, 

independence and health care needs of these vulnerable patients. 

The Committee urges the Institute to make research in epilepsy a 

priority and to coordinate research efforts with the NINDS. 

Health of Older Workers.—The Committee acknowledges NIA’s 

efforts to build a research agenda focused on maximizing older 

workers’ safety, health, productivity and life satisfaction. NIA is 
132 

encouraged to collaborate with other agencies, institutes and centers to further develop this research agenda. In particular, the 

Committee supports efforts to develop new surveys or piggyback on 

existing surveys as appropriate, to enhance the data available to 

NIA on aging workers, the designs and parameters of various jobs 

and related health information. Research should be conducted to 

assess the effectiveness, benefits, and costs of worksite health promotion programs and techniques tailored to older workers, and 

other workplace policies that may influence health and safety. 

Osteoporosis.—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 further urges 

NIA to expand research on the role of environmental and lifestyle 

factors associated with osteoporosis, Paget’s disease, and 

osteogenesis imperfecta and to work in conjunction with NIAMS on 

models for Paget’s disease. 

Parkinson’s Disease.—The Committee commends the NIA on its 

collaboration with Parkinson’s researchers at National Institute of 

Neurological Disorders and Stroke [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 

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. 

Racial and Ethnic Health Disparities in Later Life.—The Committee commends NIA’s systematic attempts to build a research 

agenda to help understand racial and ethnic health disparities in 

later life. NIA is encouraged to build on its behavioral genetics research program in order to assess genetic and environmental factors in racial and ethnic differences simultaneously, in studies that 

permit identification of main effects and of interactions. 

Social Psychology.—NIA is requested to study the feasibility of 

expanding its portfolio of basic research on social psychology, particularly basic research on stigma and race; well-being; and emotion, health and disease. 

Thrombosis.—The Committee is very pleased with the Institute’s 

plans to further research on anemia and its impact on the elderly, 

and encourages NIA to continue its collaborative research efforts 

with other Institutes on the best strategies to diagnose and treat 

elderly patients with anemia. The Committee believes that NIA collaboration could also be helpful for another area of age-related hematology research, the study of venous and arterial thrombosis, 

blood clots that can lead to heart attacks, strokes, or respiratory 

dysfunction. In light of research findings that age is one of the 

most important risk factors for thrombosis, the Committee urges 

NIA and NHLBI to collaborate on a research agenda exploring the 

underlying causes of thrombosis and its impact on the elderly. 
133 

NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN

DISEASES

Appropriations, 2005 ............................................................................. $511,157,000 

Budget estimate, 2006 ........................................................................... 513,063,000 

House allowance .................................................................................... 513,063,000 

Committee recommendation ................................................................. 525,758,000 

The Committee recommends an appropriation of $525,758,000 for 

the National Institute of Arthritis and Musculoskeletal and Skin 

Diseases [NIAMS]. The budget requested $513,063,000 and the fiscal year 2005 appropriation was $511,157,000. The comparable 

amounts for the budget estimate include funds to be transferred 

from the Office of AIDS Research. 

Mission.—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. The research agenda of NIAMS addresses many devastating and debilitating diseases that afflict millions of Americans. These diseases of the joints, muscles, bones, connective tissues, and skin, in the aggregate, will affect nearly every American 

at some point in their lives, causing tremendous human suffering 

and costing the Nation billions of dollars in both health care expenditures and lost productivity. The research activities of this Institute serve the concerns of many different special populations, including women, minorities, children, and the elderly. 

Bone Formation and Remodeling.—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 

should work with NICHD and NIDDK to expand research on the 

genetics and new treatments for the rare disorder osteopetrosis. 

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 urges NIAMS to continue to expand the research portfolio on skin disease. The Committee also encourages that NIAMS 

consider potential partnerships with the skin disease research community to address the challenges outlined by the ‘‘Burden of Skin 

Diseases’’ findings. 

Duchenne Muscular Dystrophy.—The Committee continues to be 

concerned with the amount of time taken by NIAMS to complying 

with the MD Care Act. The Committee encourages the NIAMS to 

increase research for Duchenne Muscular Dystrophy. The Committee further requests that NIAMS coordinate with NINDS on 

timelines for translational research, a consensus conference and 

the strategic plan. 

Lupus.—The Committee recognizes lupus is a serious, complex, 

debilitating chronic autoimmune disease that can cause inflammation and tissue damage to virtually any organ system in the body 

and impacts between 1.5 and 2 million individuals. This autoimmune disorder affects the skin, bones, joints, connective tissue 
134 

and vital organs. The Committee is disappointed with the pace of 

research regarding lupus and strongly urges the Director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases 

to expand and intensify research and related activities with respect 

to lupus. 

Marfan Syndrome.—The Committee commends NIAMS and its 

collaborative efforts with other Institutes to provide vital research 

on Marfan syndrome, a life-threatening, progressive and degenerative genetic disorder that is characterized by aortic aneurysms, 

painful orthopedic issues, pulmonary issues and ocular manifestations. Years of basic research are ready to be translated into a clinical trial for a drug therapy that may potentially prevent and reverse many of the life-threatening aspects of this syndrome. In addition, it may help many of the disabling characteristics not only 

of Marfan syndrome but also of other connective tissue disorders. 

The Committee urges NIAMS to support this effort through all 

available mechanisms, as deemed appropriate. 

Mucopolysaccharidosis [MPS].—The Committee encourages the 

NIAMS to work collaboratively with NIDDK in an effort to achieve 

a greater understanding of the underlying pathophysiology of bone 

and joint lesions in MPS disorders, the gene 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 the promising gene targeting stem cells research that 

represents a potential cure for osteogenesis imperfecta and encourages continued support of this research. 

Osteoporosis.—The Committee urges the study of genetics of 

osteoporosis, including studies to determine the causes of variation 

in peak bone mass and rates of bone loss and therapies to lower 

fracture risk in patients at high risk for osteoporotic fractures. 

Paget’s Disease.—The Committee urges NIAMS to study the role 

of genes and the underlying abnormal functioning of cells involved 

in bone breakdown in Paget’s disease patients. Further research is 

needed on the role the bone microenvironment plays in the development of Paget’s disease and the molecular processes involved. 

Psoriasis.—Ten to 30 percent of psoriasis patients develop psoriatic arthritis, a painful and potentially destructive joint disease. 

The Committee urges NIAMS to support additional genetic research to identify the genes responsible for psoriasis susceptibility, 

basic research to understand the mechanism of disease and clinical 

research to identify new safe and effective therapies for these 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, NIDCR, and through 

the NIH Autoimmune Coordinating Committee to generate additional research opportunities for scleroderma that may assist to 

identify genetic risk factors and the development of safe and effective treatments. 
135 

Tuberous Sclerosis Complex.—Tuberous sclerosis complex, or 

TSC, is a genetic disorder that triggers uncontrollable tumor 

growth in multiple organs of the body, including the skin. The 

Committee is encouraged that NIAMS is participating in a TransNIH Tuberous Sclerosis Coordinating Committee, and strongly encourages NIAMS to continue to assist the clinical research community in the development of standardized protocols for skin assessment and the development of pilot clinical trials. 

NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION

DISORDERS

Appropriations, 2005 ............................................................................. $394,259,000 

Budget estimate, 2006 ........................................................................... 397,432,000 

House allowance .................................................................................... 397,432,000 

Committee recommendation ................................................................. 409,432,000 

The Committee recommends an appropriation of $409,432,000 for 

the National Institute on Deafness and Other Communication Disorders [NIDCD]. The budget requested $397,432,000 and the fiscal 

year 2005 appropriation was $394,259,000. The comparable 

amounts for the budget estimate include funds to be transferred 

from the Office of AIDS Research. 

Mission.—The NIDCD funds and conducts research and research 

training in the normal and disordered processes of human communication, specifically in the areas of hearing, balance, smell, taste, 

voice, speech, and language. The Institute addresses the special 

biomedical and behavioral problems of people who have communication impairments or disorders; contributes to health promotion 

and disease prevention; and supports efforts to create devices that 

substitute for lost and impaired sensory and communication functions. 

Animal Models of Hearing Loss.—It is now clear that peripheral 

hearing loss leads to profound changes in the central nervous system, including cell death and loss of synapse function. The Committee encourages research to focus on animal models of conductive 

and sensorineural hearing loss, particularly changes in brain physiology from deafness during development. Understanding these 

mechanisms is essential to implementation of ameliorative strategies such as hearing aids and cochlear implants. 

Balance Disorders.—The Committee is aware that over 124 million Americans have experienced dizziness or a balance problem, 

and the cost of medical care for patients with balance disorders exceeds $1,400,000,000 annually. Over 50 percent of elderly patients 

interviewed at home complain of balance disorders. Despite research into the organization and function of these balance receptors 

located in the inner ear, there is a need to study the genes expressed in these tissues in order to understand why receptors commonly fail or become dysfunctional. Gene discovery techniques including cDNA libraries and microarray expression profiling are 

likely to lead to new drugs to treat or prevent vestibular disorders 

and greater understanding of how these systems work. The Institute is urged to expand its support of research in this promising 

area. 

Clinical Evaluation of Hearing Loss.—The Committee encourages 

NIDCD to partner with other Institutes at NIH to support the de-
136 

velopment of functional neuroimaging technology with more precise 

spatial and temporal resolution, as well as better molecular probes 

to monitor brain activity. 

Early Detection and Intervention.—The Committee urges the 

NIDCD to continue to use its newsletter and website to promote 

awareness among parents and clinicians that early identification 

and treatment of hearing loss are essential for normal language acquisition. Therefore, the Committee encourages expanded research 

on the early detection, diagnosis and intervention of infants with 

deafness and other communication disorders, including progressive 

hearing impairment from cytomegalovirus exposure. It is also critical to recognize that otitis media, or middle ear infection, is among 

the most frequent reasons for a sick child to visit the doctor during 

the first few years of life. The Committee recommends that the 

NIDCD continue to support research to develop novel therapeutic 

preventative strategies to lessen dependence on antibiotic therapies. 

Environmentally-induced Hearing Loss.—The Committee continues to be concerned by the number of Americans who suffer 

from chemical and noise-induced hearing loss and strongly supports the expansion of NIDCD’s Wise Ears! Campaign among 

school-age children. The Committee also supports expanded research on prosthetic and pharmacological therapies for hearing loss 

from noise stress and ototoxic drugs. 

Hearing Devices for Children.—Everything that is known about 

hearing aids and cochlear implants is based on adult needs. Hearing aids also need to be optimized for children’s needs, because 

there are so many differences between adults and children. Therefore the Committee encourages the NIDCD to support a collaborative effort of researchers to participate in a multi-center, longitudinal research project to track auditory development and speech 

perception in hearing-impaired infants. Also, the Committee encourages NIDCD to explore the feasibility of electrical stimulation 

applied to the vestibular system (analogous to the cochlear implant) to treat balance disorders. 

Hereditary Hearing Loss.—The Committee applauds the remarkable progress towards understanding the molecular basis for hereditary hearing impairment and encourages the NIDCD to continue 

to support research to identify the structure, regulation and function of genes whose mutation results in human communication disorders, including deafness. The Committee continues to encourage 

efforts to screen for the single and multi-genetic bases of hearing 

loss through contemporary techniques, including diagnostic gene 

chips. The Committee encourages the development of animal models to better assess how gene mutations result in impaired central 

auditory function. 

Inner Ear Hair Cell Regeneration.—The Committee applauds 

past support of regenerative studies, such as those in guinea pigs, 

and urges the NIDCD to continue to give a high priority to new 

and important directions in restoring hair cells of the cochlea, such 

as gene therapy, adenovirus vectors and stem cells. The Committee 

also encourages the NIDCD to request more collaborative applications among scientists working on the isolation of stem cells in the 

brain and scientists working in the inner ear hair cell field. 
137 

Language Acquisition.—The Committee encourages the NIDCD 

to explore the biological bases of infant speech perception and language acquisition. This should include studies on the impact of partial or profound hearing loss. 

Learning Disabilities.—The Committee is pleased that NIDCD 

continues to support research activities focused on speech processing and on the development of expressive and receptive language. The Committee encourages continued activity and looks forward to learning the results of this work as they hold significant 

promise for individuals with learning disabilities. The Committee 

encourages the Institute to continue to coordinate with other Institutes working on related activities. 

Neurofibromatosis.—NF2 accounts for approximately 5 percent of 

genetic forms of deafness. Unlike other genetic forms of deafness, 

NF2-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 

NF2 mice through gene therapy, with enormous implications for 

gene therapy in general and for patients suffering from 

meningiomas and other tumors in particular. The Committee 

therefore encourages NIDCD to expand its NF2 research portfolio 

through all suitable mechanisms including RFAs and clinical trials. 

Pharmaceutical Research.—Recognizing the promise of new technologies to deliver pharmaceutical agents to the inner ear, the 

Committee encourages the NIDCD to initiate molecular studies 

analyzing effectiveness of drugs, genes and gene products on cell 

death pathways and cascades, followed by trials to assess safety 

and benefits of pharmaceuticals to prevent and better treat 

sensorineural hearing loss from various causes. 

Presbycusis.—Presbycusis, the gradual loss of hearing from 

aging, is the most prevalent type of hearing loss and the third leading chronic disease (following hypertension and arthritis) in people 

over 65. It will become more common as the Nation’s population 

grows older. To improve the quality life of millions of senior citizens, the Committee encourages research into declining stria 

vascularis metabolism, an important factor, as well as continuing 

studies on the central mechanisms of presbycusis. 

Tinnitus.—Recognizing that tinnitus compromises the lives of 

tens of millions of Americans, the Committee encourages the 

NIDCD to expand its research into causal mechanisms underlying 

peripheral and central tinnitus and continue exploring potential 

treatments for this affliction. 

Translational Research.—The Committee encourages the NIDCD 

to establish a Translational Research Branch to support research 

activities aimed at accelerating the translations of new findings in 

the molecular and basic sciences into new interventions and technologies clinicians can use to treat individuals with communication 

disorders. 

NATIONAL INSTITUTE OF NURSING RESEARCH

Appropriations, 2005 ............................................................................. $138,072,000 

Budget estimate, 2006 ........................................................................... 138,729,000 

House allowance .................................................................................... 138,729,000 

Committee recommendation ................................................................. 142,549,000 
138 

The Committee recommends an appropriation of $142,549,000 for 

the National Institute of Nursing Research [NINR]. The budget request was $138,729,000 and the fiscal year 2005 appropriation was 

$138,072,000. The comparable amounts for the budget estimate include funds to be transferred from the Office of AIDS Research. 

Mission.—The National Institute of Nursing Research [NINR] 

supports clinical and basic research on biological and behavioral aspects of critical national health problems. The Institute’s programs 

have established a scientific basis for research that seeks to reduce 

the burden of acute and chronic illness and disability for individuals of all ages; improve the quality of life by preventing and delaying the onset of disease or slowing its progression; and establishing 

better approaches to promoting health and preventing disease. The 

NINR supports programs essential to improving clinical environments by testing interventions which influence patient health outcomes and reduce costs and demands for care. 

Nurse-managed Health Centers.—The Committee urges the 

NINR to increase funding for research and demonstrations projects 

involving nurse-managed health centers and advanced practice 

nurses. 

Nursing Shortage.—The nursing shortage has an adverse effect 

on the health care delivery system as well as the health of our Nation’s citizens. A shortage of nurse faculty caused schools of nursing to turn away thousands of qualified students last year. NINR 

confronts this issue by directing 8 percent of its budget to research 

training to help develop the pool of nurse researchers who also become faculty. Training support for fast-track baccalaureate-to-doctoral program participants is one important initiative. The 17 recently-funded Nursing Partnership Centers to Reduce Health Disparities is another initiative that helps produce an adequate number of nurse researchers. The Committee encourages these ongoing 

efforts. The Committee also encourages NINR to fund research 

projects located in rural areas that serve minority nursing students 

through community colleges. Not only will these partnerships between research-intensive schools of nursing and minority serving 

schools of nursing train more minority nurses, but they also expand opportunities for health disparities research. 

NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM

Appropriations, 2005 ............................................................................. $438,277,000 

Budget estimate, 2006 ........................................................................... 440,333,000 

House allowance .................................................................................... 440,333,000 

Committee recommendation ................................................................. 452,271,000 

The Committee recommends an appropriation of $452,271,000 for 

the National Institute on Alcohol Abuse and Alcoholism [NIAAA]. 

The budget request was $440,333,000 and the fiscal year 2005 appropriation was $438,277,000. The comparable amounts for the 

budget estimate include funds to be transferred from the Office of 

AIDS Research. 

Mission.—The NIAAA conducts biomedical and behavioral research for improving prevention and treatment and reducing or 

eliminating the associated health, economic, and social consequences of alcohol abuse and alcoholism. NIAAA provides leadership in the country’s effort to combat these problems by developing 
139 

new knowledge that will decrease the incidence and prevalence of 

alcohol abuse and alcoholism and associated morbidity and mortality. NIAAA addresses these questions through an integrated program of biomedical, behavioral, and epidemiologic research on alcoholism, alcohol abuse, and related problems. This broad-based program includes various areas of special emphasis such as medications development, fetal alcohol syndrome, genetics, neuroscience, 

and moderate drinking. 

Alaska Substance Abuse.—The Committee is aware of serious 

problems with alcohol and substance abuse, especially among its 

Alaska Native population, and of the need for translating research 

into clinical applications for this population. The Committee urges 

NIAAA to sponsor a Research to Practice Forum with the Substance Abuse and Mental Health Services Administration to focus 

on bridging the gap between researchers and practitioners and 

translating scientific research into clinical applications, and encourages NIAAA to support the implementation of any recommendations developed at the forum. 

Alcohol Abuse by College Students.—Colleges continue to struggle 

with the consequences of alcohol abuse by students. The Committee 

encourages NIAAA to continue its program of fast-track approval 

for research grants to be carried out collaboratively by scientists 

and college administrators who express an urgent need for intervention. The Committee understands that NIAAA is updating the 

2001 report of the NIAAA Task Force on College Drinking, to incorporate new findings. The Committee further encourages NIAAA to 

provide this update to college presidents and other relevant organizations. 

Alcohol Dependence as a Developmental Disorder.—Epidemiology 

studies show that alcohol is the drug of choice for youth and that 

it is associated with a host of consequences in this age group, including death and increased risk of harm and other negative outcomes. The Committee is aware of more recent data showing that 

18- to 24-year-olds have the highest prevalence of alcohol dependence of any age group. These and other data make it clear to the 

Committee that alcohol has become entrenched in the developmental processes of adolescence, and that the developmental 

changes of adolescence appear to make this age group particularly 

vulnerable to alcohol’s effects. The Committee urges NIAAA to continue its youth initiative, to work toward understanding how to extricate alcohol from adolescent development and how to change 

adolescents’ behaviors toward alcohol. The Committee recognizes 

the importance of including scientists from several disciplines, from 

behavior to genetics, to reflect the many factors that contribute to 

underage drinking, and encourages NIAAA to continue guiding the 

research through its team approach. 

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 

urges NIAAA to bring greater attention and resources to this relationship with special emphasis on the differentiation of impact of 
140 

alcohol consumption on the liver for specific populations, such as 

women, minorities, the elderly, and others. 

Brain Development.—The Committee is aware of recent evidence 

that the human brain continues to develop for a longer period than 

previously thought, and that NIAAA has found physical differences 

in how adult brains and adolescent brains respond to certain stimuli. Biochemical and physiological events in the brain translate into 

behaviors. NIAAA is urged to continue research that will reveal biological links between adolescent brain changes, alcohol-related behaviors, and capacity for alcohol, and research that will reveal alcohol’s short- and long-term impact on developmental changes in the 

adolescent brain. 

Underage Drinking.—The Committee recognizes that alcohol consumption represents one of the most important public health problems among youth today and commends the NIAAA on its efforts 

to collect data on the influence of environment and genetics on adolescent drinking behaviors. 

Treatments for Alcohol-use Disorders.—The Committee is aware 

that 18 million American adults abuse or are dependent on alcohol. 

The Committee encourages NIAAA to conduct research that will 

advance behavioral and pharmaceutical treatments, alone and in 

combination, for these disorders. The Committee understands that 

NIAAA recently convened more than 40 experts to establish priorities for accelerating development of medications to treat alcoholuse disorders, and requests a copy of the report on the outcome of 

that meeting, when it is completed. 

NATIONAL INSTITUTE ON DRUG ABUSE

Appropriations, 2005 ............................................................................. $1,006,419,000 

Budget estimate, 2006 ........................................................................... 1,010,130,000 

House allowance .................................................................................... 1,010,130,000 

Committee recommendation ................................................................. 1,035,167,000 

The Committee recommends an appropriation of $1,035,167,000 

for the National Institute on Drug Abuse [NIDA]. The budget request was $1,010,130,000. The fiscal year 2005 appropriation was 

$1,006,419,000. The comparable numbers for the budget estimate 

include funds to be transferred from the Office of AIDS Research. 

Mission.—Created in 1974, NIDA supports about 85 percent of 

the world’s biomedical research in the area of drug abuse and addiction. The Committee commends NIDA for demonstrating 

through research that drug use is a preventable behavior and that 

addiction is a treatable disease. NIDA’s basic research plays a fundamental role in furthering knowledge about the ways in which 

drugs act on the brain to produce dependence, and contributes to 

understanding how the brain works. In addition, NIDA research 

identifies the most effective pharmacological and behavioral drug 

abuse treatments. NIDA conducts research on the nature and extent of drug abuse in the United States and monitors drug abuse 

trends nationwide to provide information for planning both prevention and treatment services. An important component of NIDA’s 

mission is also to study the outcomes, effectiveness, and cost benefits of drug abuse services delivered in a variety of settings and to 

assure dissemination of information with respect to prevention of 

drug abuse and treatment of drug abusers. 
141 

Adolescent Brain Development.—The Committee notes 

neuroimaging research by NIDA and others showing that the 

human brain does not fully develop until about age 25. This adds 

to the rationale for referring to addiction as a ‘‘developmental disease.’’ The Committee encourages NIDA to continue its emphasis 

on adolescent brain development to better understand how developmental processes and outcomes are affected by drug exposure, the 

environment and genetics. 

Clinical Trials Network.—The Committee is pleased with the 

success and progress of NIDA’s National Drug Abuse Treatment 

Clinical Trials Network [CTN]. The CTN provides an infrastructure 

to test the effectiveness of new and improved interventions in reallife community settings with diverse populations, enabling an expansion of treatment options for providers and patients. The Committee suggests NIDA develop ways to use the CTN as a vehicle 

to address emerging public health needs. 

Collaboration with Single State Authorities [SSAs].—The Committee commends NIDA for its outreach and work with SAMHSA’s 

Center for Substance Abuse Treatment [CSAT] and 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 sciencebased policies and practices. The Committee also encourages NIDA 

to continue collaborative work with SSAs, including its ‘‘blending 

activities,’’ to ensure that research findings are relevant and adaptable by State substance abuse systems. 

Co-occurring Disorders.—The Committee recognizes that addiction is a disorder that can affect the course of other diseases, including HIV/AIDS, mental illness, trauma, cancer, cardiovascular 

disease and even obesity. To adequately address co-occurring 

health problems, the Committee encourages the Institute to work 

with other agencies to stimulate new research to develop effective 

strategies and to ensure the timely adoption and implementation 

of evidence-based practices for the prevention and treatment of cooccurring disorders. 

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 urges NIDA to continue supporting research that focuses on developing and testing drug-abuse related 

interventions designed to reduce the spread of HIV/AIDS. 

Drug-Induced Liver Injury.—The Committee notes that the 

mechanisms and causes of Drug-Induced Liver Injury [DILI] related to over-the-counter and prescription medications is not well 

understood and therefore merits further research. The Committee 

is aware that NIDDK currently funds 5 centers in the Drug-Induced Liver Injury Network [DILIN] and encourages increased support for the DILIN to help identify the underlying mechanisms and 
142 

patterns in DILI to better obtain data and find patterns in DILI. 

The Committee also encourages NIDA to work collaboratively with 

NIDDK, FDA, industry, and the liver research community to address these priorities. 

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. The Committee strongly supports NIDA’s efforts in 

this area, particularly the Criminal Justice Drug Abuse Treatment 

Studies. 

Emerging Drug Problems.—The Committee recognizes that drug 

use patterns are constantly changing and is pleased with NIDA’s 

efforts to monitor drug use trends and to rapidly inform the public 

of emerging drug problems. The Committee encourages NIDA to 

continue supporting research that provides reliable data on emerging drug trends, particularly among youth and in major cities 

across the country. 

Genetics Addiction.—The Committee recognizes that not everyone who takes drugs becomes addicted. Research has shown that 

genetics plays a critical role in addiction, and that the interplay between genetics and environment is crucial. The Institute is urged 

to further investigate this phenomenon. 

Long-term Consequences of Marijuana Use.—The Committee is 

concerned with the continuing widespread use of marijuana. The 

Committee urges NIDA to continue support for efforts to assess the 

long-term consequences of marijuana use on cognitive abilities, 

achievement, and mental and physical health, as well as work with 

the private sector to develop medications focusing on marijuana addiction. 

Medications Development.—The Committee applauds NIDA for 

over a decade of leadership in working with private industry to develop anti-addiction medications and is pleased this collaboration 

has resulted in a new medication for opiate addiction. The Committee encourages NIDA to continue its work with the private sector to develop anti-addiction medications, particularly for cocaine, 

methamphetamine, and marijuana. 

Primary Care Settings and Youth.—The Committee recognizes 

that primary care settings are potential key points of access to prevent and treat problem drug use among young people. The Committee encourages NIDA to support health services research on effective ways to educate primary care providers about drug abuse 

and develop brief behavioral interventions for preventing and treating drug use and related health problems; and develop methods to 

integrate drug abuse screening, assessment, prevention and treatment into primary health care settings. 

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. Researchers should be encouraged to 

conduct more studies in this population and to target their studies 
143 

in geographic areas where HIV/AIDS is high and/or growing among 

African Americans, including in criminal justice settings. 

Reducing Inhalant Abuse.—The Committee understands and is 

alarmed that, for the second year in a row, NIDA’s Monitoring the 

Future Survey has shown an increase in the use of inhalants by 

8th graders. The Committee urges the Institute to continue its support of research on prevention and treatment of inhalant abuse, 

and to enhance public awareness on this issue. 

Reducing Methamphetamine Abuse.—The Committee is very concerned about the continued abuse of methamphetamine across the 

United States. The Committee urges NIDA to continue supporting 

research to address the medical consequences of methamphetamine 

abuse. 

Reducing Prescription Drug Abuse.—The Committee notes the recent increases in the numbers of people who use prescription drugs 

for non-medical purposes. Research targeting a reduction in prescription drug abuse, particularly among our Nation’s youth, 

should continue to be a priority for NIDA. 

Translational Research.—The Committee commends NIDA for its 

broad and varied information dissemination programs. The Committee also understands that the Institute is focused on stimulating and supporting innovative research to determine the components necessary for adopting, adapting, delivering, and maintaining 

effective research-supported policies, programs, and practices. As 

evidence-based strategies are developed, the Committee urges 

NIDA to support research to determine how these practices can be 

best implemented at the community level. 

NATIONAL INSTITUTE OF MENTAL HEALTH

Appropriations, 2005 ............................................................................. $1,411,933,000 

Budget estimate, 2006 ........................................................................... 1,417,692,000 

House allowance .................................................................................... 1,417,692,000 

Committee recommendation ................................................................. 1,460,393,000 

The Committee recommends an appropriation of $1,460,393,000 

for the National Institute of Mental Health [NIMH]. The budget request was $1,417,692,000 and the fiscal year 2005 appropriation 

was $1,411,933,000. The comparable amounts for the budget estimate include funds to be transferred from the Office of AIDS Research. 

Mission.—The National Institute of Mental Health [NIMH] supports research on mind, brain, and behavior with the aim of reducing the public health burden of mental and behavioral disorders. 

NIMH’s ultimate goal is to generate research that will lead to the 

ability to effectively treat mental disorders so that individuals can 

truly recover from them, and, ultimately, achieve the ability to predict and prevent them from even occurring. A major goal for NIMH 

is to identify the biological basis of mental disorders to more precisely pinpoint targets for prevention and treatment. This means 

understanding the neural basis of the illness at all levels, from molecular to behavioral. 

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 teen-
144 

agers. The Committee notes that NIMH has conducted a major 

trial on adolescent depression which has yielded valuable knowledge about effective treatments for depression. The Committee 

strongly 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. 

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. 

Aging and Mental Health.—The Committee commends the NIMH 

for recently recognizing the need to place a higher priority on the 

mental health needs of older persons through the 2004 recommendations promulgated by the NIMH Aging Research 

Workgroup and the restructuring of the Adult and Geriatric Treatment and Preventive Intervention Research Branch. However, the 

Committee believes it is critical that studies related to the elderly 

keep pace with the rapid growth of this cohort. The Committee encourages the NIMH to devote greater resources to research on 

adults over age 65 to reflect the growth in numbers of this population. Therefore, the Committee strongly encourages NIMH to significantly expand research in this area. 

The Committee is pleased with NIMH’s continued emphasis on 

research involving mental disorders in the elderly population, especially since the causes of depression in the elderly and the factors 

affecting its course are not well understood. The Committee urges 

NIMH to continue its level of support in this area. 

Autism Research.—The Committee commends NIMH for its 

strong leadership of the Interagency Autism Coordinating Committee [IACC], and for the institute’s continued emphasis on autism as an urgent public health problem. Autism continues to be 

a top priority for NIH. The Committee supports continued cross-Institute investments in several new centers and projects, which have 

produced recent findings indicating that the fundamental pathology 

may be ‘‘miswiring’’ in the brains of autistic children, with an excess of local circuits and a deficit of long-range circuits. NIMH research is helping to develop new tools for detecting autism early, 

before age 2. In a new study on infant siblings of children with autism, early findings indicate that siblings later diagnosed with autism show social deficits, visual attention impairments, and unusual temperament by 12 months of age. This work could greatly 

enhance efforts for early detection and treatment. 

Basic Behavioral Science.—The Committee encourages NIMH to 

continue its commitment to support basic behavioral research fo-
145 

cused on fundamental psychological domains and factors that promote mental health or become disturbed in mental disorders. The 

Committee is concerned that the institute may be diminishing its 

support for some areas of relevant scientific inquiry and urges the 

institute to support a balanced program of grant funding and to 

maintain its support for research on the promotion of mental 

health and the study of psychological, social, and legal factors that 

influence behavior. 

Combat Veterans.—The Committee is concerned about the mental health effects of military service in Iraq and Afghanistan, particularly since so many of the combatants are members of the National Guard or Reserves who will have to assimilate quickly back 

into civilian life after service. The Committee urges NIMH to work 

closely with the Veterans Administration and with the Department 

of Defense in efforts to best address this looming problem. 

Demographics.—The Committee is aware that demographics will 

demand a greatly increased focus on mental disorders in older persons, and consequently the Committee continues to be concerned 

about funding for late-life mental health research at the National 

Institute of Mental Health [NIMH]. The Committee encourages 

NIMH to expand research in Adult and Geriatric Treatment and 

Preventive. 

Depression in the Workplace.—The Committee notes with interest 

that recent NIMH research has demonstrated the importance of 

recognizing depression in the workplace and the cost-effectiveness 

of treating those affected. Employees with depression—even compared to employees with rheumatoid arthritis, a chronic illness 

that can impair job performance—were four to five times more likely to become unemployed, to have diminished productivity, and to 

exhibit increased absenteeism. However, appropriate treatment for 

depression resulted in positive changes in all three areas. The research found that offering appropriate, evidence-based depression 

treatment for employees is a cost-effective strategy for American 

businesses. Further information on cost effectiveness will become 

available at the completion of the ongoing NIMH-funded study, 

‘‘Outreach and Treatment for Depression in the Labor Force,’’ 

which is scheduled for completion in 2006. 

Disease Prevalence.—The Committee is aware that NIMH has 

supported a major study that will provide critical information concerning the prevalence of most mental disorders in this country, as 

well as about the availability of quality care. When the study is 

published, the Committee would like to have a briefing to summarize the results of that study for interested Members of Congress 

and staff. 

Down Syndrome.—The Committee encourages the NIMH to develop new strategies for cataloging, understanding, diagnosing and 

treating behavioral disorders that are common in people with Down 

syndrome. They include autism, pervasive developmental disorder, 

obsessive compulsive disorder, depression and psychosis. The Committee urges NIMH to coordinate its research on Down syndrome 

with NICHD, NINDS, NIA and other Institutes. The Committee 

encourages NIMH to continue their studies on imaging of the 

brains of persons with Down syndrome broadening their focus to 

include behavior and motor coordination. 
146 

Epilepsy.—Recent evidence of connections between depression 

and epilepsy point to relationships between the two disorders that 

suggest potential common pathogenic mechanisms. Research could 

help improve care for both groups of patients. The Committee 

strongly urges the Institute to make research in epilepsy a priority 

and to coordinate research efforts with NINDS. 

Evidence-based Treatments for Recovery and Dissemination.—The 

first of several large, NIMH-funded clinical studies testing various 

treatment options for those with serious mental illnesses was completed last summer: a 13-site trial aimed at defining the most effective and safe treatment for children and adolescents with major depressive disorder. There has been much debate about whether a 

class of antidepressant medications, selective serotonin re-uptake 

inhibitors [SSRIs] can actually increase suicidal thinking. Results 

of the trial revealed that a combination of fluoxetine (Prozac) and 

a type of psychotherapy called cognitive behavioral therapy [CBT] 

was the most effective treatment (71 percent responded). Suicidal 

thinking, which was present in 29 percent of the participants at 

the beginning of the study, improved significantly in all four treatment groups, with those receiving medication and therapy showing 

the greatest reduction in suicidal thinking. The effectiveness of 

these treatments over a 6-month period from treatment initiation 

will soon be known. It is critical for physicians and 

psychotherapists to closely monitor their young patients on 

antidepressant medications for signs of hurtful or suicidal behavior, 

particularly during the early phases of treatment. 

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 devoted to identifying critical research needs, in November 2001, January 2003, and July 2004. 

The Committee urges NIMH to pursue the most critical 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 urges NIMH to 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 urges the NIMH to work with industry and academia 

to test available medications and bring new treatments to market. 

Frontier Mental Health Needs.—The Committee commends 

NIMH on its outreach efforts to determine the differences in mental health needs which may exist in remote frontier communities, 

including Alaska. The Committee encourages NIMH to expand its 

research efforts into these communities, which are often ignored in 

research projects, but which continue to suffer from high incidences 

of mental health problems including depression, suicide and co-occurring disorders with substance abuse. 

Health Disparities and Clinical Trials.—The Committee is aware 

of the work being done by NIMH and its National Advisory Mental 

Health Council [NAMHC] to address issues involving health dis-
147 

parities and inclusion of historically underserved minorities in clinical trials sponsored by the Institute. The Committee supports 

these efforts. 

Hepatitis.—The Committee urges the National Institute of Mental Health [NIMH] to conduct and/or facilitate research to explore 

the etiology and effective therapeutic management of 

neuropsychiatric symptoms and disorders associated with chronic 

hepatitis C and interferon-based antiviral treatment. 

Learning Disabilities.—The Committee commends NIMH for the 

work conducted to explore the neurological and behavioral aspects 

of learning disabilities. The Committee looks forward to learning 

the results of this work and encourages the Institute to continue 

to coordinate with other Institutes working on related activities. 

Morbidity and Mortality.—The burden of mental disorders is 

staggering, in terms of both morbidity and mortality. Researchers 

supported by NIMH have found that half of all lifetime cases of 

mental illness begin by age 14, and that despite effective treatments, there are long delays between the appearance of the first 

symptoms of illness and provision of even adequate treatment. Unlike most other disabling medical diseases, mental illness begins 

very early in life. Mental disorders, then, can very aptly be called 

the chronic diseases of the young. Young people with mental disorders suffer disability when they are in the prime of life, when 

they would normally be most productive. The NIMH study also 

found that mental disorders really are quite common—26 percent 

of the general population reported that they had symptoms sufficient for diagnosing a mental disorder during the past 12 months. 

Although some of these cases are mild ones that will resolve without formal interventions, many more will not. The Committee 

urges NIMH to continue its current efforts to focus on research 

that promises to yield effective results that can be translated to the 

benefit of patients, with the goal of finding new ways to intervene 

early in the development of disease—or even prevent its occurrence, and, when prevention is not possible, to achieve rational 

treatments that are tailored to be most effective to the individual 

patient. 

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. 

Prevention Research.—The Committee places a high priority on 

prevention research, particularly with respect to mental disorders 

among children and adolescents, in identifying protective factors 

against the negative impacts of stress among young adults, and in 

developing strategies to strengthen the family and other relationships that serve as protective factors. 

Psoriasis.—Psoriasis is associated with elevated rates of mental 

disability, depression and suicidal ideation. The Committee urges 

NIMH to conduct research into the mental health aspects of psoriasis, especially as it relates to quality of life and burden of the disease. Furthermore, a 2005 study of 44 autoimmune diseases found 

that only psoriasis, when present in women around the time of 

pregnancy, was significantly associated with autism, doubling the 

risk of autism spectrum disorder in their children. The Committee 
148 

urges NIMH to support further study of the link between psoriasis 

and autism. 

Psychological Impacts of Terrorism.—The Committee supports 

NIMH research related to the psychological impact of both acute 

and chronic exposure to threats of violence, including terrorism and 

war, with particular emphasis on vulnerable populations, such as 

trauma survivors, children and older adults. The Committee encourages NIMH to expand its research portfolio to include research 

related to factors that promote detection or prediction, prevention, 

and post-exposure recovery and resilience. 

Suicide.—In addition to being disabling and chronic, mental disorders can be fatal. Depression is an important risk factor for suicide, the third leading cause of death among adolescents. The Committee notes that there are far more suicides each year in this 

country than there are homicides. The Committee supports NIMH 

efforts to enhance suicide awareness and prevention, and encourages the institute to continue its ongoing collaborative efforts with 

other institutes and with SAMHSA to address this painful topic. 

Translating Behavioral Research.—The Committee commends 

NIMH for undertaking a reorganization to promote the translation 

of basic behavioral science into treatments for those with mental 

disorders. The Committee strongly supports NIMH’s efforts to advance the application of behavioral research and interventions in 

clinical settings to address the public health burden of mental disorders and develop preventive interventions. The Committee 

strongly supports additional clinical trials that examine the effectiveness of behavioral interventions in community-based settings. 

Behavioral interventions are especially needed for children and 

adolescents with mental disorders, including post-traumatic stress 

disorder, eating disorders, attention deficit-hyperactivity disorder, 

and the most common forms of depression. Translational research 

in the behavioral and social sciences is especially needed to address 

how basic behavioral processes, such as cognition, emotion, motivation, development and social interaction, inform the diagnosis, 

treatment and delivery of services for mental disorders. 

NATIONAL HUMAN GENOME RESEARCH INSTITUTE

Appropriations, 2005 ............................................................................. $488,608,000 

Budget estimate, 2006 ........................................................................... 490,959,000 

House allowance .................................................................................... 490,959,000 

Committee recommendation ................................................................. 502,804,000 

The Committee recommendation includes $502,804,000 for the 

National Human Genome Research Institute [NHGRI]. The budget 

requested $490,959,000 and the fiscal year 2005 appropriation was 

$488,608,000. The comparable amounts for the budget estimate include funds to be transferred from the Office of AIDS Research. 

Mission.—The Human Genome Project was an effort to determine the location and sequence of the estimated 30,000 genes that 

constitute the human genome. This historic achievement opens the 

genomic era of medicine. The Committee commends the NHGRI for 

developing this vision for the future of genomics. 

The Institute 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 se-
149 

quence and function of both human and non-human genomes, 

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. 

Basic Behavioral and Social Sciences Research.—The Committee 

encourages NHGRI to participate in trans-institute initiatives organized by OBSSR or another institute to strengthen basic behavioral 

research and enhance opportunities for behavioral science research 

training. 

Chromosome Abnormalities.—The Committee commends the NIH 

for its efforts over the past year to encourage new scientific work 

into molecular, genetic, clinical and therapeutic aspects of chromosome abnormalities. Because of the multisystemic consequences 

of a chromosome abnormality, multidisciplinary and multi-Institute 

support by NIH will be required in order to make progress that will 

be meaningful to those affected. The Committee continues to urge 

NIH to seek ways to expand and intensify such research, especially 

studies involving the syndromes of chromosome 18. 

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 highthroughput 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. 

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. These new developments also suggest that a 

large-scale population-based cohort study in the United States 

could provide a critical path toward improved genome-based public 

health and the Committee urges NHGRI to explore the feasibility 

of commencing such a study. 

NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING

Appropriations, 2005 ............................................................................. $298,209,000 

Budget estimate, 2006 ........................................................................... 299,808,000 

House allowance .................................................................................... 299,808,000 

Committee recommendation ................................................................. 309,091,000 

The Committee recommends an appropriation of $309,091,000 for 

the National Institute of Biomedical Imaging and Bioengineering 

[NIBIB]. The budget requested $299,808,000 and the fiscal year 

2005 appropriation was $298,209,000. The comparable amounts for 

the budget estimate include funds to be transferred from the Office 

of AIDS Research. 
150 

Mission.—The NIBIB improves 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. The Institute plans, conducts, fosters, and supports an integrated and coordinated program of research and research training that can be applied to a broad spectrum of biological processes, 

disorders and diseases and across organ systems. The Institute coordinates with the biomedical imaging and bioengineering programs of other agencies and NIH Institutes to support imaging and 

engineering research with potential medical applications and facilitates the transfer of such technologies to medical applications. 

Professional Judgment Budget.—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 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. The Committee commends the NIH and Department of 

Health and Human Services for this approach and believes that the 

projected rate of growth is necessary to enable the NIBIB to 

achieve the scientific advances that the Congress envisioned when 

it established the Institute. 

The Professional Judgment Budget recognizes the role of the 

NIBIB with respect to interdisciplinary research, the physical 

sciences, and technology development. The 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 is pleased with the role of the NIBIB has played 

and will continue to play in the development of biomedical technology related to the physical sciences. 

Imaging and Engineering Advances.—The Committee urges 

NIBIB to focus efforts on improving musculoskeletal disease detection, monitoring and treatment through focused imaging and engineering advances. The Institute also 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 urges 

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 urges NIBIB to participate actively 

in trans-NIH initiatives that address these priorities. 
151 

The Committee is encouraged by the potential of image-guided 

surgery to improve patient outcomes. The Committee supports the 

Institute’s plans to hold a conference on image-guided surgery and 

looks forward to learning about the results of this conference. 

PET and MicroPET Scans.—The Committee continues to encourage the Institute to devote significant resources to molecular imaging technologies such as positron emission tomography [PET] and 

microPET to take advantage of the capacities of molecular imaging 

to detect disease process at the molecular level and to monitor the 

effectiveness of targeted gene therapies now under development. 

The Committee also encourages the new Institute to develop its research agenda in close collaboration with other, disease-specific Institutes at NIH, so that new imaging technologies are closely tied 

to the research projects being undertaken by the various other Institutes of NIH. 

NATIONAL CENTER FOR RESEARCH RESOURCES

Appropriations, 2005 ............................................................................. $1,115,090,000 

Budget estimate, 2006 ........................................................................... 1,100,203,000 

House allowance .................................................................................... 1,100,203,000 

Committee recommendation ................................................................. 1,188,079,000 

The Committee recommends an appropriation of $1,188,079,000 

for the National Center for Research Resources [NCRR]. The budget request was $1,100,203,000 and the fiscal year 2005 appropriation was $1,115,090,000. The comparable amounts for the budget 

estimate include funds to be transferred from the Office of AIDS 

Research. 

Mission.—The NCRR develops and supports critical research 

technologies and shared resources that underpin research to maintain and improve the health of our Nation. The NCRR programs 

develop a variety of research resources; provide biomaterial and resources for complex biotechnologies, clinical research, and specialized primate research; develop research capacity in minority institutions; and enhance the science education of pre-college students 

and the general public. 

Clinical Research Curriculum Award.—The Clinical Research 

Curriculum Awards or K30, has been extremely effective in training successful clinical investigators. 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 but is concerned that this was accomplished 

by reducing the number of funded institutions. The Committee 

would encourage increased support in order to expand rather than 

reduce the number of institutions receiving this important award. 

Clinical and Translational Science Awards [CTSA].—In September 2003, NIH launched the NIH Roadmap for Medical Research, a set of trans-NIH research initiatives designed to accelerate the pace of discovery and improve the translation of research 

findings into medical and health interventions for public benefit. A 

critical component of the Roadmap is the theme of re-engineering 

the clinical research enterprise. The Committee has encouraged the 

Director to utilize the NCRR-funded General Clinical Research 

Centers as the foundation of NIH Roadmap activities related to 
152 

clinical research. NIH is now poised to capitalize on the revolutionary discoveries emerging from basic science, and has developed 

an innovative proposal to address the current difficulty recruiting 

and retaining clinical researchers; the increasing regulatory burden; fragmented training programs; and limitations and barriers 

due to NIH funding mechanisms, review and programs structures. 

The Committee supports NIH’s efforts to integrate NIH’s General 

Clinical Research Centers [GCRCs] and other relevant clinical 

mechanisms into a new and more efficient single application that 

results in awards that combine clinical science support with clinical 

career development and training. This will transform clinical and 

translational sciences for the future. The Committee has a longstanding and abiding interest in the health of the clinical research 

system supported under this appropriation, and therefore requests 

that NIH submit a report by February 6, 2006. The report should 

describe NIH’s new award for clinical and translational sciences, 

which NIH expects to fund in fiscal year 2006, describe the expected costs in fiscal year 2006 and fiscal year 2007, and indicate 

the specific components of the program and plans for transition 

from the current funding mechanisms to the new awards. The 

Committee expects that the new award will support the full spectrum of clinical research activities, from early translation between 

the laboratory and the patient to epidemiological studies and 

health services research. The report should describe how this will 

be accomplished. The Committee has included $327,000,000 for 

clinical research supported by the GCRCs and the CTSAs combined. The Committee expects the total number of awards for this 

combined program to remain at 79 in fiscal year 2006. 

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. 

Extramural Facilities Construction at Minority Institutions.—The 

Committee encourages NCRR to give priority consideration to supporting extramural facilities construction projects at historically 

minority institutions which have developed a comprehensive plan 

to address the disproportionate impact of cancer in minority communities, and those which have developed plans for enhancing 

their library facilities. 

Extramural Construction.—The Committee has included bill language identifying $30,000,000 for extramural biomedical facility 

renovation and construction. This amount is the same as the fiscal 

year 2005 appropriation. The fiscal year 2006 budget proposed to 

eliminate funding for the program. These funds are to be awarded 

competitively, consistent with the requirements of section 481A of 

the Public Health Service Act, which allocates 25 percent of the 

total funding to institutions of emerging excellence. 

General Clinical Research Centers.—The Committee is concerned 

about the growing gap between the GCRC budgets approved by the 

NCRR Advisory Council and the actual budgets awarded. The Committee requests a report comparing the Advisory Council-approved 

budgets and the actual funds awarded to each GCRC for fiscal 
153 

years 2003, 2004, and 2005. The Committee requests this same information as soon as possible. 

IDeA Grants.—The Committee has provided $230,000,000 for the 

Institutional Development Award [IDeA] Program authorized by 

section 402(g) of the Public Health Service Act. The Committee recognizes the importance of the Centers of Biomedical Research Excellence and the IDeA Networks of Biomedical Research Excellence 

programs and expects funding to be maintained for both. The focus 

of IDeA should continue to be on improving the necessary infrastructure and strengthening the biomedical research capacity and 

capability of research institutions within the IDeA States. 

National Primate Research Centers.—The Committee values the 

critical role played by the eight National Primate Research Centers 

[NPRCs]. These Centers conduct specialized basic and applied biomedical research and offer essential and valuable services to other 

researchers. Primates are increasingly important to the Nation’s 

public health priorities in areas such as biodefense, heart disease, 

cancer, diabetes, AIDS, kidney disease, Alzheimer’s, Parkinson’s 

and emerging infectious diseases. In fiscal year 2004, the Committee urged the NIH to fully commit to the NPRCs’ Five Year 

Federal Advancement Initiative in order to address the upgrades 

and program expansions required to meet the demanding research 

needs of the Nation. Nevertheless, NIH has taken only incremental 

steps to increase the NPRCs’ base grant funding. The Committee 

strongly urges the NIH to place a higher priority on funding these 

centers adequately. 

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 increase 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. 

NATIONAL CENTER FOR COMPLEMENTARY AND ALTERNATIVE

MEDICINE

Appropriations, 2005 ............................................................................. $122,105,000 

Budget estimate, 2006 ........................................................................... 122,692,000 

House allowance .................................................................................... 122,692,000 

Committee recommendation ................................................................. 126,978,000 

The Committee has included $126,978,000 for the National Center for Complementary and Alternative Medicine. The budget request was $122,692,000 and the fiscal year 2005 appropriation was 

$122,105,000. The comparable amounts for the budget estimate include funds to be transferred from the Office of AIDS Research. 

The Committee strongly supports the work of the National Center for Complementary and Alternative Medicine. The Center is 

charged with assuring that complementary and alternative thera-
154 

pies be rigorously reviewed to provide consumers reliable information. 

The Committee continues to strongly support the work of 

NCCAM. As more and more Americans are using complementary 

and alternative therapies, there is an increasing need for quality 

research into this area and for sharing research findings and other 

information with health professionals and the general public. 

The Committee expects that funding for existing and new Centers supported by the office will be maintained. The Committee expects NCCAM to renew its support of CDC’s field investigations 

program and expand its support of AHRQ’s literature reviews and 

data analysis efforts. It also commends NCCAM’s efforts to develop 

and disseminate a comprehensive set of fact sheets on CAM therapies to inform the public and health professionals of the state of 

scientific knowledge about these therapies and expects that to continue and expand. 

Antioxidants.—The Committee is aware that the role of antioxidants in maintaining health in a variety of organ systems has 

been attracting attention in recent years. Recent evidence suggests 

that the delicate inner ear structures can be protected against the 

ravages of acoustic trauma produced by noise such as that encountered on the battlefield, and may have a role to play in preventing 

or slowing the progression of age-related hearing loss in the elderly 

by routine administration of commonly available antioxidant food 

supplements. Other applications may be found for these compounds 

in the treatment or prevention of auditory or vestibular disorders. 

The Committee encourages the institute to collaborate with NIDCD 

to fund research in this very promising area. 

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. 

Bone Health.—The Committee encourages NCCAM to conduct research on complementary and alternative medical approaches to 

bone health, bone pain and nutrition, including supplements and 

nutraceuticals, for osteoporosis and later life fractures. 

Behavioral Research on Stress.—NCCAM is encouraged to continue collaborations with other NIH offices, Institutes and centers 

to identify mechanisms through which various stressors produce 

adverse health effects, and the extent to which stress reduction 

interventions improve health. 

Integrative Medicine Model.—The Committee supports the concept of integrative medicine, which reaffirms the importance of the 

relationship between practitioner and patient, focuses on the whole 

person, is informed by evidence, and makes use of all appropriate 

therapeutic approaches, healthcare professionals and disciplines to 

achieve optimal health and healing. The Committee encourages 

NCCAM and other relevant ICs to accelerate the infusion of this 

model throughout their research, research training and communication activities. 
155 

Native Hawaiian Healing.—The Committee commends the 

NCCAM for its plans to convene a working group in fiscal year 

2005 to establish communication and facilitate research collaborations among traditional and conventional healing techniques. 

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. 

PET.—The Committee continues to urge NCRR to support research resource centers for the development and refinement of 

positron emission tomography [PET] as a unique imaging technology to diagnose and stage diseases of the brain, including Alzheimer’s disease. 

Practice-Based Research Network.—One of the major advances 

achieved through the work of NCCAM has been the development 

of CAM or integrative medicine research centers at many of the 

Nation’s top medical centers. In order to build upon this important 

new research infrastructure base, the Committee expects NCCAM 

to implement one of the major recommendations of the recent Institute of Medicine CAM report—the development and utilization of 

an Integrative Medicine Practice-Based Research Network [PBRN]. 

The Committee concurs with the IOM that the PBRN model is very 

well-suited for the study of CAM therapies and would greatly enhance the ability to conduct high quality cost-effective clinical trials 

of CAM therapies and treatment modalities. Such a network would 

also allow for the rapid dissemination of data, which would directly 

affect the provision of health care to consumers. Key to the establishment of such a network would be funding for a data tracking 

system linking the network practice members and a centralized 

data coordinating center. The Committee considers the PBRN to be 

one of its top priorities for NCCAM this year. 

NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

Appropriations, 2005 ............................................................................. $196,159,000 

Budget estimate, 2006 ........................................................................... 197,379,000 

House allowance .................................................................................... 197,379,000 

Committee recommendation ................................................................. 203,367,000 

The Committee has included $203,367,000 for the National Center on Minority Health and Health Disparities. The budget request 

was $197,379,000 and the fiscal year 2005 appropriation was 

$196,159,000. The comparable amounts for the budget estimate include funds to be transferred from the Office of AIDS Research. 

Mission.—The NCMHD advises the NIH Director and Institute 

and Center [IC] directors on the development of NIH-wide policy 

issues related to minority health disparities research, research on 
156 

other health disparities, and related research training. Among 

other activities, the NCMHD develops, in consultation with the 

NIH Director, IC directors, and the advisory council, a comprehensive strategic plan that identifies and establishes objectives, priorities, budgets, and policy statements governing the conduct and 

support of all NIH minority health disparities research, research on 

other health disparities, and related research training activities. It 

also administers funds for the support of minority health disparities research and other health disparities research, by awarding 

grants and leveraging the programs of the ICs. 

Cancer in Minorities.—While the Committee remains concerned 

about the burden of cancer in African-Americans and other minorities, it is encouraged by opportunities that exist for addressing this 

devastating toll. The Committee urges the NCMHD to collaborate 

with NCRR and NCI in taking the necessary steps to expand comprehensive Cancer Center’s with a focus on research, treatment, 

prevention and control of cancer across minority and other disadvantaged populations. 

Cancer in Minority Communities.—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 the National Center for Research Resources and the National Cancer Institute 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. 

Community-Based Organization Partnership Prevention Centers.—The Committee encourages continued expansion of community-based prevention initiatives and looks forward to hearing the 

recommendations of the strategic planning subcommittee on priority areas for research funding and the NCMHD’s plans for implementation. 

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 urges NCMHD to explore 

collaboration with NIDDK to support research activities related to 

glomerular injury and requests a report on progress made in this 

area. 

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 therefore 

urges the Center to initiate and participate with NIDDK, NIDA 

and NCI in research focused on addressing and reducing these disparities. 

Minority Health Disparities.—The Committee commends the National Center on Minority Health and Health Disparities for its 

leadership in addressing the long-standing problem of health status 

disparities in minority and medically underserved populations. For 

fiscal year 2006, the Committee continues to encourage NCMHD to 

implement its successful Research Endowment program as an on-
157 

going initiative. Moreover, the Committee encourages NCMHD to 

implement the program in a manner that is consistent with the authorizing legislation. 

Project EXPORT.—The Committee commends NCMHD for its 

successful ‘‘Project EXPORT’’ initiative and urges continued support for this important program. Also, the Committee encourages 

the Director of NCMHD to coordinate with the NIH Director and 

the National Center for Research Resources in support of extramural facility construction and the development of other research 

and research library infrastructure at minority health professions 

schools. 

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. 

JOHN E. FOGARTY INTERNATIONAL CENTER FOR ADVANCED STUDY IN

THE HEALTH SCIENCES

Appropriations, 2005 ............................................................................. $66,632,000 

Budget estimate, 2006 ........................................................................... 67,048,000 

House allowance .................................................................................... 67,048,000 

Committee recommendation ................................................................. 68,745,000 

The Committee recommends an appropriation of $68,745,000 for 

the Fogarty International Center [FIC]. The budget request was 

$67,048,000 and the fiscal year 2005 appropriation was 

$66,632,000. The comparable amounts for the budget estimate include funds to be transferred from the Office of AIDS Research. 

Mission.—Adapting research advances in biomedicine to populations at home and abroad requires a continuing commitment to 

basic science as well as rigorous clinical and applied (epidemiological) studies. Examples are vaccines, anti-infective agents, drugs, 

and more efficient diagnostic tools, combinations of interventions, 

and health policies to reduce the risk of disease and its associated 

human, social, and economic consequences. These challenges will 

benefit from a more coordinated and multi-disciplinary approach to 

global health needs. It is the mission of the FIC to address these 

challenges by forging collaborations with a range of domestic and 

global partners in international research and training to pursue 

three core objectives: first, to accelerate the pace of discovery and 

its application by special projects enabling scientists worldwide to 

share conceptual insights, analytic methods, data sets, patient cohorts, or special environments; second, to engage and assist young 

as well as more established U.S. investigators to address scientific 

challenges related to global health; and third, to help develop a 

cadre of highly capable young foreign investigators positioned to cooperate with U.S. scientists in areas of the world that, due to geography, genetics, or disease burdens, provide unique opportunities to 
158 

understand disease pathogenesis, anticipate disease trends, or develop interventions of relevance and priority for both the United 

States and the collaborating country. 

Chronic Obstructive Pulmonary Disease.—The Committee notes 

that Chronic Obstructive Pulmonary Disease [COPD] is the fourth 

leading cause of death worldwide, and encourages the Fogarty 

International Center to expand its COPD research and training activities. 

Fragile X.—The Committee encourages the Fogarty International 

Center to consider Fragile X syndrome through all appropriate programs, such as the Fogarty International Research Collaboration 

Award and the FIC Brain Disorders in the Developing World Program. 

Tuberculosis Training.—The Committee is pleased with the 

Fogarty International Center’s efforts to supplement grants in 

AIDS International Training and Research Program [AITRP] or 

International Training and Research Program in Emerging Infectious Diseases [ERID], which trains 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. 

NATIONAL LIBRARY OF MEDICINE

Appropriations, 2005 ............................................................................. $323,346,000 

Budget estimate, 2006 ........................................................................... 326,291,000 

House allowance .................................................................................... 326,291,000 

Committee recommendation ................................................................. 335,422,000 

The Committee recommends an appropriation of $355,422,000 for 

the National Library of Medicine [NLM]. The budget requested 

$326,291,000 and the fiscal year 2005 appropriation was 

$323,346,000. These amounts include $8,200,000 made available 

from program evaluation funds. The recommendation includes 

$4,000,000 for improvement of information systems. The comparable amounts for the budget estimate include funds to be transferred from the Office of AIDS Research. 

Mission.—The National Library of Medicine is the Federal institution that for more than 150 years has collected, organized, preserved, and disseminated the world’s output of biomedical literature in all forms. As a result of this activity NLM is the world’s 

largest library of the health sciences, its holdings numbering more 

than 5 million items. The NLM has pioneered innovative methods 

to disseminate bibliographic information. Basic to the mission of 

the NLM is a wide-ranging research program to improve how medical information is communicated. This responsibility is aided by a 

grants program and by specialized services in toxicology, environmental health, and biotechnology. 

Communication of NIH-Supported Research Findings.—One of 

the fundamental charges to NIH is to facilitate the translation of 

research findings into practice, both in terms of the care provided 

by health professionals and behavioral and lifestyle changes by the 

public. The Committee commends the excellent work NLM does in 

this regard. The Committee endorses efforts to launch a new magazine aimed at physician offices and their patients communicating 
159 

the latest NIH research findings with authoritative content presented in a user-friendly format. 

Disease Management Technology.—The Committee urges NLM to 

conduct outreach activities to all public and private sector organizations which have demonstrated capabilities in health information 

technology. The Committee is particularly interested in disease 

management technology as it relates to saving health care dollars, 

and improving care for chronically ill individuals and the workforce. 

Health Equity Review.—The Committee congratulates NLM for 

its concern about health disparities and its sensitivity to native 

populations, such as Native Americans, Alaskans, and Hawaiians, 

and other minority communities. The Committee encourages NLM 

to fund projects to map health disparities and population profiles 

in minority communities. 

Native Hawaiian Healing.—The Committee applauds the NLM’s 

leadership for conducting ‘‘listening circles’’ to discuss the need for 

preservation and documentation of traditional cultural healing 

practices. The Committee encourages the NLM to explore the best 

ways of capturing and documenting this information through continued collaboration with Native Hawaiians. 

Outreach.—The Committee encourages NLM to continue its outreach activities aimed at educating health care professionals and 

the general public about the Library’s products and services, in coordination with medical librarians and other health information 

specialists. 

Public Access.—The Committee has noted that the National Institutes of Health has begun to implement its public access policy 

which is geared to ensuring that NIH-funded research results are 

made available as soon as possible to the public, health care providers, educators, and scientists through the National Library of 

Medicine’s PubMed Central [PMC] database. The Committee 

agrees with the need for, and a goal of, issuing a balanced policy 

to help promote increased public access to NIH-funded research 

while maintaining the integrity of the peer review system which is 

essential to ensure the quality and accuracy of medical research in 

the United States. The Committee urges NIH to work with all 

stakeholders as it moves forward in implementing this policy. To 

assist the Congress in assessing the degree of success of this new 

policy, the Committee requests a progress report by no later than 

February 1, 2006. Specifically, the Committee requests that the report contain the following information: (1) the total number of peerreviewed articles deposited in PubMed Central since the May 2, 

2005 implementation date and the distribution of chosen delay periods; (2) an assessment of the extent to which the implemented 

policy has led to improved public access; (3) an assessment of the 

impact of the policy on the peer review system; and (4) the cost of 

operating the database. 

PubChem.—The Committee is aware of the development of 

PubChem, the informatics component of the Molecular Libraries 

project of the NIH Roadmap for Medical Research. The Committee 

understands that the purpose of PubChem is to create a database 

of chemical structures and their biological activities. PubChem will 

house both data from the new NIH molecular libraries screening 
160 

center network and compound information from the scientific literature. The Committee expects the NIH to work with private sector chemical information providers, with a primary goal of maximizing progress in science while avoiding unnecessary duplication 

and competition with private sector databases. 

OFFICE OF THE DIRECTOR

Appropriations, 2005 ............................................................................. $358,047,000 

Budget estimate, 2006 ........................................................................... 385,195,000 

House allowance .................................................................................... 482,216,000 

Committee recommendation ................................................................. 487,434,000 

The Committee recommends an appropriation of $487,434,000 for 

the Office of the Director [OD]. The budget request was 

$385,195,000 and the amount appropriated in fiscal year 2005 was 

$358,047,000. The comparable amounts for the budget estimate include funds to be transferred from the Office of AIDS Research. 

The Committee has included within the total, $97,021,000 to support specific targeted research activities needed to develop radiological/nuclear ($47,021,000) and chemical threat ($50,000,000) 

countermeasures. This funding was originally requested in the Office of the Secretary Public health and Social Services Emergency 

Fund. 

Mission.—The Office of the Director provides leadership and direction to the NIH research community, and coordinates and directs initiatives which crosscut the NIH. The Office of the Director 

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 operation 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 Center 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 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 also promotes the number of women in biomedical science careers. 

Irritable Bowel Syndrome.—The Committee is pleased with the 

increased focus on irritable bowel syndrome [IBS] at the NIH’s Office Research on Women’s Health. It is estimated that between 25 

to 45 million Americans, disproportionately women, suffer from 

IBS. 

Office of AIDS Research 

Microbicides to Prevent HIV/AIDS.—Given current scientific advancements, an effective microbicide could be developed by the end 

of the decade, and once available, could well change the course of 

the epidemic. According to NIH, ‘‘the U.S. Government is firmly 

committed to accelerating the development of safe and effective 

microbicides to prevent HIV’’ because microbicides may provide 
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‘‘one of the most promising prevention interventions that could be 

inexpensive, readily available, and widely acceptable’’ (U.S. Government Strategic Plan for Microbicides). Despite these statements, 

NIH continues to spend barely 2 percent of its HIV/AIDS research 

budget on microbicides. The Committee strongly urges greater 

funding for microbicide research and development at NIH. In addition, this Committee has long advocated that NIH establish a dedicated microbicide unit with clearly identified leadership to accelerate and coordinate federally supported microbicide research, and 

is concerned that no significant progress has been made towards 

this goal. 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. If this evolves, 

the notion of a dedicated microbicide unit at the NIH would be essential. 

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 

basic research efforts, the best possibilities may be found within 

pharmaceutical companies where there are dozens of potential compounds already developed as therapeutics that could move into 

clinical development as microbicides if made available. As outlined 

in the NIH Roadmap, 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 the pharmaceutical industry to allow its drug candidates to be developed as 

microbicides. In the past year, the International Partnership for 

Microbicides has entered into innovative agreements with leading 

pharmaceutical companies to jointly test and develop leading AIDS 

drugs as microbicides. More partnerships like these between the 

pharmaceutical industry and the non-profit community will be critical, and should receive the active support of NIH leadership. 

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 urges the Director to provide 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 

NIH Director 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 shall 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 Re-
162 

search 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 Research on Women’s Health 

Stroke in Women.—As the second leading cause of death among 

women worldwide, stroke is a major health problem. Stroke kills 

more than twice as many women as do breast cancer and AIDS 

combined. Acute care of women stroke victims is often delayed, and 

61 percent of all stroke-related deaths occur in women. Recognizing 

that women are the single largest group at risk for death from 

stroke, the Committee believes that special attention should be focused on better understanding the gender-related differences in 

stroke. Studies suggest that significant gender differences occur in 

the evaluation and treatment of stroke patients, with women often 

receiving fewer diagnostic tests and intervention procedures. Increased research is needed to understand these differences and provide a means to optimize stroke care for all patients. Some aspects 

of the disease unique to women include strokes related to pregnancy and the use of oral contraceptives; stroke in younger women 

requires increased attention. Stroke is additionally a leading cause 

of serious disability among women and may contribute to late-life 

cognitive decline. The Committee supports the funding of new and 

continuing NIH studies that investigate the impact of postmenopausal hormone replacement therapy on stroke risk. Continued support of clinical and basic research on hormone physiology 

in women is necessary to understanding the impact of hormones on 

women’s vascular systems. The Committee urges NIH to increase 

research in stroke among women of all ages, with specific attention 

to gender-related differences in stroke risk, and to stroke prevention interventions, acute stroke management, post-stroke recovery, 

long-term outcomes, and quality of care. The Committee further 

urges NIH to increase research into new therapies for stroke in 

women as well as into ways of enhancing the vascular health of all 

Americans, including: (1) observational research on differences in 

the way men and women present with stroke symptoms, (2) research addressing how stroke influences the likelihood and severity 

of cognitive impairment in women, (3) a clinical trial of carotid 

endarterectomy and angioplasty/stenting in women, (4) studies of 

differences in how men and women respond to FDA-approved 

antiplatelet agents for recurrent stroke prevention, and (5) basic 
163 

science research to address unique brain cell death and repair 

mechanisms in females. 

The Committee also encourages and supports NIH’s initiatives 

toward advancing the organization of stroke care, including poststroke rehabilitation, and the identification of stroke treatment and 

research centers that would provide rapid, early, continuous 24- 

hour treatment to stroke victims, including the use of the clot-buster t-PA, when appropriate. Designated areas in medical facilities 

equipped with the resources and personnel for treating stroke 

would also promote the early evaluation of innovative stroke treatments. 

Vulvodynia.—Since fiscal year 1998, the Committee has highlighted the need for research on the prevalence, causes and treatment of vulvodynia, a painful and often debilitating disorder of the 

female reproductive system. The Committee is pleased that some 

progress has been made since that time. For example, the NICHD 

has supported a major study of the prevalence of this disorder. The 

published results of this study found that as many as 6 million 

women suffer from vulvodynia, making it one of the most prevalent 

chronic pain conditions affecting women. The Office of Research on 

Women’s Health [ORWH] was crucial in supporting an important 

2003 research conference on vulvodynia. These efforts have both 

clearly demonstrated the need for substantial additional research 

and served to heighten the research community’s level of interest 

in studying vulvodynia. The Committee calls upon the Director to 

build upon these initial successes by coordinating through the 

ORWH an expanded and collaborative extramural and intramural 

research effort into the causes of and treatments for vulvodynia. 

This expanded effort should involve ORWH, NICHD, NINDS and 

other relevant ICs as well as the NIH Pain Consortium. In addition, the Committee notes that as many as 40 percent of women 

with vulvodynia remain undiagnosed after visiting three or more 

physicians. To address this shortcoming, the Committee urges that 

NIH include information about vulvodynia on its website and that 

it work with the National Vulvodynia Association, the American 

College of Obstetricians and Gynecologists and other relevant 

groups to implement a national education program for primary care 

health professionals, patients and the general public on 

vulvodynia’s symptoms, diagnosis and treatment options. Finally, 

the Committee encourages the Director to work with the Center for 

Scientific Review and ICs to ensure that experts in vulvodynia and 

related chronic pain and female reproductive system conditions are 

adequately represented on peer review panels. 

Office of Dietary Supplements 

The Committee continues to strongly support the important work 

of this Office. Use of dietary supplements has increased significantly among Americans who want to improve their health and 

prevent disease. There is a great need for additional research to 

better inform consumers of the health benefits of supplements. Accordingly, the Committee has provided additional funds to expand 

this Office’s efforts. 

As in past years, the Committee strongly urges the Office to 

speed up ongoing collaborative efforts to develop, validate and dis-
164 

seminate analytical methods and reference materials for the most 

commonly used botanicals and other dietary supplements. This effort is a crucial underpinning for conducting quality research and 

assuring quality and consistency for consumers of dietary supplements. 

The Committee commends ODS for developing a request for proposals for a contract with industry nonprofit associations or foundations that currently have and maintain a database of dietary supplement labels to develop, create, continually update, maintain and 

make available to Government and research entities a database of 

all supplement labels sold in the United States. The creation of this 

database will allow ODS to have access for research purposes of all 

known supplements manufactured in the United States and to 

allow access by other Federal agencies for ensuring safety to consumers who purchase supplements manufactured and/or sold in the 

United States, through the mandatory listing of ingredients in 

these products on the label. 

The Committee notes that there is great potential in work being 

done on the relationship between fish oils and other dietary supplements in combating anti-inflammatory diseases. This also applies 

to work being done on the potential for selected botanicals to reverse the development of insulin resistance, the key pathophysiologic feature of metabolic syndrome. Given the growing prevalence of obesity, expansion of this area of research is clearly warranted. 

A number of recent studies point to the need for an expansion 

of ODS support for research into herb-drug interactions. ODS, 

NCCAM and other ICs at NIH are supporting important work in 

this area, and it should be expanded. Improved dissemination of results of this research to the public, health professionals and other 

interested parties is also needed. 

The Committee commends ODS for its efforts to seek input from 

consumers, industry, researchers and other stakeholders on its future agenda. ODS should continue and expand its outreach to industry stakeholders to share information, gather ideas and assure 

better coordination of privately and publicly funded research. 

Office of Behavioral and Social Sciences Research 

The Office Behavioral and Social Sciences Research furthers the 

mission of the NIH by emphasizing the role that behavioral and social factors and their interaction with biomedical variables play in 

health. The goals of the office are to enhance behavioral and social 

sciences research and training; integrate a biobehavioral perspective across the NIH; and improve communication among health scientists and with the public. 

Office of Rare Disease Research 

The Office of Rare Diseases was established in 1993 to address 

the conditions that affect fewer than 200,000 persons in the United 

States. The goals of the office are to stimulate and coordinate research on rare diseases and to support research to respond to the 

needs of patients who suffer from the more than 6,000 rare diseases known today. 
165 

Multi-Institute Research Initiatives 

Autism Spectrum Disorders.—The Committee is encouraged by 

the NIH’s autism research matrix and urges NIH to devote sufficient resources to this research agenda. The Committee urges the 

NIH when implementing the autism research matrix 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 characterizations of the disorder and screening and early diagnosis. 

Autoimmune Diseases.—The Committee commends the NIH 

Autoimmune Diseases Coordinating Committee [ADCC] for fostering collaborative, integrated multi-Institute research on issues 

affecting the genetically related family of autoimmune diseases. 

Implementation of autoimmune diseases research by the ADCC 

should focus on high-priority, cross-cutting opportunities, including 

research into the role of environmental and infectious agents in the 

initiation and/or exacerbation of autoimmune diseases. The Committee also encourages the ADCC to identify and initiate promising 

areas of autoimmune research where collaboration among the NIH 

institutes enhances the potential for major advances in understanding the common etiology of, and developing more effective diagnostic and treatment tools for, this family of debilitating and 

high-cost diseases. 

Bone Health and Osteoporosis.—The Committee is pleased that 

the Surgeon General has submitted the report on bone health requested in the fiscal year 2002 Appropriations bill. The Surgeon 

General calls for a national action plan to achieve improved bone 

health. To this end, the Committee encourages the NIH to establish a ‘‘Bone Health Research Blueprint’’ to achieve the Surgeon 

General’s objectives through enhanced cooperation between and 

among the NIH research 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 May 1, 2006. 

Chronic Fatigue Syndrome.—The Committee is deeply concerned 

that NIH has failed to expand research on chronic fatigue syndrome [CFS] and that a June 2003 commitment to issue a request 

for applications on CFS has not yet been fulfilled. The RFA should 

emphasize multi-disciplinary studies to understand the cause and 

progression of CFS in adults and children, identify diagnostic 

markers and develop effective treatment. The Committee also is 

troubled that a CFS funding report for fiscal years 1999–2003 

issued in response to congressional requests included amounts for 

grants unrelated to CFS, thus artificially inflating the total dollars 

awarded for CFS research. CFS is just one condition for which this 

has been a problem. The Committee requests that NIH report back 

to it by May 1, 2006, on the number of CFS-specific grant applications received and funded since fiscal year 2000. 

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 
166 

Human Services. The Committee applauds NIH for developing and 

implementing 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. In response 

to recommendations in the 1993 National Research Council report 

entitled Understanding Child Abuse and Neglect, the NIH child 

abuse and neglect initiative first addressed the knowledge gaps in 

child neglect. The Committee encourages NIH to proceed with the 

research agenda by examining current research gaps 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. 

Clinical Research and Academic Health Centers.—Past breakthroughs in basic biomedical sciences have provided an unprecedented supply of information for improving health and preventing 

disease. But in recent years, the Nation’s academic health centers, 

which serve as the staging ground that deploys the results of research to hospitals and health care providers, have encountered obstacles that threaten to slow the pace of clinical research, including 

unfunded mandates. Without a robust infrastructure, the translation of basic science into tangible public health improvements 

will be slowed. The Committee therefore encourages the Director to 

take concrete steps to address the problems encountered by academic health centers. 

Clinical Research Curriculum Award.—The Clinical Research 

Curriculum Award has been extremely effective in training successful clinical researchers. The Committee supports the NIH decision 

to increase the size of these awards from $200,000 to $300,000 but 

is concerned that it was accomplished by reducing the number of 

funded institutions. The Committee urges the Director to consider 

an increase in funding from Institutes and Centers that support 

the program in order to expand rather than reduce the number of 

institutions receiving this award. In addition, the Committee reiterates its support for implementation of the Congressionally authorized Graduate Training in Clinical Investigation award to provide tuition and stipend support for clinical research training program students. 

Clinical Research Workforce Training.—The Committee has 

heard testimony that virtually every medical specialty is experiencing a shortage of adequately trained clinical investigators capable of translating 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 urges allocation of sufficient resources for 

training of physician-scientists throughout all NIH institutes, to 

support studies of patient outcomes, medical effectiveness, and 

disease- and treatment-specific quality of life. 
167 

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. 

Distribution of Resources.—The Committee believes, in light of 

the doubling of the NIH budget and the emergence of new medical 

research challenges such as SARS and threats of bioweapons, NIH 

should encourage funding of large scale collaborative efforts to address these and other medical challenges. In addition, while the 

pace of new challenges has increased, review time for proposals 

submitted to the Institutes at NIH continues to average about 18 

months. The Committee strongly encourages the Director to develop means of encouraging large scale multi-institution projects to 

address significant areas of medical research and to devise means 

of reducing the time frames between submission of proposals and 

awarding of grants. 

Down Syndrome Research Task Force.—The Committee urges the 

Director of NIH to establish a NIH Down Syndrome Research Task 

Force 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 the 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 requests the NIH to report to 

Congress by June 1, 2006 on the steps it is taking to develop the 

Down Syndrome Research Task Force on Cognition. 

Duchenne Muscular Dystrophy.—The Committee remains concerned with the amount of time taken by the NIH to comply with 

requirements of the MD Care Act, which became law in December 

2001. The Committee is pleased NIH has funded one additional 

Wellstone Muscular Dystrophy Cooperative Research Center and is 

working to fund two more for a full complement of six. The Committee further encourages the Institute to provide adequate funding and resources for each center. As the original report on the activities being performed pursuant to the MD Care Act was both 

late in coming and insufficient in detail, the Committee requests 

that NIH submit a report to the Committee no later than May 1, 

2006 stating the current research goals and progress made toward 

each goal; the Institute or Center responsible for each goal; the 

total amount of money invested toward each goal as well as projected spending for the present and future fiscal year; opportunities 

for external partnerships; and a timeline for establishing a 

Duchenne/Muscular Dystrophy translational research initiative, 

modeled on the lines of the spinal muscular atrophy project. The 

Committee recognizes that several promising treatments and 

therapies for Duchenne and Becker Muscular Dystrophy are in development, and urges NIH to invest additional resources, including 

a coordinating mechanism, necessary to expedite their translation 
168 

into practice. Furthermore, the Committee urges NIH to work with 

leading stakeholders to convene a consensus conference on 

translational research opportunities in early 2006, and report back 

to the Committee, by September 2006, with a strategic plan for 

launching a translational research initiative. 

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. 

Epilepsy.—While NINDS is the primary Institute for addressing 

epilepsy research, several other Institutes are also involved in related research. The Committee urges the Director to intensify coordination of cross-cutting research on epilepsy in all Institutes. 

Fragile X.—The Committee notes the impressive progress made 

by Fragile X researchers in understanding the basic neural defects 

that cause this developmental disorder. NIH Institutes, units, and 

its National Center for Research Resources provided 75 grants in 

fiscal year 2004 to find a treatment and cure for Fragile X. The 

success of these translational research efforts has made treatment 

of Fragile X a near-term possibility. 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, 

including—but not limited to—mGluR5 antagonists, Ampakines, 

aripiprazole, and lithium. The Committee strongly urges the Director to facilitate and fund public/private partnerships which will enable these vital studies to proceed. In addition, privately-funded 

Fragile X research is rapidly expanding, often in partnership with 

NIH grants. The Committee commends the growing breadth and 

diversity of this research but strongly urges the Director to establish a coordinating mechanism to direct and coordinate these efforts in regularly-scheduled meetings. To achieve this mandate, the 

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. The Committee also encourages 

the Director to increase the number and size of institutional training grants to institutions supporting pediatric training and the 

number of grants for career development clinical research as they 

relate to Fragile X. 

Gene Therapy Research.—While the promise of gene therapy has 

not yet been realized, the Committee is encouraged by some promising 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 
169 

for the most promising areas for breakthroughs in this field and to 

develop an aggressive 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. The 

goal of this effort should be nothing less than to cure a disease in 

the shortest possible time utilizing gene therapy techniques. 

Heart Disease Research and Prevention Action Plan.—Advances 

have been made in the identification and treatment of risk factors 

for heart disease. The Committee encourages the NIH to convene 

a transagency national conference on heart disease to assess 

progress and opportunities and 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 and all relevant institutes and centers, CDC, AHRQ, DOD, and pertinent voluntary nonprofit organizations, foundations, and experts in the 

field. The Committee encourages the Director to develop a longrange, strategic Heart Disease Research and Prevention Action 

Plan and submit a report to the Committee by May 1, 2006. The 

plan should include quantifiable goals and benchmarks to measure 

progress in the battle against heart disease, and a professional 

judgment budget for each year as well as for the entire plan. 

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 occurs in 20 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. 

Hepatitis B.—Although there has been tremendous success in the 

prevention and treatment of hepatitis B, this disease remains a serious concern. The Committee proposes that the success of past research be built upon with new program development and the potential for new funding. The large number of immigrants to the 

United States from parts of the world where hepatitis B is endemic 

will keep this disease in the forefront of public health for years to 

come. For example, the more than 8 million people who are estimated to have immigrated from Asia to the United States in the 

past 10 years, alone, will significantly add as many as 600,000 people to the more than 1.2 million people already believed to be 

chronically infected, in the United States. The Committee urges the 

Director of NIH to report to Congress the amount of funding necessary to develop programs which would stimulate new research to 

find: (1) complements for the current therapies for hepatitis B, (2) 

improvements in the detection and treatment of hepatitis and liver 

cancer associated with hepatitis B, (3) improvements in the prevention of the disease by development of new vaccines, new outreach 

and population studies. Initiatives that promote truly innovative 

approaches and stimulate and excite new investigation in these 

areas is specifically encouraged. 
170 

Human Tissue Supply.—The Committee remains interested in 

matching the increased needs of NIH grantees, intramural, and 

university-based researchers who rely upon human tissues and organs to study human diseases and search for cures, including for 

those researchers dedicated to the study and cure of rare diseases. 

The Committee is aware that one of the leaders in this competitive 

field, the National Disease Research Interchange [NDRI], is 

uniquely positioned to obtain this valuable and effective alternative 

research resource. More than 500 peer-reviewed research advances 

made by NDRI-dependent researchers have been published during 

the past 4 years contributing to the research community’s fund of 

knowledge. The Committee is encouraged by NDRI’s role in these 

research advances and applauds the Director’s expanded support 

for NDRI by bringing NEI, NIDDK, NIAID, NIAMS, and the Office 

of Rare Diseases into the multi-Institute initiative. While this is 

promising, more needs to be done to match the demand for the use 

of human tissue in research. The Committee, therefore, expects the 

Director to increase the core support NDRI receives from NCRR, 

and to broaden the scope of the multi-Institute initiative by strongly urging the Institute Directors of NCI, NHGRI, NHLBI, NICHD, 

NIMH, and NINDS to identify and implement program-specific initiatives to expand support for NDRI. 

Islet Transplantation.—The Committee commends the 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 encourages 

cooperation between the NIDDK and NIAID and members of the 

Consortium to ensure the timely launch of these clinical trials. 

Kidney Disease.—The Committee is aware that kidney disease is 

a major health problem in the United States, and according to a 

recent CDC study is one of the fastest growing causes of death in 

the United States. It is estimated that at least 15 million people 

have lost 50 percent of their kidney function and another 20 million more are at increased risk of developing kidney disease due to 

diabetes, cardiovascular disease and hypertension. Of these individuals, a disproportionate share are minorities. The Committee encourages the Director to ensure that the NIDDK and NHBLI work 

closely and collaboratively to maximize the output of our national 

investment in kidney disease. 

Lupus.—The Committee recognizes lupus is a serious, complex, 

debilitating chronic autoimmune disease that can cause inflammation and tissue damage to virtually any organ system in the body. 

The Committee strongly urges the Director of the National Institutes of Health to expand, intensify and coordinate research and 

related activities with respect to lupus across all relevant institutes, centers and offices, especially the National Institute of Arthritis and Musculoskeletal and Skin Diseases, and the National 

Institute of Allergy and Infectious Diseases. 

The Committee is disappointed with the pace of research regarding lupus and strongly urges that the Director of the National Institutes of Health conduct or support research to expand the understanding of lupus, including: basic research to discover the pathogenesis and pathophysiology of the disease; research to determine 
171 

the reasons underlying the disproportionate prevalence of lupus in 

African American, Hispanic, Native American, and Asian women; 

epidemiological studies to address the frequency and natural history of the disease and the differences between the sexes and 

among racial and ethnic groups with respect to the disease; clinical 

research for the development and evaluation of new treatments, including new biological agents; and research to validate lupus biomarkers; and research to develop improved diagnostic tests. The 

Committee strongly urges the Institute to increase funding for 

lupus research by actively soliciting grant applications for lupus 

and taking aggressive steps to assure that a vigorous research program is established. 

Lymphangioleiomyomatosis [LAM].—The Committee remains 

very interested in efforts to find a cure and treatments for LAM, 

a progressive and fatal lung disease that strikes women, usually in 

their childbearing years. Currently, there are no effective treatments. The Committee understands that recent scientific findings 

have presented new treatment approaches for clinical testing, and 

that experimental trials with the drug sirolimus have begun. The 

Committee urges the NHLBI, as well as the NCI, the Office of Rare 

Diseases, and the NINDS to fund clinical treatment trials through 

both intramural and extramural means and to use all available 

mechanisms as appropriate, including support of state-of-thescience symposia, request for applications, and facilitating access to 

human tissues to stimulate a broad range of clinical and basic 

LAM research. The Committee also commends the NCRR and ORD 

for their roles in supporting the Rare Lung Disease Consortium. 

Lymphatic 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 is woefully deficient. While the Committee is pleased that a Trans-NIH Coordinating Committee on the Lymphatic System exists to ensure that 

scientific knowledge and understanding about this neglected body 

system will be advanced and coordinated, adequate efforts and 

funding are lacking. ICs are urged to include relevant language addressing basic and clinical lymphatic system research in all existing and future funding mechanisms, where such grant applications 

could be responsive. The Trans-NIH Coordinating Committee 

should be informed of relevant lymphatic language included within 

such funding initiatives. 

The Committee is encouraged to learn that the Trans-NIH Coordinating Committee on the Lymphatic System, and in particular 

the NHBLI, is working with patient advocates to address the needs 

of the lymphatic disease and lymphedema patient communities. 

Initiatives such as a national lymphatic disease patient registry/tissue bank; an NIH lymphatic disease working group and national 

guidelines for clinical care; an NIH partnership funding program; 

intramural longitudinal studies; and multidisciplinary centers for 

research, clinical care, and medical training are strongly encouraged. 

Nanosystems Biology.—The Committee encourages the Director, 

along with NCI, to support a collaborative effort to bring 

nanotechnology, systems biology and molecular imaging together to 

examine the molecular basis of cancer, consistent with the Direc-
172 

tor’s Roadmap Initiative. Initial efforts have shown that cancers 

such as breast cancer are not a single disease, but may encompass 

many different diseases, when examined at the molecular level. 

Many clinical trials of new drugs are now considered to fail if only 

10 percent of patients benefit, yet that 10 percent may represent 

a specific type of the disease, where the drug in question may be 

100 percent effective. Bringing these three disciplines together may 

allow researchers to identify specific sub-types of cancer and to better target new interventions. Successful results of such an effort 

could lead to a molecular classification of many types of cancer and 

to targeted molecular treatments for molecular-specific disease. 

Parkinson’s Disease.—The Committee understands that the Director, in accordance with the Udall Act, convened a research conference in June 2005. The Committee strongly urges the Director 

to report back to the Committee by May 1, 2006 to address current 

and ongoing Parkinson’s disease research including the final analysis of the Parkinson’s Disease Research Agenda that expired this 

year, the goals and conclusions from the summit held in June 2005, 

a thorough examination of the existing Parkinson’s research portfolio, identification of shortcomings and opportunities for more effective treatments and a cure for Parkinson’s, and recommendations of research goals for the next 3 years to help scientists better 

understand the causes, more quickly diagnose, and develop better 

treatments and a cure for Parkinson’s disease. 

The Committee strongly urges the NIH to work in conjunction 

with the Centers for Disease Control and Prevention to investigate 

and report on geographic population clusters of incidence of Parkinson’s disease. It is estimated that more than 1 million Americans 

are fighting Parkinson’s disease and 60,000 cases are newly diagnosed each year. However, these figures are only estimates. Further, it is believed that there are increasing numbers of Americans 

who are diagnosed with young onset Parkinson’s disease. With a 

stronger understanding of who is impacted by this devastating disease, the NIH will be better able to better target critical research 

funds that will find treatments or cures for the more than 1 million 

Americans who have this progressive, neurodegenerative disease. 

Peer Review of Patient-Focused Research.—In 1998, the NIH Director’s Panel on Clinical Research identified problems with NIH 

peer review of clinical research grant applications and recommended the organization of study sections capable also of reviewing patient-oriented research and the implementation of a system for tracking the review of these clinical research applications. 

Nevertheless, a 2002 General Accounting Office report to Congress 

indicated that the NIH did not have reliable methods for identifying and tracking patient-oriented research applications or reviewers. More recent analysis by the Center for Scientific Review has 

confirmed previous studies demonstrating that grant applications 

focused on patient-oriented research are less likely to receive funding than laboratory research grant proposals. The Committee believes it is critically important that the Director take action to address this disparity and requests a report regarding efforts that are 

being undertaken to recruit clinical investigators to participate in 

the peer review process, to assure that patient-oriented research 

applications are assigned to knowledgeable review groups, and to 
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improve the system for tracking the review of clinical research 

grants to assure that shortcomings of the review process are identified and corrected. 

Pioneer Awards.—The Committee is pleased with the establishment of the NIH Director’s Pioneer Award, an innovative program 

designed to encourage investigators to pursue high-risk research 

avenues of research with the potential to result in truly 

groundbreaking discoveries. The Committee is especially pleased 

that this program has attracted a large number of interested, highquality applicants, but is concerned that relatively few awards 

have been made so far. 

Population-Based Prevention Research.—The Committee commends NIH for its efforts to support research in humans that examines factors associated with preventing disease and promoting 

health. The Committee urges the NIH to seek ways to remove barriers that prevent research findings from being translated into population-wide health improvements and to expand its support for 

studies that include examination in human populations of biological, behavioral and environmental factors associated with disease 

and means to ameliorate them. 

The Committee urges the Director to support additional genetic 

research to identify the genes responsible for psoriasis susceptibility, basic research to understand the mechanism of disease and 

clinical research to identify new safe and effective therapies for 

these diseases. 

Rehabilitation Services.—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 urges the Director to establish a research program in the National Center for Medical Rehabilitation Research 

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 NCMRR is still a relatively new agency 

with a small budget and its research portfolio needs to be expanded 

particularly in the area of medical and physical rehabilitation and 

musculoskeletal conditions. The Committee urges the National Institute on Aging, the National Institute on Arthritis and Musculoskeletal and Skin Diseases, and the National Institute on Biomedical Imaging and Bioengineering to collaborate on these initiatives. 

Reproductive Health Research.—The Committee is concerned that 

the NIH does not have trans-NIH information regarding the 

amount of infertility and reproductive health research that is conducted in many Institutes including NICHD, NCI, NIDDK, NIAID, 

and NIEHS. The Committee is concerned that until NIH has accurate trans-NIH information, it is not possible to lead and coordinate this area of research to help ensure scientific and research 

progress. The Committee therefore urges that the Office of the Director ensure that such information is available in order to permit 
174 

a vigorous scientific leadership with regard to this category of diseases that has devastating physical, social, financial and psychological consequences. 

Research Centers at Minority Health Institutions.—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, Extramural Biomedical 

Research Facilities, and the National Center on Minority Health 

and Health Disparities. The Committee encourages that the NIH 

Director work closely with the Director of the National Center on 

Minority Health and Health Disparities to establish a program of 

coordination among these various mechanisms to partner with minority health professions schools to address their infrastructure 

needs. 

Spinal Muscular Atrophy.—The Committee strongly urges the 

OD to ensure the success of the SMA Project by providing active 

and ongoing support from the OD as well as from other related Institute Directors. While the Committee commends the active work 

and progress of NINDS on the SMA Project, the Committee remains concerned that other Institutes, to date, has made no commitment to SMA research. The Committee reiterates its request of 

last year that the OD take all necessary steps to ensure that relevant Institutes are fully engaged by devoting attention and resources to SMA and specifically to the SMA Project. 

Temporomandibular Joint Disorders [TMJ].—The Committee 

continues its strong support of research into TMJ disorders. The 

Committee agrees with and is encouraged by recent public statements by NIH officials that because of past and current investments in research and patient registries, the field is now ready to 

support a substantial new research investment in this complex set 

of disorders. The Committee therefore strongly urges that this path 

be followed and that a substantially expanded TMJ research effort 

be undertaken to speed up completion of the research needs and 

opportunities agenda outlined in the June 2005 NIH TMJ Report 

to Congress. As noted previously, the multifaceted nature of TMJ 

disorders requires an approach that coordinates the work of many 

interested parties at NIH. Therefore, this expanded effort should 

include increased efforts from all relevant ICs and should give priority to collaborative, cross-cutting research. 

In addition, the Committee strongly encourages the Director, 

through the NIDCR and ORWH, to undertake an effort to improve 

awareness among dentists and other relevant health professionals 

such as internists, rheumatologists, otolaryngologists, neurologists 

and other primary care professionals about TMJ disorders. Such an 

effort should include the development of a model symposium on 

this topic and the presentation of this symposium at relevant major 

medical society conferences. 

Trans-NIH Research Initiatives.—The Committee commends NIH 

for continuing to expand trans-NIH research initiatives that foster 

scientific collaboration and advancement. The Committee is particularly interested in programs like the Blueprint for Neuroscience 

Research, which pools the resources and expertise of 15 NIH institutes and centers to focus on disorders of the nervous system. The 
175 

multidimensional roots of the obesity epidemic—encompassing behavioral, biological, and environmental factors—call for research efforts across Institutes and Centers, and the Committee commends 

the activities undertaken through the trans-NIH Strategic Plan for 

Obesity Research. The Committee urges that funds allocated to the 

NIH Institutes and Centers be used for increased support of the 

Neurosciences Blueprint and increased research in obesity. 

Tuberous Sclerosis Complex.—Tuberous sclerosis complex, or 

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 in 2003 called upon the NIH Director to formulate an 

NIH-wide research agenda. The Committee is encouraged by recent 

steps taken by the Office of the Director to establish a Trans-NIH 

Tuberous Sclerosis Coordinating Committee. The Committee encourages the Office to continue its support of this Committee and 

expand it to include other Institutes such as the NEI, NIGMS and 

NICHD. 

OFFICE OF AIDS RESEARCH

The Committee recommendation does not include a direct appropriation for the Office of AIDS Research [OAR]. Instead, funding 

for AIDS research is included within the appropriation for each Institute, Center, and Division of the NIH. The recommendation also 

includes a general provision which directs that the funding for 

AIDS research, as determined by the Director of the National Institutes of Health and the OAR, be allocated directly to the OAR for 

distribution to the Institutes consistent with the AIDS research 

plan. The recommendation also includes a general provision permitting the Director of the NIH and the OAR to shift up to 3 percent of AIDS research funding among Institutes and Centers 

throughout the year if needs change or unanticipated opportunities 

arise. The Committee requests that the Director provide notification to the Committee in the event the Directors exercise the 3 percent transfer authority. 

The NIH Office of AIDS Research [OAR] coordinates the scientific, budgetary, legislative, and policy elements of the NIH AIDS 

research program. Congress provided new authorities to the OAR 

to fulfill these responsibilities in the NIH Revitalization Act 

Amendments of 1993. The law mandates the OAR to develop an 

annual comprehensive plan and budget for all NIH AIDS research 

and to prepare a Presidential bypass budget. 

BUILDINGS AND FACILITIES

Appropriations, 2005 ............................................................................. $110,288,000 

Budget estimate, 2006 ........................................................................... 81,900,000 

House allowance .................................................................................... 81,900,000 

Committee recommendation ................................................................. 113,626,000 

The Committee recommends an appropriation of $113,626,000 for 

buildings and facilities [B&F]. The budget requested $81,900,000 

and the fiscal year 2005 appropriation was $110,288,000. 
176 

Mission.—The buildings and facilities appropriation provides for 

the NIH construction programs including design, construction, and 

repair and improvement of the clinical and laboratory buildings 

and supporting facilities necessary to the mission of the NIH. This 

program maintains physical plants at Bethesda, Poolesville, Baltimore, and Frederick, MD; Research Triangle Park, NC; Hamilton, 

MT; Perrine, FL; New Iberia, LA; and Sabana Seca, PR. 

The Committee has included full-scope bill language within this 

appropriation to give flexibility to the NIH to continue work on the 

John E. Porter Neuroscience Research Center for which 

$15,000,000 has been included. Funds have also been included for 

the Animal Research Center, the Rocky Mountain Laboratories 

Buffer Replacement Facility, asbestos abatement, fire protection 

and health and safety compliance, air quality improvement programs and to eliminate barriers to persons with disabilities. 

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

Appropriations, 2005 ............................................................................. $3,391,769,000 

Budget estimate, 2006 ........................................................................... 3,336,023,000 

House allowance .................................................................................... 3,352,047,000 

Committee recommendation ................................................................. 3,385,086,000 

The Committee recommends $3,385,086,000 for the Substance 

Abuse and Mental Health Services Administration [SAMHSA] for 

fiscal year 2006. This amount is $6,683,000 below the comparable 

fiscal year 2005 level and $49,063,000 above the administration request. The recommendation includes $123,303,000 in transfers 

available under section 241 of the Public Health Service Act. 

SAMHSA is responsible for supporting mental health programs 

and alcohol and other drug abuse prevention and treatment services throughout the country, primarily through categorical grants 

and block grants to States. 

The Committee has provided funding for programs of regional 

and national significance under each of the three SAMHSA centers: 

mental health services, substance abuse treatment and substance 

abuse prevention. Separate funding is available for the children’s 

mental health services program, projects for assistance in transition from homelessness, the protection and advocacy program, data 

collection activities undertaken by the Office of Applied Studies 

and the two block grant programs: the community mental health 

services block grant and the substance abuse prevention and treatment block grant. 

The Committee strongly supports SAMHSA’s Federal leadership 

role to improve the quality and availability of empirically-based 

prevention and treatment services in the areas of mental health 

and substance abuse. To further the translation of research knowledge into practice, the Committee supports the ongoing collaboration between SAMHSA and the National Institutes of Health (specifically with the National Institute of Mental Health, the National 

Institute on Drug Abuse, and the National Institute on Alcohol 

Abuse and Alcoholism). Through this partnership, services research 

conducted by NIH will identify effective treatment and prevention 

strategies, the findings of which will be promoted by SAMHSA 

through its knowledge dissemination programs to improve the 

quality of services rendered. Furthermore, outcomes from program 
177 

evaluation research conducted by SAMHSA will be communicated 

as critical implementation feedback to NIH, and may ultimately 

lead to further improvements in the delivery of effective mental 

health and substance abuse services in community programs nationwide. 

The Committee expects that no less than the amounts allocated 

in fiscal year 2005 will be spent in fiscal year 2006 on activities 

throughout SAMHSA addressing the needs of the homeless. Specifically, the Committee has provided funding at last year’s level for 

programs directed at chronic homelessness and for programs directed at providing mental health and substance abuse treatment 

services to homeless. 

The Committee notes that, according to a study released by the 

New England Journal of Medicine, as many as one in four veterans 

of Afghanistan and Iraq treated at Veterans Affairs hospitals in the 

past 16 months have been diagnosed with mental disorders. While 

many at-risk veterans will take advantage of mental health services available through the Departments of Defense and Veterans 

Affairs, concern about possible stigmatization may lead some veterans to avoid treatment through these sources. The Committee believes that community outreach, early intervention and treatment 

for veterans will be a significant need in the coming years and encourages SAMHSA, through CMHS and CSAT, to develop opportunities for communities to prepare and coordinate mental health and 

addiction services for returning combat veterans and their families. 

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 encourages SAMHSA to expand the program. 

The Committee remains concerned by the disproportionate presence of substance abuse in rural and native communities, particularly for American Indian, Alaska Native and Native Hawaiian 

communities. The Committee reiterates its belief that funds for 

prevention and treatment programs should be targeted to those 

persons and communities most in need of service. Therefore, the 

Committee has provided sufficient funds to fund projects to increase knowledge about effective ways to deliver services to rural 

and native communities. 

CENTER FOR MENTAL HEALTH SERVICES

Appropriations, 2005 ............................................................................. $901,317,000 

Budget estimate, 2006 ........................................................................... 837,250,000 

House allowance .................................................................................... 880,294,000 

Committee recommendation ................................................................. 901,334,000 

The Committee recommends $901,334,000 for mental health 

services. This amount is $17,000 above the comparable level for fiscal year 2005 and $64,084,000 above the administration request. 

The recommendation includes $21,803,000 in transfers available 
178 

under section 241 of the Public Health Service Act. Included in the 

recommendation is funding for programs of regional and national 

significance, the mental health performance partnership block 

grant to the States, children’s mental health services, projects for 

assistance in transition from homelessness, and protection and advocacy services for individuals with mental illnesses. 

Programs of Regional and National Significance 

The Committee recommends $274,297,000 for programs of regional and national significance. This amount is the same as the 

comparable level for fiscal year 2005 and $64,084,000 above the administration request. Programs of regional and national significance address priority mental health needs through developing and 

applying best practices, offering training and technical assistance, 

providing targeted capacity expansion grants, and changing the delivery system through family, client-oriented and consumer-run activities. 

The Committee remains deeply concerned that suicide is the 

third leading cause of death among adolescents. Consistent with 

the recommendations of the President’s New Freedom Commission 

on Mental Health, the Committee in fiscal year 2005 called upon 

SAMHSA to award grants to local educational systems or non-profit entities in conjunction with local educational systems to test the 

use of screening mechanisms and to identify evidence-based practices for facilitating treatment for youth at risk. The Committee 

has provided funding at last year’s level for SAMHSA to continue 

this effort in fiscal year 2006. In addition, the Committee has provided $11,000,000 for State 

and campus-based programs that address youth suicide prevention. 

This is an increase of $2,556,000 above the comparable level for fiscal year 2005 and the administration request. The Committee has 

included funding at last year’s level to continue supporting the National Suicide Prevention Resource Center. This important initiative supports technical assistance in developing, implementing and 

evaluating effective suicide prevention programs. The Resource 

Center serves as a training and field support and acts as a clearinghouse for all pertinent best practices information regarding suicide prevention, and it promotes evaluation of suicide prevention 

programs to ensure that effective techniques, strategies, and recommended best practices are made available to users. The Committee also continues funding at last year’s level for the Suicide 

Prevention Hotline program. 

The Committee notes that the National Strategy for Suicide Prevention calls for the establishment of public/private partnerships 

for the purpose of advancing and coordinating the implementation 

of the National Strategy. While much progress has been made, 

many of the objectives included in the National Strategy have not 

been completed. The Committee commends SAMHSA for its work 

on examining the National Strategy objectives with the goal of developing a priority work plan and encourages SAMHSA to establish 

a coordinating body aimed at advancing the objectives of the National Strategy. 

The Committee continues to strongly support funding for prevention of youth violence. The Committee intends that no less than 
179 

last year’s level of funding be used for this initiative, which includes the Safe Schools/Healthy Students interdepartmental program. The administration proposed cutting this program by 

$27,427,000. The Committee believes that enhanced school and 

community-based services can strengthen healthy child development, thus reducing violent behavior and substance use. Since 

1999, over 180 communities have received and benefited from these 

grants. The Committee therefore is providing funding at last year’s 

level to assist schools in that effort. It is again expected that 

SAMHSA will collaborate with the Departments of Education and 

Justice to continue a coordinated approach. 

The Committee provides funding at last year’s level for the consumer and consumer-supporter national technical assistance centers. The Committee directs CMHS to support multi-year grants to 

five such national technical assistance centers. 

The Committee recommendation restores funding to the State Infrastructure Planning Grants activity. The administration request 

proposed to shift the funding source for this program to the CMHS 

block grant setaside. State Infrastructure Planning Grants are a 

critical initiative that informs both States and SAMHSA on practical implementation issues and mechanics related to the new performance and outcome data reporting requirements included in 

SAMHSA’s Data Strategy. 

The Committee recommendation includes funding at last year’s 

level for the elderly treatment and outreach program. The Committee notes that 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 helps 

local communities establish the infrastructure necessary to better 

serve the mental health needs of older adults. 

The Committee recommendation fully funds the administration 

request for the State Incentive Grants for Transformation program. 

The Committee directs SAMHSA to ensure that State mental 

health planning and advisory councils play a significant role in the 

development of comprehensive State plans under this new program, because the councils represent the consumer and family 

voice in States across the country. 

The Committee believes that research-based prevention and 

wellness promotion efforts that strengthen parenting and enhance 

child resilience in the face of adversity can have a significant impact on the mental health of children and youth. While some programs that use such a strengths-based approach exist for families 

already in contact with the juvenile justice system or immediate 

risk for dissolution, evidence suggests that they may be particularly effective for families that have one or more risk factors but 

are not yet in crisis and may not have had contact with child protective services or other government agencies. The Committee requests CMHS to provide it with a report by May 1, 2006 that reviews the effectiveness of such programs and the best ways to implement them so they reach families in need, and offers recommendations for future preventive efforts in this area. 
180 

Community Mental Health Services Block Grant 

The Committee recommends $432,756,000 for the community 

mental health services block grant, which is the same as the comparable fiscal year 2005 amount and the administration request. 

The recommendation includes $21,803,000 in transfers available 

under section 241 of the Public Health Service Act. 

States use these funds to support the development and implementation of innovative community-based services and maintain 

continuity of community programs. Funds are allocated 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 encourages SAMHSA to require 

that States’ plans include specific provisions for mental health 

services for older adults. 

Children’s Mental Health Services 

The Committee recommends $105,129,000 for the children’s mental health services program. This amount is $17,000 above the comparable fiscal year 2005 level and the same as the administration 

request. This program provides grants and technical assistance to 

support community-based services for children and adolescents 

with serious emotional, behavioral or mental disorders. Grantees 

must provide matching funds, and services must involve the educational, juvenile justice, and health systems. 

Projects for Assistance in Transition From Homelessness [PATH] 

The Committee recommends $54,809,000 for the PATH Program. 

This amount is the same as the comparable fiscal year 2005 level 

and the administration request. 

PATH provides outreach, mental health, and case management 

services and other community support services to individuals with 

serious mental illness who are homeless or at risk of becoming 

homeless. The PATH program makes a significant difference in the 

lives of homeless persons with mental illnesses. PATH services 

eliminate the revolving door of episodic inpatient and outpatient 

hospital care. Multidisciplinary teams address client needs within 

a continuum of services, providing needed stabilization so that 

mental illnesses and co-occurring substance abuse and medical 

issues can be addressed. Assistance is provided to enhance access 

to housing, rehabilitation and training, and other needed supports, 

assisting homeless people in returning to secure and stable lives. 

Protection and Advocacy 

The Committee recommends $34,343,000 for the protection and 

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

2005 level and the administration request. This program helps ensure that the rights of mentally ill individuals are protected while 

they are patients in treatment facilities, or while they are living in 

the community, including their own homes. Funds are allocated to 
181 

States according to a formula based on population and relative per 

capita incomes. 

CENTER FOR SUBSTANCE ABUSE TREATMENT

Appropriations, 2005 ............................................................................. $2,197,921,000 

Budget estimate, 2006 ........................................................................... 2,222,607,000 

House allowance .................................................................................... 2,184,986,000 

Committee recommendation ................................................................. 2,187,646,000 

The Committee recommends $2,187,646,000 for substance abuse 

treatment programs. This amount is $10,275,000 below the comparable fiscal year 2005 funding level and $34,961,000 below the 

administration request. The recommendation includes $83,500,000 

in transfers available under section 241 of the Public Health Service Act. This amount funds substance abuse treatment programs of 

regional and national significance and the substance abuse prevention and treatment block grant to the States. 

The Committee commends the Center for Substance Treatment 

[CSAT] for its ongoing collaboration with the National Institute on 

Drug Abuse [NIDA]. The Committee continues to be pleased that 

the CSAT/NIDA collaboration with State substance abuse directors, 

also known as Single State Authorities [SSAs] for Substance 

Abuse, is improving the manner in which evidence-based practices 

are used in our publicly funded system. The Committee encourages 

CSAT to continue its Blending Initiative with NIDA and SSAs to 

ensure that research findings are relevant and adaptable by State 

substance abuse systems. 

Programs of Regional and National Significance 

The Committee recommends $412,091,000 for programs of regional and national significance [PRNS]. The recommendation includes $4,300,000 in transfers available under section 241 of the 

Public Health Service Act. The recommendation is $10,275,000 

below the comparable fiscal year 2005 level and $34,961,000 below 

the administration request. 

Programs of regional and national significance include three primary activities: best practice programs are used to develop more 

information on how best to serve those most in need; training and 

technical assistance supports dissemination of information through 

knowledge development; and targeted capacity expansion programs 

enable the agency to respond to service needs in local communities. 

The Committee recommendation includes $100,000,000 for the 

Access to Recovery program. The Committee expects that addictive 

disorder clinical treatment providers participating in the Access to 

Recovery program, as well as their respective staff, shall meet the 

certification, accreditation, and/or licensing standards recognized in 

their respective States. 

The Committee recommends funding at no less than last year’s 

level for the Addiction Technology Transfer Centers [ATTCs]. The 

ATTC Network operates as 14 regional centers and one national office to translate the latest science of addiction, including evidencebased addiction treatment. The ATTCs are also an important component of the CSAT/NIDA Blending Initiative that seeks to improve the manner in which research findings are moved into every 

day practice. 
182 

The Committee continues to be concerned about the incidence of 

drug addiction among pregnant and parenting women. The unavailability of family-based treatment is manifested in the overrepresentation of substance-abusing mothers in the child welfare 

system. Up to 80 percent of the families who come to the attention 

of child welfare agencies are substance abusing. The absence of 

treatment opportunities for families has also extended to the criminal justice system. Nearly 70 percent of the women behind bars are 

suffering from untreated addiction. Most of these women offenders 

are mothers: approximately 65 percent of women in State prisons, 

and 59 percent of women in Federal prisons have young children. 

SAMHSA’s evaluation of both the Residential Women and Children [RWC] and Pregnant and Postpartum Women [PPW] programs showed significantly reduced alcohol and drug use, as well 

as decreased criminal behavior. Rates of premature delivery, low 

birth weight, and infant mortality were improved for participating 

women. In addition, treatment costs were offset three to four times 

by savings from reduced costs of crime, foster care, Temporary Assistance to Needy Families [TANF], and adverse birth outcomes. 

The Committee believes that increased capacity for family-based 

treatment programs is imperative. Within the funds appropriated 

for CSAT, the Committee recommends $11,000,000 for treatment 

programs for pregnant, postpartum, and residential women and 

their children. This amount is $1,080,000 above the comparable 

level for fiscal year 2005 and the administration request. No less 

than last year’s funding shall be used for the Residential Treatment Program for Pregnant and Postpartum Women [PPW], authorized under section 508 of the Public Health Service Act. In addition, the Committee strongly urges SAMHSA to explore ways to 

increase family treatment capacity. 

Substance Abuse Prevention and Treatment Block Grant 

The Committee recommends $1,775,555,000 for the substance 

abuse prevention and treatment block grant. The recommendation 

includes $79,200,000 in transfers available under section 241 of the 

Public Health Service Act. The recommendation is the same as the 

comparable level for fiscal year 2005 and the administration request. The block grant provides funds to States to support alcohol 

and drug abuse prevention, treatment, and rehabilitation services. 

Funds are allocated to the States according to formula. State plans 

must be submitted and approved annually. 

The Committee wishes to express its strong support for increased 

funding for the Substance Abuse Prevention and Treatment [SAPT] 

Block Grant, an effective and efficient funding stream that flows to 

every State and territory. The Committee is aware that the SAPT 

Block Grant funds critical prevention and treatment services for 

our Nation’s most vulnerable citizens, including those with HIV/ 

AIDS, pregnant women, and others who can not afford these lifesaving services. The Committee continues to believe that the most 

effective and efficient way to support substance abuse programs in 

every State and territory is to direct the bulk of available new resources into the SAPT Block Grant. 

The Committee is aware of SAMHSA’s efforts to improve the 

quality of substance abuse prevention and treatment data by seek-
183 

ing information on a core set of National Outcome Measures 

[NOMS] across all SAMHSA funding mechanisms, including services funded by the SAPT Block Grant. The Committee is also aware 

of SAMHSA’s work to implement a State Outcomes Measurement 

and Management System [SOMMS] as the mechanism to achieve 

this initiative. The Committee commends SAMHSA for working 

with States and territories to streamline data reporting requirements and reduce reporting burden while improving accountability. 

The Committee strongly encourages SAMHSA to continue to work 

with States and territories to reach consensus on all aspects of 

SOMMS planning, implementation and evaluation. 

The Committee recognizes that States receiving the HIV setaside within their Substance Abuse Prevention and Treatment 

Block Grant are well positioned to offer hepatitis prevention services to high risk clients, and encourages set-aside dollars to be used 

to support hepatitis prevention. The Committee recognizes that the 

majority of new hepatitis C virus infections are related to drug use, 

and asks SAMHSA to encourage all grantees to incorporate hepatitis prevention services, such as hepatitis C screening, into existing drug treatment programs. 

CENTER FOR SUBSTANCE ABUSE PREVENTION

Appropriations, 2005 ............................................................................. $198,725,000 

Budget estimate, 2006 ........................................................................... 184,349,000 

House allowance .................................................................................... 194,950,000 

Committee recommendation ................................................................. 202,289,000 

The Committee recommends $202,289,000 for programs to pre- vent substance abuse, which is $3,564,000 above the comparable 

fiscal year 2005 level and $17,940,000 above the administration request. 

The Committee recognizes the important role played by the 20 

percent prevention services set-aside within the Substance Abuse 

Prevention and Treatment [SAPT] Block Grant. This vital substance abuse prevention funding helped contribute to the fact that 

600,000 fewer teens used drugs in 2004 compared to 2001, according to the Monitoring the Future survey. The Committee also supports the need to recognize substance abuse prevention as a 

unique, separate and distinct field and encourages SAMHSA to 

promote programming consistent with this finding, including a 

strong role for CSAP as the Federal Government’s lead agency for 

substance abuse prevention. 

The Committee is concerned about the intersection of methamphetamine abuse and the transmission of infectious diseases 

such as HIV and Hepatitis C. Both SAMHSA and the Centers for 

Disease Control and Prevention [CDC] have funded crucial programs targeting methamphetamine abuse and infectious disease 

prevention. However, the intersection of methamphetamine abuse 

and infectious disease has not been adequately addressed. Recognizing that the two agencies have different responsibilities in responding to the damage caused by the drug abuse epidemic, the 

Committee requests that SAMHSA and CDC draft a list of priorities to address the intersections of these two epidemics and provide a collaborative written report by April 1, 2006, designating a 

coordinating plan between SAMSHA and CDC. The plan should in-
184 

clude a proposed infrastructure, needed resources, mechanisms of 

communication, and community 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. 

Programs of Regional and National Significance 

The Committee has provided $202,289,000 for programs of regional and national significance [PRNS]. The recommendation is 

$3,564,000 above the comparable fiscal year 2005 level and 

$17,940,000 above the administration request. The Center for Substance Abuse Prevention is the sole Federal organization with responsibility for improving accessibility and quality of substance 

abuse prevention services. Through the programs of regional and 

national significance activity, CSAP supports: development of new 

practice knowledge on substance abuse prevention; identification of 

proven effective models; dissemination of science-based intervention information; State and community capacity-building for implementation of proven effective substance abuse prevention programs; and programs addressing new needs in the prevention system. 

The Committee recommendation includes $93,488,000 for the 

Strategic Prevention Framework State Incentive Grant [SPFSIG] 

program, which is designed to promote, bolster and sustain prevention infrastructure for every State in the country. The Committee 

recognizes that a linchpin of this program is State flexibility so 

that each State may tailor initiatives and direct resources in ways 

that are most appropriate for its own jurisdiction. The Committee 

encourages SAMHSA to promote maximum State flexibility in 

managing the SPFSIG program and the 20 percent prevention setaside within the Substance Abuse Prevention and Treatment 

[SAPT] Block Grant so that each State may employ a range of effective prevention strategies to meet their own unique needs and 

local circumstances. 

The Committee expects SAMHSA to ensure that SPFSIG grantees do not fund duplicative sub-state anti-drug coalition infrastructures, but utilize those already functioning and funded by programs 

such as the Drug Free Communities program. 

The Committee remains very concerned about the prevalence of 

methamphetamine use. According to the National Survey on Drug 

Use and Health [NSDUH], approximately 12.3 million Americans 

ages 12 or over tried methamphetamine in 2003. In more than 

three-quarters of Western States, methamphetamine and amphetamine-related treatment admissions rates are higher than those for 

cocaine or heroin. While methamphetamine is a serious problem on 

the West Coast, in the Mountain States and in parts of the Midwest, recent data suggest that the problem may be spreading eastward. Since fiscal year 2003 the Committee has provided 

$14,000,000 to twelve States for grants aimed at expanding the capacity of health care and community organizations to address 

methamphetamine abuse. The Committee is disturbed that the administration did not request funding for this program in fiscal year 
185 

2006. The Committee’s recommendation includes $4,000,000 to continue this program. 

With the consolidation of the contracts for the National Clearinghouse for Alcohol and Other Drug Information and the Mental 

Health Clearinghouse, the Committee expects SAMHSA to ensure 

that the funding and materials available for substance abuse prevention be maintained at no less than current levels. 

The Committee recommendation includes $850,000 for the third 

year of the Ad Council’s parent-oriented media campaign to combat 

underage drinking. Previous funding for the campaign was provided through the Office of the Secretary. 

PROGRAM MANAGEMENT

The Committee recommends $93,817,000 for program management activities of the agency. The recommendation includes 

$18,000,000 in transfers available under section 241 of the Public 

Health Service Act. The recommendation is $11,000 above the comparable level for fiscal year 2005 and $2,000,000 above the budget 

request. 

The program management activity includes resources for coordinating, directing, and managing the agency’s programs. Program 

management funds support salaries, benefits, space, supplies, 

equipment, travel, and departmental overhead required to plan, supervise, and administer SAMHSA’s programs. 

Last year the Committee included funds for SAMHSA to ‘‘establish surveillance measures to address the mental and behavioral 

health needs of the population of the United States.’’ The Committee is pleased that SAMHSA decided to work with the Centers 

for Disease Control and Prevention [CDC] to include questions on 

mental health in a CDC survey known as the Behavioral Risk Factor Surveillance System. The funds are being used to test appropriate questions and to help defray the cost of including them in 

the survey. Funds are also being provided to help States respond 

to the surveys. The Committee recommendation for fiscal year 2006 

includes $2,000,000 to expand on the collaborative effort by 

SAMHSA and CDC to establish a population-based source of data 

on the mental and behavioral health needs in this country. These 

data will help policymakers implement the recommendations of the 

President’s New Freedom Commission on Mental Health report 

‘‘Achieving the Promise: Transforming Mental Health Care in 

America.’’ 

The Committee recognizes the benefits of client level data reporting in order to build a more accurate picture of Americans in need 

of prevention and treatment services. The Committee strongly encourages SAMHSA to reach out to the Department of Justice, Department of Education, Health Resources and Services Administration [HRSA] and other Federal agencies to ensure that all Federal 

grants seek client level data reporting in order to complement and 

coordinate with SAMHSA’s National Outcomes Measurement 

[NOMS] and State Outcomes Measurement and Management Initiative [SOMMS] initiatives. 
186 

AGENCY FOR HEALTHCARE RESEARCH AND QUALITY

Appropriations, 2005 ............................................................................. $318,695,000 

Budget estimate, 2006 ........................................................................... 318,695,000 

House allowance .................................................................................... 318,695,000 

Committee recommendation ................................................................. 323,695,000 

The Committee recommends $323,695,000 for the Agency for 

Healthcare Research and Quality [AHRQ]. This amount is 

$5,000,000 above both the administration request and the comparable funding level for fiscal year 2005. The Committee has funded AHRQ through transfers available under section 241 of the Public Health Service Act. 

The Agency for Healthcare Research and Quality was established 

in 1990 to promote improvements in clinical practice and patient 

outcomes, promote improvements in the financing, organization, 

and delivery of health care services, and increase access to quality 

care. AHRQ is the Federal agency charged to produce and disseminate scientific and policy-relevant information about the cost, quality, access, and medical effectiveness of health care. AHRQ provides policymakers, health care professionals, and the public with 

the information necessary to improve cost effectiveness and appropriateness of health care and to reduce the costs of health care. 

HEALTH COSTS, QUALITY, AND OUTCOMES

The Committee provides $265,695,000 for research on health 

costs, quality and outcomes [HCQO]. This amount is $5,000,000 

above both the administration request and the comparable amount 

for fiscal year 2005. HCQO research activity is focused upon improving clinical practice, improving the health care system’s capacity to deliver quality care, and tracking progress toward health 

goals through monitoring and evaluation. 

For fiscal year 2006, the Committee directs AHRQ to devote 

$84,000,000 of the total amount provided for HCQO to determining 

ways to reduce medical errors. Of this amount, $50,000,000 will 

support the Department’s initiative to promote the development, 

adoption and diffusion of information technology in health care. 

The Committee recognizes the work that AHRQ has done regarding comparative effectiveness research. Comparative effectiveness 

research has the potential to lower health care costs while improving quality of care. The Committee directs AHRQ to devote 

$20,000,000 of the total amount provided to research authorized 

under Section 1013 of the Medicare Prescription Drug, Improvement and Modernization Act of 2003. The Committee’s recommendation is $5,000,0000 more than the amount provided last 

year. The increased funding will allow AHRQ to continue and build 

upon the priority list of conditions identified in fiscal year 2005. 

Autoimmune Disease.—In order to support continued HHS-wide 

implementation of the HHS Autoimmune Diseases Research Plan, 

the Committee encourages AHRQ to estimate the annual treatment 

and societal costs of autoimmune diseases in the United States, in 

order to project their future impact and burden on the healthcare 

system. 

Duchenne Muscular Dystrophy.—The Committee is pleased 

AHRQ is studying standards of care issues associated with patients 
187 

diagnosed with Duchenne Muscular Dystrophy. The Committee 

urges AHRQ to build on this work by partnering with CDC to convene a consensus conference to develop these standards. 

Elderly Mental Health.—The Committee is seriously 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. 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 urges AHRQ to support evidence-based research projects focused on the diagnosis and treatment of mental 

illnesses in the geriatric population, and to disseminate evidencebased reports to physicians and other health care professionals. 

Health Disparities.—The Committee remains disturbed by the 

March 2002 Institute of Medicine report regarding the disparities 

of medical care delivery to minorities. The Committee encourages 

AHRQ to carefully evaluate the analysis, findings, and recommendations of this study in order to pursue creative ways to improve health care delivery for all minority populations, including 

African-Americans, those of Hispanic and Asian origin, Native 

Americans, Alaskans and Native Hawaiians. 

Hospital-based Initiative.—The Committee urges AHRQ to work 

with multi-site academic medical centers to identify and implement 

programs to improve patient safety in a hospital setting. The Committee is interested in patient safety improvements that are designed for rapid turnaround and for developing practical and 

replicable projects in the future. 

Investigator-initiated Research.—The Committee notes that the 

Department reallocated $11,518,000 from AHRQ in fiscal year 2005 

to fund the Department’s health information technology initiative. 

While the Committee strongly supports this initiative, it notes that 

this reallocation delayed the start of several non-patient safety 

grant programs. Research outside of targeted areas such as patient 

safety, health IT and comparative effectiveness is a critical part of 

AHRQ’s mission yet these grants are a diminishing portion of the 

agency’s research portfolio. The Committee notes that important 

initiatives like the patient safety program were based on investigator-initiated research. The Committee strongly urges AHRQ to 

maximixe investigator-initiated research. 

Nurse-Managed Health Centers.—The Committee encourages 

AHRQ to include nurse managed health centers and advanced 

practice nurses in research and demonstration projects conducted 

by the agency. 

MEDICAL EXPENDITURES PANEL SURVEYS

The Committee provides $55,300,000 for health insurance and 

medical expenditures panel surveys [MEPS], which is the same as 

the administration request and the comparable fiscal year 2004 

level. MEPS is intended to obtain 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. It also develops cost and savings esti-
188 

mates of proposed changes in policy and identifies impact of policy 

changes on payers, providers, and patients. 

Program Support 

The Committee recommends $2,700,000 for program support. 

This amount is the same as the administration request and the 

comparable fiscal year 2005 level. This activity supports the overall 

management of the Agency. 

CENTERS FOR MEDICARE AND MEDICAID SERVICES

GRANTS TO STATES FOR MEDICAID

Appropriations, 2005 ......................................................................... $123,779,019,000 

Budget estimate, 2006 ...................................................................... 156,954,419,000 

House allowance ................................................................................ 156,954,419,000 

Committee recommendation ............................................................. 156,954,419,000 

The Committee recommends $156,954,419,000 for Grants to 

States for Medicaid. This amount is $33,175,400,000 more than the 

fiscal year 2005 appropriation and the same as the administration’s 

request and House allowance. This amount excludes 

$58,517,290,000 in fiscal year 2005 advance appropriations for fiscal year 2006. In addition, $62,783,825,000 is provided for the first 

quarter of fiscal year 2007, as requested by the administration. Fiscal year 2006 funding increases by $22,910,109,000 to fund obligations incurred but not reported in fiscal year 2005, thus reflecting 

the shift in the program from a cash basis of accounting to accrualbased accounting. The Medicaid program provides medical care for 

eligible low-income individuals and families. It is administered by 

each of the 50 States, the District of Columbia, Puerto Rico, and 

the territories. Federal funds for medical assistance are made 

available to the States according to a formula, which determines 

the appropriate Federal matching rate for State program costs. 

This matching rate is based upon the State’s average per capita income relative to the national average, and shall be no less than 50 

percent and no more than 83 percent. 

PAYMENTS TO HEALTH CARE TRUST FUNDS

Appropriations, 2005 ......................................................................... $114,608,900,000 

Budget estimate, 2006 ...................................................................... 177,822,200,000 

House allowance ................................................................................ 177,742,200,000 

Committee recommendation ............................................................. 177,822,200,000 

The Committee recommends $177,822,200,000 for Federal payments to health care trust funds. This amount is the same as the 

administration’s request, $80,000,000 more than the House allowance, and is an increase of $63,213,300,000 from the fiscal year 

2005 appropriation. The significant funding increase is largely due 

to the cost 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 Part D drug benefits and administration, plus 

other reimbursements to the Federal Hospital Insurance Trust 

Fund for Part A benefits and related administrative costs that have 

not been financed by payroll taxes or premium contributions. The 

Committee has provided $128,015,000,000 for the Federal payment 
189 

to the Supplementary Medical Insurance Trust Fund. This payment provides matching funds for premiums paid by Medicare Part 

B enrollees. This amount is the same as the administration’s request and is $14,013,000,000 more than the fiscal year 2005 

amount. The Committee further provides $53,596,000,000 for the 

general fund share of benefits paid under Public Law 108–173, the 

Medicare Prescription Drug, Improvement and Modernization Act 

of 2003. The Committee includes bill language requested by the administration providing indefinite authority for paying the General 

Revenue portion of the Part B premium match and provides resources for the Part D drug benefit program in the event that the 

annual appropriation is insufficient. The recommendation also includes $202,000,000 for hospital insurance for the uninsured. This 

amount is the same as the administration’s request and is 

$115,000,000 more than the fiscal year 2005 amount. The Committee also recommends $206,000,000 for Federal uninsured benefit payment. This payment reimburses the Hospital Insurance 

Trust Fund for the cost of benefits provided to Federal annuitants 

who are eligible for Medicare. This amount is the same as the administration’s request and an increase of $7,000,000 over the fiscal 

year 2005 level, reflecting an increase on the number of covered individuals who are currently enrolled. The Committee recommendation includes $164,000,000 to be transferred to the Hospital Insurance Trust Fund as the general fund share of CMS Program Management administrative expenses. This amount is the same as the 

administration’s request and is $51,000,000 less than the fiscal 

year 2005 amount. The Committee recommendation also includes 

$677,000,000 to be transferred to the Supplementary Insurance 

Trust Fund as the general fund share of Part D administrative expenses. This amount is the same as the administration’s request. 

The recommendation also provides $99,100,000 for State low-income determination activities through the prescription drug account. This amount is the same as the administration’s request and 

is $6,800,000 less than the 2005 amount. The Committee recommends $80,000,000 as reimbursement to the Health Care Fraud 

and Abuse Control [HCFAC] fund, described in a separate account, 

for new program integrity activities to be funded as discretionary 

spending. The House did not fund this account. 

HEALTH CARE FRAUD AND ABUSE CONTROL

Appropriations, 2005 ............................................................................. ........................... 

Budget estimate, 2006 ........................................................................... $80,000,000 

House allowance .................................................................................... ........................... 

Committee recommendation ................................................................. 80,000,000 

The Committee recommends $80,000,000 for program integrity 

activities to be funded in fiscal year 2006 through a discretionary 

cap adjustment. These funds will be reimbursed from the Payment 

to the Health Care Trust Funds appropriation. Of this total, 

$75,000,000 is for program integrity activities related to the new 

Part D prescription drug benefit and $5,000,000 for enhanced Medicaid financial management. The House did not fund this account. 

The Committee notes that mandatory funding for program integrity activities has not increased since fiscal year 2003 and that the 

Part D prescription drug legislation did not include resources for 
190 

program oversight. The Committee recommends $75,000,000 to be 

used to initiate program integrity efforts related to the new prescription drug benefit in the Medicare Integrity Program. The Committee recommends $5,000,000 to augment the role of the CMS in 

financial management and oversight of program integrity efforts in 

the Medicaid and SCHIP grant programs. 

The Committee encourages CMS to consider implementing a 

Medicare analysis and detection system, aimed at reducing fraud, 

waste, and abuse through use of supercomputing technology. 

PROGRAM MANAGEMENT

Appropriations, 2005 ............................................................................. $2,664,911,000 

Budget estimate, 2006 ........................................................................... 3,177,478,000 

House allowance .................................................................................... 3,180,284,000 

Committee recommendation ................................................................. 3,203,418,000 

The Committee recommends $3,203,418,000 for CMS program 

management, which is $25,940,000 more than the amount requested by the administration $23,134,000 more than the House allowance, and $538,507,000 more than the fiscal year 2005 enacted 

level. Fiscal year 2006 marks the first year that funding for ongoing Medicare Modernization Act [MMA] activities is included in the 

CMS Program Management appropriation. The Committee recommends the budget request of $560,000,000 for ongoing MMA activities in fiscal year 2006. 

Research, Demonstrations, and Evaluations 

The Committee recommends $78,494,000 for research, demonstrations, and evaluation activities. This amount is $33,300,000 

more than the budget request, and $1,000,000 more than the 2005 

level. 

CMS research and demonstration activities facilitate informed, 

rational Medicare and Medicaid policy choices and decision making. 

These studies and evaluations include projects to measure the impact of Medicare and Medicaid policy analysis and decision making, 

projects to measure the impact of Medicare and Medicaid on health 

care costs, projects to measure patient outcomes in a variety of 

treatment settings, and projects to develop alternative strategies 

for reimbursement, coverage, and program management. 

The Committee has included $40,000,000 for Real Choice Systems Change Grants for Community Living to States to fund initiatives that establish enduring and systemic improvements in longterm services and supports. Given the progress to date, the Committee recommends the issuance of a grant solicitation designed to 

provide a greater level of support to grantees to effectively identify 

and target requisite components of a coherent and integrated system of long-term care supports. The Secretary shall also allocate a 

portion of funding to: provide technical assistance to grantees on 

the development of a strategic plan to achieve systems transformation; maintain an information system that facilitates acquisition of data and information necessary to assess the progress of 

states in transforming their long-term care systems; and conduct 

an evaluation that would provide specific, measurable indicators of 

whether systems transformation has been achieved. 
191 

The Committee commends CMS for implementing section 1860d– 

4(c)(2) of the Medicare Modernization Act requiring Part D prescription drug sponsors to provide medication therapy management 

services [MTMP] to targeted Medicare Part D enrollees. MTMP are 

critical to improving health outcomes and to reducing medication 

errors for targeted Medicare beneficiaries with chronic conditions 

and high drug costs. The Committee encourages CMS to conduct a 

demonstration project to identify effective MTMP models for targeted Medicare Part D enrollees, capable of implementation on a 

large scale. This demonstration project should include approaches 

that emphasize evidence-based prescribing, prospective medication 

management, technological innovation, and outcomes reporting. 

Medicare Operations 

The Committee recommends $2,184,984,000 for Medicare oper- ations, which is $5,003,000 less than the amount requested by the 

administration. In addition, $720,000,000 is available for the Medicare Integrity Program within the mandatory budget as well as 

$80,000,000 recommended in this bill for a new Health Care Fraud 

and Abuse Control account. 

The Medicare operations line item covers a broad range of activities including claims processing and program safeguard activities 

performed by Medicare contractors. These contractors also provide 

information, guidance, and technical support to both providers and 

beneficiaries. In addition, this line item includes a variety of 

projects that extend beyond the traditional fee-for-service arena. The Committee recommends that not less than $31,700,000 be 

made available for the State Health Insurance Counseling Program. SHIPs provide one-on-one counseling to beneficiaries on complex Medicare-related topics, including Medicare entitlement and 

enrollment, health plan options, prescription drug benefits, 

Medigap and long-term care insurance, and Medicaid. The Committee recommends that $79,934,000 be made available 

for obligation over a 2-year period ending September 30, 2007, for 

contract costs pursuant to the development of the Healthcare Integrated General Ledger Accounting System [HIGLAS]. 

CMS is encouraged to explore alternative approaches for recruiting, training and employing the severely disabled for 1–800–MEDICARE. The outcome will identify work activities performed by severely disabled individuals that fully support the needs of the 1– 

800–MEDICARE program and promote the employment of people 

with disabilities. CMS is encouraged to work directly with the National Industries for the Severely Handicapped [NISH] organization 

to develop the approach and to subsequently implement within the 

1–800–MEDICARE program. 

Medicare contractors partner with Federal Government to administer the Medicare fee-for-service program. Contractors pay 

over 1 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 5 percent cap 

on transferring funds among Medicare functions so that contractors 
192 

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 understands an existing statute capped 

Medicare Integrity Program [MIP] funding at $720,000,000 in fiscal 

year 2003. The Committee believes that Medicare contractors must 

be given greater flexibility to effectively manage their MIP resources given the continuing increases in claims volume. In fact 

claims have risen by more than 16 percent since MIP was last increased. 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. 

State Survey and Certification 

The Committee recommends $260,735,000, the budget estimate 

and House allowance, for Medicare State survey and certification 

activities, which is $2,000,000 more than the fiscal year 2005 level. 

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. 

Federal Administration 

The Committee recommends $655,000,000 for Federal administration costs, which is an increase of $73,507,000, over the fiscal 

year 2005 level. This funding level allows for fixed cost increases 

associated with the current staffing level of 4,398 full-time equivalent positions. Savings from the request level of $657,357,000 are 

expected to be made in travel expenses and such administrative 

costs as printing and postage. 

The Committee recommends continuing the Healthy Start, Grow 

Smart program, which disseminates informational brochures to 

new Medicaid-eligible mothers. These brochures are distributed at 

the time of birth, then monthly over the first year of each child’s 

life. Each publication focuses on activities that stimulate infant 

brain development and build the skills these children need to be 

successful in school. In addition to these educational suggestions, 

Healthy Start pamphlets include vital health and safety information for new parents. 

During last year’s consideration of the Omnibus Appropriations 

Act, the Committee expressed its concerns with the lack of adequate funding for section 508 of the Medicare Modernization Act. 

The Committee directed CMS to report back on the number of hospitals that qualified for reclassification under section 508; the number of hospitals that qualified but received no funding; and a cost 

estimate, by year, of the amounts needed to fully fund these hospitals over 3 years. The Committee recently received the required 

report from CMS, several months late and well into this year’s appropriations process. The report finds the cost to fully fund section 
193 

508 reclassification for hospitals that qualified for funding but received no funds to be approximately $1,050,000,000 to 

$1,080,000,000 for 3 years or $350,000,000 to $360,000,000 for 1 

year. The Committee believes that it is important to find resources 

to expand section 508 reclassifications to as many unfunded hospitals as possible as a necessary first step in addressing the inequities caused by the existing wage index determinations, while a 

long-term solution is developed. 

The Committee expects that programs funded under the authority of the Ryan White Act (title XXVI of the Public Health Service 

Act) continue to be considered as payors of last resort in any Federal or State health benefits program. The Committee expects CMS 

to conform its program guidance to preserve the status of Ryan 

White funds as the payor of last resort. The Committee further requests that the Government Accountability Office study the legislative intent regarding the interaction of Ryan White and Medicare 

Part D spending, and report its findings by October 1, 2005. The 

report should examine whether Ryan White spending should be 

able to provide ‘‘wrap around’’ coverage which counts toward true 

out-of-pocket costs and thus catastrophic coverage under Part D of 

the Medicare Modernization Act. 

The Committee commends CMS for its outreach efforts to help 

dually eligible beneficiaries transfer from Medicaid prescription 

drug coverage to the new Medicare Part D program. However, the 

Committee believes that low-income dual eligible persons with 

mental disabilities will need additional assistance 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 in order to address 

this need. 

The Committee is very pleased with the demonstration project at 

participating sites licensed by the Program for Reversing Heart 

Disease and encourages its continuation. The Committee further 

urges CMS to continue with the demonstration project being conducted at the Mind Body Institute of Boston, Massachusetts. 

The Committee is very pleased with the efforts of CMS to address the extraordinary adverse health status of Native Hawaiians 

in Waimanalo, Hawaii. The Committee continues to urge additional 

focus upon American Samoan residents in that geographical area 

utilizing the expertise of the Waimanalo Health Center. 

The Committee urges the Centers for Medicare and Medicaid 

Services to consider waivers for rural or isolated area demonstration projects when calculating such requirements as population 

density in the State of Hawaii. 

The Committee urges CMS to provide for reimbursement for 

services rendered to Native Hawaiians in federally qualified health 

centers in the same manner that it currently does for American Indians and Alaskan Natives. Further, the Committee requests a report on this matter by next year’s budget hearings. 

The Committee is aware that legislation authorizing direct Medicare reimbursement to nurse practitioners providing reimbursable 

Medicare Services, was passed by Congress and signed into law, effective January 1, 1998. Since that time nurse practitioners have 
194 

been providing reimbursable care to patients as Part B providers. 

Despite their ability to provide and bill for services rendered in all 

of these areas, they are still unable to refer patients to home 

health or hospice care. The apparent reason is that an expanded 

interpretation of the word ‘‘physician’’ is needed in Part A, Section 

1814, of the Medicare law in order for home health agencies and 

hospice centers to accept these referrals. 

The Committee is very aware that nurse practitioners have been 

demonstrated to provide safe and responsible care to the patients 

they serve. They have expert knowledge that allows them to provide high level assessments of patients needs and recognize when 

additional care, such as home health and hospice care is needed or 

not needed by their patients. The Committee urges CMS to reinterpret the statute that will authorize home health agencies and hospices to accept orders from nurse practitioners. 

The Committee recognizes that rural residents account for 25 

percent of the general population in the United States with a disproportionate number of them being seniors. Additionally, 67 percent of the country’s primary care health professional shortage 

areas are located in rural areas and access to specialized care is 

limited for seniors. The Committee urges CMS to consider funding 

projects with a focus on rural healthcare, specifically those serving 

minority populations such as Native Hawaiians, Native Alaskans, 

and Native Americans. 

The Committee expects CMS to promulgate regulations providing 

the option of direct access to licensed audiologists under similar 

terms and conditions used by the Department of Veterans Affairs 

and the Office of Personnel Management. The Department of Veterans Affairs reports that direct access provides high-quality, efficient, and cost-effective hearing care. 

The Secretary of HHS is encouraged to include, in negotiating 

Prime contracts supporting the Medicare Prescription Drug Plan 

Program Part D, small business and small disadvantaged business 

subcontracting plan requirements. These subcontract plans should 

achieve a participation rate of not less than 5 percent of the total 

value of prime contract award for each fiscal year. 

The Committee expects CMS to conduct a demonstration to develop a pilot program to assist patients with expensive chronic illnesses, including hepatitis, in securing private health insurance. 

Non-profit organizations such as Patient Services, Inc. have had 

success on a State level in assisting families burdened by chronic 

illness in retaining or obtaining insurance coverage. This transitional support has saved State dollars by reducing reliance on Medicaid and keeping patients with expensive chronic illnesses insured. 

The Committee is hopeful that this model can be expanded to 

achieve savings on a national level. 

Those State Pharmaceutical Assistance Programs (SPAPs) whose 

outreach plans have been approved and awarded outreach grants 

by CMS may rollover any unspent fiscal year 2005 grant monies 

into the next Federal fiscal year to be used to bring the initiative 

to completion (section 221). 

A qualified pharmacy workforce is necessary to fully implement 

efforts to improve the quality of care received by our Nation’s seniors, particularly high-risk seniors who have multiple chronic condi-
195 

tions and are taking multiple medications. The committee therefore 

urges CMS to carefully review its decision to cut Medicare funding 

for second-year, specialized pharmacy residency programs, which 

provide specialized training to medication use experts in areas like 

geriatrics, oncology, and critical care, taking into account new data 

submitted by national pharmacist associations, and provide a full 

report back to the Committee within 3 months with the Agency’s 

rationale for any decision that results in these programs remaining 

un-funded. 

Deep-vein thrombosis affects more than 2 million Americans 

each year and its complications also take a toll on our Nation’s hospital systems, costing approximately $860,000,000 annually. It has 

been brought to the Committee’s attention that there is a large gap 

between knowledge and practice where deep-vein thrombosis and 

associated morbidity and mortality including Pulmonary Embolus 

and Post Thrombotic Syndrome are concerned. In order to identify 

ways to reduce the burden of deep-vein thrombosis and associated 

complications including death in the inpatient setting, the Center 

for Medicare and Medicaid Services is encouraged to develop a 

demonstration project, with from experts in the field to: analyze ongoing practices to appropriately assess and prophylax ‘‘at risk’’ surgical and medical patients; implement a process within demonstration study sites to improve appropriate prophylaxis; and, create a 

follow-up report on steps of implementation and an outcomes report, to define the impact of the program. 

The Committee supports programs that can demonstrate the feasibility of achieving quality improvement as well as cost savings to 

the Medicare program through improved quality of care. In this regard, the Committee encourages CMS to consider a quality-focused 

cost containment in cardiac surgery for Medicare beneficiaries pilot 

program to demonstrate and quantify cost savings possible through 

quality improvement efforts. 

Revitalization Plan 

The Committee recommends the budget request and House allowance of $24,205,000 in 2-year budget authority, as the thirdyear investment in CMS’s efforts to make significant improvements 

to key aspects of managing the Agency and the Medicare program. 

First-year funding in fiscal year 2004 was $29,619,000 and secondyear funding was $24,205,000 for fiscal year 2005. Funding in fiscal year 2006 will target system-related improvements, and continue addressing long-term information technology issues, including 

Medicare claims processing redesign activities. The Committee 

urges CMS to augment information technology activities utilizing 

resources available under the Quality Improvement Organization 

program. 

HMO Loan and Loan Guarantee Fund 

The Committee concurs with requested bill language making receipts of this fund available for payment of obligations, but prohibiting the issuance of additional direct loans or loan guarantees to 

health maintenance organizations from this fund. 
196 

ADMINISTRATION FOR CHILDREN AND FAMILIES

PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND

FAMILY SUPPORT PROGRAMS

Appropriations, 2005 ............................................................................. $2,873,802,000 

Budget estimate, 2006 ........................................................................... 2,071,943,000 

House allowance .................................................................................... 2,121,643,000 

Committee recommendation ................................................................. 2,121,643,000 

The Committee recommends $2,121,643,000 be made available in 

fiscal year 2006 for payments to States for child support enforcement and family support programs. The comparable funding level 

for fiscal year 2005 is $2,873,802,000 and the budget request includes $2,071,943,000 for this program. The Committee recommendation provides the full amount requested under current 

law. The budget request includes net savings of $49,700,000 based 

on proposed legislation. 

These payments support the States’ efforts to promote the selfsufficiency and economic security of low-income families. These 

funds also support efforts to locate non-custodial parents, determine paternity when necessary, and establish and enforce orders of 

support. The appropriation, when combined with the 

$1,200,000,000 in advance funding provided in last year’s bill, an 

estimated $208,000,000 from offsetting collections, and an estimated carryover of $740,173,000, supports a program level of 

$4,269,816,000. 

The Committee also has provided $1,200,000,000 in advance 

funding for the first quarter of fiscal year 2007 for the child support enforcement program, the same as the budget request. 

LOW-INCOME HOME ENERGY ASSISTANCE PROGRAM

Appropriations, 2005 ............................................................................. $2,182,399,000 

Budget estimate, 2006 ........................................................................... 2,000,000,000 

House allowance .................................................................................... 2,006,799,000 

Committee recommendation ................................................................. 2,183,000,000 

The Committee recommends $2,183,000,000 for fiscal year 2006 

for LIHEAP. The comparable funding level for fiscal year 2005 is 

$2,182,399,000 and the budget request includes $2,000,000,000 for 

this program. LIHEAP is made up of two components: the State 

grant program and the contingency fund. 

The Committee recommendation includes $1,883,000,000 for fiscal year 2006 for the State grant program. The comparable funding 

level for fiscal year 2005 is $1,884,799,000 and the budget request 

includes $1,800,000,000 for this program. Within the funds provided, the Committee recommends $500,000 for a feasibility study, 

as requested by the administration. LIHEAP grants are awarded 

to States, territories, Indian tribes, and tribal organizations to assist low-income households in meeting the costs of home energy. 

States receive great flexibility in how they provide assistance, including direct payments to individuals and vendors and direct provision of fuel. These resources are distributed by formula to these 

entities as defined by statute, based in part on each State’s share 

of home energy expenditures by low-income households. 

The Committee recommendation includes $300,000,000 for fiscal 

year 2006 for an emergency fund to meet the additional home en-
197 

ergy assistance needs arising from a natural disaster or other 

emergencies. The comparable funding level for fiscal year 2005 is 

$297,600,000 and the budget request does not include funds designated as emergency for this program, but did request 

$200,000,000 for the contingency fund. The Committee intends that up to $27,500,000 of the amount 

recommended for LIHEAP for fiscal year 2006 be used for the 

leveraging incentive fund. The fund will provide a percentage 

match to States for private or non-Federal public resources allocated to low-income home energy benefits. 

REFUGEE AND ENTRANT ASSISTANCE

Appropriations, 2005 ............................................................................. $484,394,000 

Budget estimate, 2006 ........................................................................... 552,040,000 

House allowance .................................................................................... 560,919,000 

Committee recommendation ................................................................. 571,140,000 

The Committee recommends $571,140,000 for fiscal year 2006 for 

refugee and entrant assistance. The comparable funding level for 

fiscal year 2005 is $484,394,000 and the budget request includes 

$552,040,000 for this program. 

The Refugee and Entrant Assistance Program is designed to assist States in their efforts to assimilate refugees, asylees, Cuban 

and Haitian entrants, and adults and minors who are trafficking 

victims, into American society as quickly and effectively as possible. The program funds State-administered transitional and medical assistance, the voluntary agency matching grant program, programs for victims of trafficking and torture, employment and social 

services, targeted assistance, and preventive health. Based on an 

estimated refugee admission ceiling of 70,000, this appropriation 

enables States to provide at least 8 months of cash and medical assistance to eligible refugees and entrants, a variety of social and 

educational services, as well as foster care for refugee and entrant 

unaccompanied minors. 

In order to carry out the refugee and entrant assistance program, 

the Committee recommends $268,229,000 for transitional and medical assistance including State administration and the voluntary 

agency program, of which $4,100,000 is from emergency funds; 

$9,915,000 for victims of trafficking; $151,121,000 for social services; $4,796,000 for preventive health; and $49,081,000 for targeted 

assistance. 

For unaccompanied children, pursuant to section 462 of the 

Homeland Security Act of 2002, the Committee recommends 

$78,083,000, of which $15,000,000 is from emergency funds. Funds 

are provided for the care and placement of unaccompanied alien 

minors in the Office of Refugee Resettlement. In fiscal year 2006 

there will be approximately 9,600 placements for unaccompanied 

alien children apprehended in the United States by INS/Homeland 

Security agents, Border Patrol officers, or other law enforcement 

agencies. These children are then taken into care pending resolution of their claims for relief under U.S. immigration law, released 

to an adult family member, or released to a responsible adult 

guardian. 

The Committee also recommends $9,915,000 to treat and assist 

victims of torture. These funds may also be used to provide train-
198 

ing to healthcare providers to enable them to treat the physical and 

psychological effects of torture. The Committee acknowledges that 

well-established treatment centers, such as the Center for Victims 

of Torture, have developed the knowledge base that has fostered 

growth of treatment facilities around the country and strengthened 

treatment services generally. This positive trend may continue if 

leading centers are able to expand their staffs to create more trainers and improve evaluation and research needed to guide and develop new programs. The Committee recommends ORR support 

core funding of strong regional programs that invest carefully in 

building their rehabilitation programs that produce research and 

knowledge in this new field. Those organizations can then be expected to organize training for mainstream health care providers. The Committee bill includes $19,100,000 in emergency funds for 

the unanticipated and significantly increased demand for services 

to individuals eligible for assistance, of which $4,100,000 is for 

transitional and medical services and $15,000,000 is for unaccompanied alien children programs. An increasing share of refugee admissions are coming from Africa and Thailand and these refugees 

have far more costly medical needs than previous arrivals from 

Russia and Southeast Asian countries due in part to increased 

health screening tests and lab cultures, increased medical treatment for parasites, HIV, and multiple drug-resistant TB, and increased prostheses and rehabilitation for machete victims. These 

refugees also tend to stay on refugee cash assistance longer because they require more intensive services for reading and writing 

in their native language, English as a Second Language, and job 

placement. There also has been a much higher than anticipated increase in unaccompanied alien children entering the United States 

and being placed in the care of ORR. While the fiscal year 2005 appropriation assumed an increase of 20 percent in this program, the 

actual increases are close to 30 percent. These additional funds are 

needed to address these unanticipated situations. 

The Committee is deeply concerned that accompanied children, 

even as young as nursing infants, who are apprehended by the Department of Homeland Security [DHS] are being separated from 

their parents and being placed in the unaccompanied alien children 

program while their parents are held in separate adult facilities. 

The Committee is pleased that ORR has taken the initiative to 

work with DHS to correct this problem and anticipates a prompt 

resolution. 

The Committee is aware that at times ORR allows individual 

abused, abandoned, or neglected children in its custody to access 

State dependency proceedings for ultimate care and placement in 

State foster care or under legal guardianship. The Committee urges 

ORR to continue this practice in such cases as it is appropriate. 

The Committee is pleased with the steps the ORR has taken to 

improve access to legal representation for children served through 

this program. ORR has participated in roundtables, and met with 

various groups to better understand the issue. They have also put 

together a comprehensive list of pro bono attorneys and guardians 

to ensure that the children’s needs are being served and are currently working on a program that would ensure that resources are 

available to unaccompanied alien children. The Committee com-
199 

mends ORR for their commitment to providing unaccompanied 

alien children in its care access to a comprehensive range of services, from legal representatives to access to necessary unique medical care. 

The Committee directs that not later than 1 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 to deinstitutionalize the care provided to unaccompanied children in its custody, including the utilization of community-based, child welfare 

centered services. 

The Committee is pleased that the majority of the 15,000 Hmong 

refugees that were admitted will have arrived by the end of fiscal 

year 2005. The Committee was concerned that unlike prior groups 

of Hmong refugees, which were made up of military and political 

leaders with the means and education to succeed in America, these 

immigrants had spent their lives in a refugee camp. Few, if any, 

spoke English. Most are under 18 and have little schooling. Even 

with the greater level of education and skills possessed by prior refugees, statistics indicated that about 38 percent of current HmongAmericans live in poverty. 

Section 412(a)(7) of title IV of the Immigration and Nationality 

Act authorizes the use of funds appropriated under this account to 

be used to carry out monitoring, evaluation, and data collection activities to determine the effectiveness of funded programs and to 

monitor the performance of States and other grantees. 

CHILD CARE AND DEVELOPMENT BLOCK GRANT

Appropriations, 2005 ............................................................................. $2,082,921,000 

Budget estimate, 2006 ........................................................................... 2,082,910,000 

House allowance .................................................................................... 2,082,910,000 

Committee recommendation ................................................................. 2,082,910,000 

The Committee recommends $2,082,910,000 for fiscal year 2006 

for the child care and development block grant. The comparable 

funding level for fiscal year 2005 is $2,082,921,000 and the budget 

request includes $2,082,910,000 for this program. 

The child care and development block grant supports grants to 

States to provide low-income families with financial assistance for 

child care; for improving the quality and availability of child care; 

and for establishing or expanding child development programs. The 

funds are used to both expand the services provided to individuals 

who need child care in order to work, or attend job training or education, and to allow States to continue funding the activities previously provided under the consolidated programs. 

The Committee recommendation continues specific earmarks in 

appropriations language, also included in the budget request, that 

provide targeted resources to specific policy priorities including 

$19,120,000 for the purposes of supporting before and afterschool 

services, as well as resource and referral programs. This represents 

the Federal commitment to the activities previously funded under 

the dependent care block grant. The Committee expects that these 

funds will not supplant current funding dedicated to resource and 

referral and school age activities provided by the child care and development block grant. The Committee strongly encourages States 

to continue to address the matters of before and afterschool care 
200 

and the establishment of resource and referral programs with the 

funds provided in this program. 

The Committee recommendation includes an additional 

$272,672,000 for child care quality activities, and sets aside 

$100,000,000 specifically for an infant care quality initiative. These 

funds are recommended in addition to the 4 percent quality earmark established in the authorizing legislation. The Committee has 

provided these additional quality funds because of the considerable 

research that demonstrates the importance of serving children in 

high quality child care settings which include nurturing providers 

who are educated in child development and adequately compensated. While considerable progress has been made, the Committee believes States should continue to invest in education and 

training linked to compensation of the child care workforce in order 

to improve the overall quality of child care. The Committee recommendation also provides $10,000,000 for 

child care research, demonstration and evaluation activities. 

The Committee recommendation for resource and referral activities also includes $1,000,000 to continue support for the National 

Association of Child Care Resource and Referral Agencies’ information service, Child Care Aware, and the national toll-free information hotline which links families to local child care services and 

programs. 

SOCIAL SERVICES BLOCK GRANT

Appropriations, 2005 ............................................................................. $1,700,000,000 

Budget estimate, 2006 ........................................................................... 1,700,000,000 

House allowance .................................................................................... 1,700,000,000 

Committee recommendation ................................................................. 1,700,000,000 

The Committee recommends $1,700,000,000 for fiscal year 2006 

for the social services block grant. The comparable funding level for 

fiscal year 2005 is $1,700,000,000 and the budget request includes 

$1,700,000,000 for this program. The Committee has included bill 

language that allows States to transfer up to 10 percent of their 

TANF allotment to the social services block grant. 

CHILDREN AND FAMILIES SERVICES PROGRAMS

Appropriations, 2005 ............................................................................. $9,007,770,000 

Budget estimate, 2006 ........................................................................... 8,386,293,000 

House allowance .................................................................................... 8,688,707,000 

Committee recommendation ................................................................. 9,000,832,000 

The Committee recommends $9,000,832,000 for fiscal year 2006 

for children and families services programs. The comparable funding level for fiscal year 2005 is $9,007,770,000 and the budget request includes $8,386,293,000 for this program. In addition, 

$10,500,000 in transfers are available under section 241 of the 

Public Health Service Act. 

This appropriation provides funding for programs for children, 

youth, and families, the developmentally disabled, and Native 

Americans, as well as Federal administrative costs. 

Head Start 

The Committee recommends $6,874,314,000 for fiscal year 2006 

for Head Start. The comparable funding level for fiscal year 2005 
201 

is $6,843,114,000 and the budget request includes $6,899,336,000 

for this program. The Committee recommendation includes 

$1,388,800,000 in advance funding that will become available on 

October 1, 2007. The Committee recommendation does not include 

the $45,000,000 requested in the budget for a State pilot project 

that would allow States to directly administer the Head Start program. 

Head Start provides comprehensive development services for lowincome children and families, emphasizing cognitive and language 

development, socioemotional development, physical and mental 

health, and parent involvement to enable each child to develop and 

function at his or her highest potential. At least 10 percent of enrollment opportunities in each State are made available to children 

with disabilities. 

The Committee is aware that studies on early childhood that provide clear evidence that the brain undergoes its most dramatic development during the first 3 years of life, when children acquire 

the ability to think, speak, learn, and reason. Disparities in children’s cognitive and social abilities become evident well before they 

enter Head Start or pre-kindergarten programs at age 4. Early 

Head Start minimizes these disparities so that children are ready 

to enter school and learn. The National Evaluation of Early Head 

Start concluded that Early Head Start is making a positive difference in areas associated with children’s success in school, family 

self-sufficiency, and parental support of child development. Currently only 3 percent of estimated eligible infants and toddlers are 

enrolled in Early Head Start. Over the past 5 years, the Committee 

has significantly increased funding for Early Head Start, to provide 

more low-income infants and toddlers with the positive experiences 

they need for later school and life successes. The Committee intends to continue this important investment. 

The Committee understands the serious need for additional and 

expanded Head Start facilities among Native American populations 

and in rural areas. The Committee believes that the Department 

could help serve these needy communities by providing minor construction funding, as authorized, in remote Native American communities. 

The Committee strongly supports the effort to strengthen the 

qualifications of Head Start teachers. While the Committee is 

pleased that the percentage of teachers with an associate, baccalaureate, or advanced degree in early childhood education, or a degree in a related field with experience in teaching preschool children has reached 65 percent, the Committee encourages Head 

Start to continue to work toward the goal of 100 percent. The Committee expects the Department to focus staff development efforts on 

increasing the educational level of Head Start teachers in order to 

meet this goal. 

The Committee is aware that in May 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 
202 

funding may be necessary to adequately serve this population. The 

Committee requests that the Secretary submit a report on the 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 which documented that only 19 percent of eligible children 

were able to access Migrant and Seasonal Head Start. 

The Head Start Bureau shall continue to provide the Committee 

with the number and cost of buses purchased, by region with Head 

Start in the annual congressional budget justification. 

The Committee is conscious of efforts currently being undertaken 

to improve pre-literacy skills in Head Start children and lauds the 

administration for its commitment to this effort. However, the 

Committee continues to caution against anything that would detract from the comprehensive nature of the program in delivering 

early childhood development and family services. While school 

readiness is front and center in the goals of Head Start, the elements necessary to achieve that readiness range from adequate nutrition and health screening, to social and emotional development 

and family building, as well as the cognitive growth of young children. 

The Committee is aware that the Government Accountability Office came out on May 17 with the report, ‘‘Head Start: Further Development Could Allow Results of New Test to be Used for Decision 

Making,’’ on the National Reporting System [NRS] test. The report 

stated that analysis was currently incomplete to support its use for 

the purposes of accountability and targeting training and technical 

assistance, that grantees have not yet shown that the NRS provides the scope and quality of assessment information needed for 

holding grantees accountable, and that language experts raised serious concerns about whether the Spanish version of the NRS adequately measures the skills of Spanish-speaking children and 

whether results from the English and Spanish. Therefore, the Committee directs the Secretary to submit a report to House and Senate Committees on Appropriations, not later than 90 days after enactment of this Act, addressing: (1) a detailed justification to Congress regarding the planned uses of the NRS results and data in 

terms of program evaluation, professional development, technical 

assistance, and other activities; (2) an itemization of the costs of 

development, implementation, and analysis of the NRS, 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. 

Consolidated Runaway and Homeless Youth Program 

The Committee recommends $88,724,000 for fiscal year 2006 for 

the consolidated runaway and homeless youth program. The comparable funding level for fiscal year 2005 is $88,724,000 and the 

budget request includes $88,728,000 for this program. This program was reauthorized under the Runaway, Homeless, and Miss-
203 

ing Children Protection Act of 2003. In this reauthorization a statutory formula was established to distribute funds between the 

Basic Center Program and the Transitional Living Program. 

This program addresses the crisis needs of runaway and homeless youth and their families through support to local and State 

governments and private agencies. Basic centers and transitional 

living programs help address the needs of some of the estimated 

500,000 to 1.5 million and homeless youth, many of whom are running away from unsafe or unhealthy living environments. These 

programs have been proven effective at supporting positive youth 

development, securing stable and safe living arrangements and 

providing the skills required to engage in positive relationships 

with caring adults and contribute to society. 

The Committee also recognizes the need for and value of expanding transitional living opportunities for all homeless youth. Therefore, the Committee seeks to preserve the flexibility afforded in 

current law to respond to the needs of the young people who are 

most at-risk and in greatest need of transitional living opportunities in their communities by providing additional resources to the 

existing portfolio of consolidated Runaway and Homeless Youth Act 

programs. 

It is the Committee’s expectation that current and future TLP 

grantees will continue to provide transitional living opportunities 

and support 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 support 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 recommendation does not include the 

$10,000,000 requested in the budget for the maternity group homes 

program. Under this proposed program, the ACF would provide 

targeted funding for community-based, adult-supervised group 

homes for young mothers and their children. These homes would 

provide safe, stable, nurturing environments for mothers who cannot live safely with their own families and assist them in moving 

forward with their lives by providing support so they can finish 

school, acquire job skills, and learn to be good parents. 

The Committee expects the Family and Youth Services Bureau 

to continue to provide the technical assistance needed to enable 

TLP grantees and their community partners to address the unique 

needs of young mothers and their children, as well as helping interested entities in identifying sources of funding currently available 

to provide residential services to this population. 

Runaway Youth Prevention Program 

The Committee recommends $15,179,000 for fiscal year 2006 for 

the runaway youth prevention program. The comparable funding 
204 

level for fiscal year 2005 is $15,178,000 and the budget request includes $15,179,000 for this program. This is a discretionary grant 

program open to private nonprofit agencies for the provision of 

services to runaway, homeless, and street youth. Funds may be 

used for street-based outreach and education, including treatment, 

counseling, provision of information, and referrals for these youths, 

many of whom have been subjected to, or are at risk of being subjected to, sexual abuse. The goal of this program is to help young 

people leave the streets. 

Child Abuse Programs 

The Committee recommends $101,779,000 for fiscal year 2006 for 

child abuse programs. The comparable funding level for fiscal year 

2005 is $101,778,000 and the budget request includes $101,784,000 

for this program. The recommendation includes $27,280,000 for 

State grants, $31,640,000 for discretionary activities, and 

$42,859,000 for community based child abuse prevention. 

These programs seek to improve and increase activities at all levels of government which identify, prevent, and treat child abuse 

and neglect through State grants, technical assistance, research, 

demonstration, and service improvement. 

Abandoned Infants Assistance 

The Committee recommends $11,955,000 for fiscal year 2006 for 

abandoned infants assistance. The comparable funding level for fiscal year 2005 is $11,955,000 and the budget request includes 

$11,955,000 for this program. 

This program provides grants to public and private non-profit 

agencies, State and county child welfare agencies, universities, and 

community-based organizations to develop, implement, and operate 

demonstration projects that will prevent the abandonment of infants and young children, especially those impacted by substance 

abuse and HIV and who are at-risk of being or are currently abandoned. By providing respite care for families and care givers and 

assisting abandoned infants and children to reside with their natural families or in foster care. The Committee recognizes that the 

rates of prenatal substance abuse and maternal HIV/AIDS have increased, that the related problem of infants abandoned or boarding 

in hospitals has grown, and that existing grantees have experienced a large increase in demand for services nationwide. 

Child Welfare Services 

The Committee recommends $289,650,000 for fiscal year 2006 for 

child welfare services. The comparable funding level for fiscal year 

2005 is $289,650,000 and the budget request includes $289,650,000 

for this program. 

This program helps State public welfare agencies improve their 

child welfare services with the goal of keeping families together. 

State services include: preventive intervention, so that, if possible, 

children will not have to be removed from their homes; reunification so that children can return home; and development of alternative placements like foster care or adoption if children cannot remain at home. These services are provided without regard to income. 
205 

Child Welfare Training 

The Committee recommends $7,409,000 for fiscal year 2006 for 

child welfare training. The comparable funding level for fiscal year 

2005 is $7,409,000 and the budget request includes $7,409,000 for 

this program. 

Under section 426, title IV–B of the Social Security Act, discretionary grants are awarded to public and private nonprofit institutions of higher learning to develop and improve education/training 

programs and resources for child welfare service providers. These 

grants upgrade the skills and qualifications of child welfare workers. 

Given research on failings in the Child and Family Services Reviews [CFSRs] and the States’ continuing challenges in recruiting 

and retaining qualified child welfare personnel, particularly those 

who hold a degree in social work, the Committee encourages ACF 

to continue to provide grants to schools of social work and 

traineeships to social work students being trained in the specialty 

of child welfare. The Committee also encourages ACF to provide 

funding for research into how specially trained social work personnel affect outcomes for children and families. 

Adoption Opportunities 

The Committee recommends $27,119,000 for fiscal year 2006 for 

adoption opportunities. The comparable funding level for fiscal year 

2005 is $27,116,000 and the budget request includes $27,119,000 

for this program. 

This program eliminates barriers to adoption and helps find permanent homes for children who would benefit by adoption, particularly children with special needs. 

Adoption Incentives 

The Committee recommends $22,846,000 for fiscal year 2006 for 

adoption incentives. The comparable funding level for fiscal year 

2005 is $31,846,000 and the budget request includes $31,846,000 

for this program. Fewer resources were needed in fiscal year 2005 

to make bonus payments to States for the full amount for which 

they were eligible under this program, so the reduction recommended by the Committee will not have any impact on this program, unused funds will supplement the fiscal year 2006 appropriation in order to maintain a robust incentives program. 

The purpose of this program is to provide incentive funds to 

States to encourage an increase in the number of adoptions of children from the public foster care system. These funds are used to 

pay States bonuses for increasing their number of adoptions. The 

appropriation allows incentive payments to be made for adoptions 

completed prior to September 30, 2007. 

Adoption Awareness 

The Committee recommends $12,802,000 for fiscal year 2006 for 

adoption awareness. The comparable funding level for fiscal year 

2005 is $12,802,000 and the budget request includes $12,802,000 

for this program. 

This program was authorized in the Children’s Health Act of 

2000. The program consists of two activities: the Infant Adoption 
206 

Awareness Training Program and the Special Needs Awareness 

Campaign. The Infant Adoption Awareness Training Program provides grants to support adoption organizations in the training of 

designated health staff, in eligible health centers that provide 

health services to pregnant women, to inform them about adoption 

and make referrals on request on an equal basis with all other 

courses of action. Within the Committee recommendation, 

$9,826,000 is available for this purpose. 

The Special Needs Adoption Campaign supports grants to carry 

out a national campaign to inform the public about the adoption of 

children with special needs. The Committee recommendation includes $2,976,000 to continue this important activity. 

Compassion Capital Fund 

The Committee recommends $95,000,000 for fiscal year 2006 for 

the compassion capital fund. The comparable funding level for fiscal year 2005 is $54,549,000 and the budget request includes 

$100,000,000 for this program. 

The Committee expects funds made available through this program to supplement and not supplant private resources and encourages the Secretary to require private resources to match grant 

funding provided to public/private partnerships. 

Funds available will support grants to charitable organizations to 

emulate model social service programs and to encourage research 

on the best practices of social service organizations. Of the funds provided, $45,000,000 is for a new anti-gang initiative. Competitive grants will be awarded to community and faithbased organizations that will foster supportive relationships with 

youths ages 8–17 through targeted street outreach, direct youths to 

social services, and present alternatives to gang involvement. 

These grants will be especially helpful in urban areas such as 

Philadelphia that have experienced alarming increases in youth 

gang violence. 

Social Services Research 

The Committee recommends $32,012,000 for fiscal year 2006 for 

the social services research. The comparable funding level for fiscal 

year 2005 is $32,012,000 and the budget request includes 

$6,000,000 for this program. 

The Committee has funded $6,000,000 of this program through 

transfers available under section 241 of the Public Health Service 

Act. These funds support cutting-edge research and evaluation 

projects in areas of critical national interest. Research includes determining services that are more cost-effective and alternative 

ways to increase the economic independence of American families. 

The Committee notes ACF’s efforts to assist States with meeting 

the extensive record-keeping, reporting and tracking requirements 

of the 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 
207 

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. The Committee recommends that both 

collaborative efforts with the State information technology consortium be continued at their current levels. 

Abstinence Education 

The Committee recommends $105,500,000 for fiscal year 2006 for 

community based abstinence education. The comparable funding 

level for fiscal year 2005 is $103,698,000 and the budget request 

includes $142,545,000 for this program. Within the Committee recommendation, $101,000,000 is provided for community-based abstinence education, $4,500,000 is provided through an evaluation setaside, as requested by the administration. In addition, $50,000,000 

is available from pre-appropriated mandatory funds. 

This program provides support for the development and implementation of abstinence education programs for adolescents, ages 

12 through 18. These programs are unique in that their entire 

focus is to educate young people and create an environment within 

communities that supports teen decisions to postpone sexual activity until marriage. Of the funds provided up to $10,000,000 may be available for a 

national abstinence media campaign. The Committee understands 

that a portion of fiscal year 2005 funds will be used for evaluation 

purposes. The Committee intends that ACF use available funds to 

continue support for an independent group to conduct a thorough 

and rigorous evaluation of this campaign. 

Developmental Disabilities 

The Committee recommends $171,561,000 for fiscal year 2006 for 

programs administered by the Administration on Developmental 

Disabilities. The comparable funding level for fiscal year 2005 is 

$168,575,000 and the budget request includes $168,561,000 for 

these programs. Within the funds provided, $156,682,000 is for carrying out the Developmental Disability Act, and $14,879,000 is for 

carrying out the Help America Vote Act of 2002. 

The Administration on Developmental Disabilities supports community-based delivery of services which promote the rights of persons of all ages with developmental disabilities. Developmental disability is defined as severe, chronic disability attributed to mental 

or physical impairments manifested before age 22, which causes 

substantial limitations in major life activities. The ADD also administers monies for election assistance for individuals with disabilities. This program is for individuals with any type of disability. 

Of the funds provided, the Committee recommends $72,496,000 

for State councils. These councils assist each State in promoting 

the development of a comprehensive, statewide, consumer and family-centered system which provides a coordinated array of culturally-competent services, and other assistance for individuals 

with development disabilities. State councils undertake a range of 
208 

activities including demonstration of new approaches, program and 

policy analysis, interagency collaboration and coordination, outreach and training. The Committee recommends $39,109,000 for protection and advocacy grants. This formula grant program provides funds to States 

to establish protection and advocacy systems to protect the legal 

and human rights of persons with developmental disabilities who 

are receiving treatment, services, or rehabilitation within the 

State. 

The Committee recommends $14,879,000 for disabled voter services. Of these funds, $10,000,000 is to promote disabled voter access, and the remaining $4,879,000 is for disabled voters protection 

and advocacy systems. The election assistance for individuals with 

disabilities program was authorized in the Help America Vote Act 

of 2002. The program enables an applicant to establish, expand, 

and improve access to, and participation by, any individual with a 

disability in the election process. The Committee recommends $11,529,000 for projects of national 

significance to assist persons with developmental disabilities. This 

program funds grants and contracts providing nationwide impact 

by developing new technologies and applying and demonstrating innovative methods to support the independence, productivity, and 

integration into the community of persons with developmental disabilities. The Committee recognizes the potential benefits that assistive technology can have for individuals with developmental disabilities. Of these funds, $4,000,000 is available to expand activities of the Family Support Program. The Committee’s placement of 

funds for family support within the Projects of National Significance account does not provide ACF with discretion on this definition of family support as defined in Title II of the Developmental 

Disability Act. The Committee makes a crucial distinction between 

support services designed for families of children with disabilities 

and support services designed for an individual with a disability. 

The Committee intends that these funds be used for the support 

and assistance of families of children with disabilities, in accordance with the statute. 

The Committee recommends $33,548,000 for the University Centers for Excellence in Developmental Disabilities [UCEDDs] which 

is a network of 61 centers that are interdisciplinary education, research and public service units of a university system or are public 

or non-profit entities associated with universities. UCEDDs conduct 

research, develop evidence based practices and teach thousands of 

parents, professionals, students and people with disabilities about 

critical disability areas such as early intervention, health care, 

community-based services, inclusive and meaningful education, 

transition from school to work, employment, housing, assistive 

technology, aging with a disability and transportation. The Centers 

serve as the major vehicle to translate disability related research 

into community practice and service systems and to train the next 

cohort of future professionals who will provide services and supports to an increasingly diverse population of people with disabilities. 

The increase provided in the bill will allow funding for the three 

new Centers established in fiscal year 2005 to be increased to the 
209 

same grant award level as the existing 61 Centers, as well as to 

establish additional Center grants in the States that currently 

have unserved and underserved populations, and support additional training initiatives. 

Native American Programs 

The Committee recommends $44,780,000 for fiscal year 2006 for 

Native American programs. The comparable funding level for fiscal 

year 2005 is $44,786,000 and the budget request includes 

$44,780,000 for this program. 

The Administration for Native Americans [ANA] assists Indian 

tribes and Native American organizations in planning and implementing long-term strategies for social and economic development 

through the funding of direct grants for individual projects, training and technical assistance, and research and demonstration programs. 

Community Services 

The Committee recommends $708,895,000 for fiscal year 2006 for 

the community services programs. The comparable funding level 

for fiscal year 2005 is $726,506,000 and the budget request includes $24,699,000 for this program. 

Within the funds provided, the Committee recommends $636,793,000 for the community services block grant [CSBG]. 

These funds are used to make formula grants to States and Indian 

tribes to provide a wide range of services and activities to alleviate 

causes of poverty in communities and to assist low-income individuals in becoming self-sufficient. 

The Committee rejects the administration’s recommendation to 

eliminate the community services block grant funding. Although a 

restrictive Committee allocation prevented CSBG funding from 

being increased this year, the Committee continues to recognize the 

importance of CSBG and the Community Action Agencies it funds 

in helping meet the extraordinary challenges facing low-income 

communities. 

The Nation’s Community Action Agency network relies on CSBG 

funding to help initiate and administer programs designed to alleviate poverty. The universal characteristic of these CSBG-funded 

programs is that they provide people with the resources and the 

tools to become self-sufficient. The Committee understands that the 

Department of Health and Human Services, and its Office of Community Services in particular, could better use this network in developing future policy initiatives. The Committee notes that in a 

number of States, including Iowa and Pennsylvania, CAA-initiated 

family development and self-sufficiency programs are a integral 

component of welfare reform efforts. The administration is encouraged to look for further nationwide linkages between those individuals seeking to leave the welfare system and become self-sufficient 

and the many family development and self-sufficiency strategies 

operated by Community Action Agencies. 

The Committee expects the Office of Community Services [OCS] 

to release funding to States in the most timely manner and also 

expects States to make funds available promptly. The Committee 

is aware that the Office of Community Services and some States 
210 

have been extraordinarily delinquent in providing funds to local eligible entities. 

In addition, the Committee again expects the Office of Community Services to inform the State CSBG grantees of any policy 

changes affecting carryover CSBG funds within a reasonable time 

after the beginning of the Federal fiscal year. 

Several other discretionary programs are funded from this account. Funding for these programs is recommended at the following 

levels for fiscal year 2006: community economic development, 

$32,731,000; individual development accounts, $24,699,000; rural 

community facilities, $7,492,000; and community food and nutrition, $7,180,000. The Committee did not provide funds for the national youth sports program. 

The Committee continues to support strongly the Community 

Economic Development program because of the substantial record 

of achievement that Community Development Corporations have 

complied in working in distressed urban and rural communities. 

The Committee, in particular, notes that Federal funds leverage 

substantial non-Federal resources in meeting the objectives of this 

program. Therefore, it is the Committee’s intent that appropriated 

funds should be allocated to the maximum extent possible in the 

form of grants to qualified Community Development Corporations 

in order to maximize the leveraging power of the Federal investment and the number and amount of set-asides should be reduced 

to the most minimal levels. The Committee requests an operation 

plan for how OCS plans to use appropriated funds consistent with 

the Committee’s expectations. This plan should include a detailed 

breakdown of planned expenditures for program support, technical 

assistance, contracts, and research and grants. 

Community economic development grants are made to private, 

nonprofit community development corporations, which in turn provide technical and financial assistance to business and economic 

development projects that target job and business opportunities for 

low income citizens. The Committee has included bill language 

clarifying that Federal funds made available through this program 

may be used for financing for construction and rehabilitation and 

loans or investments in private business enterprises owned by 

Community Development Corporations. 

Of the total provided, the Committee has included $5,436,000 for 

the Job Opportunities for Low-Income Individuals [JOLI] program 

authorized under the Family Support Act to target community development activities to create jobs for people on public assistance. 

This demonstration program provides grants on a competitive basis 

to non-profit organizations to create new employment and business 

opportunities for TANF recipients and other low-income individuals. Funding also supports technical and financial assistance for 

private employers that will result in the creation of full-time permanent jobs for eligible individuals. The Committee recognizes that 

continued funding of this program would provide opportunities for 

more low-income individuals. The Committee expects that experienced community development corporations be given appropriate 

consideration for grants under this program. 

Most of the drinking water and wastewater systems in the country that are not in compliance with Federal standards are in com-
211 

munities of 3,000 or fewer. Rural Community Assistance Programs 

[RCAPs] use funds available from the Rural Community Facilities 

Program to assist a number of communities in gaining access to 

adequate community facilities, gaining financing for new or improved water and wastewater systems and in complying with Federal standards. 

The Committee has included bill language allocating funding to 

the Office of Community Services for Rural Community Facilities 

Technical Assistance as authorized under section 680(3)(B) of the 

Community Services Block Grant Act. In providing this funding, 

the Committee expects that it be used solely for the purpose of improving water and wastewater facilities in poor, rural communities. 

The Committee intends that funds provided above the request shall 

be made available to the six regional RCAPs. 

The Committee is concerned that many small and very small 

community water and wastewater treatment systems might be 

most vulnerable to terrorist attack, and yet least prepared to deal 

with the issue. The Committee urges OCS to continue to support 

RCAP Small Community Infrastructure Safety and Security Training and Technical Assistance project, which provides State, regional and national infrastructure safety and security training 

workshops and on-site technical assistance targeted to small and 

very small community water and wastewater treatment systems. 

The goal of the project is to improve the capacity of small systems 

to better prepare for emergencies, develop emergency preparedness 

training manuals for small water systems, identify appropriate 

technologies to secure such systems, and provide technical assistance to small communities struggling to deal with these issues. 

Domestic Violence Hotline 

The Committee recommends $3,000,000 for fiscal year 2006 for 

the national domestic violence hotline. The comparable funding 

level for fiscal year 2005 is $3,224,000 and the budget request includes $3,000,000 for this program. 

This is a cooperative agreement which funds the operation of a 

national, toll-free, 24-hours-a-day telephone hotline to provide information and assistance to victims of domestic violence. 

Battered Women’s Shelters 

The Committee recommends $125,991,000 for fiscal year 2006 for 

battered women’s shelters program. The comparable funding level 

for fiscal year 2005 is $125,630,000 and the budget request includes $125,991,000 for this program. 

This is a formula grant program to support community-based 

projects which operate shelters and provide related assistance for 

victims of domestic violence and their dependents. Emphasis is 

given to projects which provide counseling, advocacy, and self-help 

services to victims and their children. 

Early Learning Opportunities Program 

The Committee does not include funds for fiscal year 2006 for the 

early learning opportunities program. The comparable funding 

level for fiscal year 2005 is $35,712,000 and the budget request did 

not include funds for this program. 
212 

This program supports grants to local community councils comprised of representatives from agencies involved in early learning 

programs, parent organizations and key community leaders. Funds 

are used to increase the capacity of local organizations to facilitate 

development of cognitive skills, language comprehension and learning readiness; enhance childhood literacy; improve the quality of 

early learning programs through professional development and 

training; and remove barriers to early learning programs. 

Faith-Based Center 

The Committee recommends $1,400,000 for fiscal year 2006 for 

the operation of the Department’s Center for Faith-Based and Community Initiatives. The comparable funding level for fiscal year 

2005 is $1,375,000 and the budget request includes $1,400,000 for 

this program. 

Mentoring Children of Prisoners 

The Committee recommends $49,993,000 for fiscal year 2006 for 

mentoring children of prisoners. The comparable funding level for 

fiscal year 2005 is $49,598,000 and the budget request includes 

$49,993,000 for this program. 

The mentoring children of prisoners program was authorized in 

2001 under section 439 of the Social Security Act. The purpose of 

this program is to help children while their parents are imprisoned 

and includes activities that keep children connected to a parent in 

prison in order to increase the chances that the family will come 

together successfully when the parent is released. As a group, children of prisoners are less likely than their peers to succeed in 

school and more likely to become engaged in delinquent behavior. 

Independent Living Training Vouchers 

The Committee recommends $46,623,000 for fiscal year 2006 for 

independent living training vouchers. The comparable funding level 

for fiscal year 2005 is $46,623,000 and the budget request includes 

$59,999,000 for this program. 

These funds will support vouchers of up to $5,000 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 

and contribute productively to society. Studies have shown that 

25,000 youth leave foster care each year at age 18 and just 50 percent will have graduated high school, 52 percent will be unemployed and 25 percent will be homeless for one or more nights. 

Program Administration 

The Committee recommends $186,000,000 for fiscal year 2006 for 

program administration. The comparable funding level for fiscal 

year 2005 is $185,210,000 and the budget request includes 

$185,217,000 for this program. 

The Committee continues its interest in the Department’s Child 

and Family Services reviews. These reviews are an effective method for monitoring the progress States are making in assuring the 

safety, health, and permanency for children in child welfare and 

foster care as required in the Adoption and Safe Families Act. The 

Committee encourages the Department to make available sufficient 
213 

resources to ensure full implementation of the new collaborative 

monitoring system. The Committee directs ACF to continue to provide information on the progress of the reviews in the annual congressional justification. 

PROMOTING SAFE AND STABLE FAMILIES

Appropriations, 2005 ............................................................................. $403,586,000 

Budget estimate, 2006 ........................................................................... 410,000,000 

House allowance .................................................................................... 404,000,000 

Committee recommendation ................................................................. 395,000,000 

The Committee recommends $395,000,000 for fiscal year 2006 for 

promoting safe and stable families. The comparable funding level 

for fiscal year 2005 is $403,586,000 and the budget request includes $410,000,000 for this program. 

Funding available provides grants to States in support of: (1) 

family preservation services; (2) time-limited family reunification 

services; (3) community-based family support services; and (4) 

adoption promotion and support services. The Committee notes 

that most of the Federal funding related to child welfare is provided for the removal and placement of children outside of their 

own homes. Funds available through the Promoting Safe and Stable Families program are focused on supporting those activities 

that can prevent family crises from emerging which might require 

the temporary or permanent removal of a child from his or her own 

home. 

The Promoting Safe and Stable Families program is comprised of 

$305,000,000 in capped entitlement funds authorized by the Social 

Security Act and $90,000,000 in discretionary appropriations. 

PAYMENTS TO STATES FOR FOSTER CARE AND ADOPTION ASSISTANCE

Appropriations, 2005 ............................................................................. $5,037,900,000 

Budget estimate, 2006 ........................................................................... 4,852,800,000 

House allowance .................................................................................... 4,852,800,000 

Committee recommendation ................................................................. 4,852,800,000 

The Committee recommends $4,852,800,000 for fiscal year 2006 

for payments to States for foster care and adoption assistance. The 

comparable funding level for fiscal year 2005 is $5,037,900,000 and 

the budget request includes $4,852,800,000 for this program. In addition, the Committee recommendation concurs with the administration’s request of $1,730,000 for an advance appropriation for the 

first quarter of fiscal year 2007. 

The Foster Care Program provides Federal reimbursement to 

States for: maintenance payments to families and institutions caring for eligible foster children, matched at the Federal medical assistance percentage [FMAP] rate for each State; and administration 

and training costs to pay for the efficient administration of the Foster Care Program, and for training of foster care workers and parents. 

The Adoption Assistance Program provides funds to States for 

maintenance costs and the nonrecurring costs of adoption for children with special needs. The goal of this program is to facilitate the 

placement of hard-to-place children in permanent adoptive homes, 

and thus prevent long, inappropriate stays in foster care. As in the 
214 

Foster Care Program, State administrative and training costs are 

reimbursed under this program. 

The Independent Living Program provides services to foster children under 18 and foster youth ages 18–21 to help them make the 

transition to independent living by engaging in a variety of services 

including educational assistance, life skills training, health services 

and room and board. States are awarded grants from the annual 

appropriation proportionate to their share of the number of children in foster care, subject to a matching requirement. 

ADMINISTRATION ON AGING

Appropriations, 2005 ............................................................................. $1,393,342,000 

Budget estimate, 2006 ........................................................................... 1,369,028,000 

House allowance .................................................................................... 1,376,217,000 

Committee recommendation ................................................................. 1,391,699,000 

The Committee recommends an appropriation of $1,391,699,000 for aging programs. This amount is $1,643,000 below the comparable fiscal year 2005 level and $22,671,000 above the administration request. 

Supportive Services and Senior Centers 

The Committee recommends an appropriation of $354,136,000 for 

supportive services and senior centers, which is the same as the 

comparable fiscal year 2005 level and the administration request. 

This State formula grant program funds a wide range of social 

services for the elderly, including multipurpose senior centers, 

adult day care, and ombudsman activities. State agencies on aging 

award funds to designated area agencies on aging who in turn 

make awards to local services providers. All individuals age 60 and 

over are eligible for services, although, by law, priority is given to 

serving those who are in the greatest economic and social need, 

with particular attention to low-income minority older individuals 

and those residing in rural areas. Under the basic law, States have 

the option to transfer up to 30 percent of funds appropriated between the senior centers program and the nutrition programs, 

which allows the State to determine where the resources are most 

needed. 

Preventive Health Services 

The Committee recommends $21,616,000 for preventive health 

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

and the administration request. Funds appropriated for this activity are part of the comprehensive and coordinated service systems 

targeted to those elderly most in need. Preventive health services 

include nutritional counseling and education, exercise programs, 

health screening and assessments, and prevention of depression. 

Protection of Vulnerable Older Americans 

The Committee recommends $20,360,000 for grants to States for 

protection of vulnerable older Americans. This is $1,072,000 above 

the comparable fiscal year 2005 level and $1,000,000 above the administration request. Within the Committee recommendation, 

$15,162,000 is for the ombudsman services program and $5,198,000 

is for the prevention of elder abuse program. Both programs pro-
215 

vide formula grants to States to prevent the abuse, neglect, and exploitation of older individuals. The ombudsman program focuses on 

the needs of residents of nursing homes and board and care facilities, while elder abuse prevention targets its message to the elderly 

community at large. 

National Family Caregiver Support Program 

The Committee recommends $160,744,000 for the national family 

caregiver support program, which is $5,000,000 above the comparable fiscal year 2005 level and the administration request. 

Funds appropriated for this activity established a multifaceted support system in each State for family caregivers. All States are expected to implement the following five components into their program: individualized referral information services; assistance to 

caregivers in locating services from a variety of private and voluntary agencies; caregiver counseling, training and peer support; 

respite care provided in the home, an adult day care center or 

other residential setting located in an assisted living facility; and 

limited supplemental services that fill remaining service gaps. 

Native American Caregiver Support Program 

The Committee recommendation includes $6,304,000 to carry out 

the Native American Caregiver Support Program, which is the 

same as the comparable fiscal year 2005 level and the administration request. The program will assist tribes in providing multifaceted systems of support services for family caregivers and for 

grandparents or older individuals who are relative caregivers. 

Congregate and Home-delivered Nutrition Services 

For congregate nutrition services, the Committee recommends an 

appropriation of $387,274,000, which is the same as the comparable fiscal year 2005 level and the administration request. For 

home-delivered meals, the Committee recommends $182,827,000, 

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

$1,000 above the administration request. These programs address 

the nutritional need of older individuals. Projects funded must 

make home-delivered and congregate meals available at least once 

a day, 5 days a week, and each meal must meet one-third of the 

minimum daily dietary requirements. While States receive separate allotments of funds for congregate and home-delivered nutrition services and support services, they are permitted to transfer 

up to 40 percent of funds between these programs. 

Nutrition Services Incentives Program 

The Committee recommendation includes $148,596,000 for the 

nutrition services incentives program [NSIP], the same as the comparable fiscal year 2005 funding level and the administration request. This program augments funding for congregate and homedelivered meals provided to older adults. Funds provided under 

this program are dedicated exclusively to the provision of meals. 

NSIP rewards effective performance by States and Tribal organizations in the efficient delivery of nutritious meals to older individuals through the use of cash or commodities. 
216 

Aging Grants to Indian Tribes and Native Hawaiian Organizations 

The Committee recommends $26,398,000 for grants to Native 

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

funding level and the administration request. Under this program 

awards are made to tribal and Alaskan Native organizations and 

to public or nonprofit private organizations serving native Hawaiians which represent at least 50 percent Indians or Alaskan Natives 60 years of age or older to provide a broad range of supportive 

services and assure that nutrition services and information and assistance are available. 

The Committee recognizes that this program is the primary vehicle for providing nutrition and other supportive services to Indian, 

Alaska Native, and Native Hawaiian elders. The Committee urges 

the Administration on Aging to devote its attention toward this 

purpose. 

Training, Research, and Discretionary Projects 

The Committee recommends $40,513,000 for training, research, and discretionary projects, which is $2,773,000 below the comparable fiscal year 2005 level and $16,670,000 above the administration request. These funds support activities designed to expand 

public understanding of aging and the aging process, apply social 

research and analysis to improve access to and delivery of services 

for older individuals, test innovative ideas and programs to serve 

older individuals, and provide technical assistance to agencies that 

administer the Older Americans Act. Given the enormous demands 

on Alzheimer’s family caregivers, the Committee has included 

$1,000,000 to support an Alzheimer’s family contact center for 

round-the-clock help to Alzheimer’s families in crisis. 

The Committee continues to support funding at no less than last 

year’s level for national programs scheduled to be refunded in fiscal 

year 2006 that address a variety of issues, including elder abuse, 

Native American issues, and legal services. 

The Committee encourages the Administration on Aging to facilitate the expansion of demonstration projects gauging the efficiency 

of nurse-managed Geriatric Wellness Centers. 

The Committee expects the Administration on Aging to continue 

to fund the national program of statewide senior legal services hotlines (also called legal helplines) at their current levels and ideally 

to provide an increase in the number of States served by these 

legal hotlines. 

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 

the agency to develop partnerships with organizations that enable 

older Americans to help meet critical social needs effectively. 

Aging Network Support Activities 

The Committee recommends $13,266,000 for aging network support activities, the same as the comparable amount for fiscal year 

2005 and the administration request. The Committee recommendation includes funding at the administration request level for the 

Eldercare Locator and for the Pension Information and Counseling 

Program. 
217 

The Eldercare Locator, a toll-free, nationwide directory assistance service for older Americans and their caregivers, is operated 

by the National Association of Area Agencies on Aging. Since 1991, 

the service has linked more than 700,000 callers to an extensive 

network of resources for aging Americans and their caregivers. 

Pension counseling projects provide information, advice, and assistance to workers and retirees about pension plans, benefits, and 

how to pursue claims when pension problems arise. The information dissemination and outreach activities of the pension counseling 

projects have served over 25,000 people and has helped obtain 

more than $50,000,000 in retirement benefits for older individuals. 

The Committee has provided funding at the administration request level for the National Long Term Care Ombudsman Resource 

Center, the National Center on Elder Abuse and the Health Care 

Anti-Fraud, Waste and Abuse Program. 

Alzheimer’s Disease Demonstration Grants to States 

As a result of the aging of the baby boom generation, the number 

of individuals affected by Alzheimer’s disease will double in the 

next 20 years. The Committee recommends a funding level of 

$11,786,000 for Alzheimer’s disease demonstration grants to States. 

This is the same as the comparable fiscal year 2005 funding level 

and the administration request. 

Currently, an estimated 70 percent of individuals with Alzheimer’s disease live at home, where families provide the preponderance of care. For these families, caregiving comes at enormous 

physical, emotional, and financial sacrifice. The Alzheimer’s disease 

demonstration grant program currently provides matching grants 

to 38 States to stimulate and better coordinate services for families 

coping with Alzheimer’s. With a relatively small amount of Federal 

support to provide the stimulus, States have found innovative ways 

to adapt existing health, long-term care, and community services to 

reach previously underserved populations, particularly minorities 

and those living in rural communities. 

White House Conference on Aging 

The Committee recommendation does not include funding for the 

White House Conference on Aging. This conference will be held in 

December 2005 and is required by the Older Americans Act 

Amendments of 2000. White House Conferences on Aging are decennial events held to develop recommendations for the President 

and Congress on issues, policy, and research in the field of aging. 

Program Administration 

The Committee recommends $17,879,000 for program administration, which is $422,000 below the comparable fiscal year 2005 

funding level and the same as the administration request. These 

funds support salaries and related expenses for program management and oversight activities. 
218 

OFFICE OF THE SECRETARY

GENERAL DEPARTMENTAL MANAGEMENT

Appropriations, 2005 ............................................................................. $369,931,000 

Budget estimate, 2006 ........................................................................... 359,176,000 

House allowance .................................................................................... 344,546,000 

Committee recommendation ................................................................. 359,465,000 

The Committee recommends $359,465,000 for general depart- mental management [GDM]. This amount is $10,466,000 below the 

comparable level for fiscal year 2005 and $289,000 above the administration request. The Committee recommendation includes the 

transfer of $5,851,000 from Medicare trust funds, which is the 

same as the administration request. In addition, for policy evaluation activities the Committee recommends $39,552,000 in transfers 

available under section 241 of the Public Health Service Act. 

The Committee directs that specific information requests from 

the chairman and ranking member of the Subcommittee on Labor, 

Health and Human Services, and Education, and Related Agencies, 

on scientific research or any other matter, shall be transmitted to 

the Committee on Appropriations in a prompt professional manner 

and within the time frame specified in the request. The Committee 

further directs that scientific information requested by the Committees on Appropriations and prepared by Government researchers 

and scientists be transmitted to the Committee on Appropriations, 

uncensored and without delay. 

This appropriation supports those activities that are associated 

with the Secretary’s role as policy officer and general manager of 

the Department. It supports certain health activities performed by 

the Office of Public Health and Science, including the Office of the 

Surgeon General. GDM funds also support the Department’s centralized services carried out by several Office of the Secretary staff 

divisions, including personnel management, administrative and 

management services, information resources management, intergovernmental relations, legal services, planning and evaluation, finance and accounting, and external affairs. 

The Office of the Surgeon General, in addition to its other responsibilities, provides leadership and management oversight for 

the PHS Commissioned Corps, including the involvement of the 

Corps in departmental emergency preparedness and response activities. 

The Committee recommendation includes $3,000,000 for the Citizens’ Health Care Working Group which was authorized by the 

Medicare Prescription Drug, Improvement, and Modernization Act 

of 2003. These funds are available for all activities of the Working 

Group, including preparation and distribution of reports. 

Advance Directives.—The Committee believes that through the 

execution of advance directives, including living wills and durable 

powers of attorney for health care according to the laws of the 

State in which they reside, individuals can better protect their 

right to express their wishes about end-of-life care and have those 

wishes respected. The Committee directs the Secretary to conduct 

a study to determine the best way to promote the use of advance 

directives among competent adults as a means of specifying their 

wishes about end of life care, and provide recommendations to Con-
219 

gress on changes to Federal law needed to ensure appropriate use 

of advance directives. As part of that study, the Department shall 

consider that decisions relating to advance directives are often 

made without adequate information about what it is like to live 

with a significant disability. The Committee intends that the study 

directly involve persons with disabilities, family members, disability experts and organizations in assessing this reality and identifying what information and support is necessary. This study 

should also review options related to those individuals whose significant cognitive disabilities limit or prohibit them from making 

decisions about directing their care and treatment. 

Childhood Drinking.—In April 2004 the Secretary created, at the 

request of Congress, an Interagency Coordinating Committee on 

the Prevention of Underage Drinking [ICCPUD], chaired by the 

Administrator of SAMHSA. Since then the ICCPUD has developed 

a draft plan for combating underage drinking which contained a 

complete listing of Federal programs related to underage drinking 

prevention. However, the Committee is concerned that the 

ICCPUD has not made more progress; it has not produced meaningful coordination among Federal agencies, identified effective and 

underperforming programs, or created a plan for improving Federal 

data collection. In addition, the ICCPUD has not identified the resources currently available for programs targeting underage drinking or made recommendations on the allocation of additional resources. Finally, the interim plan lacks measurable goals or benchmarks which would serve to monitor the progress and accountability of the ICCPUD’s efforts. The Committee looks forward to 

the ICCPUD’s final plan to be issued later this year and hopes that 

it will address these issues. 

Chiropractic Care.—The Committee notes that chiropractic 

health care services are now available to beneficiaries within the 

Department of Veterans’ Affairs health care system, the Department of Defense health care program for active duty military personnel and, through a demonstration, within the Medicare health 

program. Despite this broad integration of chiropractic care into 

the mainstream of Federal and private sector health care systems, 

the Committee notes that there are not Doctors of Chiropractic 

Medicine commissioned to serve within the U.S. Public Service 

Commissioned Corps. The Committee notes that authority for the 

Surgeon General to appoint such commissioned officers exists 

under current law, but that none have been appointed. The Committee encourages the Surgeon General to begin to develop a plan 

to commission Doctors of Chiropractic into the U.S. Public Health 

Service Commissioned Corps and directs the Surgeon General to 

update the Committee on its progress within 6 months after enactment of this Act. 

Chronic Fatigue.—The Committee is pleased that the Department’s Chronic Fatigue Syndrome Advisory Committee [CFSAC] 

has been meeting quarterly. This advisory committee serves an important role in setting priorities for Federal research and education 

programs related to chronic fatigue syndrome [CFS] and in keeping 

the Department abreast of the needs of persons with CFS. The 

Committee awaits the Secretary’s written response to the CFSAC’s 

recommendations dated August 23, 2004. 
220 

Health Disparities.—The Committee is committed to ensuring 

the overall improved health of the American people, and strongly 

urges the Secretary to intensify efforts 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 expects the Secretary to report on the 

progress of this action during next year’s appropriations hearings. 

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. 

HIV1–2 Rapid Testing.—The Committee is aware that wide-scale 

deployment of new oral fluid testing for AIDS is a significant step 

towards helping citizens, throughout the United States and around 

the world, to know their HIV status. The Committee urges the Secretary to significantly increase the use of bulk purchasing and 

wide-scale deployment of FDA-approved oral fluid HIV1–2 rapid 

tests for domestic and international programs. 

Parental Website.—It has come to the Committee’s attention that 

an independent study reviewed 4parents.gov, the Department’s 

website created to help parents counsel their teenagers about risky 

health behaviors. While noting positive aspects about the website, 

the study found numerous examples of inaccurate information. The 

Committee is aware that this web site was designed by outside contractors, not by the Department’s public health experts. The Committee directs the Department to review the findings of the study, 

undertake a review of the website by Departmental public health 

and scientific experts, and make any necessary changes to conform 

with scientific evidence. The Committee also directs the Department to include scientifically accurate information about underage 

drinking and tobacco use. 

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 urges the Surgeon General to consider development of 

a Surgeon General’s Report on Sleep and Sleep Disorders. 

Adolescent Family Life 

The Committee has provided $30,742,000 for the Adolescent 

Family Life Program [AFL], which is the same as the administra-
221 

tion request. This is $158,000 below the comparable fiscal year 

2005 level. 

AFL is the only Federal program focused directly on the issue of 

adolescent sexuality, pregnancy, and parenting. Through demonstration grants and contracts, AFL focuses on a comprehensive 

range of health, educational, and social services needed to improve 

the health of adolescents, including the complex issues of early adolescent sexuality, pregnancy, and parenting. 

Minority Health 

The Committee recommends $50,980,000 for the Office of Minority Health, which is $462,000 above the comparable level for fiscal 

year 2005 and $3,744,000 above the administration request. 

The Office of Minority Health [OMH] focuses on strategies designed to decrease the disparities and to improve the health status 

of racial and ethnic minority populations in the United States. 

OMH establishes goals, and coordinates all departmental activity 

related to improving health outcomes for disadvantaged and minority individuals. OMH supports several demonstration projects, including the Minority Community Health Coalition, the Bilingual/ 

Bicultural Service, the Center for Linguistic and Cultural Competency in Health Care, and the Family and Community Violence 

Prevention Program. 

The Committee expects OMH and the National Center for Minority Health and Health Disparities at the National Institutes of 

Health to play a joint role in coordinating and monitoring the implementation of the Department’s elimination of health disparities 

initiatives and strategic plans. The Committee expects the Secretary to report on the progress and implementation of the strategic plans during next year’s appropriations hearings, and to include a progress update in the Department’s Budget Justification. 

Office on Women’s Health 

The Committee recommends $28,715,000 for the Office on Women’s Health. This is $103,000 below the comparable level for fiscal 

year 2005 and the same as the administration request. 

The PHS Office on Women’s Health [OWH] develops, stimulates, 

and coordinates women’s health research, health care services, and 

public and health professional education and training across HHS 

agencies. It advances important crosscutting initiatives and develops public-private partnerships, providing leadership and policy direction, and initiating and synthesizing program activities to redress the disparities in women’s health. 

Bodywise.—The Committee is impressed with the efforts of the 

OWH to address the growing problem of negative body image and 

eating disorders through the Bodywise Project. This has been a 

widely successful project and the Committee urges the Secretary to 

continue this educational initiative and broaden the efforts by collaborating with the Department of Education to disperse the educational materials resulting from Bodywise and expand the educational project to target all levels of education from elementary to 

high school. 

Lupus.—The Committee understands that Lupus is a serious, 

complex, debilitating chronic autoimmune disease that can cause 
222 

inflammation and tissue damage to virtually any organ system in 

the body and impacts an estimated 1.5 and 2 million individuals. 

The Committee is aware that public and professional recognition 

and understanding of lupus is extremely low, contributing to 

misdiagnoses or late diagnoses that can result in disability or 

death. The Committee strongly urges OWH to develop and implement a sustained lupus awareness and education campaign aimed 

at reaching health care professionals and the general public, with 

an emphasis on reaching women at greatest risk for developing 

Lupus. 

Offices of Women’s Health.—The Committee has great interest in 

women’s health and wants to encourage further health research, 

education, and services for women. The Committee also recognizes 

that the Offices of Women’s Health within the Department, the 

Food and Drug Administration, the Centers for Disease Control 

and Prevention, the Health Resources and Services Administration, 

and the Agency for Healthcare Research and Quality provide critical services in support of these needs. The Committee strongly encourages the Secretary to see that these offices continue to receive 

sufficient funding to assure their ability to continue to meet their 

missions. 

Afghanistan 

The Committee recommendation includes $5,952,000 for the Secretary’s Afghanistan health initiative. This amount is the same as 

the comparable fiscal year 2005 funding level and the administration request. Funds will be used in partnership with the Department of Defense for medical training activities at the Rabia Balkhi 

Women’s Hospital in Kabul, and for support of maternal and child 

health throughout Afghanistan. 

Embryo Adoption 

The Committee continues to believe that increasing public awareness of embryo donation and adoption remains an important goal. 

The Committee has provided $2,000,000 for the Department’s embryo adoption awareness campaign, which is $1,008,000 more than 

the comparable fiscal year 2005 funding level and the administration request. 

HIV/AIDS in Minority Communities 

To address high-priority HIV prevention and treatment needs of 

minority communities heavily impacted by HIV/AIDS, the Committee recommends $52,415,000. This amount is the same as the 

comparable fiscal year 2005 level and the administration request. 

These funds are available to key operating divisions of the Department with capability and expertise in HIV/AIDS services to assist 

minority communities with education, community linkages, and 

technical assistance. 

Information Technology Security and Innovation Fund 

The Committee recommendation does not include funding for the 

Information Technology Security and Innovation Fund, which is 

$14,695,000 below the comparable fiscal year 2005 level and 

$14,630,000 below the administration request. This activity funds 
223 

investments such as information technology services, security and 

infrastructure that enable common administrative systems 

throughout the Department. 

OFFICE OF MEDICARE HEARINGS AND APPEALS

Appropriations, 2005 ............................................................................. $57,536,000 

Budget estimate, 2006 ........................................................................... 80,000,000 

House allowance .................................................................................... 60,000,000 

Committee recommendation ................................................................. 75,000,000 

The Committee provides $75,000,000 for the Office of Medicare Hearings and Appeals, which is $17,464,000 above the comparable 

fiscal year 2005 level and $5,000,000 below the administration request. 

The Office of Medicare Hearings and Appeals is responsible for 

hearing Medicare appeals at the administrative law judge level, 

which is the third level of Medicare claims appeals. Since fiscal 

year 1995 these appeals have been processed by the Social Security 

Administration under an interagency agreement with the Centers 

for Medicare and Medicaid Services. This function was transferred 

to the Office of the Secretary by the Medicare Prescription Drug, 

Improvement and Modernization Act of 2003. 

OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION

TECHNOLOGY

Appropriations, 2005 ............................................................................. $24,011,000 

Budget estimate, 2006 ........................................................................... 77,750,000 

House allowance .................................................................................... 75,000,000 

Committee recommendation ................................................................. 45,150,000 

The Committee provides $45,150,000 to the Office of the National 

Coordinator for Health Information Technology [ONCHIT]. This 

amount is $21,139,000 above the comparable fiscal year 2005 level 

and $32,600,000 below the administration request. The Committee 

recommendation includes $12,350,000 in transfers available under 

section 241 of the Public Health Service Act. In addition, the Committee has provided $50,000,000 for health information technology 

to the Agency for Healthcare Research and Quality. 

The Office of The National Coordinator for Health Information 

Technology is responsible for promoting the use of electronic health 

records in clinical practice, coordinating Federal health information 

systems and collaborating with the private sector to develop standards for a nationwide interoperable health information technology 

infrastructure. 

The Committee urges the Coordinator for the ONCHIT to conduct outreach activities to all public and private sector organizations which have demonstrated capabilities in health information 

technology. The Committee is particularly interested in disease 

management technology as it relates to saving health care dollars, 

and improving care for chronically ill individuals and the workforce. 

Interoperability.—The Committee commends the efforts by the 

Secretary to increase interoperability within healthcare. Through 

the Consolidated Health Informatics [CHI] Project, 24 electronic 

standards have been identified to allow sharing of clinical information. The Committee urges the Secretary to implement procedures 
224 

to enable the Department to accept the optional submission of data 

derived from health care reporting requirements for the purposes 

of quality, surveillance, epidemiology, adverse event reporting, or 

research using the electronic standards identified under the CHI 

project. 

OFFICE OF INSPECTOR GENERAL

Appropriations, 2005 ............................................................................. $39,930,000 

Budget estimate, 2006 ........................................................................... 39,813,000 

House allowance .................................................................................... 39,813,000 

Committee recommendation ................................................................. 39,813,000 

The Committee recommends an appropriation of $39,813,000 for 

the Office of Inspector General, which is the same as the administration request. The fiscal year 2005 comparable level was 

$39,930,000. In addition to discretionary funds, the Health Insurance Portability and Accountability Act of 1996 provides 

$160,000,000 in mandatory funds for the Office of Inspector General in fiscal year 2006; the total funds provided to the Office by 

this bill and the authorizing bill would be $199,813,000 in fiscal 

year 2006. 

The Office of Inspector General conducts audits, investigations, 

inspections, and evaluations of the operating divisions within the 

Department of Health and Human Services. The OIG functions 

with the goal of reducing the incidence of waste, abuse, and fraud. 

It also pursues examples of mismanagement toward the goal of promoting economy and efficiency throughout the Department. 

OFFICE FOR CIVIL RIGHTS

Appropriations, 2005 ............................................................................. $35,013,000 

Budget estimate, 2006 ........................................................................... 34,996,000 

House allowance .................................................................................... 34,996,000 

Committee recommendation ................................................................. 34,996,000 

The Committee recommends $34,996,000 for the Office for Civil 

Rights [OCR]. This is the same as the administration request. The 

comparable fiscal year 2005 level was $35,013,000. The recommendation includes the transfer of $3,314,000 from the Medicare trust funds. 

The Office for Civil Rights is responsible for enforcing civil 

rights-related statutes in health care and human services programs. To enforce these statutes, OCR investigates complaints of 

discrimination, conducts program reviews to correct discriminatory 

practices, and implements programs to generate voluntary compliance among providers and constituency groups of health and 

human services. 

RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED

OFFICERS

Appropriations, 2005 ............................................................................. $330,636,000 

Budget estimate, 2006 ........................................................................... 328,552,000 

House allowance .................................................................................... 328,552,000 

Committee recommendation ................................................................. 328,552,000 

The Committee provides an estimated $328,552,000 for retirement pay and medical benefits for commissioned officers of the U.S. 
225 

Public Health Service, the same as the administration request. The 

comparable level for fiscal year 2005 was $330,636,000. 

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 

to 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

Appropriations, 2005 ............................................................................. $2,407,415,000 

Budget estimate, 2006 ........................................................................... 2,427,833,000 

House allowance .................................................................................... 183,589,000 

Committee recommendation ................................................................. 183,589,000 

The Committee provides $183,589,000 to the Public Health and Social Services Emergency Fund. This is $2,223,826,000 below the 

comparable fiscal year 2005 level and $2,244,244,000 below the administration request. The Committee’s recommendation for fiscal 

year 2006 includes $63,589,000 for bioterrorism preparedness within the Office of the Secretary and $120,000,000 for pandemic flu activities. 

The Committee has provided funding for bioterrorism preparedness directly to other agencies within the Department instead of to 

this account as it has done in the past. When these funding levels 

are included, the Committee has provided a total of $2,357,581,000 

for bioterrorism preparedness, which is $49,834,000 less than the 

comparable fiscal year 2005 level and $70,252,000 less than the administration request. 

The Committee is aware that a recent study projected that over 

half a million Americans could die and over 2.3 million could be 

hospitalized if a moderately severe strain of a pandemic flu virus 

hits the United States. Given the potential for such a scenario, the 

Committee urges the Department to finalize its August 2004 draft 

Pandemic Influenza Preparedness and Response Plan and make it 

publicly available. In addition, the Committee urges the Department to examine the study’s key recommendations, including those 

relating to stockpiling medical supplies, and developing emergency 

communications plans; stockpiling additional antivirals and developing surge capacity plans for hospitals and health care providers; 

and increasing vaccine production and the development of new 

technologies for vaccines. 

GENERAL PROVISIONS, DEPARTMENT OF HEALTH AND HUMAN

SERVICES

The Committee recommendation continues a provision placing a 

$50,000 ceiling on official representation expenses (sec. 201). 

The Committee recommendation continues a provision which limits the assignment of certain public health personnel (sec. 202). 

The Committee recommendation retains language regarding setasides in the authorizing statute of the National Institutes of 

Health (sec. 203). 

The Committee recommendation continues a provision limiting 

the use of grant funds to pay individuals no more than an annual 

rate of Executive Level I (sec. 204). 
226 

The Committee recommendation continues a provision restricting 

the Secretary’s use of taps for program evaluation activities unless 

a report is submitted to the Appropriations Committees on the proposed use of funds (sec. 205). 

The Committee recommendation includes language authorizing 

the transfer of up to 2.5 percent of Public Health Service funds for 

evaluation activities (sec. 206). 

The Committee modifies a provision restricting transfers of appropriated funds and requires a 15 day notification to both the 

House and Senate Appropriations Committees (sec. 207). 

The Committee recommendation continues a provision permitting 

the transfer of up to 3 percent of AIDS funds among Institutes and 

Centers by the Director of NIH and the Director of the Office of 

AIDS Research at NIH (sec. 208). 

The Committee recommendation retains language which requires 

that the use of AIDS research funds be determined jointly by the 

Director of the National Institutes of Health and the Director of the 

Office of AIDS Research and that those funds be allocated directly 

to the Office of AIDS Research for distribution to the Institutes and 

Centers consistent with the AIDS research plan (sec. 209). 

The Committee recommendation continues a provision regarding 

requirements for family planning applicants (sec. 210). 

The Committee recommendation retains language which restricts 

the use of funds to carry out the Medicare Advantage Program if 

the Secretary denies participation to an otherwise eligible entity 

(sec. 211). 

The Committee recommendation retains language which States 

that no provider services under Title X of the PHS Act may be exempt from State laws regarding child abuse (sec. 212). 

The Committee recommendation retains language which prohibits the Secretary from withholding substance abuse treatment 

funds (sec. 213). 

The Committee recommendation continues a provision which facilitates the expenditure of funds for international AIDS activities 

(sec. 214). 

The Committee recommendation includes a provision allowing 

the Division of Federal Occupational Health to use personal services contracting to employ professional, administrative, and occupational health professionals (sec. 215). 

The Committee recommendation retains a provision authorizing 

the Director of the National Institutes of Health to enter into certain transactions to carry out research in support of the NIH Roadmap Initiative of the Director (sec. 216). 

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. 217). 

The Committee recommendation includes bill language allowing 

use of funds to continue operating the Council on Graduate Medical 

Education (sec. 218). 

The Committee recommendation includes a general provision, 

which rescinds $10,000,000 in unobligated balances from amounts 

appropriated in Public Law 108–11 under the heading ‘‘Public 
227 

Health and Social Services Emergency Fund’’, the smallpox compensation program (sec. 219). The Committee recommendation rescinds $15,912,000 of unobligated balances in the Health Professions Student Loan Program 

(sec. 220). 

The Committee recommendation extends availability of funds for 

the State Pharmaceutical Assistance Programs (sec. 221). 
(228) 

TITLE III—DEPARTMENT OF EDUCATION 

EDUCATION FOR THE DISADVANTAGED

Appropriations, 2005 ............................................................................. $14,843,974,000 

Budget estimate, 2006 ........................................................................... 16,431,473,000 

House allowance .................................................................................... 14,728,735,000 

Committee recommendation ................................................................. 14,525,135,000 

The Committee recommends an appropriation of $14,525,135,000 

for education for the disadvantaged. The comparable funding level 

for fiscal year 2005 is $14,843,974,000 and the budget request includes $16,431,473,000 for this account. 

The programs in the education for the disadvantaged account 

help ensure that poor and low-achieving children are not left behind in the Nation’s effort to raise the academic performance of all 

children and youth. That goal is more pressing than ever since the 

passage of the No Child Left Behind Act, which incorporates numerous accountability measures into Title I programs, especially 

part A grants to local educational agencies—the largest Federal elementary and secondary education program. 

In particular, the law strengthens Title I accountability by requiring States to implement statewide accountability systems covering all public schools and students. These systems must be based 

on challenging State standards in reading and mathematics, annual statewide progress objectives ensuring that all groups of students reach proficiency in reading and math by the end of the 

2013–2014 school year, and annual testing for all students in 

grades 3–8. State progress objectives and assessment results must 

be broken out by poverty, race and ethnicity, disability, and limited 

English proficiency. States, school districts, and schools must report annually on their progress toward statewide proficiency goals. 

Districts and schools that fail to make adequate yearly progress 

[AYP] toward these goals will, over time, be subject to increasingly 

rigorous improvement, corrective action, and restructuring measures aimed at getting them back on course to meet State standards. Students attending schools that fail to meet annual State 

AYP objectives for 2 consecutive years will be permitted to transfer 

to a better public school or, if the school continues to fail to meet 

AYP for 3 years or more, to use Title I funds to obtain educational 

services from a public- or private-sector provider selected by their 

parents. 

Funds appropriated in this account primarily support activities 

in the 2006–2007 school year. 

Grants to Local Educational Agencies 

Title I Grants to Local Educational Agencies [LEAs] provide supplemental education funding, especially in high-poverty areas, for 

local programs that provide extra academic support to help raise 
229 

the achievement of eligible students or, in the case of schoolwide 

programs, help all students in high-poverty schools to meet challenging State academic standards. The program serves more than 

15 million students in nearly all school districts and more than half 

of all public schools—including two-thirds of the Nation’s elementary schools. 

Title I schools help students reach challenging State standards 

through one of two models: ‘‘targeted assistance’’ that supplements 

the regular education program of individual children deemed most 

in need of special assistance, or a ‘‘schoolwide’’ approach that allows schools to use Title I funds—in combination with other Federal, State, and local funds—to improve the overall instructional 

program for all children in a school. 

Starting with the fiscal year 2004 appropriation, States are required to reserve 4 percent of their allocation under this program 

for school improvement activities, unless such action would require 

a State to reduce the grant award of a local educational agency to 

an amount below the preceding year. At the funding level recommended by the Committee for fiscal year 2006, this set-aside 

could generate up to $504,000,000 for this purpose. States must 

distribute 95 percent of these reserved funds to local educational 

agencies for schools identified for improvement, corrective action, 

or restructuring. The Committee is concerned about the effect of 

the authorizing language, which in some States is requiring highpoverty districts to receive much less funding than they would otherwise receive, in order for States to ‘‘hold harmless’’ other districts 

and redistribute the required amount of school improvement funds. 

As a result, districts with the most eligible children in those States 

are not receiving the funds needed to serve their students adequately. In addition, some States are not able to set aside the full 

4 percent, which means fewer resources to help struggling schools 

implement school improvement plans, support public school choice 

or offer supplemental education services. 

More than any other Federal program, Title I grants to LEAs are 

critical to the success of the No Child Left Behind Act. The Committee recommends $12,839,571,000 for this program. The comparable funding level for fiscal year 2005 is $12,739,571,000 and 

the budget request includes $13,342,309,000 for Title I grants to 

LEAs. The Committee recommendation proposes an increase of 

46.5 percent over the amount provided prior to passage of the No 

Child Left Behind Act. These Federal resources represent the significant commitment this Committee has made to provide the resources necessary to help all children succeed in school. 

The appropriation for Title I grants to LEAs primarily supports 

activities associated with the 2006–2007 academic year. Of the 

funds available for this program, up to $3,472,000 shall be available on October 1, 2005, not less than $5,452,798,000 will become 

available on July 1, 2006 and $7,383,301,000 will become available 

on October 1, 2006. The funds that become available on July 1, 

2006 and October 1, 2006 will remain available for obligation until 

September 30, 2007. 

Title I grants are distributed through four formulas: basic, concentration, targeted, and education finance incentive grant [EFIG]. 
230 

For Title I basic grants, including up to $3,472,000 transferred 

to the Census Bureau for poverty updates, the Committee recommends an appropriation of $6,934,854,000. The comparable 

funding level for fiscal year 2005 and the budget request are both 

$6,934,854,000 for the basic grants funding stream. Basic grants 

are awarded to school districts with at least 10 poor children who 

make up more than 2 percent of enrollment. 

For concentration grants, the Committee recommends an appropriation of $1,365,031,000. The comparable funding level for fiscal 

year 2005 and the budget request are both $1,365,031,000. Funds 

under this program are distributed according to the basic grants 

formula, except that they go only to LEAs where the number of 

poor children exceeds 6,500 or 15 percent of the total school-aged 

population. 

Last year, Congress provided all of the additional funding for 

Title I grants to LEAs above the fiscal year 2004 level through the 

EFIG and targeted formulas. The Committee recommends allocating all of the increase proposed this year in a similar manner. 

The Committee notes that analysis conducted by the Congressional 

Research Service has demonstrated that these formulas deliver a 

larger share of Title I funds to high-poverty school districts than 

any other Title I formula. In addition, the EFIG formula uses 

State-level ‘‘equity’’ and ‘‘effort’’ factors to make allocations to 

States that are intended to encourage States to spend more on education and to improve the equity of State funding systems. Once 

State allocations are determined, suballocations to the LEA level 

are based on a modified version of the targeted grants formula, described below. 

The targeted grants formula weights child counts to make higher 

payments to school districts with high numbers or percentages of 

poor students. For these grants, the Committee recommends an appropriation of $2,269,843,000. The comparable funding level for fiscal year 2005 is $2,219,843,000 and the budget request includes 

$2,822,581,000 for this funding stream. 

The Committee recommends an appropriation of $2,269,843,000 

for education finance incentive grants. The comparable funding 

level for fiscal year 2005 and the budget request both are 

$2,219,843,000 for the EFIG funding stream. 

William F. Goodling Even Start Family Literacy Program 

The Committee does not recommend additional funds for the 

Even Start program. The comparable funding level for fiscal year 

2005 is $225,095,000 and the budget request does not include any 

funds for this program. 

The Even Start program provides grants for family literacy programs that serve disadvantaged families with children under 8 

years of age and adults eligible for services under the Adult Education and Family Literacy Act. Programs combine early childhood 

education, adult literacy, and parenting education. Funding is provided to States based on their relative share of Title I, Part A 

funds and States use these resources to make competitive subgrants to partnerships comprised of local educational agencies and 

other organizations serving families in high-poverty areas. 
231 

Reading First State Grants 

The Committee recommends $1,041,600,000 for the Reading 

First State Grants program, the same amount as the comparable 

funding level for fiscal year 2005 and the budget request. 

Reading First is a comprehensive effort to provide States and 

LEAs with funds to implement comprehensive reading instruction 

for children in grades K–3. The purpose of the program is to help 

ensure that every child can read by the end of third grade. LEAs 

and schools that receive funds under this program should use the 

money to provide professional development in reading instruction 

for teachers and administrators, adopt and use reading diagnostics 

for students in grades K–3 to determine where they need help, implement reading curricula that are based on scientific research, and 

provide reading interventions for children who are not reading at 

grade level. 

The Committee intends for funds available under the Reading 

First program to encourage and support the use of reading programs with the strongest possible scientific evidence of effectiveness. The Committee urges the Department to provide clear guidance to its technical assistance centers and the States to: fully consider scientific evidence of effectiveness in rating programs for use 

under Reading First; contemplate expanded lists of allowable programs that include innovative programs with scientific evidence of 

effectiveness; when awarding new grants, consider giving preference to those schools that select programs with strong, scientific 

evidence of effectiveness; emphasize that the Department has not 

established a predetermined approved list of reading materials; 

and allow comprehensive reading programs that have scientific evidence of effectiveness to be implemented in full, as they have been 

researched, without modification to conform to other models of instruction. The Committee also is concerned that certain practices 

under the Reading First program may unduly interfere with local 

control of curriculum. The Committee notes that Reading First materials decisions are to be made at the school level, subject to the 

approval of the State. 

Early Reading First 

The Committee recommends $104,160,000 for the Early Reading 

First program, the same amount as the comparable funding level 

for fiscal year 2005 and the budget request. 

Early Reading First complements Reading First State Grants by 

providing competitive grants to school districts and nonprofit 

groups to support activities in existing preschool programs that are 

designed to enhance the verbal skills, phonological awareness, letter knowledge, pre-reading skills, and early language development 

of children ages 3 through 5. Funds are targeted to communities 

with high numbers of low-income families. 

Striving Readers 

The Committee recommends $35,000,000 for the Striving Readers initiative. The comparable fiscal year 2005 funding level is 

$24,800,000 and the budget request includes $200,000,000 for the 

Striving Readers program. This program supports grants to develop, implement, and evaluate reading interventions for middle- or 
232 

high-school students reading significantly below grade level. Under 

this program, awards will be made to local educational agencies eligible to receive funds under Part A of Title I with one or more high 

schools or middle schools serving a significant number of students 

reading below grade level. Awards also may be made to partnerships including institutions of higher education and eligible nonprofit or for-profit organizations. The Committee intends that funds 

provided in this bill be utilized in accordance with the priorities established in the statement of the managers accompanying the fiscal 

year 2005 appropriations Act that relate to a rigorous evaluation 

requirement and parity in funding for middle schools and high 

schools. 

Improving Literacy Through School Libraries 

The Committee recommends $19,683,000 for the Improving Literacy Through School Libraries program, the same amount as the 

comparable funding level for fiscal year 2005 and the budget request. 

This program provides funds for urgently needed, up-to-date 

school library books and training for school library media specialists in order to support the scientifically based reading programs 

authorized by the Reading First initiative. LEAs with a child-poverty rate of at least 20 percent are eligible for the competitive 

awards. Funds may be used to acquire school library media resources, including books and advanced technology; facilitate resource-sharing networks among schools and school libraries; provide professional development for school library media specialists; 

and provide students with access to school libraries during nonschool hours. 

The Committee is concerned that funds provided under this program are not reaching those schools that are most in need of financial assistance for updating their school libraries, either because 

they are not applying for funds or are unsuccessful in writing their 

grant applications. The Committee encourages the Department to 

work with the Institute of Museum and Library Services and other 

relevant organizations to improve awareness, among the most 

needy schools, of the availability of this financial assistance, and to 

help them increase their success rates in competing for available 

funds. The Committee requests that the Department explain in its 

fiscal year 2007 congressional budget justification the actions it has 

taken or will take to address this issue with respect to the 2006 

and future grant competitions. 

High School Intervention 

The Committee recommendation does not include any funding for 

the new High School Intervention initiative. The budget proposed 

$1,240,000,000 for this new initiative. Funds would have been used 

to develop, implement and evaluate interventions that increase the 

achievement of all high school students, particularly those at risk 

of failing to meet challenging State academic content standards; 

eliminate achievement gaps between student from different socioeconomic backgrounds; and help all students graduate with the 

education, skills, and knowledge to succeed in postsecondary education and a high-technology economy. The proposed initiative 
233 

would have provided funds to States based on a formula and SEAs 

would then make competitive grants to LEAs using 95 percent of 

appropriated funds. 

The budget request proposes bill language that would authorize 

this new high school initiative and require each State to participate 

in 12th grade State National Assessment of Educational Progress 

reading and math assessments. The Committee bill does not include the requested language. 

The Committee is supportive of the administration’s goal of preparing all students for postsecondary education and the high-technology economy. However, the Committee notes that this initiative 

has not been acted on by the appropriate authorizing committees 

of Congress and would have been funded by the elimination of 

GEAR–UP, certain TRIO activities and the Perkins Vocational and 

Technical Education program, each of which have been restored to 

their fiscal year 2005 funding levels. 

Migrant Education Program 

The Committee recommends $390,428,000 for the Migrant Education program, the same amount as the comparable fiscal year 

2005 funding level and the budget request. 

The Title I Migrant Education program authorizes grants to 

State educational agencies for programs to meet the special educational needs of the children of migrant agricultural workers and 

fishermen. Funds are allocated to the States through a statutory 

formula based on each State’s average per-pupil expenditure for 

education and actual counts of migratory children ages 3 through 

21 residing within the States in the previous year. Only migratory 

children who have moved within the last 3 years are generally eligible to be counted and served by the program. 

This appropriation also supports activities to improve interstate 

and intrastate coordination of migrant education programs, as well 

as identifying and improving services to the migrant student population. 

Neglected and Delinquent 

The Committee recommends $51,000,000 for the Title I neglected 

and delinquent program. The comparable funding level for fiscal 

year 2005 and the budget request both are $49,600,000 for the neglected and delinquent program. 

This program provides financial assistance to State educational 

agencies for education services to neglected and delinquent children and youth in State-run institutions and for juveniles in adult 

correctional institutions. Funds are allocated to individual States 

through a formula based on the number of children in State-operated institutions and per-pupil education expenditures for the 

State. 

States are authorized to set aside at least 15 percent, but not 

more than 30 percent, of their neglected and delinquent funds to 

help students in State-operated institutions make the transition 

into locally operated programs and to support the successful reentry of youth offenders, who are age 20 or younger and have received a secondary school diploma or its recognized equivalent. Reentry activities may include strategies designed to expose the youth 
234 

to, and prepare the youth for, postsecondary education, or vocational and technical training programs. 

Under the No Child Left Behind Act, the Congress provided the 

Secretary with the authority to reserve up to 2.5 percent of the appropriation for national activities. The Committee continues to urge 

the Secretary to fully utilize this authority to support capacity 

building in and dissemination of best practices to State agency programs and to develop a uniform model for evaluating State performance under this program. 

Evaluation 

The Committee recommends $9,424,000 for evaluation of Title I 

programs, the same amount as the comparable funding level for fiscal year 2005 and the budget request. 

Evaluation funds are used to support large-scale national surveys that examine how the Title I programs are contributing to 

student academic achievement. Funds also are used to evaluate 

State assessment and accountability systems and analyze the effectiveness of educational programs supported with Title I funds. 

Comprehensive School Reform Demonstration 

The Committee does not recommend additional funds for the 

comprehensive school reform demonstration program. The comparable funding level for fiscal year 2005 is $205,344,000 and the 

budget request did not include any funds for the comprehensive 

school reform program. 

This program provided schools with funding to develop or adopt, 

and implement, comprehensive school reforms that will enable children in participating schools to meet State standards. The Department allocated funds to States based on their relative shares of the 

previous year’s Title I basic grants funds. 

High School Equivalency Program 

The Committee recommends $18,737,000 for the high school 

equivalency program [HEP], the same amount as the comparable 

funding level for fiscal year 2005 and the budget request. 

This program provides 5-year grants to institutions of higher 

education and other nonprofit organizations to recruit migrant students ages 16 and over and provide the academic and support services needed to help them obtain a high school equivalency certificate and subsequently gain employment, win admission to a postsecondary institution or a job-training program, or join the military. Projects provide counseling, health services, stipends, and 

placement assistance. At the funding level recommended by the 

Committee, HEP will serve roughly 7,000 migrants. 

College Assistance Migrant Program 

For the College Assistance Migrant Program [CAMP], the Committee recommends $15,532,000, the same amount as the comparable funding level for fiscal year 2005 and the budget request. 

Funds provide 5-year grants to institutions of higher education 

and nonprofit organizations for projects that provide tutoring, counseling, and financial assistance to migrant students during their 

first year of postsecondary education. Projects also may use up to 
235 

10 percent of their grants for follow-up services after students have 

completed their first year of college, including assistance in obtaining student financial aid. 

The Committee encourages the Department to consider efficient 

and effective means for collecting performance outcome data related to postsecondary persistence and completion rates of CAMP 

program participants beyond those measures currently employed. 

The Committee notes that the follow-up services set aside may be 

used to monitor and report on the progress of students participating in projects during such students’ subsequent years in college. 

IMPACT AID

Appropriations, 2005 ............................................................................. $1,243,862,000 

Budget estimate, 2006 ........................................................................... 1,240,862,000 

House allowance .................................................................................... 1,240,862,000 

Committee recommendation ................................................................. 1,240,862,000 

The Committee recommends an appropriation of $1,240,862,000 

for impact aid for the Department of Education. The comparable 

funding level for fiscal year 2005 is $1,243,862,000 and the budget 

request proposes $1,240,862,000 for this purpose. 

Impact aid provides financial assistance to school districts for the 

costs of educating children when enrollments and the availability 

of revenues from local sources have been adversely affected by the 

presence of Federal activities. Children who reside on Federal or 

Indian lands generally constitute a financial burden on local school 

systems because these lands do not generate property taxes—a 

major revenue source for elementary and secondary education in 

most communities. In addition, realignments of U.S. military forces 

at bases across the country often lead to influxes of children into 

school districts without producing the new revenues required to 

maintain an appropriate level of education. 

The Committee bill includes language that provides for continued 

eligibility for students affected by the deployment or death of their 

military parent, as long as these children still attend the same 

school district. This language was included in the budget request 

and last year’s appropriation bill. 

Basic Support Payments.—The Committee recommends 

$1,102,896,000 for basic support payments. The comparable funding level for fiscal year 2005 and the budget request both are 

$1,075,018,000. Under this statutory formula, payments are made 

on behalf of all categories of federally connected children, with a 

priority placed on making payments first to heavily impacted 

school districts and providing any remaining funds for regular 

Basic Support Payments. 

Payments for Children with Disabilities.—The Committee bill includes $49,966,000 for this purpose, the same amount as the comparable funding level for fiscal year 2005 and the budget request. 

Under this program, additional payments are made for certain federally connected children eligible for services under the Individuals 

with Disabilities Education Act. 

Facilities Maintenance.—The Committee recommends $5,000,000 

for facilities maintenance. The comparable funding level for fiscal 

year 2005 and the budget request both are $7,838,000 for this pur-
236 

pose. This activity provides funding for emergency repairs and comprehensive capital improvements to certain school facilities owned 

by the Department of Education and used by local educational 

agencies to serve federally connected military dependent students. 

Funds appropriated for this purpose are available until expended. 

Construction.—The Committee recommends $18,000,000 for this 

program. The comparable fiscal year 2005 funding level is 

$48,544,000 and the budget request includes $45,544,000 for this 

purpose. Formula and competitive grants are awarded to eligible 

LEAs for emergency repairs and modernization of school facilities. 

Funds appropriated for the construction activity are available for 

obligation for a period of 2 years. 

While the Committee recommendation is less than last year, formula and competitive grant funds will still be made available 

under this appropriation for those districts in need of and eligible 

for additional financial assistance to improve their school facilities. 

In addition, funds are still remaining from the fiscal year 2005 appropriation for competitive grants under this program. 

Payments for Federal Property.—The Committee recommends 

$65,000,000 for this activity. The comparable funding level for fiscal year 2005 and the budget request both are $62,496,000 for this 

program. These payments compensate local educational agencies in 

part for revenue lost due to the removal of Federal property from 

local tax rolls. Payments are made to LEAs that have a loss of tax 

base of at least 10 percent of assessed value due to the acquisition 

since 1938 of real property by the U.S. Government. 

SCHOOL IMPROVEMENT PROGRAMS

Appropriations, 2005 ............................................................................. $5,619,657,000 

Budget estimate, 2006 ........................................................................... 5,332,219,000 

House allowance .................................................................................... 5,393,765,000 

Committee recommendation ................................................................. 5,457,953,000 

The Committee recommends an appropriation of $5,457,953,000 

for school improvement programs. The comparable funding level in 

fiscal year 2005 for this account is $5,619,657,000 and the budget 

request includes $5,332,219,000. 

State Grants for Improving Teacher Quality 

The No Child Left Behind Act requires States to ensure that all 

teachers teaching in core academic subjects are ‘‘highly qualified’’ 

by the end of the 2005–2006 school year. The Committee recommends $2,916,605,000 for State grants for improving teacher 

quality, the same as both the comparable funding level for fiscal 

year 2005 and the budget request. 

The appropriation for this program primarily supports activities 

associated with the 2006–2007 academic year. Of the funds provided, $1,481,605,000 will become available on July 1, 2006 and 

$1,435,000,000 will become available on October 1, 2006. These 

funds will remain available for obligation until September 30, 2007. 

Under the Committee recommendation, funding for programs 

that specifically support high-quality professional development for 

teachers and school leadership will have increased by 40 percent 

since passage of the No Child Left Behind Act. The Committee recommendation for fiscal year 2006 includes nearly $3,600,000,000 
237 

for such activities in recognition of the critical role that these individuals occupy in educating the Nation’s children and the significant academic benefit that students may derive from the presence 

of a highly qualified teacher in their classroom. In addition, State 

and local educational agencies have considerable flexibility to use 

funds from their Title I grants to LEAs allocations, as well as other 

State grant program dollars in support of high-quality professional 

development opportunities. 

States and LEAs may use the funds for a range of activities related to the certification, recruitment, professional development, 

and support of teachers and administrators. Activities may include 

reforming teacher certification and licensure requirements, addressing alternative routes to State certification of teachers, recruiting teachers and principals, and implementing teacher mentoring systems, teacher testing, merit pay, and merit-based performance systems. 

These funds may also be used by districts to hire teachers to reduce class sizes. The Committee recognizes that smaller classes, 

particularly in the early grades, can have a positive impact on students by improving classroom discipline, providing students with 

more individualized attention, and allowing parents and teachers 

to work more closely together. Funds within the teacher quality 

State grants program may be used to continue this commitment to 

our Nation’s students, parents, and teachers, without taking away 

from other efforts to invest in professional development. 

Early Childhood Educator Professional Development 

The Committee recommends $14,696,000 to support professional 

development activities for early childhood educators and caregivers 

in high-poverty communities. The comparable funding level for fiscal year 2005 and the budget request are both $14,696,000 for this 

program. From this appropriation, the Secretary makes competitive 

grants to partnerships of early childhood and family literacy caregivers and educators in order to provide high quality, sustained 

and intensive professional development for early childhood educators to help them provide developmentally appropriate schoolreadiness services for preschool-age children. 

Mathematics and Science Partnerships 

The Committee recommends $178,560,000 for the mathematics 

and science partnerships program. The comparable funding level 

for fiscal year 2005 is $178,560,000 and the budget request includes $269,000,000 for this purpose. These funds will be used to 

improve the performance of students in the areas of math and 

science by bringing math and science teachers in elementary and 

secondary schools together with scientists, mathematicians, and engineers to increase the teachers’ subject-matter knowledge and improve their teaching skills. When the appropriation for this program is $100,000,000 or greater, the Secretary is authorized to 

award grants to States by a formula which includes consideration 

of the number of children aged 5 to 17 below the poverty line. 

States then are required to make grants competitively to eligible 

partnerships to enable the entities to pay the Federal share of the 

costs of developing or redesigning more rigorous mathematics and 
238 

science curricula that are aligned with State and local standards; 

creating opportunities for enhanced professional development that 

improves the subject-matter knowledge of math and science teachers; recruiting math and science majors; and improving and expanding training of math and science teachers, including the effective integration of technology into curricula and instruction. 

The budget request includes legislative language that would allow the Secretary to use $120,000,000 in appropriated funds to 

make competitive awards to projects designed to improve the mathematics learning of secondary students. The Committee has not 

provided this requested authority. 

Innovative Education Program Strategies State Grants 

The Committee recommends $100,000,000 for innovative education program strategies State grants. The comparable funding 

level for fiscal year 2005 is $198,400,000 and the budget request 

is $100,000,000 for this purpose. 

The innovative education program is a flexible source of Federal 

funds that provides support to States and LEAs for developing education reform initiatives that will improve the performance of students, schools, and teachers. 

Educational Technology State Grants 

The Committee recommends $425,000,000 for educational technology State grants. The comparable funding level for fiscal year 

2005 is $496,000,000 and the budget request did not include any 

funds for this program. 

The educational technology State grants program supports efforts 

to integrate technology into curricula to improve student learning. 

Funds flow by formula to States and may be used for the purchase 

of hardware and software, teacher training on integrating technology into the curriculum, and efforts to use technology to improve 

communication with parents, among other related purposes. An 

LEA must use at least 25 percent of its formula allocation for professional development in the integration of technology into the curricula unless it can demonstrate that it already provides such highquality professional development. 

Supplemental Education Grants 

The Committee recommendation includes $18,183,000 for the 

supplemental education grants program, the same as both the comparable funding level for fiscal year 2005 and the budget request. 

This grant program was authorized by the Compact of Free Association Amendments Act of 2003. The Act discontinued the eligibility of Republic of Marshall Islands [RMI] and the Federated 

States of Micronesia [FSM] for funding available from Adult, Dislocated Worker and Youth Workforce Investment Act programs, 

Head Start, Title I Grants to LEAs, Adult and Vocational Education State Grants, Federal Work-Study and Federal Supplemental Educational Opportunities Grants. In place of funding from 

these sources, the Act provided a separate supplemental education 

grant program that provides these entities with a more flexible 

source of funds that can be tailored to local needs. These funds will 

be transferred from the Department of Education to the Secretary 
239 

of Interior for grants to these entities. The Committee bill includes 

language that allows up to 5 percent to be used by the FSM and 

RMI to purchase oversight and technical assistance, which may include reimbursement of the Departments of Labor, Health and 

Human Services and Education for such services. Of the funds appropriated, $12,132,000 is for the Federated States of Micronesia 

and $6,051,000 is for the Republic of the Marshall Islands. 

21st Century Community Learning Centers 

The Committee recommends an appropriation of $991,077,000 for 

the 21st Century Community Learning Centers program, the same 

as both the comparable level for fiscal year 2005 and the budget 

request. 

Funds are allocated to States by formula, which in turn, award 

at least 95 percent of their allocations to local educational agencies, 

community-based organizations and other public and private entities. Grantees use these resources to establish or expand community learning centers that provide activities offering significant extended learning opportunities, such as before- and after-school programs, recreational activities, drug and violence prevention and 

family literacy programs for students and related services to their 

families. Centers must target their services on students who attend 

schools that are eligible to operate a schoolwide program under 

Title I of the Elementary and Secondary Education Act or serve 

high percentages of students from low-income families. 

State Assessments and Enhanced Assessment Instruments 

The Committee recommends $411,680,000 for State assessments, 

the same as both the comparable funding level for fiscal year 2005 

and the budget request. 

A key accountability measure in the No Child Left Behind Act 

requires annual State assessments in reading and mathematics for 

all students in grades 3–8 beginning in the 2005–2006 school year. 

The new assessments will be used to determine whether States, 

LEAs, and schools are making adequate yearly progress toward the 

goal of helping all students attain proficiency within 12 years of 

the 2001–2002 school year. 

This program has two components. The first provides formula 

grants to States to pay the cost of developing standards and assessments required by the new law. The statute includes funding ‘‘trigger amounts’’ for fiscal years 2002–2007; States may defer the new 

assessments for each year the appropriation falls below the trigger 

level. The trigger for fiscal year 2006 is $400,000,000. The Committee recommendation includes $400,000,000 for this purpose. 

Under the second component of State assessments—Grants for 

Enhanced Assessment Instruments—appropriations in excess of 

the trigger level are used for a competitive grant program designed 

to support efforts by States to improve the quality and fairness of 

their assessment systems. The Committee recommendation for the 

second component is $11,680,000, the same as both the comparable 

funding level for fiscal year 2005 and the budget request. 

The Committee continues to be concerned that many schools are 

unable to properly assess the performance of students with disabilities and students with limited English proficiency. Therefore, the 
240 

Committee urges the Department to place a high priority on grant 

applications that aim to improve the quality of State assessments 

for these two groups of students and to ensure the most accurate 

means of measuring their performance on these assessments. 

High School Assessments 

The Committee recommendation does not include funds for the 

proposed High School Assessments program. The budget request 

includes $250,000,000 for this new activity. This proposed program 

was designed to complement the administration’s High School Reform initiative. Funds requested under this program would be used 

to provide grants to States to pay for the reading and math assessments that would be required in two additional grades during high 

school by school year 2009–2010. The budget request includes legislative language which would authorize this program. As noted earlier, the High School Reform proposal has not been considered by 

the appropriate authorizing committees of Congress, so the Committee has not included the legislative language or provided the requested funds. 

Javits Gifted and Talented Education 

The Committee recommends $11,022,000 for the Javits Gifted 

and Talented Students Education Program, the same as the comparable fiscal year 2005 funding level. The President’s budget proposes to eliminate funding for this program. Funds are used for 

awards to State and local education agencies, institutions of higher 

education, and other public and private agencies for research, demonstration, and training activities designed to enhance the capability of elementary and secondary schools to meet the special educational needs of gifted and talented students. 

Foreign Language Assistance 

The Committee recommends $25,000,000 for the Foreign Language Assistance program. The comparable funding level for fiscal 

year 2005 is $17,856,000 and the budget request proposes eliminating funds for foreign language assistance activities. 

The Committee recommendation provides funds above what is 

needed for continuation costs for current activities. These additional funds shall be used for a new grant competition to school districts with poverty rates of 15 percent or more, to help the highestneed elementary schools within such districts establish foreign language instruction programs. 

Funds from this program support competitive grants to increase 

the quality and quantity of foreign language instruction. At least 

75 percent of the appropriation must be used to expand foreign language education in the elementary grades. The Committee has included bill language that prohibits Foreign Language Assistance 

program funds from being be used for the Foreign Language Incentive program. 

The Committee is concerned that this program, which is the only 

Federal program designed to help schools meet the need for foreign 

language instruction, is unavailable to the poorest schools because 

grant recipients must provide a 50 percent match from non-Federal 

sources. The Committee, therefore, strongly urges the Secretary to 
241 

use her ability to waive the matching requirement for qualifying 

schools and to increase awareness of this accommodation among 

the affected school population. The Committee also believes that 

the sustainability preference established in the authorizing legislation should not prohibit the highest-need applicants from receiving 

one or more grants under this program or from being eligible to 

have the matching requirement waived during their initial or subsequent grants. 

Education for Homeless Children and Youth 

For carrying out education activities authorized by Title VII, subtitle B of the Stewart B. McKinney Homeless Assistance Act, the 

Committee recommends $62,496,000. The comparable fiscal year 

2005 funding level and the budget request both are $62,496,000. 

This program provides assistance to each State to support an office of the coordinator of education for homeless children and 

youth, to develop and implement State plans for educating homeless children, and to make subgrants to LEAs to support the education of those children. Grants are made to States based on the 

total that each State receives in Title I grants to LEAs. 

Under the McKinney-Vento Homeless Children and Youths Program, State educational agencies [SEAs] must ensure that homeless children and youth have equal access to the same free public 

education, including a public preschool education, as is provided to 

other children and youth. States must review and undertake steps 

to revise any laws, regulations, practices, or policies that may act 

as barriers to the enrollment, attendance, or success in school of 

homeless children and youth. 

Training and Advisory Services 

For training and advisory services authorized by Title IV of the Civil Rights Act, the Committee recommends $7,185,000. The comparable fiscal year 2005 funding level and the budget request both 

are $7,185,000 for these services. 

The funds provided will support awards to operate the 10 regional equity assistance centers [EACs]. Each EAC provides services to school districts upon request. Activities include disseminating information on successful practices and legal requirements 

related to nondiscrimination on the basis of race, color, sex, or national origin in education programs. 

Education for Native Hawaiians 

For programs for the education of Native Hawaiians, the Committee recommends $34,500,000. The comparable fiscal year 2005 

funding level is $34,224,000 and the budget request is $32,624,000 

for these programs. 

The Committee bill includes language allowing $1,250,000 of the 

funds recommended to be used for construction and renovation of 

Native Hawaiian educational facilities. 

Education for Native Hawaiians.—The Committee recognizes the 

Department’s continuing support in working with the Native Hawaiian Education Council as a vehicle for assessing, evaluating, 

and coordinating all education programs for Native Hawaiians. The 

Committee urges the Secretary to work with the Executive Director 
242 

of the Council to ensure adequate funds are set aside to perform 

the tasks assigned to the Council in title VII of the No Child Left 

Behind Act. In addition, the Committee requests that the Department provide the Council with the grantee reports on a timely 

basis to allow the Council to fully undertake the assessment, evaluation and issuance of recommendations, as required by law. 

Native Hawaiian Law Center of Excellence.—The Committee 

commends the Department’s support in establishing a Center of 

Excellence in Native Hawaiian Law at the University of Hawaii. 

This Center will provide a forum for the examination and preservation of law with respect to the Native Hawaiian culture and spirit. 

The Committee bill includes language stipulating that $1,250,000 

shall be used for a grant to the Center of Excellence at the University of Hawaii School of Law. 

Alaska Native Educational Equity 

The Committee recommends $34,500,000 for the Alaska Native 

educational equity assistance program. The comparable fiscal year 

2005 funding level is $34,224,000 and the budget request includes 

$31,224,000 for this purpose. 

These funds address the severe educational handicaps of Alaska 

Native schoolchildren. Funds are used for the development of supplemental educational programs to benefit Alaska Natives. The 

Committee bill includes language which allows funding provided by 

this program to be used for construction. The Committee expects 

the Department to use some of these funds to address the construction needs of rural schools. 

Rural Education 

The Committee recommends $170,624,000 for rural education 

programs, the same as both the comparable fiscal year 2005 funding level and the budget request. 

The Committee strongly supports the continued use of Federal 

funding specifically for rural education. Rural schools face difficult 

challenges in meeting the mandates in the No Child Left Behind 

Act, particularly in the areas of attracting highly qualified teachers 

and adapting to new assessment requirements and reporting expectations. The rural education programs are intended to help level 

the playing field for small and high-poverty rural school systems 

that typically receive less Federal formula funding than their 

urban and suburban counterparts, and are frequently unable to 

compete for competitive grants. In addition to providing more total 

funding for such districts, the program also allows these districts 

to combine funds from four categorical programs and use the 

money to address their highest priorities, such as recruiting teachers, purchasing technology, or upgrading curricula. 

The Committee expects that rural education funding will be 

equally divided between the Small, Rural Schools Achievement 

Program, which provides funds to LEAs that serve a small number 

of students, and the Rural and Low-Income Schools Program, 

which provides funds to LEAs that serve concentrations of poor 

students, regardless of the number of students served. 
243 

Comprehensive Centers 

The Committee recommends $56,825,000 for the comprehensive 

centers program, the same as both the comparable fiscal year 2005 

funding level and the budget request. 

These funds will provide continued support to 10–20 comprehensive centers expected to be established before September 2005. At 

least one center will operate in each of the 10 regions of the United 

States. The centers, which would be operated by research organizations, agencies, institutions of higher education or partnerships 

thereof, would provide training and technical assistance on various 

issues to States, LEAs, and schools as identified through needs assessments undertaken in each region. Grantees will develop 5-year 

plans for undertaking authorized activities that address the needs 

of States in a region and develop an advisory board to advise the 

center on allocation of resources, maintaining a high standard of 

quality in services delivery and ensuring that activities promote 

progress toward improving student achievement. The National 

Center for Education Evaluation and Regional Assistance will provide for ongoing independent evaluation of each center to assess 

whether each is meeting its objectives. 

INDIAN EDUCATION

Appropriations, 2005 ............................................................................. $119,889,000 

Budget estimate, 2006 ........................................................................... 119,889,000 

House allowance .................................................................................... 119,889,000 

Committee recommendation ................................................................. 119,889,000 

The Committee recommends $119,889,000 for Indian Education 

programs. The comparable fiscal year 2005 funding level and the 

budget request both are $119,889,000 for such activities. 

Grants to Local Education Agencies 

For grants to local education agencies, the Committee recommends $96,294,000. The comparable fiscal year 2005 funding 

level is $95,165,000 and the budget request includes $96,294,000 

for authorized activities. 

These funds provide financial support to elementary and secondary school programs that serve Indian students, including preschool children. Funds are awarded on a formula basis to local educational agencies, schools supported and operated by the Bureau of 

Indian Affairs, and in some cases directly to Indian Tribes. 

Special Programs for Indian Children 

The Committee recommends $19,595,000 for special programs for 

Indian children, the same as the comparable fiscal year 2005 funding level and the budget request. 

Funds are used for demonstration grants to improve Indian student achievement through early childhood education and college 

preparation programs, and for professional development grants for 

training Indians who are preparing to begin careers in teaching 

and school administration. 
244 

National Activities 

The Committee recommends $4,000,000 for national activities. 

The comparable fiscal year 2005 amount is $5,129,000 and the 

budget request is $4,000,000 for authorized activities. Funds will 

be used to expand efforts to improve research, evaluation, and data 

collection on the status and effectiveness of Indian education programs. 

INNOVATION AND IMPROVEMENT

Appropriations, 2005 ............................................................................. $1,092,642,000 

Budget estimate, 2006 ........................................................................... 1,307,871,000 

House allowance .................................................................................... 708,522,000 

Committee recommendation ................................................................. 1,057,385,000 

The Committee recommends an appropriation of $1,057,385,000 

for programs within the innovation and improvement account. The 

comparable fiscal year 2005 funding level for these programs is 

$1,092,642,000 and the budget request includes $1,307,871,000 for 

this account. 

Troops-to-Teachers 

The Committee recommends an appropriation of $14,793,000 for 

the Troops-to-Teachers program, the same as both the comparable 

funding level for fiscal year 2005 and the budget request. 

This program supports the Defense Department’s Troops to 

Teachers program, which helps recruit and prepare retiring and 

former military personnel to become highly qualified teachers serving in high-poverty school districts. The Secretary of Education 

transfers program funds to the Department of Defense for the Defense Activity for Non-Traditional Education Support to provide assistance, including stipends of up to $5,000 and bonuses of up to 

$10,000, to eligible members of the Armed Forces so that they can 

obtain teacher certification or licensing. In addition, the program 

helps these individuals find employment in a school. 

The Committee notes that the GAO and Department are required to report to Congress on the effectiveness of this program 

in placing highly-qualified teachers in high-need districts. The 

Committee looks forward to receiving a copy of the report and 

urges the Department to utilize the findings in implementing this 

program. 

Transition to Teaching 

The Committee recommends $44,933,000 for the transition to 

teaching program, the same as both the comparable fiscal year 

2005 funding level and the budget request. 

This program provides grants to help support efforts to recruit, 

train, and place nontraditional teaching candidates into teaching 

positions and to support them during their first years in the classroom. In particular, this program is intended to attract mid-career 

professionals and recent college graduates. Program participants 

are placed in high-need schools in high-need LEAs. 

The Committee encourages the Department to continue to work 

with grantees to ensure that appropriated funds are used effectively to recruit highly qualified teachers to and retain them in em-
245 

ployment in high need schools. The Committee looks forward to receiving more performance outcome information regarding this program, and, in particular, the results of the ongoing evaluation of 

grantee progress toward their goals and objectives. 

National Writing Project 

The Committee recommends $23,000,000 for the National Writing Project. The comparable funding level for fiscal year 2005 is 

$20,336,000 and the budget request proposes to eliminate Federal 

funding for this program. 

These funds are awarded to the National Writing Project, a nonprofit organization that supports and promotes K–16 teacher training programs in the effective teaching of writing. From the funds 

provided by the fiscal year 2006 appropriation, the Committee intends that $500,000 shall be used to continue support for the pilot 

program on the integration of technology training in the NWP program. 

Teaching of Traditional American History 

The Committee recommends $121,000,000 for the teaching of traditional American history program. The comparable fiscal year 

2005 funding level is $119,040,000 and the budget request is 

$119,040,000 for this activity. This program supports competitive 

grants to LEAs, and funds may be used only to undertake activities 

that are related to American history, and cannot be used for social 

studies coursework. Grant awards are designed to augment the 

quality of American history instruction and to provide professional 

development activities and teacher education in the area of American history. The Committee directs the Department to continue its 

current policy of awarding 3-year grants. 

The budget request includes bill language that would allow the 

Department to reserve up to 3 percent of funds appropriated for 

this program for national activities. The Committee bill includes 

the requested language. The Committee requests that the Department prepare and submit an operating plan to the House and Senate Committees on Appropriations, within 30 days of enactment of 

this Act, on how these reserved funds will be used to support the 

intent of this program. 

School Leadership 

The Committee recommends $15,000,000 for the school leadership program. The comparable fiscal year 2005 funding level is 

$14,880,000 and the budget request proposes to eliminate funding 

for this program. This program provides competitive grants to assist high-need LEAs to recruit and train principals and assistant 

principals through activities such as professional development and 

training programs. The Committee continues to recognize the critical role that principals and assistant principals play in creating an 

environment that fosters effective teaching and high academic 

achievement for students. 

Advanced Credentialing 

The Committee recommends $10,000,000 for the advanced 

credentialing program. The comparable fiscal year 2005 funding 
246 

level is $16,864,000 and the budget request includes $8,000,000 for 

one component of the authorized program. 

The Committee recommendation includes $10,000,000 for the National Board for Professional Teaching Standards [NBPTS]. The 

comparable fiscal year 2005 funding level is $9,920,000 and the 

budget request proposes to eliminate funding for the National 

Board. Funds available assist the Board’s work in providing financial support to States for teachers applying for certification, increasing the number of minority teachers seeking certification and 

developing outreach programs about the advanced certification program. The fiscal year 2006 appropriation will support continuation 

of an award to the National Board for Professional Teaching Standards. 

The Committee continues its strong support of the National 

Board for Professional Teaching Standards, based on the significant body of rigorous research that has demonstrated the benefits 

to students from being taught by a Board-certified educator. The 

Committee notes that the National Board has developed standards 

that describe the knowledge and skills characterizing effective 

teaching in 24 different areas, including school counseling. The accomplished educators who achieve certification in these standards 

do so by demonstrating their understanding through actual teaching, as well as through a written exam and teaching portfolio. The 

Committee believes that these activities are consistent with the 

mission of the National Board, which is to advance the quality of 

teaching and learning in the United States. 

Charter Schools Grants 

The Committee recommends $216,952,000 for the support of 

charter schools. The comparable fiscal year 2005 funding level is 

$216,952,000 and the budget request is $218,702,000 for this program. 

This program supports the planning, development, and initial 

implementation of charter schools, which are public schools that receive exemption from many statutory and regulatory requirements 

in exchange for promising to meet agreed-upon accountability 

measures. State educational agencies that have the authority 

under State law to approve charter schools are eligible to compete 

for grants. If an eligible SEA does not participate, charter schools 

from the State may apply directly to the Secretary. The authorizing 

statute requires that amounts appropriated in excess of 

$200,000,000 and less than $300,000,000 be used for 5-year competitive grants to States that operate per-pupil facilities aid programs for charters schools. Federal funds are used to match State 

funded programs in order to provide charter schools with additional 

resources for charter school facilities financing. At the Committee 

recommendation, almost $17,000,000 will be available to continue 

support for per-pupil facilities aid grants. 

The Committee notes that the Department plans to use 

$8,000,000 in appropriated funds for national activities, which may 

include support for a rigorous evaluation of charter schools and the 

expansion of State capacity to administer their charter schools. The 

Committee encourages the Department to support such efforts and 
247 

requests that additional information on these activities be included 

in the fiscal year 2007 congressional budget justification. 

Credit Enhancement for Charter School Facilities 

The Committee does not recommend additional for this program. 

The comparable funding level for fiscal year 2005 and the budget 

request both are $36,981,000 for this purpose. The Committee 

notes that the authorization for this program expired in fiscal year 

2005, and due to limited resources, does not fund this unauthorized 

activity. The budget request includes bill language that would continue to authorize this activity in fiscal year 2006. 

This program provides assistance to help charter schools meet 

their facility needs. Funds are provided on a competitive basis to 

public and non-profit entitities, to leverage non-Federal funds that 

help charter schools obtain school facilities through purchase, 

lease, renovation and construction. 

Voluntary Public School Choice 

The Committee recommends $26,543,000 for the voluntary public 

school choice program, the same as both the comparable funding 

level for fiscal year 2005 and the budget request. 

This program supports efforts by States and school districts to 

establish or expand State- or district-wide public school choice programs, especially for parents whose children attend low-performing 

public schools. 

Magnet Schools Assistance 

The Committee recommends $107,771,000 for the magnet schools 

assistance program, the same as both the comparable fiscal year 

2005 funding level and the budget request. 

This program supports grants to local educational agencies to establish and operate magnet schools that are part of a court-ordered 

or federally approved voluntary desegregation plan. Magnet schools 

are designed to attract substantial numbers of students from different social, economic, ethnic, and racial backgrounds. Grantees 

may use funds for planning and promotional materials, teacher salaries, purchase of computers, and other educational materials and 

equipment. 

Choice Incentive Fund 

The Committee does not recommend any funding for this proposed program, which is not specifically authorized. The budget request includes $50,000,000 for this purpose. Through this proposed 

program, funds would be used to award competitive grants to establish or expand public or private school choice opportunities. 

Fund for the Improvement of Education 

The Committee recommends an appropriation of $417,924,000 for 

the Fund for the Improvement of Education [FIE]. The comparable 

funding level for fiscal year 2005 is $414,078,000 and the budget 

request includes $106,296,000 for comparable activities. 

The Committee recommendation includes $700,000 for the National Institute of Building Sciences to continue operation of the 

National Clearinghouse for Educational Facilities, the Nation’s sole 
248 

source for comprehensive information about school planning, design, financing, construction and maintenance. The Committee recommends an additional $300,000 for this purpose within Safe and 

Drug-Free Schools and Communities National Programs to address 

issues related to school safety and healthy school buildings. 

The Committee recommends $25,296,000 to award a contract to 

Reading Is Fundamental, Inc. [RIF] to provide reading-motivation 

activities. The comparable funding level for fiscal year 2005 and 

the budget request both are $25,296,000 for this purpose. RIF, a 

private nonprofit organization, helps prepare young children and 

motivate older children to read, through activities including the 

distribution of books. Federal funds provide up to 75 percent of the 

costs of books, except for migrant and seasonal farmworker programs which may receive up to 100 percent of the costs of books. 

The administration proposes $40,000,000 for a new adjunct 

teacher corps initiative. Through this new categorical grant program, the Department of Education would make competitive grants 

to partnerships of school districts and public and private institutions to create opportunities for professionals to teach secondaryschool courses in the core academic subjects, particularly math and 

science. Due to budget constraints, the Committee recommendation 

does not include funds for this purpose. 

The Committee recommendation does not include any funds for 

State scholars capacity building. The comparable funding level for 

fiscal year 2005 is $2,500,000 and the budget request includes 

$12,000,000 for this program. This program supports State-level 

business and education partnerships that encourage high school 

students to complete a rigorous curriculum in core academic subjects. 

The administration recommended eliminating funding for activities listed below. 

The Committee recommends $21,000,000 for the Star Schools 

program. The comparable funding level for fiscal year 2005 is 

$20,832,000. The Star Schools program is designed to improve instruction in math, science, foreign languages, and other areas such 

as vocational education, to underserved populations by means of 

telecommunications technologies. 

The Committee recommends $11,000,000 for the Ready to Teach 

program. The comparable funding level for fiscal year 2005 is 

$14,291,000. Ready to Teach is the successor to the Public Broadcasting Service’s Mathline program, which was one of the first to 

provide online professional development and continuing education 

for teachers. Ready to Teach was reauthorized by the No Child Left 

Behind Act of 2001 and continues to evolve to enhance teacher 

quality and meet the goals of that Act. Ready to Teach encompasses funding for PBS TeacherLine and one or more nonprofit entities, for the purpose of continuing to develop telecommunicationsbased programs to improve teacher quality in core areas. It also includes digital educational programming grants, which encourages 

community partnerships among local public television stations, 

State and local educational agencies, and other institutions to develop and distribute digital instructional content based on State 

and local standards. 
249 

The Committee recommendation includes $10,000,000 for the 

Education through Cultural and Historical Organizations [ECHO] 

Act of 2001, as authorized by the No Child Left Behind Act. The 

comparable funding level for fiscal year 2005 is $8,631,000 and the 

budget request did not include any funds for this purpose. Programs authorized under ECHO provide a broad range of educational, cultural, and job training opportunities for students from 

communities across the Nation, including Alaska, Hawaii and Massachusetts. Funds also are available to support a range of services 

to the Mississippi Band of Choctaw Indians. 

The Committee has included $35,700,000 for arts in education. 

The comparable funding level for fiscal year 2005 is $35,633,000. 

Within the total, $6,369,000 is for the John F. Kennedy Center for 

the Performing Arts; $7,440,000 is for VSA arts; $13,455,000 is for 

the competitive art education model grant program for the development of model projects that effectively strengthen and integrate 

arts and cultural partnerships into the core curriculum; $7,936,000 

is for grants for professional development for music, dance, drama, 

and visual arts educators to be administered by the U.S. Department of Education; $500,000 is to continue the evaluation and national dissemination of information regarding model programs and 

professional development projects funded through the Arts in Education section, including dissemination promising practices from 

funded projects and technical assistance for self-evaluation. 

The Committee recommends $42,000,000 for Parental Information and Resource Centers, which provide training, information, 

and support to parents, State and local education agencies, and 

other organizations that carry out parent education and family involvement programs. The comparable funding level for fiscal year 

2005 is $41,886,000. The Committee notes that research overwhelmingly demonstrates that parent involvement in children’s 

learning is positively related to student achievement. 

The Committee also notes that the No Child Left Behind Act requires grantees to use at least 30 percent of their awards to establish, expand, or operate Parents as Teachers, Home Instruction 

Program for Preschool Youngsters, or other early childhood parent 

education programs. 

The Committee recommends $5,000,000 to continue support for 

the Mental Health Integration in School program. The comparable 

funding level for fiscal year 2005 is $4,960,000. This program supports grants to or contracts with State educational agencies, local 

educational agencies or Indian tribes to increases student access to 

mental health care by linking schools with their local mental 

health systems. The Committee expects this program to continue to 

be carried out by the Office of Safe and Drug-Free Schools. 

The Committee includes $3,000,000 for the women’s educational 

equity program. The comparable funding level for fiscal year 2005 

is $2,956,000. This program supports projects that assist in the 

local implementation of gender equity policies and practices. 

The Committee recommendation includes $1,500,000 for activities authorized by the Excellence in Economics Education Act. The 

comparable fiscal year 2005 funding is $1,488,000. These funds will 

support a grant to a non profit educational organization to promote 
250 

economic and financial literacy among kindergarten through 12th 

grade students. 

The Committee is pleased that, according to a nationwide survey 

of more than 4,000 high school seniors conducted by the Jump$tart 

Coalition, the level of financial literacy among 12th grade students 

has increased. However, with an average score of just 52.3 percent 

on the national exam, there is still much room for improvement. 

The Committee urges the Department to continue funding programs that improve the money management skills of young people 

through the inclusion of financial literacy materials, standards and 

assessments in high school math, economics and business courses. 

The Committee recommendation includes $10,000,000 to carry 

out the American History and Civics Education Act of 2004. From 

the amount available, $5,000,000 shall be used to establish Presidential Academies for Teaching of American History and Civics. 

These Presidential Academies will strengthen the knowledge and 

teaching capacity of K–12 teachers of American history and civics. 

The remaining $5,000,000 will support the establishment of Congressional Academies for Students of American History and Civics. 

These Congressional Academies will help outstanding students of 

American history and civics develop a broader and deeper understanding of these subject matters. 

The Committee expects funds to be awarded on a competitive 

basis to institutions of higher education, non-profit educational institutions, and consortia thereof, to establish and operate such 

Academies. The Committee further intends grant awards to last for 

a period of 2 years. The Committee urges the Secretary to give considerable weight to sustainability plans, which shall be required of 

applicants to show how they plan to sustain their project after 

their grant expires, when considering awards under this program. 

The Committee recommendation also includes resources for the 

following activities: teacher quality initiatives; evaluation and data 

quality initiatives designed to improve the quality of data collected 

from, and evaluations conducted by, grantees under elementary 

and secondary education programs; Reach Out and Read; and peer 

review. 

Teacher Incentive Fund 

The Committee recommendation does not include any funds for 

this new program. The budget request includes $500,000,000 for 

this new activity. 

Under the budget request, $450,000,000 would be available for 

formula grants to States for monetary awards to teachers who raise 

student achievement or reduce the achievement gap, and to ‘‘highly 

qualified’’ teachers who teach in high-need schools. Under the proposed program, States would be required to spend at least 25 percent of their funds for each of these two activities. The remaining 

$50,000,000 proposed in the budget request would be available for 

competitive grants from the U.S. Department of Education to partnerships of State educational agencies, local educational agencies 

and non-profit organizations for the development and implementation of performance-based teacher compensation systems in States 

and school districts. 
251 

The budget request includes bill language that would authorize 

this new program. However, the Committee notes that this program was not specifically authorized under the No Child Left Behind Act, so it is not included in the Committee bill. 

Ready to Learn Television 

The Committee recommends an appropriation of $25,000,000 for 

the Ready to Learn Television program. The comparable funding 

level for fiscal year 2005 and the budget request both are 

$23,312,000 for this purpose. 

Ready to Learn Television supports the development and distribution of educational television programming designed to improve the readiness of preschool children to enter kindergarten and 

elementary school. The program also supports the development, 

production, and dissemination of educational materials designed to 

help parents, children, and caregivers obtain the maximum advantage from educational programming. 

The original objective of RTL was to place educational programming within the reach of every American child, especially those in 

culturally disadvantaged households or communities. 

The Committee commends the research collaboration of WGBH 

Between the Lions, Sesame Workshop, and the National Center for 

Rural Early Childhood Education regarding Ready to Learn television shows and outreach programming. This new research for the 

first time shows the unique learning that occurs in rural areas and 

how they can be best addressed with technologically accessible enhancing programming coupled with regular public broadcasting of 

a variety of RTL television shows. 

The Committee notes that awards have yet to be made with fiscal year 2005 funds available for this program. The Committee understands that the competition placed a priority on reading programming, but does not intend to restrict program content to that 

subject only. The Committee appreciates the Department’s commitment to creating high-quality learning environments for children 

through this program and intends that funds provided in last 

year’s bill and this Act will support the Department’s broad view 

of the educational value of this program. While successful reading 

is clearly an important foundation that will allow children to 

achieve at grade level in future years, it is not the only factor that 

will help them reach that goal. 

The Committee appreciates and continues to support the community outreach efforts that support programming developed and delivered through the Ready to Learn partnership during prior funding cycles. While not all of the local outreach activities achieved 

their goal of adequately supporting Ready to Learn programming, 

many leveraged significant local resources, fostered broad community collaboration with a small amount of Federal funding, and led 

to more frequent and longer periods of reading and other learning 

activities by those adults who attended local training workshops. 

The Committee notes that this small investment in local community outreach greatly extended the scope and educational value of 

this program, not only through the services offered to parents but 

also because of the incentive that it created for local stations to air 

Ready to Learn programming. The Committee believes this frame-
252 

work should continue to be supported and strongly urges the Department to utilize funds appropriated in fiscal year 2005 and continued in fiscal year 2006 for this purpose. 

Dropout Prevention 

The Committee does not recommend additional funds for the 

dropout prevention program. The comparable funding level for fiscal year 2005 is $4,930,000 and the budget request did not include 

any funding for the dropout prevention program. These funds are 

used to help schools implement effective school dropout prevention 

and re-entry programs. 

In addition, the Committee notes that in fiscal year 2005, States 

reserved more than $105,000,000 from their Title I, Part A allocations to operate State-administered projects in LEAs with the highest dropout rates and in areas serving a large number of children 

in local correctional facilities, as is required by law. 

Close Up Fellowships 

The Committee recommendation includes $1,469,000 for Close 

Up Fellowships. The comparable funding level for fiscal year 2005 

is $1,469,000 and the budget request did not include any funds for 

this purpose. The Close Up Fellowships, formerly called Ellender 

Fellowships, which is administered by the Close Up Foundation of 

Washington, DC, provides fellowships to students from low-income 

families and their teachers to enable them to spend 1 week in 

Washington attending seminars and meeting with representatives 

of the three branches of the Federal Government. 

The Committee notes that the Close Up Foundation, in collaboration with the Secretary of Education, is required to develop and implement procedures for measuring the efficacy of the Foundation’s 

authorized programs, including the extent to which the programs 

are providing young people with an increased understanding of the 

Federal Government; heightening a sense of civic responsibility 

among young people; and enhancing the skills of educators in 

teaching young people about civic responsibility, the Federal Government, and attaining citizenship competencies. The Committee 

requests a more complete discussion of the actions taken to meet 

this statutory requirement, as well as program performance information, in the fiscal year 2007 Congressional Budget Justification. 

Advanced Placement Program 

The Committee recommends $33,000,000 for Advanced Placement. The comparable funding level for fiscal year 2005 is 

$29,760,000 and the budget request includes $51,500,000 for the 

Advanced Placement program. 

The first priority of the program is to subsidize test fees for lowincome students who are enrolled in an Advanced Placement class 

and plan to take an Advanced Placement test. The balance of the 

funds are allocated for Advanced Placement Incentive Program 

grants, which are used to expand access for low-income individuals 

to Advanced Placement programs. Eligible activities include teacher training and participation in online Advanced Placement 

courses, among other related purposes. 
253 

SAFE SCHOOLS AND CITIZENSHIP EDUCATION

Appropriations, 2005 ............................................................................. $833,987,000 

Budget estimate, 2006 ........................................................................... 396,767,000 

House allowance .................................................................................... 763,870,000 

Committee recommendation ................................................................. 697,300,000 

Safe and Drug-Free Schools and Communities 

The Committee recommends a total of $697,300,000 for activities 

to promote Safe Schools and Citizenship Education. The comparable fiscal year 2005 funding level is $833,987,000 and the 

budget request includes $396,767,000 for these activities. 

State Grant Program.—The Committee recommends 

$300,000,000 for the safe and drug-free schools and communities 

State grant program. The comparable fiscal year 2005 funding level 

is $437,381,000 and the budget request did not include any funds 

for this purpose. The State grant program is the backbone of youth 

drug prevention efforts in the United States. This formula-based 

State grant program provides resources to Governors, State educational agencies and local educational agencies for developing and 

implementing activities that help create and maintain safe and 

drug-free learning environments in and around schools. 

National Programs.—The Committee has included $150,000,000 

for the national programs portion of the safe and drug-free schools 

and communities program. The comparable funding level for fiscal 

year 2005 is $152,537,000 and the budget request includes 

$267,967,000 for these programs. The Committee does not recommend additional funding for Project SERV (School Emergency 

Response to Violence), which provides education-related services to 

LEAs in which the learning environment has been disrupted due 

to a violent or traumatic crisis. The budget request includes 

$5,000,000 for Project SERV. However, the Committee notes that 

the Department currently has roughly $8,000,000 available for this 

purpose. These funds are available until expended. The Committee 

will monitor the availability of funding and consider action in subsequent appropriations bills. 

The Committee continues to be concerned about the increasing 

problem of alcohol and drug abuse on college campuses. The Committee has included bill language requiring the Department to 

spend $850,000 on a program under the guidelines in section 120(f) 

of Public Law 105–244. This program identifies and provides models of alcohol and drug abuse prevention and education programs 

in higher education. The Committee includes these funds within 

the requested $10,000,000 for post-secondary alcohol prevention efforts proposed in the budget request. 

The Committee expects that the Department will provide 

$300,000 for the continued operation of the National Clearinghouse 

for Educational Facilities. These funds will be used to address 

issues related to school safety and healthy school buildings. The 

Committee has included additional funds for the Clearinghouse 

through the Fund for the Improvement of Education. 

The Committee recommendation does not include $87,500,000 as 

requested by the Department for a new grant program for local 

educational agencies. This program was proposed to replace the 

State grant program, a proposal rejected by the Commmittee. 
254 

The Committee recommendation includes $30,000,000 to continue the school safety initiative. The budget request includes 

$30,000,000 to support grants and technical assistance to elementary and secondary schools for responding to emergency response 

challenges identified in the Department of Homeland Security’s 

Critical Infrastructure plan. The Committee notes that not all districts in need of planning funds previously provided have received 

them, so the Department is encouraged to consider running an additional planning grant competition to ensure that the most at-risk 

districts receive planning grants before moving to this next phase. 

The Committee expects to receive a letter report on the plan for fiscal year 2006 funds, prior to the announcement of the next grant 

competition under this program. 

The Committee recommendation includes $7,492,000 for schoolbased drug testing programs for students. The comparable fiscal 

year 2005 funding level is $9,920,000 and the budget request includes $25,000,000. The Committee expects that this funding will 

be used to continue and evaluate current drug testing grants. 

The Committee recommendation also includes $9,372,000 to continue data management improvement grants and related technical 

assistance; $82,336,000 for safe schools healthy students; 

$2,000,000 for the required impact evaluation; $2,000,000 for information and materials; $2,000,000 for data collection and analysis; 

$1,500,000 for other joint project with Federal agencies; and 

$3,000,000 for other program improvement activities. 

Research studies have found that mental health greatly affects 

academic achievement and educational outcomes. The Committee 

recognizes the negative impact that depression, anxiety, substance 

abuse, and other mental disorders can have on a youth’s academic 

performance and urges the Office of Safe and Drug Free Schools to 

join the Substance Abuse and Mental Health Services Administration, the Centers for Disease Control, and other Federal agency efforts to take concrete steps to improve the mental health of America’s youth through the early identification of mental health problems, including the use of voluntary, evidence-based mental health 

screening of adolescents. The Committee urges the Department to 

continue to promote school-wide mental health strategies, provide 

training to school personnel to recognize early warning signs of 

mental illness, and increase access to high-quality mental health 

services. In addition, the Department is encouraged to include an 

evaluation component to determine the most effective programs 

and practices for the early identification of youth mental illness. 

Alcohol Abuse Reduction 

The Committee recommends $33,500,000 for grants to LEAs to 

develop and implement programs to reduce underage drinking in 

secondary schools. The comparable funding level for fiscal year 

2005 is $32,736,000 and the budget request did not include any 

funds for this purpose. The Committee directs the Department and 

the Substance Abuse and Mental Health Services Administration 

[SAMHSA] in the Department of Health and Human Services to 

work together on this effort. 
255 

Mentoring 

The Committee recommends $49,307,000 to support mentoring 

programs and activities for children who are at risk of failing academically, dropping out of school, getting involved in criminal or 

delinquent activities, or who lack strong positive role models. The 

comparable fiscal year 2005 funding level and the budget request 

both are $49,307,000 for this purpose. 

Character Education 

The Committee recommends $24,493,000 to provide support for 

the design and implementation of character education programs. 

The comparable funding level for fiscal year 2005 and the budget 

request both are $24,493,000 for this purpose. 

Elementary and Secondary School Counseling 

The Committee recommends $36,000,000 to establish or expand 

counseling programs in elementary schools. The comparable fiscal 

year 2005 funding level is $34,720,000 and the President’s budget 

proposes to eliminate funding for this program. As authorized by 

the No Child Left Behind Act, all amounts appropriated up to 

$40,000,000 are used only for elementary school counseling programs. 

Carol M. White Physical Education for Progress Program 

The Committee recommends $74,000,000 to help LEAs and community-based organizations initiate, expand and improve physical 

education programs for students in grades K–12, as authorized by 

Public Law 107–110. The comparable funding level for fiscal year 

2005 is $73,408,000 and the budget request includes $55,000,000 

for this program. Provision of this funding will help schools and 

communities nationwide improve their structured physical education programs for students and help children develop healthy 

lifestyles to combat the epidemic of obesity in the Nation. The Committee does not agree with the administration’s proposal to phaseout and eventually eliminate funding for this program. 

The Committee notes that in the past 15 years, obesity has increased by over 50 percent among adults and in the past 20 years, 

obesity has increased by 100 percent among children and adolescents. The National Institute of Child Health and Human Development [NICHD] Study of Early Child Care and Youth Development 

found that third grade children in the study received an average 

of 25 minutes per week in school of moderate to vigorous activity, 

while experts in the United States have recommended that young 

people should participate in physical activity of at least moderate 

intensity for 30 to 60 minutes each day. While not nationally represented, this information is consistent with the 2002 Youth Risk 

Behavior Surveillance System which found that only roughly onehalf of all students report attending a physical education class one 

or more times a week. The Committee believes Federal funding is 

critical to the effort to reducing these trends and helping improve 

the health of the American public. 
256 

Civic Education 

The Committee recommends $30,000,000 for grants to improve 

the quality of civics and government education, to foster civic competence and responsibility, and to improve the quality of civic and 

economic education through exchange programs with emerging democracies. The comparable fiscal year 2005 funding level is 

$29,405,000 and the budget request proposed to eliminate funding 

for this purpose. 

Civic Education program funds support both the We the People 

programs and the Cooperative Education Exchange. The Committee recommends $17,560,000 for the nonprofit Center for Civic 

Education to support the We the People programs. We the People 

has two primary components: the Citizen and the Constitution program, which provides teacher training, curriculum materials, and 

classroom instruction for upper elementary, middle, and high 

school students; and Project Citizen, a program for middle school 

students that focuses on the role of State and local governments in 

the American Federal system. 

Within the amount for the We the People program, the Committee recommends the following: that $3,087,000 be reserved to 

continue the comprehensive program to improve public knowledge, 

understanding, and support of American democratic institutions 

which is a cooperative project among the Center for Civic Education, the Center on Congress at Indiana University, and the 

Trust for Representative Democracy at the National Conference of 

State Legislatures; and that $1,543,000 be used for continuation 

and expansion of the school violence prevention demonstration program including the Native American program. 

The Committee recommends $12,440,000 for the Cooperative 

Education Exchange program. Within this amount, the Committee 

has included $4,665,000 for the Center for Civic Education and 

$4,665,000 for the National Council on Economic Education. The 

remaining $3,110,000 should be used for a competitive grant program for civics and government education, and for economic education. 

ENGLISH LANGUAGE ACQUISITION

Appropriations, 2005 ............................................................................. $675,765,000 

Budget estimate, 2006 ........................................................................... 675,765,000 

House allowance .................................................................................... 675,765,000 

Committee recommendation ................................................................. 675,765,000 

The Committee recommends an appropriation of $675,765,000 for 

English language acquisition. The comparable funding level for fiscal year 2005 and the budget request both are $675,765,000 for authorized activities. 

The Department makes formula grants to States based on each 

State’s share of the Nation’s limited-English-proficient and recent 

immigrant student population. The program is designed to increase 

the capacity of States and school districts to address the needs of 

these students. The No Child Left Behind Act also requires that 6.5 

percent of the appropriation, an amount equal to $43,925,000 at 

the Committee recommendation funding level, be used to support 

national activities, which include professional development activi-
257 

ties designed to increase the number of highly qualified teachers 

serving limited English proficient students; a National Clearinghouse for English Language Acquisition and Language Instructional Programs; and evaluation activities. The budget request includes language that would allow national activities funds to be 

available for 2 years. The Committee bill includes the requested 

language. 

At the level of the Committee recommendation, the State grant portion of this account will increase by more than $44,000,000, as 

funding for expiring projects under the prior law are redirected to 

the State grant program. These additional funds will help States 

improve the educational outcomes for limited English proficient 

students. 

SPECIAL EDUCATION

Appropriations, 2005 ............................................................................. $11,673,606,000 

Budget estimate, 2006 ........................................................................... 12,126,130,000 

House allowance .................................................................................... 11,813,783,000 

Committee recommendation ................................................................. 11,774,107,000 

The Committee recommends $11,774,107,000 for special education programs authorized by the Individuals with Disabilities 

Education Act [IDEA]. The comparable fiscal year 2005 funding 

level is $11,673,606,000 and the budget request includes 

$12,126,130,000 for such programs. 

Office of Special Education and Rehabilitative Services [OSERS] 

No Child Left Behind [NCLB].—The Committee notes that the 

Department recently announced changes in NCLB policy regarding 

students with disabilities who have shown academic difficulties. 

The Department estimates that 2 percent of students with academic disabilities can make progress toward grade-level standards 

when they receive high-quality instruction and when their assessments are based on modified academic achievement standards assessments. The Committee is concerned that States do not yet have 

the tools and resources to appropriately implement the new policy 

in the 2005–2006 school year. To help States prepare for future implementation based on the promulgation of final regulations, the 

Committee strongly urges OSERS to provide support guidance to 

States, and LEAs, and parents that will define how students are 

identified for this category and ensure that eligible students have 

every possible opportunity for full and consistent participation in 

the general education curriculum and be on track to graduate with 

a regular diploma. 

Office of Special Education Programs [OSEP] 

Specific Learning Disabilities [SLD].—The Committee urges 

OSEP to ensure that the National Research Center on Learning 

Disabilities [NRCLD] continues to conduct and synthesize research 

on how to best implement and take to scale identification methods 

that rely on students’ responses to scientific research-based instruction. OSEP, through the NRCLD, should assist States and LEAs in 

identifying the criteria for determining an SLD and ensuring the 

consistency and integrity of the classification system across the 

States, and provide guidance and technical assistance systems for 
258 

the improvement of SLD identification and eligibility. The NRCLD 

should disseminate to and assist both States and LEAs with 

replicable models that produce measurable positive improvements 

in student learning. The NRCLD should coordinate with the PTIs, 

the National Dissemination Center for Children with Disabilities 

and other national partners to disseminate information about accurate identification of SLDs to parents. The Committee encourages 

OSEP to coordinate efforts within the Department of Education, 

NIH, NSF and other Federal agencies working on related activities. 

No Child Left Behind [NCLB] and the Individuals with Disabilities Education Improvement Act of 2004.—The Committee urges 

OSEP to educate parents of students with learning disabilities with 

the critical information they need to understand the impact of decisions made by the IEP team regarding assessments required by 

NCLB, school choice, supplemental education services, and other 

provisions of NCLB. 

Grants to States 

The Committee recommends $10,689,746,000 for special education grants to States, as authorized under part B of the IDEA. 

The comparable fiscal year 2005 funding level is $10,589,746,000 

and the budget request includes $11,097,746,000. This program 

provides formula grants to assist States, Outlying Areas, and other 

entities in meeting the costs of providing special education and related services for children with disabilities. States pass along most 

of these funds to local educational agencies, but may reserve some 

for program monitoring, enforcement, technical assistance and 

other activities. 

The appropriation for this program primarily supports activities 

associated with the 2006–2007 academic year. Of the funds available for this program, $5,265,546,000 will become available on July 

1, 2006 and $5,424,200,000 will become available on October 1, 

2006. These funds will remain available for obligation until September 30, 2007. 

The reauthorization established a new activity under this program, which allows funds to be used by the Secretary for grants 

to and contracts with States that improve their capacity to collect 

data required under the Act. The reauthorization also established 

a separate program for IDEA studies and evaluations, which is now 

funded as a separate program under the Institute of Education 

Sciences. Studies and evaluations were funded previously under 

this program, in accordance with the former law. 

The Committee’s recommended funding level represents approximately 18 percent of the average per-pupil expenditure, an increase 

of 50 percent from the level in fiscal year 2000 when the Federal 

share of average per-pupil expenditure was 12 percent. 

The budget request includes language capping the Department of 

Interior set-aside at the prior year level, adjusted by the increase 

in inflation. The Committee bill includes this language. 

Preschool Grants 

The Committee recommends $384,597,000 for preschool grants. 

The comparable fiscal year 2005 funding level and the budget request both are $384,597,000. The preschool grants program pro-
259 

vides formula grants to States to make available special education 

and related services for children with disabilities aged 3 through 

5. States are eligible for funds, which they in turn pass on to local 

educational agencies, if they serve all eligible children with disabilities aged 3 through 5 and have an approved application under the 

Individuals with Disabilities Education Act. 

Grants for Infants and Families 

The Committee recommends $444,308,000 for grants for the infants and families program under part C of the IDEA. The comparable fiscal year 2005 funding level and the budget request both 

are $440,808,000. This program provides formula grants to States, 

Outlying Areas and other entities to implement statewide systems 

of coordinated, comprehensive, multidisciplinary interagency programs to make available early intervention services to all children 

with disabilities, ages 2 and under, and their families. 

The Individuals with Disabilities Education Improvement Act of 

2004 created a new State Incentive Grant program, triggered when 

the appropriation for this program exceeds $460,000,000. Under 

this new authority, 15 percent of the appropriation is reserved by 

the Secretary for grants to States that have chosen to extend Part 

C services to 3-year-old children through their enrollment in kindergarten or elementary school who otherwise would be eligible for 

services under the Preschool Grants program. 

State Personnel Development 

The Committee recommends $50,653,000 for the State personnel 

development program. The comparable fiscal year 2005 funding 

level is $50,653,000 and the budget request does not include any 

funds for this program. The program formerly was known as the 

State improvement grant program, until it was changed by the Individuals with Disabilities Education Improvement Act of 2004. 

Under the reauthorization, this program focuses on the professional development needs in States by requiring that 90 percent of 

funds be used for professional development activities. The program 

supports grants to State educational agencies to help them reform 

and improve their personnel preparation and professional development related to early intervention, educational and transition services that improve outcomes for students with disabilities. 

Under this program, competitive grants are made when the appropriation is less than $100,000,000, but are made by formula to 

States when the appropriation exceeds this amount and 

$100,000,000 is remaining after covering continuation costs. 

Transition Initiative 

The Committee recommendation does not include any funds for 

this new program. The budget request includes $5,000,000 for this 

new initiative. Funds would be used to help States improve high 

school graduation rates, transition activities, and post-school outcomes, establish better data collection systems, and analyze and 

use student information. Grants would be made to State educational agencies on a competitive basis. 

The Committee notes that the budget request includes 

$2,000,000 under the demonstration and training program in the 
260 

Rehabilitation Services and Disability Research account to support 

this initiative. Funds are available under that program for this initiative, but the Committee is unable to provide the additional special education funds requested for the new program given budgetary constraints. 

Technical Assistance and Dissemination 

The Committee recommends $49,397,000 for technical assistance 

and dissemination. The comparable fiscal year 2005 funding level 

is $52,396,000 and the budget request is $49,397,000 for these activities. This program supports awards for technical assistance, 

model demonstration projects, the dissemination of useful information and other activities. Funding supports activities that are designed to improve the services provided under IDEA. 

Personnel Preparation 

The Committee recommends $90,626,000 for the personnel preparation program. The comparable fiscal year 2005 funding level 

and the budget request both are $90,626,000 for this program. 

Funds support competitive awards to help address State-identified 

needs for personnel who are qualified to work with children with 

disabilities, including special education teachers and related services personnel. 

The Committee is particularly concerned about the shortage of 

qualified occupational therapists available to work in school systems, to assist children with disabilities, and with the shortage of 

leadership-level faculty to train such professionals. The Committee 

intends that funds be used to address these shortages. 

Parent Information Centers 

The Committee recommends $25,964,000 for parent information 

centers. The comparable fiscal year 2005 funding level and the 

budget request both are $25,964,000 for authorized activities. This 

program makes awards to parent organizations to support parent 

training and information centers, including community parent resource centers. These centers provide training and information to 

meet the needs of parents of children with disabilities living in the 

areas served by the centers, particularly underserved parents, and 

parents of children who may be inappropriately identified. 

Technology and Media Services 

The Committee recommends $38,816,000 for technology and 

media services. The comparable fiscal year 2005 funding level is 

$38,816,000 and the budget request includes $31,992,000 for such 

activities. This program makes competitive awards to support the 

development, demonstration, and use of technology, and educational media activities of value to children with disabilities. 

The Committee recommendation includes $12,000,000 for Recording for the Blind and Dyslexic, Inc. [RFB&D]. These funds support 

the continued production and circulation of recorded textbooks, increased outreach activities to print-disabled students and their 

teachers, and accelerated use of digital technology. The administration proposed eliminating support of RFB&D for these activities. 
261 

The Committee also recommends $1,500,000 to continue support 

of the Reading Rockets program. Last year, this program received 

$1,488,000. The administration proposed eliminating support for 

this program. 

This activity is authorized by section 687(b)(2)(G) of the Individuals with Disabilities Education Act, as amended. The Committee 

recognizes the progress of the Reading Rockets program, which is 

developing a wide range of media resources to disseminate research 

conducted by the National Institutes of Health, as well as other research concerning effective teaching strategies, early diagnosis of, 

and intervention for, young children with reading disabilities. 

These resources include an extensive web site, videos, and programming for television and radio broadcast. The Committee includes funding for the continued development and distribution of 

media resources to reach the parents and teachers of children with 

reading disabilities. 

The Committee notes that, within the budget request, funds are 

available to provide better access to educational media and materials for individuals with disabilities, including activities related to 

the National Instructional Materials Accessibility Standard. The 

Committee supports these efforts, and encourages the Department 

to provide sufficient funds to fulfill the requirements related to this 

standard established by the Individuals with Disabilities Education 

Improvement Act of 2004. 

REHABILITATION SERVICES AND DISABILITY RESEARCH

Appropriations, 2005 ............................................................................. $3,074,574,000 

Budget estimate, 2006 ........................................................................... 3,059,298,000 

House allowance .................................................................................... 3,128,638,000 

Committee recommendation ................................................................. 3,133,638,000 

The Committee recommends $3,133,638,000 for rehabilitation 

services and disability research. The comparable fiscal year 2005 

funding level is $3,074,574,000 and the budget request includes 

$3,059,298,000 for programs in this account. 

The authorizing statute for programs funded in this account, except for those authorized under the Assistive Technology Act, expired September 30, 2004. The program descriptions provided 

below assume the continuation of current law. 

The Committee recognizes the importance, efficiency, and return 

on the taxpayer dollar of community rehabilitation programs and 

other nonprofit organizations in providing support for people with 

disabilities. The Committee urges the Rehabilitation Services Administration to support the utilization of community rehabilitation 

programs to the maximum extent possible in the delivery of employment and other support services to people with disabilities. 

Vocational Rehabilitation State Grants 

The Committee provides $2,720,192,000 for vocational rehabilitation grants to States. The Committee recommendation provides the 

full amount authorized by the Rehabilitation Act of 1973. The comparable funding level for fiscal year 2005 is $2,635,845,000. 

Basic State grant funds assist States in providing a range of 

services to help persons with physical and mental disabilities prepare for and engage in meaningful employment. Authorizing legis-
262 

lation requires States to give priority to persons with the most significant disabilities. Funds are allotted to States based on a formula that takes into account population and per capita income. 

States must provide a 21.3 percent match of Federal funds, except 

the State’s share is 50 percent for the cost of construction of a facility for community rehabilitation program purposes. 

The Rehabilitation Act requires that no less than 1 percent and 

not more than 1.5 percent of the appropriation in fiscal year 2006 

for vocational rehabilitation State grants be set aside for grants for 

Indians. Service grants are awarded to Indian tribes on a competitive basis to help tribes develop the capacity to provide vocational 

rehabilitation services to American Indians with disabilities living 

on or near reservations. 

Client Assistance 

The Committee recommends $11,901,000 for the client assistance 

program. The comparable fiscal year 2005 funding level and the 

budget request both are $11,901,000 for authorized activities. 

The client assistance program funds State formula grants to assist vocational rehabilitation clients or client applicants in understanding the benefits available to them and in their relationships 

with service providers. Funds are distributed to States according to 

a population-based formula, except that increases in minimum 

grants are guaranteed to each of the 50 States, the District of Columbia, and Puerto Rico, and guaranteed to each of the outlying 

areas, by a percentage not to exceed the percentage increase in the 

appropriation. States must operate client assistance programs in 

order to receive vocational rehabilitation State grant funds. 

Training 

The Committee recommends $38,826,000 for training rehabilitation personnel. The comparable fiscal year 2005 funding level and 

the budget request both are $38,826,000 for training activities. 

The purpose of this program is to ensure that skilled personnel 

are available to serve the rehabilitation needs of individuals with 

disabilities. It supports training, traineeships, and related activities 

designed to increase the numbers of qualified personnel providing 

rehabilitation services. The program awards grants and contracts 

to States and public or nonprofit agencies and organizations, including institutions of higher education, to pay all or part of the 

cost of conducting training programs. Long-term, in-service, shortterm, experimental and innovative, and continuing education programs are funded, as well as special training programs and programs to train interpreters for persons who are deaf, hard of hearing and deaf-blind. 

Demonstration and Training Programs 

The Committee bill includes $6,577,000 for demonstration and 

training programs for persons with disabilities. The comparable fiscal year 2005 funding level is $25,607,000 and the budget request 

includes $6,577,000 for authorized activities. This program awards 

grants to States and nonprofit agencies and organizations to develop innovative methods and comprehensive services to help individuals with disabilities achieve satisfactory vocational outcomes. 
263 

Demonstration programs support projects for individuals with a 

wide array of disabilities. 

The Committee is pleased with the partnership between RSA 

and the American Academy of Orthotists and Prosthetists to support and improve the quality of applied orthotic and prosthetic research and help meet the increasing demand for provider services. 

The Committee has provided sufficient funds to support this partnership at its current level. Funds are to be used to further develop 

the orthotic and prosthetic awareness campaign, which includes an 

educational outreach initiative designed to recruit and retain professionals. Funds also will continue to support a series of consensus 

conferences and the dissemination of best practices to the field. 

Migrant and Seasonal Farmworkers 

The Committee recommends $2,302,000 for migrant and seasonal 

farmworkers, the same amount as the comparable fiscal year 2005 

funding level. The Department proposes eliminating separate funding for this program. 

This program provides grants limited to 90 percent of the costs 

of the projects providing comprehensive rehabilitation services to 

migrant and seasonal farm workers with disabilities and their families. Projects also develop innovative methods for reaching and 

serving this population. The program emphasizes outreach, specialized bilingual rehabilitation counseling, and coordination of vocational rehabilitation services with services from other sources. 

Recreational Programs 

The Committee provides $2,543,000 for recreational programs, 

the same amount as the comparable fiscal year 2005 funding level. 

The budget request does not include funding for this program. 

Recreational programs help finance activities such as sports, 

music, dancing, handicrafts, and art to aid in the employment, mobility, and socialization of individuals with disabilities. Grants are 

awarded to States, public agencies, and nonprofit private organizations, including institutions of higher education. Grants are awarded for a 3-year period with the Federal share at 100 percent for the 

first year, 75 percent for the second year, and 50 percent for the 

third year. Programs must maintain the same level of services over 

the 3-year period. 

Protection and Advocacy of Individual Rights 

The Committee recommends $16,656,000 for protection and advocacy of individual rights. The comparable fiscal year 2005 funding 

level and the budget request both are $16,656,000. 

This program provides grants to agencies to protect and advocate 

for the legal and human rights of persons with disabilities who are 

not eligible for protection and advocacy services available through 

the Developmental Disabilities Assistance and Bill of Rights Act or 

the Protection and Advocacy for Individuals with Mental Illness 

Act. 

Projects with Industry 

The Committee recommends $19,735,000 for projects with industry. The comparable fiscal year 2005 funding level is $21,625,000 
264 

and the administration proposes eliminating separate funding for 

this program. 

The projects with industry [PWI] program promotes greater participation of business and industry in the rehabilitation process. 

PWI provides training and experience in realistic work settings to 

prepare individuals with disabilities for employment in the competitive job market. Postemployment support services are also provided. The program supports grants to a variety of agencies and organizations, including corporations, community rehabilitation programs, labor and trade associations, and foundations. 

Supported Employment State Grants 

The Committee’s bill includes $30,000,000 for the supported employment State grant program. The comparable fiscal year 2005 

funding level is $37,379,000 and the administration proposes eliminating separate funding for this program. 

This program assists the most severely disabled individuals by 

providing the ongoing support needed to obtain competitive employment. Short-term vocational rehabilitation services are augmented 

with extended services provided by State and local organizations. 

Federal funds are distributed on the basis of population. 

Independent Living State Grants 

The Committee recommends $22,816,000 for independent living 

State grants. The comparable funding level for fiscal year 2005 and 

the budget request both are $22,816,000 for authorized activities. 

The independent living State formula grants program provides 

funding to improve independent living services, support the operation of centers for independent living, conduct studies and analysis, and provide training and outreach. 

Independent Living Centers 

The Committee recommends $75,392,000 for independent living 

centers. The comparable fiscal year 2005 funding level and the 

budget request both are $75,392,000 for the centers. 

These funds support consumer-controlled, cross-disability, nonresidential, community-based centers that are designed and operated within local communities by individuals with disabilities. 

These centers provide an array of independent living services. 

Independent Living Services for Older Blind Individuals 

The Committee provides $33,227,000 for independent living services to older blind individuals. The comparable fiscal year 2005 

funding level and the budget request both are $33,227,000 for these 

activities. Through this program, assistance is provided to persons 

aged 55 or older to adjust to their blindness, continue living independently and avoid societal costs associated with dependent care. 

Services may include the provision of eyeglasses and other visual 

aids, mobility training, braille instruction and other communication 

services, community integration, and information and referral. 

These services help older individuals age with dignity, continue to 

live independently and avoid significant societal costs associated 

with dependent care. The services most commonly provided by this 

program are daily living skills training, counseling, the provision of 
265 

low-vision devices community integration, information and referral, 

communication devices, and low-vision screening. 

The Committee notes that there are 5 million Americans in this 

country age 55 and older who are experiencing vision loss and that 

the number of Americans in this category is expected to double in 

the next 30 years. The Committee recognizes the very important 

and cost-effective work carried out through this program. By allowing older individuals to remain in their homes and communities, 

substantial savings are achieved. 

Program Improvement Activities 

The Committee recommends $843,000 for program improvement 

activities. The comparable fiscal year 2005 funding level and the 

budget request both are $843,000 for authorized activities. In fiscal 

year 2006, funds for these activities will continue to support technical assistance efforts to improve the efficiency and effectiveness 

of the vocational rehabilitation program and improve accountability 

efforts. The funds provided are sufficient to support technical assistance and other ongoing program improvement activities, such 

as improved program performance measurement. 

Evaluation 

The Committee recommends $1,488,000 for evaluation activities. 

The comparable fiscal year 2005 funding level and the budget request both are $1,488,000 for such activities. 

These funds support evaluations of the impact and effectiveness 

of programs authorized by the Rehabilitation Act. The Committee 

recommendation continues to support a new multi-year study of 

the State Vocational Rehabilitation Services program. The Department awards competitive contracts for studies to be conducted by 

persons not directly involved with the administration of Rehabilitation Act programs. 

Helen Keller National Center 

The Committee recommends $8,597,000 for the Helen Keller National Center for Deaf-Blind Youth and Adults. The comparable fiscal year 2005 funding level is $10,581,000 and the budget request 

includes $8,597,000 for this purpose. The difference between fiscal 

year 2005 funding and the Committee recommendation relates to 

earmarked funds provided in the Consolidated Appropriations Act, 

2005. These funds are still available for expenditure and it is estimated it could take another 2 years before they are exhausted. 

The Helen Keller National Center consists of a national headquarters in Sands Point, NY, with a residential training and rehabilitation facility where deaf-blind persons receive intensive specialized services; a network of 10 regional field offices which provide referral and counseling assistance to deaf-blind persons; and 

an affiliate network of agencies. At the recommended level, the center would serve more than 110 persons with deaf-blindness at its 

headquarters facility and provide field services to approximately 

2,500 individuals and families and approximately 1,100 organizations. 
266 

National Institute on Disability and Rehabilitation Research 

The Committee recommends $107,783,000 for the National Institute on Disability and Rehabilitation Research [NIDRR]. The comparable fiscal year 2005 funding level and the budget request both 

are $107,783,000 for authorized activities. 

NIDRR develops and implements a comprehensive and coordinated approach to the conduct of research, demonstration projects, 

and related activities that enable persons with disabilities to better 

function at work and in the community, including the training of 

persons who provide rehabilitation services or who conduct rehabilitation research. The Institute awards competitive grants to support research in federally designated priority areas, including rehabilitation research and training centers, rehabilitation engineering 

research centers, research and demonstration projects, and dissemination and utilization projects. NIDRR also supports field-initiated research projects, research training, and fellowships. The Committee recommendation includes $11,863,000, as proposed in the budget request, for NIDRR’s spinal cord injury model 

systems projects. The Committee intends that these funds should 

be used to support investments that would facilitate multi-center 

research and encourages NIDRR to continue its collaboration with 

other Federal agencies in order to leverage Federal investments in 

this area. 

Assistive Technology 

The Committee recommends $34,760,000 for assistive technology. The comparable fiscal year 2005 funding level is $29,760,000. The 

budget request includes $15,000,000 solely for the alternative financing program. 

The Assistive Technology program is designed to improve occupational and educational opportunities and the quality of life for people of all ages with disabilities through increased access to assistive 

technology services and devices. The program support various activities that help States to develop comprehensive, consumer-responsive statewide programs that increase access to, and the availability of, assistive technology devices and services. Under the recent reauthorization, the administration of this program was 

moved to the Rehabilitation Services Administration from the National Institute on Disability and Rehabilitation Research. The reauthorization also requires that an annual report be submitted to 

Congress by December 31 of each year. The Committee recommendation includes $25,300,000 for State 

grant activities authorized under section 4, $4,500,000 for protection and advocacy systems authorized by section 5, and $1,200,000 

for technical assistance activities authorized under section 6. 

The Committee recommendation also includes $3,760,000 for the 

alternative financing program. The Committee recommendation includes bill language requested by the administration designed to 

encourage States to support alternative financing programs. These 

changes allow States to receive less than $500,000 for an award, 

require a match of 25 percent and enable States to receive more 

than one grant. The Committee urges the Department to ensure 

that grantees design and operate their programs in a consumer-directed fashion. The Committee also urges the Department to utilize 
267 

these funds to expand the number of States operating alternative 

financing programs. 

SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES

AMERICAN PRINTING HOUSE FOR THE BLIND

Appropriations, 2005 ............................................................................. $16,864,000 

Budget estimate, 2006 ........................................................................... 16,864,000 

House allowance .................................................................................... 17,000,000 

Committee recommendation ................................................................. 18,500,000 

The Committee recommends $18,500,000 for the American Printing House for the Blind [APH]. The comparable fiscal year 2005 

funding level is $16,864,000 and the budget request includes 

$16,864,000 for this purpose. 

This appropriation helps support the American Printing House 

for the Blind, which provides educational materials to students who 

are legally blind and enrolled in programs below the college level. 

The Federal subsidy provides almost 60 percent of APH’s total 

sales income. Materials are distributed free of charge to schools 

and States through per capita allotments based on the total number of students who are blind. Materials provided include textbooks 

and other educational aids in braille, large type, and recorded form 

and microcomputer applications. Appropriated funds may be used 

for staff salaries and expenses, as well as equipment purchases and 

other acquisitions consistent with the purpose of the Act to Promote the Education of the Blind. 

In addition to its ongoing activities, the Individuals with Disabilities Education Improvement Act assigned to the American Printing House for the Blind the responsibility of establishing and maintaining a National Instructional Materials Access Center. The Center will serve as a national clearinghouse, maintaining a repository 

of textbook files provided in the National Instructional Materials 

Accessibility Standard format by textbook publishers. The Center 

will manage the transfer of these files to State Education Agencies 

for production in media that are readily accessible to the blind, visually impaired, and print disabled. The Committee supports this effort, and encourages the Department to provide sufficient funds to 

fulfill the requirements of the law. 

NATIONAL TECHNICAL INSTITUTE FOR THE DEAF

Appropriations, 2005 ............................................................................. $55,344,000 

Budget estimate, 2006 ........................................................................... 54,472,000 

House allowance .................................................................................... 56,137,000 

Committee recommendation ................................................................. 57,279,000 

The Committee recommends $57,279,000 for the National Technical Institute for the Deaf [NTID]. The comparable fiscal year 

2005 funding level is $55,344,000 and the budget request includes 

$54,472,000 for this purpose. 

The Institute, located on the campus of the Rochester Institute 

of Technology, was created by Congress in 1965 to provide a residential facility for postsecondary technical training and education 

for persons who are deaf. NTID also provides support services for 

students who are deaf, trains professionals in the field of deafness, 

and conducts applied research. Within the amount provided, 
268 

$800,000 is for construction. At the discretion of the Institute, 

funds may be used for the Endowment Grant program. 

GALLAUDET UNIVERSITY

Appropriations, 2005 ............................................................................. $104,557,000 

Budget estimate, 2006 ........................................................................... 104,557,000 

House allowance .................................................................................... 107,657,000 

Committee recommendation ................................................................. 108,500,000 

The Committee recommends $108,500,000 for Gallaudet University. The comparable fiscal year 2005 funding level and the budget 

request both are $104,557,000 for the university. 

Gallaudet University is a private, nonprofit institution offering 

undergraduate, and continuing education programs for students 

who are deaf, as well as graduate programs in fields related to 

deafness for students who are hearing-impaired and who are deaf. 

The University conducts basic and applied research related to hearing impairments and provides public service programs for the deaf 

community. 

The Model Secondary School for the Deaf serves as a laboratory 

for educational experimentation and development, disseminates 

models of instruction for students who are deaf, and prepares adolescents who are deaf for postsecondary academic or vocational education. The Kendall Demonstration Elementary School develops 

and provides instruction for children from infancy through age 15. 

The Committee recommendation includes funding to enable Gallaudet University to continue to offer competitive pay increases for 

faculty and staff, support investments in information technology 

and address other cost increases and program improvements. 

Funds also are available, at the discretion of the University, for the 

Endowment Grant program. 

VOCATIONAL AND ADULT EDUCATION

Appropriations, 2005 ............................................................................. $2,037,733,000 

Budget estimate, 2006 ........................................................................... 215,734,000 

House allowance .................................................................................... 1,991,782,000 

Committee recommendation ................................................................. 1,923,766,000 

The Committee recommendation includes a total of 

$1,923,766,000 for vocational and adult education, consisting of 

$1,309,400,000 for vocational education, $585,406,000 for adult 

education and $28,960,000 for other activities. The comparable 

funding level in fiscal year 2005 is $2,037,733,000 and the budget 

request includes $215,734,000 for this account. 

The authorizing statute for vocational and adult education programs and the State grants for incarcerated youth offenders program funded in this account expired September 30, 2004. Descriptions for these programs provided below assume the continuation 

of current law. 

VOCATIONAL EDUCATION

The Committee recommends $1,309,400,000 for vocational education. The comparable fiscal year 2005 funding level is 

$1,326,107,000 and the budget request does not include any funds 

for these activities. The administration proposed to redirect the 

funds currently allocated for vocational education to a new High 
269 

School initiative. The Committee notes that this initiative has not 

been acted on by the appropriate authorizing committees of Congress. 

Basic Grants.—The Committee recommends $1,194,331,000 for 

basic grants, the same amount as the comparable fiscal year 2005 

funding level. The budget request does not include any funds for 

this purpose. Funds provided under the State grant program assist 

States, localities, and outlying areas to expand and improve their 

programs of vocational education and provide equal access to vocational education for populations with special needs. Persons assisted range from secondary students in prevocational courses 

through adults who need retraining to adapt to changing technological and labor market conditions. Funds are distributed according to a formula based on State population and State per capita income. 

Under the Indian and Hawaiian Natives programs, competitive 

grants are awarded to federally recognized Indian tribes or tribal 

organizations and to organizations primarily serving and representing Hawaiian Natives for services that are in addition to 

services such groups are eligible to receive under other provisions 

of the Perkins Act. 

Of the funds available for this program, $403,331,000 will be- come available on July 1, 2006 and $791,000,000 will become available on October 1, 2006. These funds will remain available for obligation until September 30, 2007. 

Tech-Prep Education.—The Committee recommends $105,812,000 

for tech-prep programs. The comparable fiscal year 2005 funding 

level is $105,812,000 and the budget request proposes to eliminate 

funding for this program. This program is designed to link academic and vocational learning and to provide a structured link between secondary schools and postsecondary education institutions. 

Funds are distributed to the States through the same formula as 

the basic State grant program. States then make planning and 

demonstration grants to consortia of local educational agencies and 

postsecondary institutions to develop and operate model 4-year programs that begin in high school and provide students with the 

mathematical, science, communication, and technological skills 

needed to earn a 2-year associate degree or 2-year certificate in a 

given occupational field. 

National Programs, Research.—The Committee recommends 

$9,257,000 for national research programs and other national activities. The comparable fiscal year 2005 funding level is 

$11,757,000 and the budget request proposes to eliminate separate 

funding for this program. The Committee recommendation maintains the current spending on national programs because 

$2,500,000 has been utilized under this appropriation for the State 

Scholars program. Funding for State Scholars was requested under 

the Fund for the Improvement of Education. 

Funds provided under this program support research, development, dissemination, evaluation and assessment designed to improve the quality and effectiveness of vocational and technical education. Funds have been provided to the National Research Center 

for Career and Technical Education and the National Dissemination Center for Career and Technical Education to conduct research 
270 

and provide technical assistance to vocational educators. The results of the applied research done by these Centers inform technical assistance to reform and improve vocational education instruction in schools and colleges. Resources made available through 

this program also are used to support a variety of activities to identify and promote effective research-based programs and practice in 

vocational education. 

Tech-Prep Education Demonstration Program.—The Committee 

recommendation does not include additional funding for this program. The comparable fiscal year 2005 funding level is $4,900,000 

and the budget request proposes to eliminate funding for this program. Under this demonstration authority, the Secretary has 

awarded grants competitively to consortia that involve a business 

as a member, locate a secondary school on the site of a community 

college, and seek voluntary participation of secondary school students enrolled such a high school. The purpose of the demonstration program is to support development of the ‘‘middle college’’ 

model of high school, which promotes higher student achievement 

and postsecondary enrollment. Funds have been used for curriculum, professional development, equipment, and other start-up 

and operational costs. 

The Committee notes that evaluations for the first round of funded grantees will be available this year. The Committee urges the 

Department to identify effective programs from these projects that 

have positive findings, based on rigorous evaluations, and disseminate them to States, so they can further benefit from the investment made in this program. 

Occupational and Employment Information Program.—The Committee does not recommend additional funds for activities authorized by section 118 of the Carl Perkins Act. The comparable fiscal 

year 2005 funding level is $9,307,000, and the budget request proposes to eliminate this program. The Act requires that at least 85 

percent of the amount appropriated be provided directly to State 

entities to develop and deliver occupational and career information 

to students, job seekers, employers, education, employment and 

training programs. 

ADULT EDUCATION

The Committee recommends $585,406,000 for adult education, 

the same amount as the comparable fiscal year 2005 funding level. 

The budget request includes $215,734,000 for this purpose. 

Adult Education State Programs.—For adult education State programs, the Committee recommends $569,672,000, the same amount 

as the comparable fiscal year 2005 funding level. The budget request includes $200,000,000 for authorized activities. These funds 

are used by States for programs to enable economically disadvantaged 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. 

The Committee recommendation continues the English literacy 

and civics education State grants set aside within the Adult Education State grant appropriation. Within the total, $68,582,000 is 

available to help States or localities affected significantly by immi-
271 

gration and large limited-English populations to implement programs that help immigrants acquire English literacy skills, gain 

knowledge about the rights and responsibilities of citizenship and 

develop skills that will enable them to navigate key institutions of 

American life. 

The Committee is pleased with the progress States are making 

in reporting on and improving performance outcomes generated by 

this program and urges the Department to continue to work with 

States to assist them in these efforts. The Commmittee recognizes 

the diverse population eligible for services under this program, 

ranging from adults striving to complete their secondary education 

to workers requiring better English skills to benefit from employerprovided job training and to grandparents desiring the skills necessary to help grandchildren to learn to read. The Committee also 

notes that while some participants cite employment as their reason 

for enrolling in an adult education program, many program participants do not establish this as a goal. Furthermore, even if employment is a goal, increased earnings might not be associated with the 

career goals of the more than one-third of adult education participants currently employed. Therefore, the Committee has recommended level funding for this program, and urges the Department to consider these facts when assessing program performance 

under the Adult Education program and the appropriateness of including this education program under the Administration’s initiative to identify common measures for job training and employment 

programs. 

National Activities.—The Committee recommends $9,096,000 for 

national leadership activities. The comparable funding level for fiscal year 2005 and the budget request both are $9,096,000 for this 

purpose. Under this program, the Department supports applied research, development, dissemination, evaluation and program improvement activities to assist States in their efforts to improve the 

quality of adult education programs. 

National Institute for Literacy.—The Committee recommends 

$6,638,000 for the National Institute for Literacy, authorized under 

section 242 of the Adult Education and Family Literacy Act. The 

comparable fiscal year 2005 funding level and the budget request 

both are $6,638,000 for this purpose. The Institute provides leadership and coordination for national literacy efforts by conducting research and demonstrations on literacy, establishing and maintaining a national center for adult literacy and learning disabilities, 

and awarding fellowships to outstanding individuals in the field to 

conduct research activities under the auspices of the Institute. 

Smaller Learning Communities 

The Committee does not recommend additional funds for this 

program. The comparable fiscal year 2005 funding level is 

$94,476,000 and the budget request does not include any funds for 

this purpose. This program has supported competitive grants to 

local educational agencies to enable them to create smaller learning 

communities in large schools. Funds have been used to study, research, develop and implement strategies for creating smaller 

learning communities, as well as professional development for staff. 

Two types of grants were made under this program: 1-year plan-
272 

ning grants, which help LEAs plan smaller learning communities 

and 3-year implementation grants, which help create or expand 

such learning environments. 

The Committee notes that the fiscal year 2004 and 2005 appropriations are still available for obligation and the Department 

lapsed more than $26,000,000 from the fiscal year 2003 appropriation because of a lack of fundable applications. 

Community Technology Centers 

The Committee recommends $4,960,000 for community technology centers, the same amount as the comparable funding level 

for fiscal year 2005. The budget request proposes to eliminate funding for this program. Community technology centers provide disadvantaged residents of economically distressed urban and rural 

communities with access to information technology and related 

training. They can provide, among other things, preschool and 

after-school programs, adult education and literacy, and workforce 

development and training. 

State Grants for Incarcerated Youth Offenders 

The Committee has included $24,000,000 for education and 

training for incarcerated youth offenders. The comparable funding 

level for fiscal year 2005 is $21,824,000. The Administration proposes to eliminate funding for these activities. This program provides grants to State correctional education agencies to assist and 

encourage incarcerated youth to acquire functional literacy, life and 

job skills, through the pursuit of a postsecondary education certificate or an associate of arts or bachelor’s degree. Grants also assist 

correction agencies in providing employment counseling and other 

related services that start during incarceration and continue 

through prerelease and while on parole. Under current law, each 

student is eligible for a grant of not more than $1,500 annually for 

tuition, books, and essential materials, and not more than $300 annually for related services such as career development, substance 

abuse counseling, parenting skills training, and health education. 

In order to participate in a program, a student must be no more 

than 25 years of age and be eligible to be released from prison 

within 5 years. Youth offender grants are for a period not to exceed 

5 years, 1 year of which may be devoted to study in remedial or 

graduate education. 

The Committee expects the Department to administer this program through the Office of Correctional Education within the Office of Vocational and Adult Education. The Committee notes that 

this would be consistent with the Department’s recent reorganization, which designated the Under Secretary with the authority to 

coordinate the efforts of postsecondary programs and initiatives. 

Literacy Programs for Prisoners 

The Committee recommendation does not include funds for this 

program. The comparable funding level for fiscal year 2005 is 

$4,960,000 and the budget request does not include any funds for 

this purpose. Under this program, grants have been made to State 

and local correctional education agencies and correctional education 

agencies to establish and operate programs that develop and im-
273 

prove the life skills of prisoners so they may more effectively reintegrate into society. 

STUDENT FINANCIAL ASSISTANCE

Appropriations, 2005 ............................................................................. $14,265,749,000 

Budget estimate, 2006 ........................................................................... 15,050,977,000 

House allowance .................................................................................... 15,283,752,000 

Committee recommendation ................................................................. 15,103,795,000 

The Committee recommends an appropriation of $15,103,795,000 

for student financial assistance. The comparable fiscal year 2005 

funding level is $14,265,749,000 and the budget request includes 

$15,050,977,000 for this purpose. 

Programs in this account are authorized through September 30, 

2005. Program authorities and descriptions assume the continuation of current law. 

Federal Pell Grant Program 

For Pell grant awards in the 2006–2007 academic year, the Committee recommends $13,177,000,000 to maintain the record maximum Pell Grant award level of $4,050. The Committee is very supportive of the President’s proposal to increase the Pell Grant maximum award using mandatory funds. This proposal would have 

guaranteed $100 increases in the Pell Grant maximum award for 

each of the next 5 years. Unfortunately, the Budget Resolution rejected this proposal and proposed that an increase in the maximum 

award should compete against funding for other student aid programs, vocational and technical education and other activities 

funded in this bill. The Committee encourages the Administration 

to make this worthwhile proposal again next year and take necessary action to ensure its adoption. 

Pell grants provide need-based financial assistance that helps 

low- and middle-income undergraduate students and their families 

defray a portion of the costs of postsecondary education and vocational training. Awards are determined according to a statutory 

need analysis formula that takes into account a student’s family income and assets, household size, and the number of family members, excluding parents, attending postsecondary institutions. Pell 

grants are considered the foundation of Federal postsecondary student aid. 

The Committee has deferred action on the proposed enhanced 

Pell grants for State scholars program. This program is not currently authorized. The budget request includes $33,000,000 to provide additional Pell grant support to students completing specific 

challenging coursework while in secondary school. 

The Committee bill also includes language in section 305 of the 

general provisions to pay off the estimated $4,300,000,000 accumulated shortfall in the Pell Grant program. The administration provided mandatory funds within its budget request for this purpose. 

These funds are provided pursuant to section 303 of the Concurrent 

Resolution on the Budget for fiscal year 2006 (H. Con. Res. 95, 

House Report 109–62) and are not reflected in the totals for this 

program or account. 
274 

Federal Supplemental Educational Opportunity Grants 

The Committee recommends $804,763,000 for Federal supplemental educational opportunity grants [SEOG]. The comparable fiscal year 2005 funding level and the budget request both are 

$778,720,000 for this purpose. This program provides funds to postsecondary institutions for need-based grants to undergraduate students. Institutions must contribute 25 percent towards SEOG 

awards, which are subject to a maximum grant level of $4,000. 

School financial aid officers have flexibility to determine student 

awards, though they must give priority to Pell grant recipients. 

Federal Work-Study Programs 

The Committee bill provides $990,257,000 for the Federal workstudy program, the same amount as both the comparable fiscal 

year 2005 funding level and the budget request. 

This program provides grants to more than 3,300 institutions to 

help an estimated 800,000 undergraduate, graduate, and professional students meet the costs of postsecondary education through 

part-time employment. Work-study jobs must pay at least the Federal minimum wage and institutions must provide at least 25 percent of student earnings. Institutions also must use at least 7 percent of their grants for community-service jobs. 

The Committee strongly supports continued funding for the work 

colleges program authorized in section 448 of the Higher Education 

Act of 1965. These funds help support comprehensive work-service 

learning programs at seven work colleges, and cooperative efforts 

among the work colleges to expose other institutions of higher education to the work college concept. Of the amount recommended by 

the Committee, $6,000,000 is available for this program. 

Federal Perkins Loans 

The Committee bill does not include additional funds for Federal 

Perkins loans capital contributions. The comparable fiscal year 

2005 funding level did not include such funds and the budget request does not provide any funds for this purpose. 

The Federal Perkins loan program supports student loan revolving funds built up with capital contributions to nearly 1,900 participating institutions. Institutions use these revolving funds, 

which also include Federal capital contributions [FCC], institutional contributions equal to one-third of the FCC, and student repayments, to provide low-interest (5 percent) loans that help financially needy students pay the costs of postsecondary education. The Committee recommends $66,132,000 for loan cancellations, 

the same amount as the comparable funding level for fiscal year 

2005. The budget request did not include any funds for this purpose. These funds reimburse institutional revolving funds on behalf 

of borrowers whose loans are cancelled in exchange for statutorily 

specified types of public or military service, such as teaching in a 

qualified low-income school, working in a Head Start Program, 

serving in the Peace Corps or VISTA, or nurses and medical technicians providing health care services. 

The Committee recommendation will maintain a robust loan program that will support more than $1,100,000,000 in loans to more 

than 550,000 individuals. 
275 

Presidential Math and Science Scholars 

The Committee recommendation does not include funds for this 

new program. The budget request includes $50,000,000 for this 

purpose, based on proposed legislation. 

This proposed program would support a public-private partnership designed to provide grant aid to low-income math and science 

students. Grants of up to $5,000 for each eligible student would be 

available through this proposed partnership. 

Leveraging Educational Assistance Partnership Program 

For the leveraging educational assistance partnership [LEAP] 

program, the Committee recommends $65,643,000, the same 

amount as the comparable funding level for fiscal year 2005. The 

budget proposes to eliminate funding for this program. 

The leveraging educational assistance partnership program provides a Federal match to States as an incentive for providing needbased grant and work-study assistance to eligible postsecondary 

students. When the appropriation exceeds $30,000,000, amounts 

above this threshold must be matched by States on a 2:1 basis. 

Federally supported grants and job earnings are limited to $5,000 

per award year for full-time students. 

STUDENT AID ADMINISTRATION

Appropriations, 2005 ............................................................................. $119,084,000 

Budget estimate, 2006 ........................................................................... 939,285,000 

House allowance .................................................................................... 124,084,000 

Committee recommendation ................................................................. 120,000,000 

The Committee recommends $120,000,000 in discretionary resources for the Student Aid Administration account. The comparable fiscal year 2005 discretionary funding level is $119,084,000 

and the budget request includes $939,285,000 in such funding. 

However, the budget request assumes enactment of a proposal to 

rescind mandatory budget authority available in Section 458 of the 

Higher Education Act and to provide these funds through discretionary appropriations. The Committee does not agree with the administration’s legislative proposal to fund this new account solely 

through annual appropriations. 

Funds appropriated for 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 Office of Federal Student Aid and 

Office of Postsecondary Education have primary responsibility for 

administering Federal student financial assistance programs. 

LOANS FOR SHORT-TERM TRAINING

Appropriations, 2005 ............................................................................. ........................... 

Budget estimate, 2006 ........................................................................... $11,000,000 

House allowance .................................................................................... ........................... 

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

The Committee defers action on this program, which is to be established by proposed legislation. The budget request includes 

$11,000,000 for this new activity. Under this proposed program, 

dislocated workers, the unemployed, transitioning and older work-
276 

ers, and students would be eligible to borrow funds to engage in 

training needed to acquire new or upgraded skills through shortterm training programs. Such training programs must lead to an 

industry credential, certificate, or employer-endorsed technical or 

occupational skill. 

HIGHER EDUCATION

Appropriations, 2005 ............................................................................. $2,116,698,000 

Budget estimate, 2006 ........................................................................... 1,202,315,000 

House allowance .................................................................................... 1,936,936,000 

Committee recommendation ................................................................. 2,104,508,000 

The Committee recommends an appropriation of $2,104,508,000 

for higher education programs. The comparable fiscal year 2005 

funding level is $2,116,698,000 and the budget request includes 

$1,202,315,000 for such activities. 

Except for the activities authorized by the Mutual Educational 

and Cultural Exchange Act of 1961, programs in this account are 

authorized through September 30, 2005. Program authorities and 

descriptions assume the continuation of current law. 

Aid for Institutional Development 

The Committee recommends $510,923,000 for aid for institutional development authorized by titles III and V of the Higher 

Education Act. The comparable funding level for fiscal year 2005 

is $507,764,000 and the budget request includes $505,519,000 for 

authorized activities. 

Strengthening Institutions.—The Committee bill includes 

$80,338,000 for the part A strengthening institutions program. The 

comparable fiscal year 2005 funding level and the budget request 

both are $80,338,000 for this activity. The part A program supports 

competitive, 1-year planning and 5-year development grants for institutions with a significant percentage of financially needy students and low educational and general expenditures per student in 

comparison with similar institutions. Applicants may use part A 

funds to develop faculty, strengthen academic programs, improve 

institutional management, and expand student services. Institutions awarded funding under this program are not eligible to receive grants under other sections of part A or part B. 

Hispanic-Serving Institutions [HSI].—The Committee recommends $95,873,000 for institutions at which Hispanic students 

make up at least 25 percent of enrollment. The comparable fiscal 

year 2005 funding level is $95,106,000 and the budget request includes $95,873,000 for these institutions. Institutions applying for 

title V funds must meet the regular part A requirements and show 

that at least one-half of their Hispanic students are low-income college students. Funds may be used for acquisition, rental or lease 

of scientific or laboratory equipment, renovation of instructional facilities, development of faculty, support for academic programs, institutional management, and purchase of educational materials. 

Title V recipients are not eligible for other awards provided under 

title III, parts A and B. 

Strengthening Historically Black Colleges and Universities.—The 

Committee recommends $240,500,000 for part B grants. The comparable fiscal year 2005 funding level is $238,576,000 and the 
277 

budget request includes $240,500,000 for authorized activities. The 

part B strengthening historically black colleges and universities 

[HBCU] program makes formula grants to HBCUs that may be 

used to purchase equipment, construct and renovate facilities, develop faculty, support academic programs, strengthen institutional 

management, enhance fundraising activities, provide tutoring and 

counseling services to students, and conduct outreach to elementary and secondary school students. The minimum allotment is 

$500,000 for each eligible institution. Part B recipients are not eligible for awards under part A. 

Strengthening Historically Black Graduate Institutions.—The 

Committee recommends $58,500,000 for the part B, section 326 

program. The comparable fiscal year 2005 funding level is 

$58,032,000 and the budget request includes $58,500,000 for such 

activities. The section 326 program provides 5-year grants to 

strengthen historically black graduate institutions [HBGIs]. The 

Higher Education Amendments of 1998 increased the number of recipients to 18 named institutions, but reserved the first 

$26,600,000 appropriated each year to the 16 institutions included 

in the previous authorization. Grants may be used for any part B 

purpose and to establish an endowment. 

Strengthening Alaska Native and Native Hawaiian-Serving Institutions.—The Committee recommends $11,904,000 for this program, the same amount as last year. The budget request includes 

$6,500,000 for authorized activities. The purpose of this program is 

to improve and expand the capacity of institutions serving Alaska 

Native and Native Hawaiian students. Funds may be used to plan, 

develop, and implement activities that encourage: faculty and curriculum development; better fund and administrative management; 

renovation and improvement of educational facilities; student services; and the purchase of library and other educational materials. 

As initial funding cycles expire, the Committee encourages the Department to use simplified application forms to permit participating institutions to obtain continuation funding for successful 

programs funded under this program. 

Strengthening Tribally Controlled Colleges and Universities.— 

The Committee recommends $23,808,000 for strengthening tribal 

colleges and universities [TCUs]. The comparable funding level for 

fiscal year 2005 and the budget request both are $23,808,000 for 

this program. Tribal colleges and universities rely on a portion of 

the funds provided to address developmental needs, including faculty development, curriculum and student services. 

International Education and Foreign Language Studies 

The bill includes a total of $106,819,000 for international education and foreign language programs. The comparable fiscal year 

2005 funding level is $106,818,000 and the budget request includes 

$106,819,000 for such activities. 

The Committee bill includes language allowing funds to be used 

to support visits and study in foreign countries by individuals who 

plan to utilize their language skills in world areas vital to the 

United States national security in the fields of government, international development and the professions. Bill language also allows 

up to 1 percent of the funds provided to be used for program eval-
278 

uation, national outreach and information dissemination activities. 

This language is continued from last year’s bill. 

Domestic Programs.—The Committee recommends $92,466,000 

for domestic program activities related to international education 

and foreign language studies, including international business education, under title VI of the HEA. The comparable fiscal year 2005 

funding level is $92,465,000 and the budget request includes 

$92,466,000 for authorized activities. Domestic programs include 

national resource centers, undergraduate international studies and 

foreign language programs, international research and studies 

projects, international business education projects and centers, 

American overseas research centers, language resource centers, foreign language and area studies fellowships, and technological innovation and cooperation for foreign information access. 

Overseas Programs.—The bill includes $12,737,000 for overseas 

programs authorized under the Mutual Educational and Cultural 

Exchange Act of 1961, popularly known as the Fulbright-Hays Act. 

The comparable fiscal year 2005 funding level and the budget request both are $12,737,000 for these programs. Under these overseas programs, grants are provided for group and faculty research 

projects abroad, doctoral dissertation research abroad, and special 

bilateral projects. Unlike other programs authorized by the Fulbright-Hays Act and administered by the Department of State, 

these Department of Education programs focus on training American instructors and students in order to improve foreign language 

and area studies education in the United States. 

Institute for International Public Policy.—The Committee bill recommends $1,616,000 for the Institute for International Public Policy. The comparable funding level for fiscal year 2005 and the 

budget request both are $1,616,000 for authorized activities. This 

program is designed to increase the number of minority individuals 

in foreign service and related careers by providing a grant to a consortium of institutions for undergraduate and graduate level foreign language and international studies. An institutional match of 

50 percent is required. 

Fund for the Improvement of Postsecondary Education 

The Committee recommends $162,211,000 for the Fund for the 

Improvement of Postsecondary Education [FIPSE]. The comparable 

fiscal year 2005 funding level is $162,108,000 and the budget request includes $22,211,000 for this purpose. FIPSE stimulates improvements in education beyond high school by supporting exemplary, locally developed projects that have potential for addressing 

problems and recommending improvements in postsecondary education. The Fund is administered by the Department with advice 

from an independent board and provides small, competitive grants 

and contracts to a variety of postsecondary institutions and agencies, including 2- and 4-year colleges and universities, State education agencies, community-based organizations, and other nonprofit institutions and organizations concerned with education beyond high school. 

The Committee recommendation includes $17,423,000, the full 

amount requested for the comprehensive program, as well as funds 

for international consortia programs. 
279 

Minority Science and Engineering Improvement 

The Committee recommends $8,818,000 for the Minority Science 

and Engineering Improvement program [MSEIP]. The comparable 

fiscal year 2005 funding level and the budget request both are 

$8,818,000 for this program. Funds are used to provide discretionary grants to institutions with minority enrollments greater 

than 50 percent to purchase equipment, develop curricula, and support advanced faculty training. Grants are intended to improve 

science and engineering education programs and increase the number of minority students in the fields of science, mathematics, and 

engineering. 

Interest Subsidy Grants 

The Committee does not recommend additional funds for interest 

subsidy grants. The comparable fiscal year 2005 funding level is 

$1,488,000 and the budget request does not include funds for these 

grants. Unobligated balances from prior year appropriations are 

available to meet the Federal commitment to pay interest subsidies 

on 13 loans made in past years for constructing, renovating, and 

equipping postsecondary academic facilities. No new interest subsidy commitments have been entered into since 1973 but subsidy 

payments on existing loans are expected to continue until the year 

2013. 

Tribally Controlled Postsecondary Vocational Institutions 

The Committee recommends $7,440,000 on a current-funded 

basis for tribally controlled postsecondary vocational institutions. 

The comparable fiscal year 2005 funding level and the budget request both are $7,440,000 for this purpose. This program provides 

grants for the operation and improvement of two tribally controlled 

postsecondary vocational institutions to ensure continued and expanding opportunities for Indian students: United Tribes Technical 

College in Bismarck, North Dakota, and Crownpoint Institute of 

Technology in Crownpoint, New Mexico. 

The Committee bill includes language carried over from last 

year’s bill that allows grantees to charge the regular indirect cost 

rate to their grants. 

Federal TRIO Programs 

The Committee recommends $836,543,000 for Federal TRIO Programs. The comparable fiscal year 2005 funding level is 

$836,543,000 and the budget request includes $369,390,000 for authorized activities. The budget request redirects the savings from 

the reduction proposed for TRIO programs to provide support for 

a proposed High School initiative. 

TRIO programs provide a variety of services to improve postsecondary education opportunities for low-income individuals and 

first-generation college students: Upward Bound offers disadvantaged high school students academic services to develop the skills 

and motivation needed to continue their education; Student Support Services provides remedial instruction, counseling, summer 

programs and grant aid to disadvantaged college students to help 

them complete their postsecondary education; Talent Search identifies and counsels individuals between ages 11 and 27 regarding op-
280 

portunities for completing high school and enrolling in postsecondary education; Educational Opportunity Centers provide information and counseling on available financial and academic assistance to low-income adults who are first-generation college students; 

and the Ronald E. McNair Postbaccalaureate Achievement Program supports research internships, seminars, tutoring, and other 

activities to encourage disadvantaged college students to enroll in 

graduate programs. 

Gaining Early Awareness and Readiness for Undergraduate Programs [GEARUP] 

The Committee recommends $306,488,000 for GEARUP. The 

comparable fiscal year 2005 funding level is $306,488,000 and the 

budget request does not include any funds for this purpose. The 

budget proposes to redirect these funds to provide support for a 

proposed High School intiative. 

Under this program funds are used by States and partnerships 

of colleges, middle and high schools, and community organizations 

to assist middle and high schools serving a high percentage of lowincome students. Services provided help students prepare for and 

pursue a postsecondary education. 

Byrd Honors Scholarships 

The Committee recommends $41,000,000 for the Byrd honors 

scholarship program. The comparable fiscal year 2005 funding level 

is $40,672,000 and the budget request does not include any funds 

for this program. 

The Byrd honors scholarship program is designed to promote student excellence and achievement and to recognize exceptionally 

able students who show promise of continued excellence. Funds are 

allocated to State education agencies based on each State’s schoolaged population. The State education agencies select the recipients 

of the scholarships in consultation with school administrators, 

teachers, counselors, and parents. The funds provided will support 

a new cohort of first-year students in 2006, and continue support 

for the 2003, 2004, and 2005 cohorts of students in their fourth, 

third and second years of study, respectively. The amount recommended will provide scholarships of $1,500 to 27,333 students. 

Javits Fellowships 

The Committee recommends $9,797,000 for the Javits Fellowships program. The comparable fiscal year 2005 funding level and 

the budget request both are $9,797,000 for this program. 

The Javits Fellowships program provides fellowships of up to 4 

years to students of superior ability who are pursuing doctoral degrees in the arts, humanities, and social sciences at any institution 

of their choice. Each fellowship consists of a student stipend to 

cover living costs, and an institutional payment to cover each fellow’s tuition and other expenses. Funds provided in the fiscal year 

2006 appropriation support fellowships for the 2007–2008 academic 

year. 
281 

Graduate Assistance in Areas of National Need [GAANN] 

The Committee recommends $30,371,000 for graduate assistance 

in areas of national need. The comparable fiscal year 2005 funding 

level and the budget request both are $30,371,000 for GAANN. 

This program awards competitive grants to graduate academic departments and programs for fellowship support in areas of national 

need as determined by the Secretary. In fiscal year 2004, the Secretary designated the following areas of national need: biology, 

chemistry, computer and information sciences, engineering, geological and related sciences, mathematics and physics. Recipients must 

demonstrate financial need and academic excellence, and seek the 

highest degree in their fields. 

Teacher Quality Enhancement Grants 

The Committee recommends $58,000,000 for the teacher quality 

enhancement grants program. The comparable fiscal year 2005 

funding level is $68,337,000 and the budget request proposes to 

eliminate funding for this program. 

The program was established to support initiatives that best 

meet specific teacher preparation and recruitment needs. Further, 

the Act provides and designates funding for the program in three 

focus areas: 45 percent of resources support a State grant program, 

45 percent of funds are used for a partnership program, and 10 

percent are designated for a recruitment grant program. 

The Committee bill includes language that would allow the Department to fund awards under the three program areas at the discretion of the Department, instead of as mandated by the Higher 

Education Act. The Committee continues this language from last 

year’s bill in order to prevent funds available under this program 

from going unused. 

Under the State grant program, funds may be used for a variety 

of State-level reforms, including more rigorous teacher certification 

and licensure requirements; provision of high-quality alternative 

routes to certification; development of systems to reward high-performing teachers and principals; and development of efforts to reduce the shortage of qualified teachers in high-poverty areas. 

Teacher training partnership grants, which are awarded to local 

partnerships comprised of at least one school of arts and science, 

one school or program of education, a local education agency, and 

a K–12 school, may be used for a variety of activities designed to 

improve teacher preparation and performance, including efforts to 

provide increased academic study in a proposed teaching specialty 

area; to prepare teachers to use technology effectively in the classroom; to provide preservice clinical experiences; and to integrate reliable research-based teaching methods into the curriculum. Partnerships may work with other entities, with those involving businesses receiving priority consideration. Partnerships are eligible to 

receive a one-time-only grant to encourage reform and improvement at the local level. 

The recruitment grant program supports efforts to reduce shortages of qualified teachers in high-need school districts as well as 

provide assistance for high-quality teacher preparation and induction programs to meet the specific educational needs of the local 

area. 
282 

Child Care Access Means Parents in Schools 

The Committee recommends an appropriation of $15,970,000 for 

the Child Care Access Means Parents in School [CCAMPIS] program. The comparable fiscal year 2005 funding level and the budget request both are $15,970,000 for this program. CCAMPIS was 

established in the Higher Education Amendments of 1998 to support the efforts of a growing number of non-traditional students 

who are struggling to complete their college degrees at the same 

time that they take care of their children. Discretionary grants of 

up to 4 years are made to institutions of higher education to support or establish a campus-based childcare program primarily serving the needs of low-income students enrolled at the institution. 

Community College Access 

The Committee recommendation does not include any resources 

for this proposed program. The budget request includes 

$125,000,000 for this purpose. 

Under this proposed program, funds would support competitive 

awards that serve as an incentive for States and partnerships to 

increases access, particularly for low-income and minority students, 

to a college education. Two main activities would be supported 

under this proposed program, community college access grants and 

state consortia initiatives. Community college access grants would 

create incentives for community colleges to create dual enrollment 

programs. Grants under the state consortia initiative would provide 

incentives to States to establish credit transfer programs across 

State lines. 

Demonstration Projects to Ensure Quality Higher Education for 

Students With Disabilities 

The Committee recommends $6,944,000 for this program, the 

same amount as the comparable fiscal year 2005 funding level. The 

budget proposes no funding for this program. This program’s purpose is to ensure that students with disabilities receive a highquality postsecondary education. Grants are made to support model 

demonstration projects that provide technical assistance and professional development activities for faculty and administrators in 

institutions of higher education. 

The Committee recognizes that the Department has made limited efforts to work with grantees to collect the type of outcome 

data that would demonstrate the value of this program. The Committee is aware of the significant progress that grantees have made 

in developing standards for information dissemination, faculty and 

staff awareness, policies and procedures, and program administration and evaluation that institutions of higher education can adopt 

to more effectively support students with disabilities. The Committee urges the Department to utilize resources available under 

the GPRA/data collection program to support a rigorous evaluation 

of outcomes achieved by grantees funded under this program and 

to identify the impact that these funds are having on improving opportunities for students with disabilities at institutions of higher 

education throughout the United States. 
283 

Underground Railroad Program 

The Committee recommendation includes $2,204,000 for the Underground Railroad program, the same amount as the comparable 

fiscal year 2005 funding level. The budget request does not include 

any funds for this activity. The program was authorized by the 

Higher Education Amendments of 1998 and was funded for the 

first time in fiscal year 1999. Grants are provided to research, display, interpret, and collect artifacts relating to the history of the 

underground railroad. Educational organizations receiving funds 

must demonstrate substantial private support through a public-private partnership, create an endowment fund that provides for ongoing operation of the facility, and establish a network of satellite 

centers throughout the United States to share information and 

teach people about the significance of the Underground Railroad in 

American history. 

GPRA/Higher Education Act Program Evaluation 

The Committee recommends $980,000 for data collection associated with the Government Performance and Results Act data collection and to evaluate programs authorized by the Higher Education Act. The comparable fiscal year 2005 funding level and the 

budget request both are $980,000 for these activities. These funds 

are used to comply with the Government Performance and Results 

Act, which requires the collection of data and evaluation of Higher 

Education programs and the performance of recipients of Higher 

Education funds. 

B.J. Stupak Olympic Scholarships 

The Committee recommendation does not include funding for this 

program. The comparable fiscal year 2005 funding level is $980,000 

and the budget request did not include funds for this activity. 

Funds appropriated in fiscal year 2005 will be used to provide financial assistance to athletes who are training at the United 

States Olympic Education Center or one of the United States 

Olympic Training Centers and who are pursuing a postsecondary 

education at an institution of higher education. Unlike most other 

Federal student aid programs, scholarships are provided without 

consideration of expected family contributions. 

Thurgood Marshall Legal Educational Opportunity Program 

The Committee recommendation does not include any funds for 

the Thurgood Marshall Legal Educational Opportunity Program. 

The comparable funding level for fiscal year 2005 is $2,976,000 and 

the budget request does not include any funds for this purpose. 

Under this program, funds help low-income, minority or disadvantaged college students with the information, preparation and 

financial assistance to enter and complete law school study. The 

Higher Education Act stipulates that the Secretary make an award 

to or contract with the Council on Legal Education Opportunity to 

carry out authorized activities. 
284 

HOWARD UNIVERSITY

Appropriations, 2005 ............................................................................. $238,790,000 

Budget estimate, 2006 ........................................................................... 238,789,000 

House allowance .................................................................................... 240,790,000 

Committee recommendation ................................................................. 238,789,000 

The Committee recommends an appropriation of $238,789,000 for 

Howard University. The comparable fiscal year 2005 funding level 

is $238,790,000 and the budget request includes $238,789,000 for 

this purpose. Howard University is located in the District of Columbia and offers undergraduate, graduate, and professional degrees through 12 schools and colleges. The university also administers the Howard University Hospital, which provides both inpatient and outpatient care, as well as training in the health professions. Federal funds from this account support more than 50 percent of the university’s projected educational and general expenditures, excluding the hospital. The Committee recommends, within 

the funds provided, not less than $3,600,000 shall be for the endowment program. 

Howard University Hospital.—Within the funds provided, the 

Committee recommends $29,759,000 for the Howard University 

Hospital. The comparable fiscal year 2005 funding level and the 

budget request both are $29,759,000 for this purpose. The hospital 

serves as a major acute and ambulatory care center for the District 

of Columbia and functions as a major teaching facility attached to 

the university. The Federal appropriation provides partial funding 

for the hospital’s operations. 

COLLEGE HOUSING AND ACADEMIC FACILITIES LOANS

Appropriations, 2005 ............................................................................. $573,000 

Budget estimate, 2006 ........................................................................... 573,000 

House allowance .................................................................................... 573,000 

Committee recommendation ................................................................. 573,000 

Federal Administration.—The Committee bill includes $573,000 

for Federal administration of the CHAFL program. The comparable 

fiscal year 2005 funding level and the budget request both are 

$573,000 for such expenses. 

These funds will be used to reimburse the Department for expenses incurred in managing the existing CHAFL loan portfolio 

during fiscal year 2006. These expenses include salaries and benefits, travel, printing, contracts (including contracted loan servicing 

activities), and other expenses directly related to the administration of the CHAFL Program. 

HISTORICALLY BLACK COLLEGE AND UNIVERSITY CAPITAL

FINANCING PROGRAM

Appropriations, 2005 ............................................................................. $210,000 

Budget estimate, 2006 ........................................................................... 210,000 

House allowance .................................................................................... 210,000 

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

Federal Administration.—The Committee recommends $210,000 

for Federal administration of the Historically Black College and 

University [HBCU] Capital Financing Program. The comparable 
285 

fiscal year 2005 funding level and the budget request both are 

$210,000 for this activity. 

The HBCU Capital Financing Program makes capital available 

to HBCUs for construction, renovation, and repair of academic facilities by providing a Federal guarantee for private sector construction bonds. Construction loans will be made from the proceeds 

of the sale of the bonds. 

INSTITUTE OF EDUCATION SCIENCE

Appropriations, 2005 ............................................................................. $523,234,000 

Budget estimate, 2006 ........................................................................... 479,064,000 

House allowance .................................................................................... 522,696,000 

Committee recommendation ................................................................. 522,695,000 

The bill includes $522,695,000 for the Institute of Education 

Sciences. The comparable fiscal year 2005 funding level is 

$523,234,000 and the budget request includes $479,064,000 for 

comparable activities. This account supports education research, 

data collection and analysis activities, and the assessment of student progress. 

Research, Development and Dissemination 

The Committee recommends $164,194,000 for education research, 

development and national dissemination activities. The comparable 

fiscal year 2005 amount and the budget request both are 

$164,194,000 for these activities. Funds are available for obligation 

for 2 fiscal years. These funds support research, development, and 

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. 

The Committee strongly supports the premise that developing, 

identifying and implementing scientifically based research is critical to the success of the No Child Left Behind Act [NCLB] and to 

the increased effectiveness generally of education programs and 

interventions. The Committee recognizes the current scarcity of 

educational interventions that have been proven effective in research that meets the rigorous standards set out in the NCLB. In 

particular, the Committee believes that a greater focus must be 

placed on the use of randomized controlled trials, longitudinal studies, and other research that meets the standards set by the National Research Council. The Committee commends the Department for its efforts in this area. 

The Committee strongly supports the Department’s efforts to 

carry out authorized evaluations of Federal education programs 

using rigorous methodologies, particularly random assignment, 

that are capable of producing scientifically valid knowledge regarding which program activities are effective. To ensure that such 

evaluations have sufficient participation required to make them 

scientifically valid, the Committee urges the Department, wherever 

feasible and not specifically prohibited by the authorizing legislation, to take appropriate action to secure grantee involvement, 

which may include requests to be randomly assigned to intervention and control groups. The Committee notes that the National 

Board for Education Sciences recently recommended such a policy. 
286 

The Committee recognizes the critical role that IES plays in 

achieving the important goals set by the No Child Left Behind Act 

and encourages IES to continue its progress in translating scientifically based research findings into classroom practice. The Committee would like to see increased support for programs that bring 

advances in cognitive, developmental, educational and neuroscience 

research into the classroom by informing curriculum development 

in schools and in graduate schools of education. Research that focuses on the key processes of attention, memory, reasoning, and 

cognitive styles are essential for learning and are likely to produce 

substantial gains in academic achievement. 

Statistics 

The Committee recommends $90,931,000 for data-gathering and 

statistical-analysis activities of the National Center for Education 

Statistics [NCES]. The comparable fiscal year 2005 funding level 

and the budget request both are $90,931,000 for this purpose. 

The NCES collects, analyzes, and reports statistics on education 

in the United States. Activities are carried out directly and through 

grants and contracts. The Center collects data on educational institutions at all levels, longitudinal data on student progress, and 

data relevant to public policy. The NCES also provides technical 

assistance to State and local education agencies and postsecondary 

institutions. 

Regional Educational Laboratories 

The Committee recommends $66,131,000 to continue support for 

the regional educational laboratories. The comparable fiscal year 

2005 funding level is $66,132,000 and the budget request proposes 

to eliminate funding for this purpose. Program funds support a network of 10 laboratories that are responsible for promoting the use 

of broad-based systemic strategies to improve student achievement. 

Fiscal year 2006 funding will support a new competition under 

this program. The Committee believes it is important that the research, development, dissemination, and technical assistance activities carried out by the regional educational laboratories be consistent with the standards for scientifically based research prescribed in the Education Sciences Reform Act of 2002. The Committee therefore urges IES to ensure, through its competitive selection and evaluation of the laboratories and system of peer review 

of laboratory activities, that the laboratories adhere to these rigorous research standards. The Committee believes that the laboratories have an important role to play in helping parents, States and 

school districts improve student achievement as called for in No 

Child Left Behind. 

Research and Innovation in Special Education 

The Committee recommends $72,566,000 for research and innovation in special education. The comparable funding level for fiscal 

year 2005 is $83,104,000 and the budget request includes 

$72,566,000 for this purpose. The reauthorization of the Individuals with Disabilities Education Act created a new National Center 

for Special Education Research. This new center will address gaps 

in scientific knowledge in order to improve special education and 
287 

early intervention services and outcomes for infants, toddlers, and 

children with disabilities. Funds provided to the center will be 

available for obligation for 2 fiscal years. 

Similarly, the Committee recognizes the new role IES will play 

in special education research with the enactment and implementation of the Individuals with Disabilities Education Improvement 

Act of 2004. The Committee encourages IES to investigate alternative assessment models for determining learning disabilities for 

the purposes of special education placement in the absence of the 

discrepancy criterion requirement and the effectiveness of behavioral interventions and early intervening services. The Committee 

encourages IES to commit funding for research focusing on pupil 

services and related services providers. 

Special Education Studies and Evaluations 

The Committee recommends $10,000,000 for special education 

studies and evaluations. Funding for this activity was made available previously as a set-aside from the Special Education State 

Grants program until this new authority was created by the Individuals with Disabilities Education Improvement Act of 2004. The 

budget request includes $10,000,000 for this purpose. 

This program will support competitive grants, contracts and cooperative agreements to assess the implementation of the Individuals with Disabilities Education Act. Funds also will be used to 

evaluate the effectiveness of State and local efforts to deliver special education services and early intervention programs. Funds are 

available for obligation for 2 fiscal years. 

The Committee is concerned that school districts across the country are inadequately prepared to provide appropriate educational 

services to students with intellectual disabilities (mental retardation and related disabilities). This lack of preparedness is particularly acute as it relates to the universal design of standards, curriculum, instructional strategies and materials, and assessments. 

This too often results in a lack of access to the general education 

curriculum and families and teachers developing curricula, instructional materials and assessments on an ad hoc basis. The Committee urges the Department to prepare a comprehensive plan to 

address this matter that would be sufficiently detailed to serve as 

an outline for proposals for K–12 projects to meet the needs of intellectual disabilities. Consideration should be given to research, 

model demonstration, technical assistance and dissemination, technology innovations, personnel preparation and other means to develop and apply universally designed standards, curriculum instructional strategies and materials, and assessments. The plan 

also shall include proposed funding levels and timelines for implementing the various research, development and dissemination activities and other components of the plan. The Department is urged 

to consult with experts in the field, including the several national 

organizations representing the interests of children with intellectual disabilities in the development of this plan. Finally, the Committee requests the Department to submit a report to the House 

and Senate Committees on Appropriations not later than April 15, 

2006 on this issue. 
288 

Statewide Data Systems 

The Committee recommendation includes $24,800,000 for Statewide Data Systems. The comparable funding level for fiscal year 

2005 and the budget request both are $24,800,000. 

Under this program, the Department awards grants competitively to State Educational Agencies to enable such agencies to design, develop, and implement statewide, longitudinal data systems 

to manage, analyze, disaggregate, and use individual student data. 

Funds are available for obligation for 2 fiscal years. The Committee 

believes these funds are necessary to help States measure individual student performance, particularly as it relates to adequate 

yearly progress goals, more efficiently and accurately. The Committee urges the Department to continue to support those States 

that currently have the most limited ability to collect, analyze and 

report student achievement data when considering applications for 

funds available through this program. 

Assessment 

The Committee recommends $94,073,000 for assessment. The 

comparable fiscal year 2005 funding level is $94,073,000 and the 

budget request includes $116,573,000 for authorized activities. 

These funds provide support for the National Assessment of Educational Progress [NAEP], a congressionally mandated assessment 

created to measure the educational achievement of American students. The primary goal of NAEP is to determine and report the 

status and trends over time in educational achievement, subject by 

subject. Beginning in 2002, the Department began paying for State 

participation in biennial reading and mathematics assessments in 

grades 4 and 8. The budget request includes an increase of $22,500,000 to expand the State NAEP to reading and mathematics in the 12th 

grade. The Committee recommendation does not include these 

funds. 

Within the funds appropriated, the Committee recommends $5,088,000 for the National Assessment Governing Board [NAGB], 

which is responsible for formulating policy for NAEP. The comparable fiscal year 2005 amount and the budget request both are 

$5,088,000 for NAGB. 

DEPARTMENTAL MANAGEMENT

PROGRAM ADMINISTRATION

Appropriations, 2005 ............................................................................. $419,280,000 

Budget estimate, 2006 ........................................................................... 418,992,000 

House allowance .................................................................................... 410,612,000 

Committee recommendation ................................................................. 418,992,000 

The Committee recommends $418,992,000, for program administration. The comparable fiscal year 2005 funding level is 

$419,280,000 and the budget request includes $418,992,000 for this 

purpose. 

Funds support personnel compensation and benefits, travel, rent, 

communications, utilities, printing, equipment and supplies, automated data processing, and other services required to award, administer, and monitor approximately 180 Federal education pro-
289 

grams. Support for program evaluation and studies and advisory 

councils is also provided under this activity. 

The Committee is concerned that the Department, in implementing Reading First and other programs authorized by the No 

Child Left Behind Act which are required to implement activities 

that are backed by scientifically based research, may not be effectively helping States and local educational agencies implement programs shown to work in randomized controlled trials and other rigorous studies. The Committee therefore requests the Secretary to 

submit a report to the Committee, within 90 days of the enactment 

of this Act, on the actions that program offices have taken or will 

take in the selection, oversight, and evaluation of grantees, to ensure that grantees effectively implement such research-based programs, including close replication of the specific elements of these 

programs. 

The Committee understands that the Department is taking steps 

to implement the proposed reorganization of the regional office 

structure within the Rehabilitation Services Administration [RSA] 

that was described in the fiscal year 2006 congressional budget justification. The Committee is concerned about the impact that this 

proposal will have on regional office staff, as well as the ability of 

the Department to effectively administer RSA programs. The Committee understands that the Department believes that its proposed 

reorganization will result in more consistent, timely and higher 

quality policy guidance, technical assistance and program monitoring. The Committee believes these are worthy goals, given the 

millions of individuals served through RSA programs. Therefore, 

the Committee requests a report that describes the steps taken to 

reach out to stakeholder groups on this issue; a detailed plan for 

ensuring that policy guidance, technical assistance and program 

monitoring will be of higher quality and more timely than that currently available; and the specific performance goals under the proposed reorganization for frequency of monitoring visits, and timeliness and relevancy of technical assistance, compared to the actual 

performance under the current administrative structure. The Committee expects to receive this report not later than 60 days after 

enactment of this Act, but urges the Department to make it available as soon as possible. 

OFFICE FOR CIVIL RIGHTS

Appropriations, 2005 ............................................................................. $89,375,000 

Budget estimate, 2006 ........................................................................... 91,526,000 

House allowance .................................................................................... 91,526,000 

Committee recommendation ................................................................. 91,526,000 

The Committee bill includes $91,526,000 for the Office for Civil 

Rights [OCR]. The comparable fiscal year 2005 amount was 

$89,375,000 and the budget request is $91,526,000 for this purpose. 

The Office for Civil Rights is responsible for the enforcement of 

laws that prohibit discrimination on the basis of race, color, national origin, sex, disability, and age in all programs and institutions funded by the Department of Education. To carry out this responsibility, OCR investigates and resolves discrimination complaints, monitors desegregation and equal educational opportunity 

plans, reviews possible discriminatory practices by recipients of 
290 

Federal education funds, and provides technical assistance to recipients of funds to help them meet civil rights requirements. 

The Committee understands that Title IX of the Education 

Amendments of 1972 and their implementing regulations, which 

prohibit discrimination on the basis of sex in federally funded education programs or activities, have been instrumental in providing 

unprecedented opportunities for women in the Nation’s classrooms 

and athletic programs. While much progress has been made, the 

Committee continues to recognize that more needs to be done to ensure equal access for women. The Committee believes that the intent of the Department’s clarification is to provide institutions with 

additional guidance on compliance with the third part of the threepart test, as stated in the Department’s March 17, 2005 Dear Colleague. The Committee acknowledges this effort, but is concerned 

that confusion has been created with regard to the use of interest 

surveys to demonstrate compliance. The Committee believes survey 

results are not sufficient to demonstrate compliance if other evidence exists, such as requests for athletic teams, that contradicts 

the conclusions drawn from the survey. The Committee urges the 

Department to clarify that a presumption of compliance is not 

achieved by a survey if evidence to the contrary exists, whether 

that knowledge is known or it is reasonable to expect an institution 

to have known. Further, the Committee urges that the Department 

clarify that institutions must show that they have made reasonable, good faith efforts to explore such evidence if they choose to 

use part three of the three-part test to comply with Title IX. The 

Committee also encourages the Department to provide additional 

technical assistance to institutions on the appropriate use of interest surveys to comply with Title IX. 

The Committee requests that the Department prepare a report, 

based on random compliance reviews of institutions utilizing interest surveys, to determine what actions, if any, they take to gather 

and consider other sources of information for assessing student interest used in demonstrating compliance with part three of the 

Title IX test. The report should include what other information was 

considered in assessing student interest, if any, and the decisions 

made about athletic opportunities at these institutions. The Committee requests to receive this report no later than March 17, 2006. 

OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2005 ............................................................................. $47,327,000 

Budget estimate, 2006 ........................................................................... 49,408,000 

House allowance .................................................................................... 49,000,000 

Committee recommendation ................................................................. 49,408,000 

The Committee recommends $49,408,000 for the Office of the Inspector General. The comparable fiscal year 2005 amount is 

$47,327,000 and the budget request includes $49,408,000 for authorized activities. 

The Office of the Inspector General has the authority to investigate all departmental programs and administrative activities, including those under contract or grant, to prevent and detect fraud 

and abuse, and to ensure the quality and integrity of those programs. The Office investigates alleged misuse of Federal funds, and 

conducts audits to determine compliance with laws and regula-
291 

tions, efficiency of operations, and effectiveness in achieving program goals. 

GENERAL PROVISIONS

The Committee bill contains language which has been included 

in the bill since 1974, prohibiting the use of funds for the transportation of students or teachers in order to overcome racial imbalance 

(sec. 301). 

The Committee bill contains language included in the bill since 

1977, prohibiting the transportation of students other than to the 

school nearest to the student’s home (sec. 302). 

The Committee bill contains language which has been included 

in the bill since 1980, prohibiting the use of funds to prevent the 

implementation of programs of voluntary prayer and meditation in 

public schools (sec. 303). 

The Committee bill includes a provision giving the Secretary of 

Education authority to transfer up to 1 percent of any discretionary 

funds between appropriations (sec. 304). 

The Committee bill includes a new provision, pursuant to section 

303 of the Congressional Budget Resolution, to eliminate the accumulated shortfall in the Pell Grant program (sec. 305). 

The Committee bill includes a new provision which expands the 

programs authorized under subpart 12 of part D of title V of the 

Elementary and Secondary Education Act of 1965 (sec. 306). 
(292) 

TITLE IV—RELATED AGENCIES 

COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR

SEVERELY DISABLED

Appropriations, 2005 ............................................................................. $4,669,000 

Budget estimate, 2006 ........................................................................... 4,669,000 

House allowance .................................................................................... 4,669,000 

Committee recommendation ................................................................. 4,669,000 

The Committee recommends $4,669,000 for fiscal year 2006 for 

Committee for Purchase from People Who Are Blind or Severely 

Disabled. The comparable funding level for fiscal year 2005 is 

$4,669,000 and the budget request includes $4,669,000 for this program. 

The Committee for Purchase From People Who Are Blind or Severely Disabled was established by the Javits, 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

Appropriations, 2005 ............................................................................. $927,006,000 

Budget estimate, 2006 ........................................................................... 921,049,000 

House allocation ..................................................................................... 909,049,000 

Committee recommendation ................................................................. 935,205,000 

The Committee recommends $935,205,000 for the Corporation for 

National and Community Service, an increase of $8,199,000 over 

the fiscal year 2005 enacted level and $14,156,000 above the budget request. 

The Committee requests that the Corporation include information in the fiscal year 2007 budget justification on the economic impact of its programs. 

The Corporation for National and Community Service, a Corporation owned by the Federal Government, was established by the National and Community Service Trust Act of 1993 (Public Law 103– 

82) to enhance opportunities for national and community service 

and provide national service education awards. The Corporation 

makes grants to States, institutions of higher education, public and 

private nonprofit organizations, and others to create service opportunities for students, out-of-school youth, and adults. 

DOMESTIC VOLUNTEER SERVICE PROGRAMS

The Committee recommends $316,212,000 for fiscal year 2006 for 

the domestic volunteer service programs of the Corporation for National and Community Service. The comparable funding level for 

fiscal year 2005 is $353,745,000 and the budget request includes 

$359,962,000 for these programs. Programs authorized under the 
293 

Domestic Volunteer Service Act include: the Volunteers in Service 

to America Program [VISTA]; the Foster Grandparent Program; 

the Senior Companion Program; and the Retired and Senior Volunteer Program. 

VISTA 

The Committee recommends $96,428,000 for fiscal year 2006 for 

the Volunteers in Service to America [VISTA] Program. The comparable funding level for fiscal year 2005 is $94,240,000 and the 

budget request includes $96,428,000 for this program. 

VISTA, created in 1964 under the Economic Opportunity Act, 

provides capacity building for small community-based organizations. VISTA volunteers raise resources for local projects, recruit 

and organize volunteers, and establish and expand local community-based programs in housing, employment, health, and economic 

development activities. 

The Committee is pleased by reports that the Corporation is 

moving toward integrating grant writing and issue specific presentations into the training sessions currently given to all new VISTA 

members. The Committee feels that more substantive training is 

needed to enhance the effectiveness of VISTA members in their 

placements. As part of their capacity-building mission, VISTA 

members are increasingly called upon to write grant applications 

and to raise funds as a way of making their service projects selfsufficient, requiring knowledge of grant writing that cannot be 

gained in the local organization, as well as training in the general 

field in which they are slated to serve. The Committee looks forward to a report in the fiscal year 2007 budget justification on the 

percentage of training funds and percentage of training time spent 

on each of the following categories: organizational training, grant 

writing and fundraising training, and issue specific training (i.e. 

early childhood education, environment, disaster assistance, etc). 

Special Volunteer Programs 

The Committee has included no funding for the Special Volunteer programs. The comparable funding level for fiscal year 2005 

was $4,960,000. The budget requested $4,000,000 for an expansion 

of Teach For America under the Special Volunteer Programs. Teach 

for America has been a long-standing grantee under the 

Americorps State and National Program. Therefore, the Committee 

has recommended that funds for this expansion be allocated within 

the appropriation for the National and Community Service Act programs. 

The Special Volunteer Program is authorized under Part C of 

Title I of the Domestic Volunteer Service Act of 1973, which provides grants to volunteer organizations to encourage and enable 

persons from all age groups to perform volunteer service in agencies, institutions, and situations of need. 

National Senior Volunteer Corps 

The Committee recommends $219,784,000 for fiscal year 2006 for 

the National Senior Volunteer Corps programs. The comparable 

funding level for fiscal year 2005 is $215,857,000 and the budget 

request includes $219,784,000 for these programs. The Committee 
294 

recognizes the valuable contributions of seniors participating in the 

Foster Grandparent [FGP], Retired and Senior Volunteer Program 

[RSVP], and Senior Companion Programs [SCP]. In accordance 

with the Domestic Volunteer Service Act [DVSA], the Committee 

intends that at least one-third of each program’s increase over the 

fiscal year 2005 level shall be used to fund Programs of National 

Significance [PNS] expansion grants to allow existing FGP, RSVP, 

and SCP 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 existing 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. 

The Committee directs that the Corporation shall comply with the 

directive that use of PNS funding increases in the FGP, RSVP, 

SCP, and VISTA shall not be restricted to any particular activity. 

The Committee further directs that the Corporation shall not stipulate a minimum or maximum for PNS grant augmentation. 

In addition, the maximum dollars CNCS may use in fiscal year 

2006 for Communications and Training, Technical Assistance, and 

Recruitment and Retention activities shall not exceed the amount 

enacted for these two activities in fiscal year 2005. Funds appropriated for fiscal year 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. In addition, none of these increases 

may be used to fund demonstration activities. 

Foster Grandparent Program 

The Committee recommends $112,058,000 for fiscal year 2006 for 

the Foster Grandparent Program. The comparable funding level for 

fiscal year 2005 is $111,424,000 and the budget request includes 

$112,058,000 for this program. 

This program provides volunteer opportunities to seniors age 60 

and over who serve at-risk youth. This program not only involves 

seniors in their communities, but it also provides a host of services 

to children. 

Senior Companion Program 

The Committee recommends $47,438,000 for fiscal year 2006 for 

the Senior Companion Program. The comparable funding level for 

fiscal year 2005 is $45,905,000 and the budget request includes 

$47,438,000 for this program. 

This program enables senior citizens to provide personal assistance and companionship to adults with physical, mental, or emotional difficulties. Senior companions provide vital in-home services 

to elderly Americans who would otherwise have to enter nursing 

homes. The volunteers also provide respite care to relieve care 

givers. 
295 

Retired and Senior Volunteer Program 

The Committee recommends $60,288,000 for fiscal year 2006 for 

the Retired and Senior Volunteer Program. The comparable funding level for fiscal year 2005 is $58,528,000 and the budget request 

includes $60,288,000 for this program. This program involves persons age 55 and over in volunteer opportunities in their communities such as tutoring youth, responding to natural disasters, 

teaching parenting skills to teen parents, and mentoring troubled 

youth. 

Program Administration 

The Committee included funds for the administration of the 

DVSA program administration in the NCSA Salaries and Expenses 

account. The Committee believes that the integration of these accounts will streamline the management of the Corporation and increase efficiency and accountability across the agency. The comparable funding level for fiscal year 2005 is $38,688,000 and the 

budget request includes $39,750,000 for program administration. 

NATIONAL AND COMMUNITY SERVICE PROGRAMS

The Committee recommends $546,243,000 for the programs authorized under the National Community Service Act of 1990, an increase of $4,726,000 over the fiscal year 2005 enacted level and 

$18,156,000 above the budget request. 

The National and Community Service Programs of the Corporation for National and Community Service include: the AmeriCorps 

program (including AmeriCorps State and National and the National Civilian Community Corps); Learn and Serve America, Innovation, Demonstration, Assistance and Evaluation activities; State 

Commission Administration grants; and the National Service 

Trust. 

The Committee recommendation includes: $546,243,000 for the 

Corporation’s programs operating expenses. This appropriation provides $280,000,000 for AmeriCorps State and National operating 

grants (including $12,642,000 for State administrative expenses); 

$149,000,000 for the National Service Trust; $15,945,000 for subtitle H fund activities; $27,000,000 for AmeriCorps NCCC; 

$42,656,000 for Learn and Serve; $4,000,000 for audits and evaluations; $10,000,000 for the Points of Light Foundation; $5,000,000 

for America’s Promise. 

AmeriCorps Grants Program (not including NCCC) 

Within the amount provided for AmeriCorps grants, the Committee is providing $55,000,000 for national direct grantees. 

The Committee requests that the Corporation continue providing 

monthly reports to the Committee on Appropriations and the Corporation’s Inspector General on the actual and projected year-end 

level of AmeriCorps membership enrollment, usage, and earnings, 

and the financial status of the Trust fund (revenue, expenses, outstanding liabilities, reserve, etc.). 

To keep the Committee better informed of the recipients receiving AmeriCorps funding, the Committee directs the Corporation to 

publish in its fiscal year 2007 budget justifications a list of recipi-
296 

ents that have received more than $500,000 from the Corporation, 

delineated by program, and the amount and source of both other 

Federal and non-Federal funds that were received by each recipient. 

Innovation, Assistance and Other Activities 

Within the amount recommended for innovation, demonstration, 

and assistance activities, the Committee recommends $1,300,000 

for next generation grants; $500,000 for Martin Luther King Jr. 

Day grants; $725,000 for Service Learning Clearinghouse and Exchange; $2,250,000 for training and technical assistance; 

$4,338,000 for disability programs; $400,000 for Presidential Freedom Scholarships; $125,000 for Faith-Based and Community Initiatives; $52,000 for the Presidential Council on Service; $250,000 for 

Presidential Volunteer Service Award; $5,000 for the National Volunteer Hotline; $4,000,000 for Teach for America; and $2,000,000 

for Communities in Schools, Inc. The Committee is not allocating 

any money for the challenge grant programs in fiscal year 2006, in 

accordance with the budget request and House allocation. 

AmeriCorps National Civilian Community Corps 

Within the amount provided, $1,500,000 is to conduct an evaluation of current NCCC site placement and expansion of new sites in 

the Southern and Midwestern United States, in accordance with 

the report issued on March 1, 2005. 

SALARIES AND EXPENSES

The Committee recommends an appropriation of $66,750,000 for 

the Corporation’s salaries and expenses. This amount is equal to 

the budget request and $2,270,000 above the fiscal year 2005 enacted level. This includes $39,750,000 for administration of the 

DVSA programs. The Committee reiterates the directive under the 

program account that the Corporation must fund all staffing needs 

from the salaries and expenses account. 

The salaries and expenses appropriation provides funds for staff 

salaries, benefits, travel, training, rent, advisory and assistance 

services, communications and utilities expenses, supplies, equipment, and other operating expenses necessary for management of 

the Corporation’s activities under the National and Community 

Service Act of 1990 and the Domestic Volunteer Service Act of 

1973. 

The Committee is disappointed in the quality of assistance provided by the Corporation during the reorganization of the Corporation’s appropriation. Periodically, the Committee requires technical 

assistance from officers of the Corporation. The Committee expects 

that such assistance will be provided without prejudice in a 

straightforward and timely manner. 

The Committee is aware that local administrative support offices 

are critical to the success of programs such as the National Senior 

Volunteer Corps, especially in areas that are difficult to reach such 

as rural areas and islands like Hawaii. Mainland United States is 

over 1,500 miles from the State of Hawaii and the Committee is 

concerned that program support would suffer from locating that 

support across this distance. The Committee urges the Department 
297 

to continue funding existing full-time, local administrative CNCS 

offices. 

OFFICE OF INSPECTOR GENERAL

The Committee recommends an appropriation of $6,000,000 for 

the Office of Inspector General [OIG]. This amount is equal to the 

budget request and $48,000 above the fiscal year 2005 enacted 

level. 

The Committee directs the OIG to continue reviewing the Corporation’s management of the National Service Trust fund. The 

Committee directs the OIG to review the monthly Trust reports 

and to notify the Committees on Appropriations on the accuracy of 

the reports. 

The goals of the Office of Inspector General are to increase organizational efficiency and effectiveness and to prevent fraud, waste, 

and abuse. The Office of Inspector General within the Corporation 

for National and Community Service was transferred to the Corporation from the former ACTION agency when ACTION was abolished and merged into the Corporation in April 1994. 

ADMINISTRATIVE PROVISIONS

The Committee has included four administrative provisions carried in prior year appropriations acts as follows: language regarding: qualified student loans eligible for education awards; the availability of funds for the placement of volunteers with disabilities; 

the Inspector General to levy sanctions in accordance with standard Inspector General audit resolutions procedures; and language 

regarding the Corporation to make significant changes to program 

requirements or policy through public rulemaking and public notice 

and grant selection process. 

CORPORATION FOR PUBLIC BROADCASTING

Appropriations, 2006 ............................................................................. $400,000,000 

Appropriations, 2007 ............................................................................. 400,000,000 

Budget estimate, 2008 ........................................................................... ........................... 

House allowance .................................................................................... 400,000,000 

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

The Committee recommends $400,000,000 be made available for 

the Corporation for Public Broadcasting [CPB], an advance appropriation for fiscal year 2008. The comparable funding level provided last year was $400,000,000 for fiscal year 2007. The budget 

request does not include advance funds for this program. 

In addition, the Committee recommends $35,000,000 be made 

available in fiscal year 2006 for the conversion to digital broadcasting. The comparable funding level for fiscal year 2005 was 

$39,387,000. The budget request included no funding for this purpose. The House included authority to permit CPB to spend up to 

$30,000,000 in previously appropriated fiscal year 2006 funds for 

digital conversion activities. 

In addition, the Committee recommends $40,000,000 be made 

available in fiscal year 2006 for the replacement project of the 

interconnection system. In fiscal year 2005, $39,680,000 was appropriated for this purpose. The House included authority to permit 
298 

CPB to spend up to $52,000,000 in previously appropriated fiscal 

year 2006 funds for the Satellite Interconnection system. 

The current interconnection system is entirely satellite based. 

This satellite is currently nearing the end of its useful life, and 

while satellite technology is currently the most cost-effective method for distribution in a point-to-multipoint system, terrestrial technology is far more economical when data is distributed between 

single points. The Next Generation Interconnection System will utilize a combination of satellite and terrestrial technologies for a 

more flexible system. In addition, a portion of the provided funds 

will be used to upgrade existing ground station and transmit/receive equipment to be compatible with the new system. 

The Committee recognizes the importance of the partnership 

CPB has with the National Minority Public Broadcasting Consortia, which helps develop, acquire, and distribute public television programming to serve the needs of African American, Asian 

American, Latino, Native American, Pacific Islander, and many 

other viewers. As many communities in the Nation welcome increased numbers of citizens of diverse ethnic backgrounds, the local 

public television stations should strive to meet these viewers’ 

needs. With an increased focus on programming to meet local community needs, the Committee encourages CPB to continue to support and expand this critical partnership. 

The Committee is aware that public radio stations are taking advantage of experimental authority to develop their digital operations including multicasting. We encourage the Corporation to 

work with the Federal Communications Commission to enable public radio and television stations to utilize the full range of digital 

broadcasting technology as soon as possible, including the use of 

multicasting for public radio stations. 

FEDERAL MEDIATION AND CONCILIATION SERVICE

Appropriations, 2005 ............................................................................. $44,439,000 

Budget estimate, 2006 ........................................................................... 42,331,000 

House allowance .................................................................................... 42,331,000 

Committee recommendation ................................................................. 43,439,000 

The Committee recommends $43,439,000 for fiscal year 2006 for 

the Federal Mediation and Conciliation Service [FMCS]. The comparable funding level for fiscal year 2005 is $44,439,000 and the 

budget request includes $42,331,000 for this program. 

The FMCS was established by Congress in 1947 to provide mediation, conciliation, and arbitration services to labor and management. FMCS is authorized to provide dispute resolution consultation and training to all Federal agencies. 

The Committee continues to support the FMCS program to prevent youth violence and is especially pleased with the initiative to 

train educators in conflict resolution. The Committee commends 

FMCS for their innovative look at youth violence conflict resolution 

and their development of a CD–ROM that will address this issue 

among preschool and elementary age children. 
299 

FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION

Appropriations, 2005 ............................................................................. $7,809,000 

Budget estimate, 2006 ........................................................................... 7,809,000 

House allowance .................................................................................... 7,809,000 

Committee recommendation ................................................................. 7,809,000 

The Committee recommends $7,809,000 for fiscal year 2006 for 

the Federal Mine Safety and Health Review Commission. The comparable funding level for fiscal year 2005 is $7,809,000 and the 

budget request includes $7,809,000 for this program. 

The Federal Mine Safety and Health Review Commission provides administrative trial and appellate review of legal disputes 

under the Federal Mine Safety and Health Act of 1977. The fivemember Commission provides review of the Commission’s administrative law judge decisions. 

INSTITUTE OF MUSEUM AND LIBRARY SERVICES

Appropriations, 2005 ............................................................................. $280,564,000 

Budget estimate, 2006 ........................................................................... 262,240,000 

House allowance .................................................................................... 249,640,000 

Committee recommendation ................................................................. 290,129,000 

The Committee recommends $290,129,000 for fiscal year 2006 for 

the Institute of Museum and Library Services. The comparable 

funding level for fiscal year 2005 is $280,564,000 and the budget 

request includes 262,240,000 for this program. 

Office of Museum Services Operations Grants 

The Committee recommends $17,500,000 for operations grants. 

These funds support grants to museums for building increased public access, expanding educational services, reaching families and 

children, and using technology more effectively in support of these 

goals. In addition, non-competitive grants are awarded for technical 

assistance in four types of assessments: Institutional, Collections 

Management, Public Dimension, and Governance. In addition to 

the total recommended, $992,000 has been provided for the 21st 

Century Museum Professionals program, $446,000 for museum assessment, $850,000 for Native American Museum service grants, 

and $850,000 for Museum Grants for African American History 

and Culture. 

Museum Conservation Programs 

The Committee recommends $3,615,000 for Conservation programs. These funds support grants to allow museums to survey collections, perform training, research, treatment, and environmental 

improvements. In addition, grantees may receive additional funds 

to develop an education component that relates to their conservation project. In addition, non-competitive grants are awarded for 

technical assistance in conservation efforts. 

Museum National Leadership Projects 

The Committee recommends $29,000,000 for National Leadership 

projects. The National Leadership Grants encourage innovation in 

meeting community needs, widespread and creative use of new 
300 

technologies, greater public access to museum collections, and an 

extended impact of Federal dollars through collaborative projects. 

Office of Library Services State Grants 

The Committee recommends $165,000,000 for State grants. 

Funds are provided to States by formula to carry out 5-year State 

plans. These plans must set goals and priorities for the State consistent with the purpose of the Act, describe activities to meet the 

goals and priorities and describe the methods by which progress toward the goals and priorities and the success of activities will be 

evaluated. States may apportion their funds between two activities, 

technology and targeted services. For technology, States may use 

funds for electronic linkages among libraries, linkages to educational, social and information services, accessing information 

through electronic networks, or link different types of libraries or 

share resources among libraries. For targeted services, States may 

direct library and information services to persons having difficulty 

using a library, underserved urban and rural communities, and 

children from low income families. In addition to the total recommended, $3,675,000 has been provided for library services to 

Native Americans and Native Hawaiians. The Committee is aware 

that many traditional healers are aging and the world may soon 

lose the knowledge that they possess. For that reason, the Committee encourages IMLS to work for the preservation and documentation of Native Hawaiian traditional cultural healing practices. It is essential that these practices be documented in creative 

media formats due to the variety and complexity of the practices 

and the healers. 

Library National Leadership Projects 

The Committee recommends $33,284,000 for national leadership 

projects. These funds support activities of national significance to 

enhance the quality of library services nationwide and to provide 

coordination between libraries and museums. Activities are carried 

out through grants and contracts awarded on a competitive basis 

to libraries, agencies, institutions of higher education and museums. Priority is given to projects that focus on education and training of library personnel, research and development for the improvement of libraries, preservation, digitization of library materials, 

partnerships between libraries and museums and other activities 

that enhance the quality of library services nationwide. In addition 

to the total recommended, $23,000,000 has been provided for the 

21st Century Librarian Initiative. 

Museum and Library Services Administration 

The Committee recommends $11,917,000 for program administration, the same as the budget request. Funds support personnel 

compensation and benefits, travel, rent, communications, utilities, 

printing, equipment and supplies, automated data processing, and 

other services. 
301 

MEDICARE PAYMENT ADVISORY COMMISSION

Appropriations, 2005 ............................................................................. $9,899,000 

Budget estimate, 2006 ........................................................................... 10,168,000 

House allowance .................................................................................... 10,168,000 

Committee recommendation ................................................................. 10,168,000 

The Committee recommends $10,168,000 for fiscal year 2006 for 

the Medicare Payment Advisory Commission. The comparable 

funding level for fiscal year 2005 is $9,899,000 and the budget request includes $10,168,000 for this program. 

The Medicare Payment Advisory Commission [MedPAC] was established by Congress as part of the Balanced Budget Act of 1997 

(Public Law 105–33). Congress merged the Physician Payment Review Commission with the Prospective Payment Assessment Commission to create MedPAC. 

NATIONAL COMMISSION ON LIBRARIES AND INFORMATION SCIENCE

Appropriations, 2005 ............................................................................. $993,000 

Budget estimate, 2006 ........................................................................... 993,000 

House allowance .................................................................................... 993,000 

Committee recommendation ................................................................. 993,000 

The Committee recommends $993,000 for fiscal year 2006 for the 

National Commission on Libraries and Information Science. The 

comparable funding level for fiscal year 2005 is $993,000 and the 

budget request includes $993,000 for this program. 

The Commission determines the need for, and makes recommendations on, library and information services, and advises the 

President and Congress on the development and implementation of 

national policy in library and information sciences. 

NATIONAL COUNCIL ON DISABILITY

Appropriations, 2005 ............................................................................. $3,344,000 

Budget estimate, 2006 ........................................................................... 2,800,000 

House allowance .................................................................................... 2,800,000 

Committee recommendation ................................................................. 3,344,000 

The Committee recommends $3,344,000 for fiscal year 2006 for 

the National Council on Disability. The comparable funding level 

for fiscal year 2005 is $3,344,000 and the budget request includes 

$2,800,000 for this program. 

The Council is mandated to make recommendations to the President, the Congress, the Rehabilitation Services Administration, and 

the National Institute on Disability and Rehabilitation Research, 

on the public issues of concern to individuals with disabilities. The 

Council gathers information on the implementation, effectiveness, 

and impact of the Americans with Disabilities Act and looks at 

emerging policy issues as they affect persons with disabilities and 

their ability to enter or reenter the Nation’s work force and to live 

independently. 

NATIONAL LABOR RELATIONS BOARD

Appropriations, 2005 ............................................................................. $249,860,000 

Budget estimate, 2006 ........................................................................... 252,268,000 

House allowance .................................................................................... 252,268,000 

Committee recommendation ................................................................. 252,268,000 
302 

The Committee recommends $252,268,000 for fiscal year 2006 for 

the National Labor Relations Board [NLRB]. The comparable funding level for fiscal year 2005 is $249,860,000 and the budget request includes $252,268,000 for this program. 

The Committee continues to be concerned that the NLRB’s plan 

to restructure its regional offices will slow the decision making 

process in some regions and hurt workers access to a fair and timely hearing. The Committee reiterates its opposition to the elimination of Region 30 and the subsequent downgrading of the Region 

30 Office to sub-regional status. Downgrading this office will force 

interested parties to travel long distances while increasing the 

backlog of cases in Region 18. 

The NLRB is a law enforcement agency which adjudicates disputes under the National Labor Relations Act. 

The Committee is aware that the mission of the NLRB is to carry 

out the statutory responsibilities of the National Labor Relations 

Act as efficiently as possible and in a manner that gives full effect 

to the rights afforded to employees, unions, and employers under 

the Act. The Committee strongly supports this mission and understands that the caseload fluctuates based on economic conditions 

and changes in labor regulations. The Committee continues to be 

disappointed that the Administration has repeatedly underestimated the funding necessary to process the increase in case intakes, but stands firm in its commitment to ensure that all cases 

are heard and given due process. 

NATIONAL MEDIATION BOARD

Appropriations, 2005 ............................................................................. $11,628,000 

Budget estimate, 2006 ........................................................................... 11,628,000 

House allowance .................................................................................... 11,628,000 

Committee recommendation ................................................................. 11,628,000 

The Committee recommends $11,628,000 for fiscal year 2006 for 

the National Mediation Board. The comparable funding level for 

fiscal year 2005 is $11,628,000 and the budget request includes 

$11,628,000 for this program. 

The National Mediation Board protects interstate commerce as it 

mediates labor-management relations in the railroad and airline 

industries under the Railway Labor Act. The Board mediates collective bargaining disputes, determines the choice of employee bargaining representatives through elections, and administers arbitration of employee grievances. 

The Committee notes that the National Mediation Board has yet 

to issue a final rule regarding certain administrative changes to 

case management. The Committee has made repeated statements 

that the institution of a fee, such as the one outlined in the initial 

proposed rule, would require statutory authorization that the 

Board currently lacks. The fiscal year 2006 President’s Budget included no request to change the authorization of the Board to include the collection of any fees. Therefore, the Committee concludes 

that the Board has abandoned the effort to institute new fees in 

the coming year and expects that any final rule the Board may 

publish will omit the fee proposal. 
303 

OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION

Appropriations, 2005 ............................................................................. $10,510,000 

Budget estimate, 2006 ........................................................................... 10,510,000 

House allowance .................................................................................... 10,510,000 

Committee recommendation ................................................................. 10,510,000 

The Committee recommends $10,510,000 for fiscal year 2006 for 

the Occupational Safety and Health Review Commission. The comparable funding level for fiscal year 2005 is $10,510,000 and the 

budget request includes $10,510,000 for this program. 

The Commission serves as a court to justly and expeditiously resolve disputes between the Occupational Safety and Health Administration [OSHA] and employers charged with violations of health 

and safety standards enforced by OSHA. 

RAILROAD RETIREMENT BOARD

DUAL BENEFITS PAYMENTS ACCOUNT

Appropriations, 2005 ............................................................................. $99,200,000 

Budget estimate, 2006 ........................................................................... 97,000,000 

House allowance .................................................................................... 97,000,000 

Committee recommendation ................................................................. 97,000,000 

The Committee recommends $97,000,000 for fiscal year 2006 for 

the Dual Benefits Payments Account, of these funds $7,000,000 is 

from income taxes on vested dual benefits. The comparable funding 

level for fiscal year 2005 is $99,200,000 and the budget request includes $97,000,000 for this program. 

This appropriation provides for vested dual benefit payments authorized by the Railroad Retirement Act of 1974, as amended by 

the Omnibus Reconciliation Act of 1981. This separate account, established for the payment of dual benefits, is funded by general 

fund appropriations and income tax receipts of vested dual benefits. 

FEDERAL PAYMENTS TO THE RAILROAD RETIREMENT ACCOUNT

Appropriations, 2005 ............................................................................. $150,000 

Budget estimate, 2006 ........................................................................... 150,000 

House allowance .................................................................................... 150,000 

Committee recommendation ................................................................. 150,000 

The Committee recommends $150,000 for fiscal year 2006 for interest earned on unnegotiated checks. The comparable funding 

level for fiscal year 2005 is $150,000 and the budget request includes $150,000 for this program. 

LIMITATION ON ADMINISTRATION

Appropriations, 2005 ............................................................................. $102,543,000 

Budget estimate, 2006 ........................................................................... 102,543,000 

House allowance .................................................................................... 102,543,000 

Committee recommendation ................................................................. 102,543,000 

The Committee recommends $102,543,000 for fiscal year 2006 for 

the administration of railroad retirement/survivor benefit programs. The comparable funding level for fiscal year 2005 is 

$102,543,000 and the budget request includes $102,543,000 for this 

program. 
304 

The Board administers comprehensive retirement-survivor and 

unemployment-sickness insurance benefit programs for the Nation’s railroad workers and their families. This account limits the 

amount of funds in the railroad retirement and railroad unemployment insurance trust funds which may be used by the Board for 

administrative expenses. 

The Committee has included language to prohibit 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. 

LIMITATION ON THE OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2005 ............................................................................. $7,196,000 

Budget estimate, 2006 ........................................................................... 7,196,000 

House allowance .................................................................................... 7,196,000 

Committee recommendation ................................................................. 7,196,000 

The Committee recommends $7,196,000 for fiscal year 2006 for 

the Office of the Inspector General. The comparable funding level 

for fiscal year 2005 is $7,196,000 and the budget request includes 

$7,196,000 for this program. 

The Committee has included bill language to allow the Office of 

the Inspector General to use funds to conduct audits, investigations, and reviews of the Medicare program. The Committee finds 

that as long as the RRB has the authority to negotiate and administer the separate Medicare contract, the RRB Inspector General 

should not be prohibited from using funds to review, audit, or investigate the Railroad Retirement Board’s separate Medicare contract. 

SOCIAL SECURITY ADMINISTRATION

PAYMENTS TO SOCIAL SECURITY TRUST FUNDS

Appropriations, 2005 ............................................................................. $20,454,000 

Budget estimate, 2006 ........................................................................... 20,470,000 

House allowance .................................................................................... 20,470,000 

Committee recommendation ................................................................. 20,470,000 

The Committee recommends an appropriation of $20,470,000 for 

payments to Social Security trust funds. The comparable fiscal year 

2005 funding level is $20,454,000 and the budget request includes 

$20,470,000 for this purpose. This amount reimburses the old age 

and survivors and disability insurance trust funds for special payments to certain uninsured persons, costs incurred administering 

pension reform activities, and the value of the interest for benefit 

checks issued but not negotiated. This appropriation restores the 

trust funds to the same financial position they would have been in 

had they not borne these costs, properly charged to the general 

funds. 

SUPPLEMENTAL SECURITY INCOME

Appropriations, 2005 ............................................................................. $28,586,829,000 

Budget estimate, 2006 ........................................................................... 29,533,174,000 

House allowance .................................................................................... 29,533,174,000 

Committee recommendation ................................................................. 29,510,574,000 
305 

The Committee recommends an appropriation of $29,510,574,000 

for supplemental security income. This is in addition to the 

$10,930,000,000 appropriated last year as an advance for the first 

quarter of fiscal year 2006. The comparable fiscal year 2005 funding level is $28,586,829,000 and the budget request includes 

$29,533,174,000. The Committee also recommends an advance appropriation of $11,110,000,000 for the first quarter of fiscal year 

2007 to ensure uninterrupted benefits payments. The program 

level supported by the Committee recommendation is 

$40,440,574,000, compared to the total program level requested in 

the budget of $40,463,174,000. The Committee recommendation 

also includes bill language which adjusts the timing of the October 

2006 SSI benefit payment. 

These funds are used to pay benefits under the SSI Program, 

which was established to ensure a Federal minimum monthly benefit for aged, blind, and disabled individuals, enabling them to 

meet basic needs. It is estimated that approximately 7 million persons will receive SSI benefits each month during fiscal year 2006. 

In many cases, SSI benefits supplement income from other sources, 

including Social Security benefits. The funds are also used to reimburse the Social Security trust funds for the administrative costs 

for the program with a final settlement by the end of the subsequent fiscal year as required by law, to reimburse vocational rehabilitation agencies for costs incurred in successfully rehabilitating 

SSI recipients and for research and demonstration projects. 

Beneficiary Services 

The Committee recommendation includes $52,000,000 for beneficiary services. The comparable funding level in fiscal year 2005 

is $45,929,000 and the budget request includes $52,000,000 for 

these services. This amount is available for payments to Employment Networks for successful outcomes or milestone payments 

under the Ticket to Work program and for reimbursement of State 

vocational rehabilitation agencies and alternate public or private 

providers. Carryover budget authority of more than $130,000,000 is 

available for obligations made during fiscal years 2005 and 2006. 

Research and Demonstration Projects 

The Committee recommendation includes $27,000,000 for research and demonstration projects conducted under sections 1110 

and 1115 of the Social Security Act. The comparable fiscal year 

2005 funding level is $35,000,000 and the budget request includes 

$27,000,000 for authorized activities. 

This amount will support SSA’s efforts to strengthen its policy 

evaluation capability and focus on research of: program issues, the 

impact of demographic changes on future workloads and effective 

return-to-work strategies for disabled beneficiaries. 

Administration 

The Committee recommendation includes $2,874,400,000 for payment to the Social Security trust funds for the SSI Program’s share 

of SSA’s base administrative expenses. The comparable fiscal year 

2005 amount is $2,986,900,000 and the budget request includes 

$2,897,000,000 for such activities. 
306 

LIMITATION ON ADMINISTRATIVE EXPENSES

Appropriations, 2005 ............................................................................. $8,729,901,000 

Budget estimate, 2006 ........................................................................... 9,388,400,000 

House allowance .................................................................................... 9,279,700,000 

Committee recommendation ................................................................. 9,329,400,000 

The Committee recommends a program funding level of $9,329,400,000 for the limitation on administrative expenses. The 

comparable fiscal year 2005 funding level is $8,729,901,000 and the 

budget request includes $9,388,400,000 for this purpose. 

This account provides resources from the Social Security trust 

funds to administer the Social Security retirement and survivors 

and disability insurance programs, and certain Social Security 

health insurance functions. As authorized by law, it also provides 

resources from the trust funds for certain nontrust fund administrative costs, which are reimbursed from the general funds. These 

include administration of the supplemental security income program for the aged, blind and disabled; work associated with the 

Pension Reform Act of 1984; and the portion of the annual wage 

reporting work done by the Social Security Administration for the 

benefit of the Internal Revenue Service. The dollars provided also 

support automated data processing activities and fund the State 

disability determination services which make initial and continuing 

disability determinations on behalf of the Social Security Administration. Additionally, the limitation provides funding for computer 

support, and other administrative costs. The Committee recommendation includes $9,209,400,000 for routine operating expenses of the Agency, as well as the resources derived from the user fees which are discussed below. 

The budget request includes bill language earmarking not less than $412,000,000 of funds available within this account for continuing disability reviews under Social Security’s disability programs. The Committee bill language includes this earmark and 

also includes an additional $189,000,000 for this purpose requested 

in the budget and provided for by section 404(b)(1) of the Concurrent Resolution on the Budget for fiscal year 2006. The Committee 

requests that the Social Security Administration provide reports to 

the Committee for each fiscal year 2005, 2006, and 2007 that detail 

the amount of funds spent on continuing disability reviews for each 

year and the number of such reviews, by category of review; the results of such continuing disability reviews in terms of cessation of 

benefits or determinations of continuing eligibility, by programs; 

and the amount of savings generated over the short-, medium-, and 

long-term by each program administered by the Agency. The Committee notes that during the last period of special funding for continuing disability reviews the benefit to cost ratio was more than 

$10 for each $1 spent on this workload. 

The Committee bill also includes language that authorizes fiscal 

year 2006 funds available to SSA to be used to complete Medicare 

appeals received by the Agency prior to July 1, 2005. Medicare appeals filed after this date were transferred to the Department of 

Health and Human Services, as required by the Medicare Prescription Drug, Improvement and Modernization Act of 2003. The Committee bill also allows the Commissioner of Social Security to enter 

into a reimbursable agreement with the Secretary of Health and 
307 

Human Services to provide assistance with and process Medicare 

appeals work received prior to October 1, 2005. This language will 

ensure that Medicare beneficiaries are not impacted negatively by 

the transfer of this workload. 

The Committee recommendation also includes $320,000,000, the 

full amount included in the budget request, to support the implementation of the Medicare Prescription Drug Benefit program. 

These resources will be used to identify low-income beneficiaries 

who may be eligible for financial assistance with their prescription 

drug costs; to make eligibility determinations for those individuals 

eligible for financial assistance; and to withhold premiums associated with beneficiaries’ plans; and to calculate Medicare Part B 

premiums for high-income beneficiaries. 

The Committee encourages SSA officials to educate adjudicators 

at all levels about the functional impact of CFS and the application 

of the April 1999 CFS ruling (99–2p) to ensure that adjudicators 

remain up-to-date on the evaluation of disability that results from 

this condition. The Committee encourages SSA to examine obstacles to benefits for persons with CFS and to keep medical information updated throughout all levels of the application and review 

process. 

Social Security Advisory Board 

The Committee has included not less than $2,000,000 within the 

limitation on administrative expenses account for the Social Security Advisory Board for fiscal year 2006. 

User Fees 

In addition to other amounts provided, the Committee rec- ommends $120,000,000 for administrative activities funded from 

user fees. Of this amount, $119,000,000 is derived from fees paid 

to SSA by States that request SSA to administer State SSI supplementary payments. The remaining $1,000,000 will be generated 

from a fee payment process for non-attorney representatives of 

claimants. 

OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2005 ............................................................................. $90,378,000 

Budget estimate, 2006 ........................................................................... 93,000,000 

House allowance .................................................................................... 92,805,000 

Committee recommendation ................................................................. 93,000,000 

The Committee recommends $93,000,000 for activities for the Office of the Inspector General. The comparable fiscal year 2005 funding level is $90,378,000 and the budget request includes 

$93,000,000 for this office. This includes a general fund appropriation of $26,000,000 together with an obligation limitation of 

$67,000,000 from the Federal old-age and survivors insurance trust 

fund and the Federal disability insurance trust fund. 
(308) 

TITLE V—GENERAL PROVISIONS 

The Committee recommendation includes provisions which: authorize transfers of unexpended balances (sec. 501); limit funding 

to 1 year availability unless otherwise specified (sec. 502); limit lobbying and related activities (sec. 503); limit official representation 

expenses (sec. 504); prohibit funding of any program to carry out 

distribution of sterile needles for the hypodermic injection of any 

illegal drug (sec. 505); clarify Federal funding as a component of 

State and local grant funds (sec. 506); limit use of funds for abortion (sec. 507 and sec. 508); restrict human embryo research (sec. 

509); limit the use of funds for promotion of legalization of controlled substances included last year (sec. 510); limits use of funds 

to enter into or review contracts with entities subject to the requirement in section 4212(d) of title 38, United States Code, if the 

report required by that section has not been submitted (sec. 511); 

prohibits the use of funds to promulgate regulations regarding the 

individual health identifier (sec. 512); prohibits transfer of funds 

made available in this Act to any department, agency, or instrumentality of the U.S. Government, except as otherwise provided by 

this or any other Act (sec. 513); prohibits funds for the Railroad Retirement Board from being used for a non-governmental disbursing 

agent (sec. 514); maintains a provision clarifying procedures for reprogramming of funds (sec. 515); and specifies that none of the 

funds made available by this Act may be used to reimburse, or provide reimbursement for drugs approved to treat erectile dysfunction 

(sec. 516). 
309 

BUDGETARY IMPACT OF BILL 

PREPARED IN CONSULTATION WITH THE CONGRESSIONAL BUDGET OFFICE PURSUANT TO SEC. 

308(a), PUBLIC LAW 93–344, AS AMENDED 

[In millions of dollars] 

Budget authority Outlays 

Committee 

allocation 

Amount 

of bill 

Committee 

allocation 

Amount 

of bill 

Comparison of amounts in the bill with Committee allocations 

to its subcommittees of amounts in the Budget Resolution 

for 2006: Subcommittee on Labor-HHS-Education. 

Discretionary ........................................................................ 141,344 141,653 142,975 1 141,350 

Mandatory ............................................................................ 405,311 405,311 405,171 1 405,171 

Projection of outlays associated with the recommendation: 

2006 ..................................................................................... .................... .................... .................... 2 368,096 

2007 ..................................................................................... .................... .................... .................... 58,074 

2008 ..................................................................................... .................... .................... .................... 15,470 

2009 ..................................................................................... .................... .................... .................... 3,789 

2010 and future years ........................................................ .................... .................... .................... 542 

Financial assistance to State and local governments for 

2006 ......................................................................................... NA 221,957 NA 159,755 

1 Includes outlays from prior-year budget authority. 

2 Excludes outlays from prior-year budget authority. 

NA: Not applicable. 

COMPLIANCE WITH PARAGRAPH 7, RULE XVI, OF THE 

STANDING RULES OF THE SENATE 

Paragraph 7 of rule XVI requires that Committee report on general appropriations bills identify each Committee amendment to 

the House bill ‘‘which proposes an item of appropriation which is 

not made to carry out the provisions of an existing law, a treaty 

stipulation, or an act or resolution previously passed by the Senate 

during that session.’’ 

The following items are identified pursuant to this requirement: 

Workforce Investment Act; Title VII and Title VIII of the Public 

Health Services Act; National Cord Blood Stem Cell Bank Program; 

Universal Newborn Hearing Screening; Organ Transplantation; 

Rural Hospital Flexibility Grants; Denali Commission; Family 

Planning; State Offices of Rural Health; Rural and Community Access to Emergency Devices; Trauma/EMS; Infectious Diseases; 

Health Promotion; Health Information and Services; Environmental Health and Injury; Occupational Safety and Health; Global 

Health; Public Health Research; Public Health Improvement and 

Leadership; Preventive Health and Health Services Block Grant; 

CDC Business Services; Title V of the Public Health Services Act; 

Adolescent Family Life; Office of Minority Health; Office of Disease 

Prevention and Health Promotion; Low Income Home Energy Assistance Program; Refugee and Entrant Assistance; Child Care and 

Development Block Grant; Head Start; Abstinence Education; Native American Programs; Community Services; Alzheimer’s Disease 

Demonstration Grants to States; High school equivalency program; 

College assistance migrant program; State grants for incarcerated 

youth offenders; Rehabilitation Services and Disability Research, 

except sections 4, 5 and 6 of the Assistive Technology Program; National Technical Institute for the Deaf; Gallaudet University; Voca-
310 

tional Education; Adult Education; Student Financial Assistance; 

Student Aid Administration; Higher Education, except for section 

102(b)(6) of the Mutual Educational and Cultural Exchange Act; 

Corporation for National and Community Service; National Council 

on Disability. 

COMPLIANCE WITH PARAGRAPH 7(C), RULE XXVI OF THE 

STANDING RULES OF THE SENATE 

Pursuant to paragraph 7(c) of rule XXVI, on July 14, 2005, the 

Committee ordered reported, H.R. 3010, making appropriations for 

the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 

30, 2006, and for other purposes, with an amendment in the nature 

of a substitute, provided that the bill be subject to further amendment and the bill be consistent with its budget allocation, by a recorded vote of 27–0, a quorum being present. The vote was as follows: 

Yeas Nays 

Chairman Cochran 

Mr. Stevens 

Mr. Specter 

Mr. Domenici 

Mr. Bond 

Mr. McConnell 

Mr. Burns 

Mr. Shelby 

Mr. Bennett 

Mr. Craig 

Mrs. Hutchison 

Mr. DeWine 

Mr. Brownback 

Mr. Allard 

Mr. Byrd 

Mr. Inouye 

Mr. Leahy 

Mr. Harkin 

Ms. Mikulski 

Mr. Reid 

Mr. Kohl 

Mrs. Murray 

Mr. Dorgan 

Mrs. Feinstein 

Mr. Durbin 

Mr. Johnson 

Ms. Landrieu 

COMPLIANCE WITH PARAGRAPH 12, RULE XXVI OF THE 

STANDING RULES OF THE SENATE 

Paragraph 12 of rule XXVI requires that Committee reports on 

a bill or a joint resolution repealing or amending any statute include ‘‘(a) the text of the statute or part thereof which is proposed 

to be repealed; and (b) a comparative print of that part of the bill 

or joint resolution making the amendment and of the statute or 
311 

part thereof proposed to be amended, showing by stricken through 

type and italics, parallel columns, or other appropriate typographical devices the omissions and insertions which would be 

made by the bill or joint resolution if enacted in the form recommended by the committee.’’ 

NO CHILD LEFT BEHIND ACT OF 2001, PUBLIC LAW 107– 

110 

* * * * * * * 

‘‘Subpart 12—Educational, Cultural, Apprenticeship, and Exchange Programs for Alaska Natives, Native Hawaiians, and Their Historical 

Whaling and Trading Partners in Massachusetts 

‘‘SEC. 5521. SHORT TITLE. 

‘‘This subpart may be cited as the ‘Alaska Native and Native 

Hawaiian Education Through Cultural and Historical Organizations Act’. 

‘‘SEC. 5522. FINDINGS AND PURPOSES. 

‘‘(a) * * * 

* * * * * * * 

‘‘(b) PURPOSES.—The purposes of this subpart are the following: 

‘‘(1) To authorize and develop innovative culturally-based 

educational programs and cultural exchanges to assist Alaska 

Natives, Native Hawaiians, and children and families of Massachusetts linked by history and tradition to Alaska and Hawaii to learn about shared culture and traditions. 

‘‘(2) To authorize and develop internship and apprentice 

programs to assist Alaska Natives, Native Hawaiians, and children and families of Massachusetts linked by history and tradition with Alaska and Hawaii to prepare for careers with cultural institutions. 

‘‘(3) To supplement programs and authorities in the area 

of education to further the objectives of this subpart. 

‘‘(4) To authorize and develop cultural and educational programs relating to the Mississippi Band of Choctaw Indians.’’ 

‘‘SEC. 5523. PROGRAM AUTHORIZATION. 

‘‘(a) GRANTS AND CONTRACTS.—In order to carry out programs 

that fulfill the purposes of this subpart, the Secretary is authorized 

to make grants to, or enter into contracts with, the following: 

‘‘(1) The Alaska Native Heritage Center in Anchorage, 

Alaska. 

‘‘(2) The Inupiat Heritage Center in Barrow, Alaska. 

‘‘(3) The Bishop Museum in Hawaii. 

‘‘(4) The Peabody-Essex Museum in Salem, Massachusetts. 

‘‘(5) The New Bedford Whaling Museum and the New Bedford Oceanarium in New Bedford, Massachusetts. 

‘‘(6) The Mississippi Band of Choctaw Indians in Choctaw, 

Mississippi.’’ 
312 

‘‘ø(6)¿ (7) Other Alaska Native and Native Hawaiian cultural and educational organizations. ‘‘ø(7)¿ (8) Cultural and educational organizations with experience in developing or operating programs that illustrate 

and interpret the contributions of Alaska Natives, Native Hawaiians, the whaling industry, and the China trade to the economic, social, and environmental history of the United States. ‘‘ø(8)¿ (9) Consortia of the organizations and entities described in this subsection. 

* * * * * * * 

‘‘SEC. 5525. AVAILABILITY OF FUNDS. 

‘‘If sufficient funds are made available under section 5401 to 

carry out this subpart for a fiscal year, the Secretary shall make 

available, to support activities described in section 5523(b), the following amounts: ‘‘(1) Not less than $2,000,000 each to— 

‘‘(A) the New Bedford Whaling Museum, in partnership with the New Bedford Oceanarium, in Massachusetts; 

and 

‘‘(B) the Inupiat Heritage Center in Alaska. 

‘‘(2) For the New Trade Winds project, not less than $1,000,000 each to— 

‘‘(A) the Alaska Native Heritage Center in Alaska; 

‘‘(B) the Bishop Museum in Hawaii; and 

‘‘(C) the Peabody-Essex Museum in Massachusetts. 

‘‘(3) For internship and apprenticeship programs (including 

the Museum Action Corps of the Peabody-Essex Museum), not 

less than $1,000,000 each to— 

‘‘(A) the Alaska Native Heritage Center in Alaska; 

‘‘(B) the Bishop Museum in Hawaii; and 

‘‘(C) the Peabody-Essex Museum in Massachusetts. 

‘‘(4) For cultural and educational programs, not less than 

$2,000,000 to the Mississippi Band of Choctaw Indians in 

Choctaw, Mississippi.’’ 
313 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2005 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2006 

[In thousands of dollars] 

Item 2005 comparable Budget estimate House allowance Committee rec- ommendation Senate Committee recommendation compared with (∂ or ¥) 2005 comparable Budget estimate House allowance 

TITLE I—DEPARTMENT OF LABOR 

EMPLOYMENT AND TRAINING ADMINISTRATION 

TRAINING AND EMPLOYMENT SERVICES 

Grants to States: 

Adult Training, current year ............................................................ 184,618 153,736 153,736 181,618 ¥3,000 ∂27,882 ∂27,882 

Advance from prior year ........................................................ (706,304 ) (712,000 ) (712,000 ) (712,000 ) (∂5,696 ) ............................ ............................Fiscal year 2007 .................................................................... 712,000 712,000 712,000 712,000 ............................ ............................ ............................

Adult Training .................................................................... 896,618 865,736 865,736 893,618 ¥3,000 ∂27,882 ∂27,882 

Youth Training ................................................................................. 986,288 950,000 950,000 986,288 ............................ ∂36,288 ∂36,288 Dislocated Worker Assistance, current year ................................... 345,264 226,867 345,264 345,264 ............................ ∂118,397 ............................

Advance from prior year ........................................................ (841,216 ) (848,000 ) (848,000 ) (848,000 ) (∂6,784 ) ............................ ............................Fiscal year 2007 .................................................................... 848,000 848,000 848,000 848,000 ............................ ............................ ............................

Dislocated Worker Assistance ............................................ 1,193,264 1,074,867 1,193,264 1,193,264 ............................ ∂118,397 ............................

Federally Administered Programs: 

Dislocated Worker Assistance National Reserve: 

Current year ........................................................................... 70,800 56,717 ............................ 70,800 ............................ ∂14,083 ∂70,800 Advance from prior year ........................................................ (210,304 ) (212,000 ) (212,000 ) (212,000 ) (∂1,696 ) ............................ ............................Fiscal year 2007 .................................................................... 212,000 212,000 212,000 212,000 ............................ ............................ ............................

Dislocated Worker Assistance Nat’l Reserve ..................... 282,800 268,717 212,000 282,800 ............................ ∂14,083 ∂70,800 

Less funding reserved for Community College Initiative 

(NA) .................................................................................... (¥125,000 ) ............................ ............................ (¥125,000 ) ............................ (¥125,000 ) (¥125,000 ) 

Dislocated Worker Assistance Nat’l Reserve ................ 157,800 268,717 212,000 157,800 ............................ ¥110,917 ¥54,200 Total, Dislocated Worker Assistance ............................. 1,476,064 1,343,584 1,405,264 1,476,064 ............................ ∂132,480 ∂70,800 

Native Americans ............................................................................ 54,238 54,238 54,238 54,238 ............................ ............................ ............................
314 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2005 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2006—Continued 

[In thousands of dollars] 

Item 2005 comparable Budget estimate House allowance Committee rec- ommendation Senate Committee recommendation compared with (∂ or ¥) 2005 comparable Budget estimate House allowance 

Migrant and Seasonal Farmworkers ............................................... 75,759 ............................ 75,759 80,053 ∂4,294 ∂80,053 ∂4,294 Job Corps: 

Operations .............................................................................. 844,670 851,019 851,019 881,000 ∂36,330 ∂29,981 ∂29,981 

Advance from prior year ............................................... (586,272 ) (591,000 ) (591,000 ) (591,000 ) (∂4,728 ) ............................ ............................Fiscal year 2007 ........................................................... 591,000 591,000 591,000 591,000 ............................ ............................ ............................

Construction and Renovation ................................................. 16,190 ............................ ............................ 10,000 ¥6,190 ∂10,000 ∂10,000 

Advance from prior year ............................................... (99,200 ) (100,000 ) (100,000 ) (100,000 ) (∂800 ) ............................ ............................Fiscal year 2007 ........................................................... 100,000 75,000 100,000 100,000 ............................ ∂25,000 ............................

Subtotal, Job Corps .................................................. 1,551,860 1,517,019 1,542,019 1,582,000 ∂30,140 ∂64,981 ∂39,981 

National Activities: 

Pilots, Demonstrations and Research .................................... 85,167 30,000 74,000 90,367 ∂5,200 ∂60,367 ∂16,367 Responsible Reintegration of Youthful Offender ................... 49,600 ............................ ............................ 50,000 ∂400 ∂50,000 ∂50,000 Evaluation .............................................................................. 7,936 7,936 7,936 7,936 ............................ ............................ ............................Prisoner Re-entry .................................................................... 19,840 35,000 19,840 19,840 ............................ ¥15,160 ............................Community College initiative ................................................. 124,000 250,000 125,000 ............................ ¥124,000 ¥250,000 ¥125,000 

Community College initiative (NA) 1 ............................. (125,000 ) ............................ ............................ (125,000 ) ............................ (∂125,000 ) (∂125,000 ) 

Subtotal, CC initiative, program level ..................... 249,000 250,000 125,000 125,000 ¥124,000 ¥125,000 ............................

Denali Commission ................................................................ 6,944 ............................ ............................ 6,944 ............................ ∂6,944 ∂6,944 Other ....................................................................................... 3,458 2,000 2,000 3,458 ............................ ∂1,458 ∂1,458 

Subtotal, National activities .............................................. 296,945 324,936 228,776 178,545 ¥118,400 ¥146,391 ¥50,231 Subtotal, Federal activities ............................................... 2,261,602 2,164,910 2,112,792 2,177,636 ¥83,966 ∂12,726 ∂64,844 

Current Year ............................................................. 1,358,602 1,286,910 1,209,792 1,274,636 ¥83,966 ¥12,274 ∂64,844 Fiscal year 2007 ....................................................... 903,000 878,000 903,000 903,000 ............................ ∂25,000 ............................

Total, Training and Employment Services ......................... 5,337,772 5,055,513 5,121,792 5,250,806 ¥86,966 ∂195,293 ∂129,014 

Current Year ............................................................. (2,874,772 ) (2,617,513 ) (2,658,792 ) (2,787,806 ) (¥86,966 ) (∂170,293 ) (∂129,014 ) 
315 

Fiscal year 2007 ....................................................... (2,463,000 ) (2,438,000 ) (2,463,000 ) (2,463,000 ) ............................ (∂25,000 ) ............................

COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS ................ 436,678 436,678 436,678 436,678 ............................ ............................ ............................FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES ......................... 1,057,300 966,400 966,400 966,400 ¥90,900 ............................ ............................

STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE 

OPERATIONS 

Unemployment Compensation: 

State Operations ............................................................................. 2,663,040 2,622,499 2,622,499 2,600,000 ¥63,040 ¥22,499 ¥22,499 National Activities ........................................................................... 10,416 10,416 10,416 10,000 ¥416 ¥416 ¥416 

Subtotal, Unemployment Compensation ..................................... 2,673,456 2,632,915 2,632,915 2,610,000 ¥63,456 ¥22,915 ¥22,915 

Employment Service: 

Allotments to States: 

Federal Funds ......................................................................... 23,114 23,300 23,300 23,114 ............................ ¥186 ¥186 Trust Funds ............................................................................ 757,478 672,700 672,700 723,188 ¥34,290 ∂50,488 ∂50,488 

Subtotal, allotments to States .......................................... 780,592 696,000 696,000 746,302 ¥34,290 ∂50,302 ∂50,302 

ES National Activities ..................................................................... 64,976 33,766 33,766 33,766 ¥31,210 ............................ ............................

Subtotal, Employment Service .................................................... 845,568 729,766 729,766 780,068 ¥65,500 ∂50,302 ∂50,302 

Federal Funds .................................................................... 23,114 23,300 23,300 23,114 ............................ ¥186 ¥186 Trust Funds ........................................................................ 822,454 706,466 706,466 756,954 ¥65,500 ∂50,488 ∂50,488 

One-Stop Career Centers/Labor Market Information ............................... 97,974 87,974 87,974 90,000 ¥7,974 ∂2,026 ∂2,026 Work Incentives Grants ............................................................................ 19,711 19,711 19,711 19,711 ............................ ............................ ............................

Total, State Unemployment & Employment Srvcs ...................... 3,636,709 3,470,366 3,470,366 3,499,779 ¥136,930 ∂29,413 ∂29,413 

Federal Funds .................................................................... 140,799 130,985 130,985 132,825 ¥7,974 ∂1,840 ∂1,840 Trust Funds ........................................................................ 3,495,910 3,339,381 3,339,381 3,366,954 ¥128,956 ∂27,573 ∂27,573 

ADVANCES TO THE UI AND OTHER TRUST FUNDS 2 ................................. 517,000 465,000 465,000 465,000 ¥52,000 ............................ ............................

PROGRAM ADMINISTRATION 

Adult Employment and Training .............................................................. 38,874 44,631 44,631 43,631 ∂4,757 ¥1,000 ¥1,000 

Trust Funds ..................................................................................... 6,901 7,925 7,925 7,925 ∂1,024 ............................ ............................

Youth Employment and Training ............................................................. 39,627 38,805 38,805 38,805 ¥822 ............................ ............................Employment Security ................................................................................ 6,045 6,039 6,039 6,039 ¥6 ............................ ............................

Trust Funds ..................................................................................... 48,235 77,952 77,952 72,841 ∂24,606 ¥5,111 ¥5,111 

Apprenticeship Services ........................................................................... 21,136 21,655 21,655 21,655 ∂519 ............................ ............................Executive Direction ................................................................................... 6,845 6,993 6,993 6,993 ∂148 ............................ ............................
316 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2005 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2006—Continued 

[In thousands of dollars] 

Item 2005 comparable Budget estimate House allowance Committee rec- ommendation Senate Committee recommendation compared with (∂ or ¥) 2005 comparable Budget estimate House allowance 

Trust Funds ..................................................................................... 2,065 2,111 2,111 2,111 ∂46 ............................ ............................

Welfare to Work ........................................................................................ 373 ............................ ............................ ............................ ¥373 ............................ ............................

Total, Program Administration ................................................... 170,101 206,111 206,111 200,000 ∂29,899 ¥6,111 ¥6,111 

Federal Funds .................................................................... 112,900 118,123 118,123 117,123 ∂4,223 ¥1,000 ¥1,000 Trust Funds ........................................................................ 57,201 87,988 87,988 82,877 ∂25,676 ¥5,111 ¥5,111 

Total, Employment and Training Administration ....................... 11,155,560 10,600,068 10,666,347 10,818,663 ¥336,897 ∂218,595 ∂152,316 

Federal Funds .................................................................... 7,602,449 7,172,699 7,238,978 7,368,832 ¥233,617 ∂196,133 ∂129,854 

Current Year ............................................................. (5,139,449 ) (4,734,699 ) (4,775,978 ) (4,905,832 ) (¥233,617 ) (∂171,133 ) (∂129,854 ) Fiscal year 2007 ....................................................... (2,463,000 ) (2,438,000 ) (2,463,000 ) (2,463,000 ) ............................ (∂25,000 ) ............................

Trust Funds ........................................................................ 3,553,111 3,427,369 3,427,369 3,449,831 ¥103,280 ∂22,462 ∂22,462 

EMPLOYEE BENEFITS SECURITY ADMINISTRATION 

SALARIES AND EXPENSES 

Enforcement and Participant Assistance ................................................ 109,374 114,462 114,462 112,362 ∂2,988 ¥2,100 ¥2,100 Policy and Compliance Assistance .......................................................... 17,357 17,458 17,458 17,458 ∂101 ............................ ............................Executive Leadership, Program Oversight and Admin ............................ 4,482 5,080 5,080 5,080 ∂598 ............................ ............................

Total, EBSA ................................................................................. 131,213 137,000 137,000 134,900 ∂3,687 ¥2,100 ¥2,100 

PENSION BENEFIT GUARANTY CORPORATION 

Pension insurance activities .................................................................... (12,211 ) (42,122 ) (42,122 ) (42,122 ) (∂29,911 ) ............................ ............................Pension plan termination ......................................................................... (169,739 ) (161,117 ) (161,117 ) (161,117 ) (¥8,622 ) ............................ ............................Operational support ................................................................................. (84,380 ) (93,739 ) (93,739 ) (93,739 ) (∂9,359 ) ............................ ............................

Total, PBGC (Program level) ....................................................... (266,330 ) (296,978 ) (296,978 ) (296,978 ) (∂30,648 ) ............................ ............................

EMPLOYMENT STANDARDS ADMINISTRATION 

SALARIES AND EXPENSES 

Enforcement of Wage and Hour Standards ............................................. 164,493 167,359 167,359 167,359 ∂2,866 ............................ ............................
317 

Office of Labor-Management Standards ................................................. 41,681 48,799 48,799 43,599 ∂1,918 ¥5,200 ¥5,200 Federal Contractor EEO Standards Enforcement ..................................... 80,059 82,106 82,106 82,106 ∂2,047 ............................ ............................Federal Programs for Workers’ Compensation ......................................... 97,339 100,129 100,129 100,129 ∂2,790 ............................ ............................

Trust Funds ..................................................................................... 2,023 2,048 2,048 2,048 ∂25 ............................ ............................

Program Direction and Support ............................................................... 15,252 15,891 15,891 17,375 ∂2,123 ∂1,484 ∂1,484 

Total, ESA salaries and expenses .............................................. 400,847 416,332 416,332 412,616 ∂11,769 ¥3,716 ¥3,716 

Federal Funds .................................................................... 398,824 414,284 414,284 410,568 ∂11,744 ¥3,716 ¥3,716 Trust Funds ........................................................................ 2,023 2,048 2,048 2,048 ∂25 ............................ ............................

SPECIAL BENEFITS 

Federal employees compensation benefits .............................................. 230,000 234,000 234,000 234,000 ∂4,000 ............................ ............................Longshore and harbor workers’ benefits ................................................. 3,000 3,000 3,000 3,000 ............................ ............................ ............................

Total, Special Benefits ............................................................... 233,000 237,000 237,000 237,000 ∂4,000 ............................ ............................

SPECIAL BENEFITS FOR DISABLED COAL MINERS 

Benefit payments ..................................................................................... 358,806 308,000 308,000 308,000 ¥50,806 ............................ ............................Administration .......................................................................................... 5,191 5,250 5,250 5,250 ∂59 ............................ ............................

Subtotal, Fiscal year 2006 program level .................................. 363,997 313,250 313,250 313,250 ¥50,747 ............................ ............................

Less funds advanced in prior year ................................... ¥88,000 ¥81,000 ¥81,000 ¥81,000 ∂7,000 ............................ ............................

Total, Current Year, Fiscal year 2006 .......................... 275,997 232,250 232,250 232,250 ¥43,747 ............................ ............................

New advances, 1st quarter Fiscal year 2007 ................... 81,000 74,000 74,000 74,000 ¥7,000 ............................ ............................

Total, Special Benefits for Disabled Coal Miners ........ 356,997 306,250 306,250 306,250 ¥50,747 ............................ ............................

ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION FUND, 

Part B Administrative Expenses .......................................................... 40,321 96,081 96,081 96,081 ∂55,760 ............................ ............................

BLACK LUNG DISABILITY TRUST FUND 

Benefit payments and interest on advances .......................................... 1,004,951 1,010,011 1,010,011 1,010,011 ∂5,060 ............................ ............................Employment Standards Adm. S&E ........................................................... 32,615 33,050 33,050 33,050 ∂435 ............................ ............................Departmental Management S&E .............................................................. 23,705 24,239 24,239 24,239 ∂534 ............................ ............................Departmental Management, Inspector General ....................................... 342 344 344 344 ∂2 ............................ ............................

Subtotal, Black Lung Disability .................................................. 1,061,613 1,067,644 1,067,644 1,067,644 ∂6,031 ............................ ............................

Treasury Administrative Costs ................................................................. 356 356 356 356 ............................ ............................ ............................
318 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2005 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2006—Continued 

[In thousands of dollars] 

Item 2005 comparable Budget estimate House allowance Committee rec- ommendation Senate Committee recommendation compared with (∂ or ¥) 2005 comparable Budget estimate House allowance 

Total, Black Lung Disability Trust Fund .................................... 1,061,969 1,068,000 1,068,000 1,068,000 ∂6,031 ............................ ............................Total, Employment Standards Administration ............................ 2,093,134 2,123,663 2,123,663 2,119,947 ∂26,813 ¥3,716 ¥3,716 

Federal Funds .................................................................... 2,091,111 2,121,615 2,121,615 2,117,899 ∂26,788 ¥3,716 ¥3,716 

Current year .............................................................. (2,010,111 ) (2,047,615 ) (2,047,615 ) (2,043,899 ) (∂33,788 ) (¥3,716 ) (¥3,716 ) Fiscal year 2007 ....................................................... (81,000 ) (74,000 ) (74,000 ) (74,000 ) (¥7,000 ) ............................ ............................

Trust Funds ........................................................................ 2,023 2,048 2,048 2,048 ∂25 ............................ ............................

OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION 

SALARIES AND EXPENSES 

Safety and Health Standards .................................................................. 16,003 16,628 16,628 16,628 ∂625 ............................ ............................Federal Enforcement ................................................................................ 169,652 174,318 174,318 174,318 ∂4,666 ............................ ............................State Programs ........................................................................................ 91,013 92,013 92,013 92,013 ∂1,000 ............................ ............................Technical Support .................................................................................... 20,742 21,652 21,652 21,652 ∂910 ............................ ............................Compliance Assistance: 

Federal Assistance .......................................................................... 70,859 73,278 73,278 73,278 ∂2,419 ............................ ............................State Consultation Grants .............................................................. 53,362 53,896 53,896 53,896 ∂534 ............................ ............................Training Grants ............................................................................... 10,218 ............................ 10,218 10,510 ∂292 ∂10,510 ∂292 

Subtotal, Compliance Assistance ............................................... 134,439 127,174 137,392 137,684 ∂3,245 ∂10,510 ∂292 

Safety and Health Statistics .................................................................... 22,203 24,498 24,498 24,498 ∂2,295 ............................ ............................Executive Direction and Administration ................................................... 10,106 10,698 10,698 10,698 ∂592 ............................ ............................

Total, OSHA ................................................................................. 464,158 466,981 477,199 477,491 ∂13,333 ∂10,510 ∂292 

MINE SAFETY AND HEALTH ADMINISTRATION 

SALARIES AND EXPENSES 

Coal Enforcement ..................................................................................... 115,251 118,335 118,335 118,335 ∂3,084 ............................ ............................Metal/Non-Metal Enforcement .................................................................. 66,752 68,750 68,750 68,750 ∂1,998 ............................ ............................Standards Development ........................................................................... 2,334 2,506 2,506 2,506 ∂172 ............................ ............................
319 

Assessments ............................................................................................. 5,238 5,445 5,445 5,445 ∂207 ............................ ............................Educational Policy and Development ....................................................... 31,255 32,021 32,021 32,021 ∂766 ............................ ............................Technical Support .................................................................................... 25,111 25,736 25,736 25,736 ∂625 ............................ ............................Program evaluation and information resources (PEIR) ........................... 17,525 15,671 15,671 15,671 ¥1,854 ............................ ............................Program Administration ........................................................................... 15,670 12,026 12,026 12,026 ¥3,644 ............................ ............................

Total, Mine Safety and Health Administration ........................... 279,136 280,490 280,490 280,490 ∂1,354 ............................ ............................

BUREAU OF LABOR STATISTICS 

SALARIES AND EXPENSES 

Employment and Unemployment Statistics ............................................. 162,714 167,047 167,047 167,047 ∂4,333 ............................ ............................Labor Market Information (Trust Funds) ................................................. 77,845 77,845 77,845 77,845 ............................ ............................ ............................Prices and Cost of Living ........................................................................ 169,370 174,779 174,779 174,779 ∂5,409 ............................ ............................Compensation and Working Conditions ................................................... 78,942 81,532 81,532 81,532 ∂2,590 ............................ ............................Productivity and Technology .................................................................... 10,503 10,847 10,847 10,847 ∂344 ............................ ............................Executive Direction and Staff Services .................................................... 29,629 30,473 30,473 30,473 ∂844 ............................ ............................

Total, Bureau of Labor Statistics ............................................... 529,003 542,523 542,523 542,523 ∂13,520 ............................ ............................

Federal Funds .................................................................... 451,158 464,678 464,678 464,678 ∂13,520 ............................ ............................Trust Funds ........................................................................ 77,845 77,845 77,845 77,845 ............................ ............................ ............................

OFFICE OF DISABILITY EMPLOYMENT POLICY 

Ofce of Disability Employ. Policy, Salaries & expenses .......................... 47,164 27,934 27,934 47,164 ............................ ∂19,230 ∂19,230 

DEPARTMENTAL MANAGEMENT 

SALARIES AND EXPENSES 

Executive Direction ................................................................................... 26,720 29,504 24,864 26,720 ............................ ¥2,784 ∂1,856 Departmental IT Crosscut ........................................................................ 29,760 29,760 29,760 29,760 ............................ ............................ ............................Departmental Management Crosscut ...................................................... 4,960 1,700 1,700 1,700 ¥3,260 ............................ ............................Legal Services .......................................................................................... 79,769 81,907 81,907 80,000 ∂231 ¥1,907 ¥1,907 

Trust Funds ..................................................................................... 311 311 311 311 ............................ ............................ ............................

International Labor Affairs ....................................................................... 93,248 12,419 12,419 93,248 ............................ ∂80,829 ∂80,829 Administration and Management ............................................................ 32,414 33,197 33,197 33,197 ∂783 ............................ ............................Frances Perkins building security enhancements ................................... 6,944 6,944 6,944 6,944 ............................ ............................ ............................Adjudication ............................................................................................. 25,665 27,126 27,126 27,126 ∂1,461 ............................ ............................Women’s Bureau ...................................................................................... 9,478 9,764 9,764 9,764 ∂286 ............................ ............................Civil Rights Activities .............................................................................. 6,237 6,451 6,451 6,451 ∂214 ............................ ............................Chief Financial Officer ............................................................................. 5,182 5,340 5,340 5,340 ∂158 ............................ ............................
320 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2005 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2006—Continued 

[In thousands of dollars] 

Item 2005 comparable Budget estimate House allowance Committee rec- ommendation Senate Committee recommendation compared with (∂ or ¥) 2005 comparable Budget estimate House allowance 

Total, Salaries and expenses ..................................................... 320,688 244,423 239,783 320,561 ¥127 ∂76,138 ∂80,778 

Federal Funds .................................................................... 320,377 244,112 239,472 320,250 ¥127 ∂76,138 ∂80,778 Trust Funds ........................................................................ 311 311 311 311 ............................ ............................ ............................

VETERANS EMPLOYMENT AND TRAINING 

State administration, Grants ................................................................... 161,097 162,415 162,415 162,415 ∂1,318 ............................ ............................Federal Administration ............................................................................. 30,438 30,435 31,935 30,435 ¥3 ............................ ¥1,500 National Veterans Training Institute ....................................................... 1,984 1,984 2,484 1,984 ............................ ............................ ¥500 Homeless Veterans Program .................................................................... 20,832 22,000 25,000 22,000 ∂1,168 ............................ ¥3,000 Veterans Workforce Investment Programs ............................................... 8,482 7,500 7,500 7,500 ¥982 ............................ ............................

Total, Veterans Employment and Training ................................. 222,833 224,334 229,334 224,334 ∂1,501 ............................ ¥5,000 

Federal Funds .................................................................... 29,314 29,500 32,500 29,500 ∂186 ............................ ¥3,000 Trust Funds ........................................................................ 193,519 194,834 196,834 194,834 ∂1,315 ............................ ¥2,000 

OFFICE OF THE INSPECTOR GENERAL 

Program Activities .................................................................................... 63,478 65,211 65,211 67,211 ∂3,733 ∂2,000 ∂2,000 

Trust Funds ..................................................................................... 5,517 5,608 5,608 5,608 ∂91 ............................ ............................

Total, Office of the Inspector General ........................................ 68,995 70,819 70,819 72,819 ∂3,824 ∂2,000 ∂2,000 

Federal funds ..................................................................... 63,478 65,211 65,211 67,211 ∂3,733 ∂2,000 ∂2,000 Trust funds ........................................................................ 5,517 5,608 5,608 5,608 ∂91 ............................ ............................

Total, Departmental Management .............................................. 612,516 539,576 539,936 617,714 ∂5,198 ∂78,138 ∂77,778 

Federal Funds .................................................................... 413,169 338,823 337,183 416,961 ∂3,792 ∂78,138 ∂79,778 Trust Funds ........................................................................ 199,347 200,753 202,753 200,753 ∂1,406 ............................ ¥2,000 

WORKING CAPITAL FUND 

Working capital fund ............................................................................... 9,920 6,230 6,230 6,230 ¥3,690 ............................ ............................

Total, Title I, Department of Labor ............................................ 15,321,804 14,724,465 14,801,322 15,045,122 ¥276,682 ∂320,657 ∂243,800 

Federal Funds .................................................................... 11,489,478 11,016,450 11,091,307 11,314,645 ¥174,833 ∂298,195 ∂223,338 
321 

Current Year ............................................................. (8,945,478 ) (8,504,450 ) (8,554,307 ) (8,777,645 ) (¥167,833 ) (∂273,195 ) (∂223,338 ) Fiscal year 2007 ....................................................... (2,544,000 ) (2,512,000 ) (2,537,000 ) (2,537,000 ) (¥7,000 ) (∂25,000 ) ............................

Trust Funds ........................................................................ 3,832,326 3,708,015 3,710,015 3,730,477 ¥101,849 ∂22,462 ∂20,462 

TITLE II—DEPARTMENT OF HEALTH AND HUMAN SERVICES 

HEALTH RESOURCES AND SERVICES ADMINISTRATION 

HEALTH RESOURCES AND SERVICES BUREAU OF PRIMARY HEALTH CARE 

Community health centers ....................................................................... 1,734,311 2,037,871 1,834,311 1,839,311 ∂105,000 ¥198,560 ∂5,000 Free Clinics Medical Malpractice ............................................................. 99 ............................ ............................ 99 ............................ ∂99 ∂99 Radiation Exposure Compensation Act .................................................... 1,958 1,936 1,900 1,958 ............................ ∂22 ∂58 Healthy Community Access Program ....................................................... 82,993 ............................ ............................ 60,000 ¥22,993 ∂60,000 ∂60,000 Hansen’s Disease Services ...................................................................... 17,251 16,066 16,066 17,066 ¥185 ∂1,000 ∂1,000 Buildings and Facilities ........................................................................... 247 222 222 222 ¥25 ............................ ............................Payment to Hawaii, treatment of Hansen’s ............................................ 2,017 2,016 2,016 2,017 ............................ ∂1 ∂1 Black lung clinics .................................................................................... 5,951 5,912 5,912 5,975 ∂24 ∂63 ∂63 

Subtotal, Bureau of Primary Health Care .................................. 1,844,827 2,064,023 1,860,427 1,926,648 ∂81,821 ¥137,375 ∂66,221 

BUREAU OF HEALTH PROFESSIONS 

National Health Service Corps: 

Field placements ............................................................................. 45,068 40,705 40,705 40,705 ¥4,363 ............................ ............................Recruitment ..................................................................................... 86,380 86,091 86,091 86,091 ¥289 ............................ ............................

Subtotal, National Health Service Corps .................................... 131,448 126,796 126,796 126,796 ¥4,652 ............................ ............................

Health Professions 

Training for Diversity: 

Centers of excellence ...................................................................... 33,609 ............................ 12,000 33,609 ............................ ∂33,609 ∂21,609 Health careers opportunity program ............................................... 35,647 ............................ ............................ 35,647 ............................ ∂35,647 ∂35,647 Faculty loan repayment ................................................................... 1,302 ............................ ............................ 1,302 ............................ ∂1,302 ∂1,302 Scholarships for disadvantaged students ...................................... 47,128 9,831 35,128 47,128 ............................ ∂37,297 ∂12,000 

Subtotal, Training for Diversity .................................................. 117,686 9,831 47,128 117,686 ............................ ∂107,855 ∂70,558 

Training in Primary Care Medicine and Dentistry ................................... 88,816 ............................ ............................ 90,000 ∂1,184 ∂90,000 ∂90,000 Interdisciplinary Community-Based Linkages: 

Area health education centers ........................................................ 28,971 ............................ ............................ 28,971 ............................ ∂28,971 ∂28,971 Health education and training centers .......................................... 3,819 ............................ ............................ 3,819 ............................ ∂3,819 ∂3,819 
322 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2005 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2006—Continued 

[In thousands of dollars] 

Item 2005 comparable Budget estimate House allowance Committee rec- ommendation Senate Committee recommendation compared with (∂ or ¥) 2005 comparable Budget estimate House allowance 

Allied health and other disciplines ................................................ 11,753 ............................ ............................ 11,753 ............................ ∂11,753 ∂11,753 Geriatric programs .......................................................................... 31,548 ............................ ............................ 29,548 ¥2,000 ∂29,548 ∂29,548 Quentin N. Burdick program for rural training .............................. 6,076 ............................ ............................ 6,076 ............................ ∂6,076 ∂6,076 

Subtotal, Interdisciplinary Comm. Linkages .............................. 82,167 ............................ ............................ 80,167 ¥2,000 ∂80,167 ∂80,167 

Health Professions Workforce Info & Analysis ......................................... 716 712 ............................ 712 ¥4 ............................ ∂712 Public Health Workforce Development: 

Public health, preventive med. and dental programs ................... 9,097 ............................ ............................ 9,097 ............................ ∂9,097 ∂9,097 Health administration programs ..................................................... 1,070 ............................ ............................ 1,070 ............................ ∂1,070 ∂1,070 

Subtotal, Public Health Workforce Development ........................ 10,167 ............................ ............................ 10,167 ............................ ∂10,167 ∂10,167 

Nursing Programs: 

Advanced Education Nursing .......................................................... 58,160 42,806 57,637 58,160 ............................ ∂15,354 ∂523 Nurse education, practice, and retention ....................................... 36,468 46,325 36,468 40,468 ∂4,000 ¥5,857 ∂4,000 Nursing workforce diversity ............................................................. 16,270 21,244 16,270 17,270 ∂1,000 ¥3,974 ∂1,000 Loan repayment and scholarship program ..................................... 31,482 31,369 31,369 31,482 ............................ ∂113 ∂113 Comprehensive geriatric education ................................................ 3,450 3,426 3,426 3,450 ............................ ∂24 ∂24 Nursing faculty loan program ......................................................... 4,831 4,821 4,821 4,831 ............................ ∂10 ∂10 

Subtotal, Nursing programs ....................................................... 150,661 149,991 149,991 155,661 ∂5,000 ∂5,670 ∂5,670 Subtotal, Health Professions ...................................................... 450,213 160,534 197,119 454,393 ∂4,180 ∂293,859 ∂257,274 

Children’s Hospitals Graduate Medical Education .................................. 300,730 200,000 300,000 300,000 ¥730 ∂100,000 ............................National Practitioner Data Bank .............................................................. 15,700 15,700 15,700 15,700 ............................ ............................ ............................

User Fees ......................................................................................... ¥15,700 ¥15,700 ¥15,700 ¥15,700 ............................ ............................ ............................

Health Care Integrity and Protection Data Bank .................................... 4,000 4,000 4,000 4,000 ............................ ............................ ............................

User Fees ......................................................................................... ¥4,000 ¥4,000 ¥4,000 ¥4,000 ............................ ............................ ............................

Subtotal, Bureau of Health Professions ..................................... 882,391 487,330 623,915 881,189 ¥1,202 ∂393,859 ∂257,274 
323 

MATERNAL AND CHILD HEALTH BUREAU 

Maternal and Child Health Block Grant .................................................. 723,928 723,928 700,000 710,000 ¥13,928 ¥13,928 ∂10,000 Sickle cell service demonstration program ............................................. 198 ............................ ............................ 500 ∂302 ∂500 ∂500 Traumatic Brain Injury ............................................................................. 9,297 ............................ 9,000 9,297 ............................ ∂9,297 ∂297 Healthy Start ............................................................................................ 102,543 97,747 97,747 104,000 ∂1,457 ∂6,253 ∂6,253 Universal Newborn Hearing ...................................................................... 9,792 ............................ 10,000 9,792 ............................ ∂9,792 ¥208 Emergency medical services for children ................................................ 19,830 ............................ 19,000 20,000 ∂170 ∂20,000 ∂1,000 Poison control ........................................................................................... 23,499 23,301 23,301 23,301 ¥198 ............................ ............................

Subtotal, Maternal and Child Health Bureau ............................ 889,087 844,976 859,048 876,890 ¥12,197 ∂31,914 ∂17,842 

HIV/AIDS BUREAU 

Ryan White AIDS Programs: 

Emergency Assistance ..................................................................... 610,094 610,094 610,094 610,094 ............................ ............................ ............................Comprehensive Care Programs ....................................................... 1,121,836 1,131,836 1,131,836 1,131,836 ∂10,000 ............................ ............................

AIDS Drug Assistance Program (ADAP) (NA) ......................... (787,521 ) (797,521 ) (797,521 ) (797,521 ) (∂10,000 ) ............................ ............................

Early Intervention Program ............................................................. 195,578 195,578 195,578 195,578 ............................ ............................ ............................Pediatric HIV/AIDS ........................................................................... 72,519 72,519 72,519 72,519 ............................ ............................ ............................AIDS Dental Services ....................................................................... 13,218 13,218 13,218 13,218 ............................ ............................ ............................Education and Training Centers ..................................................... 35,051 35,051 35,051 35,051 ............................ ............................ ............................

Subtotal, Ryan White AIDS programs ......................................... 2,048,296 2,058,296 2,058,296 2,058,296 ∂10,000 ............................ ............................

Evaluation Tap Funding (NA) .......................................................... (25,000 ) (25,000 ) (25,000 ) (25,000 ) ............................ ............................ ............................

Subtotal, Ryan White AIDs program level .................................. (2,073,296 ) (2,083,296 ) (2,083,296 ) (2,083,296 ) (∂10,000 ) ............................ ............................

Telehealth ........................................................................................ 3,916 3,888 3,888 3,888 ¥28 ............................ ............................

Subtotal, HIV/AIDS Bureau ......................................................... 2,052,212 2,062,184 2,062,184 2,062,184 ∂9,972 ............................ ............................

SPECIAL PROGRAMS BUREAU 

Organ Transplantation ............................................................................. 24,413 23,282 23,282 24,413 ............................ ∂1,131 ∂1,131 Cord Blood Stem Cell Bank ..................................................................... 9,859 ............................ ............................ 9,859 ............................ ∂9,859 ∂9,859 Bone Marrow Program .............................................................................. 25,416 22,916 25,416 22,916 ¥2,500 ............................ ¥2,500 Trauma Care ............................................................................................ 3,418 ............................ ............................ 3,418 ............................ ∂3,418 ∂3,418 State Planning Grants for Health Care Access ....................................... 10,910 ............................ ............................ ............................ ¥10,910 ............................ ............................

Subtotal, Special programs bureau ........................................... 74,016 46,198 48,698 60,606 ¥13,410 ∂14,408 ∂11,908 
324 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2005 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2006—Continued 

[In thousands of dollars] 

Item 2005 comparable Budget estimate House allowance Committee rec- ommendation Senate Committee recommendation compared with (∂ or ¥) 2005 comparable Budget estimate House allowance 

RURAL HEALTH PROGRAMS 

Rural outreach grants .............................................................................. 39,278 10,767 10,767 39,278 ............................ ∂28,511 ∂28,511 Rural Health Research ............................................................................. 8,825 8,528 ............................ 8,825 ............................ ∂297 ∂8,825 Rural Hospital Flexibility Grants .............................................................. 39,180 ............................ 39,180 64,180 ∂25,000 ∂64,180 ∂25,000 Rural and community access to emergency devices .............................. 8,927 1,960 1,960 8,927 ............................ ∂6,967 ∂6,967 Rural EMS ................................................................................................ 496 ............................ ............................ 500 ∂4 ∂500 ∂500 State Offices of Rural Health .................................................................. 8,321 8,223 8,223 8,321 ............................ ∂98 ∂98 Denali Commission .................................................................................. 39,680 ............................ ............................ 39,680 ............................ ∂39,680 ∂39,680 

Subtotal, Rural health programs ............................................... 144,707 29,478 60,130 169,711 ∂25,004 ∂140,233 ∂109,581 

Bioterrorism preparedness 3 ..................................................................... ............................ ............................ 500,000 510,500 ∂510,500 ∂510,500 ∂10,500 Family Planning ....................................................................................... 285,963 285,963 285,963 285,963 ............................ ............................ ............................Health Care-related Facilities and activities .......................................... 482,729 ............................ ............................ 480,751 ¥1,978 ∂480,751 ∂480,751 Program Management .............................................................................. 147,080 145,992 143,072 143,992 ¥3,088 ¥2,000 ∂920 

Total, Health resources and services ......................................... 6,803,012 5,966,144 6,443,437 7,398,434 ∂595,422 ∂1,432,290 ∂954,997 Total, Health resources & services program level ..................... (6,828,012 ) (5,991,144 ) (6,468,437 ) (7,423,434 ) (∂595,422 ) (∂1,432,290 ) (∂954,997 ) 

Evaluation tap funding ..................................................... (25,000 ) (25,000 ) (25,000 ) (25,000 ) ............................ ............................ ............................

HEALTH EDUCATION ASSISTANCE LOANS (HEAL) PROGRAM: 

Liquidating account ........................................................................ (4,000 ) (4,000 ) (4,000 ) (4,000 ) ............................ ............................ ............................Program management ..................................................................... 3,244 2,916 2,916 2,916 ¥328 ............................ ............................

Total, HEAL ................................................................................. 3,244 2,916 2,916 2,916 ¥328 ............................ ............................

VACCINE INJURY COMPENSATION PROGRAM TRUST FUND: 

Post-Fiscal Year 1988 claims ......................................................... 66,000 70,884 70,884 70,884 ∂4,884 ............................ ............................HRSA administration ....................................................................... 3,151 2,832 3,500 3,600 ∂449 ∂768 ∂100 

Total, Vaccine Injury Compensation Trust Fund ........................ 69,151 73,716 74,384 74,484 ∂5,333 ∂768 ∂100 Total, Health Resources and Services Admin ............................ 6,875,407 6,042,776 6,520,737 7,475,834 ∂600,427 ∂1,433,058 ∂955,097 
325 

Total, HRSA program level ......................................................... (6,904,407 ) (6,071,776 ) (6,549,737 ) (7,504,834 ) (∂600,427 ) (∂1,433,058 ) (∂955,097 ) 

CENTERS FOR DISEASE CONTROL AND PREVENTION 

Infectious Diseases .................................................................................. 1,667,095 1,696,964 1,704,529 1,696,567 ∂29,472 ¥397 ¥7,962 

Evaluation Tap Funding .................................................................. (12,794 ) (12,794 ) (12,794 ) (12,794 ) ............................ ............................ ............................

Subtotal, Program level .............................................................. (1,679,889 ) (1,709,758 ) (1,717,323 ) (1,709,361 ) (∂29,472 ) (¥397 ) (¥7,962 ) 

Health Promotion ...................................................................................... 1,021,709 964,421 983,647 974,080 ¥47,629 ∂9,659 ¥9,567 Health Information and Service ............................................................... 94,438 89,564 195,069 89,564 ¥4,874 ............................ ¥105,505 

Evaluation Tap Funding .................................................................. (134,235 ) (134,235 ) (28,730 ) (134,235 ) ............................ ............................ (∂105,505 ) 

Subtotal, Program level .............................................................. (228,673 ) (223,799 ) (223,799 ) (223,799 ) (¥4,874 ) ............................ ............................

Environmental health and injury ............................................................. 285,721 284,820 285,721 288,982 ∂3,261 ∂4,162 ∂3,261 Occupational safety and health 4 ............................................................ 198,970 198,859 164,170 170,050 ¥28,920 ¥28,809 ∂5,880 

Evaluation Tap Funding .................................................................. (87,071 ) (87,071 ) (87,071 ) (87,071 ) ............................ ............................ ............................

Subtotal, Program level 4 ............................................................ (286,041 ) (285,930 ) (251,241 ) (257,121 ) (¥28,920 ) (¥28,809 ) (∂5,880 ) 

Global health ............................................................................................ 293,863 306,079 309,076 313,227 ∂19,364 ∂7,148 ∂4,151 

Supplemental (Public Law 109–13) (emergency) .......................... 15,000 ............................ ............................ ............................ ¥15,000 ............................ ............................

Subtotal, Program level .............................................................. (308,863 ) (306,079 ) (309,076 ) (313,227 ) (∂4,364 ) (∂7,148 ) (∂4,151 ) 

Terrorism preparedness and response 3 .................................................. ............................ ............................ 1,616,723 1,566,471 ∂1,566,471 ∂1,566,471 ¥50,252 Public Health research: 

Evaluation Tap Funding .................................................................. (31,000 ) (31,000 ) (31,000 ) (31,000 ) ............................ ............................ ............................

Public health improvement and leadership ............................................ 266,842 206,541 258,541 269,055 ∂2,213 ∂62,514 ∂10,514 Preventive health and health services block grant ................................ 118,526 ............................ 100,000 100,000 ¥18,526 ∂100,000 ............................Buildings and Facilities ........................................................................... 269,708 30,000 30,000 225,000 ¥44,708 ∂195,000 ∂195,000 Business services ..................................................................................... 278,838 263,715 298,515 296,119 ∂17,281 ∂32,404 ¥2,396 

Total, Centers for Disease Control ............................................. 4,510,710 4,040,963 5,945,991 5,989,115 ∂1,478,405 ∂1,948,152 ∂43,124 

Evaluation Tap Funding (NA) ............................................ (265,100 ) (265,100 ) (159,595 ) (265,100 ) ............................ ............................ (∂105,505 ) 

Total, Centers for Disease Control program level ...................... (4,775,810 ) (4,306,063 ) (6,105,586 ) (6,254,215 ) (∂1,478,405 ) (∂1,948,152 ) (∂148,629 ) 

NATIONAL INSTITUTES OF HEALTH 

National Cancer Institute ......................................................................... 4,825,259 4,841,774 4,841,774 4,960,828 ∂135,569 ∂119,054 ∂119,054 National Heart, Lung, and Blood Institute .............................................. 2,941,201 2,951,270 2,951,270 3,023,381 ∂82,180 ∂72,111 ∂72,111 National Institute of Dental & Craniofacial Research ............................ 391,829 393,269 393,269 405,269 ∂13,440 ∂12,000 ∂12,000 National Institute of Diabetes and Digestive and Kidney Diseases ....... 1,713,584 1,722,146 1,722,146 1,767,919 ∂54,335 ∂45,773 ∂45,773 
326 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2005 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2006—Continued 

[In thousands of dollars] 

Item 2005 comparable Budget estimate House allowance Committee rec- ommendation Senate Committee recommendation compared with (∂ or ¥) 2005 comparable Budget estimate House allowance 

Juvenile diabetes (mandatory) ........................................................ (150,000 ) (150,000 ) (150,000 ) (150,000 ) ............................ ............................ ............................

Subtotal, NIDDK .......................................................................... (1,863,584 ) (1,872,146 ) (1,872,146 ) (1,917,919 ) (∂54,335 ) (∂45,773 ) (∂45,773 ) 

National Institute of Neurological Disorders & Stroke ............................ 1,539,448 1,550,260 1,550,260 1,591,924 ∂52,476 ∂41,664 ∂41,664 National Institute of Allergy and Infectious Diseases ............................. 4,303,640 4,359,395 4,359,395 4,447,136 ∂143,496 ∂87,741 ∂87,741 

Global HIV/AIDS Fund Transfer ....................................................... 99,200 100,000 ............................ 100,000 ∂800 ............................ ∂100,000 

Subtotal, NIAID ........................................................................... 4,402,840 4,459,395 4,359,395 4,547,136 ∂144,296 ∂87,741 ∂187,741 

National Institute of General Medical Sciences ...................................... 1,944,067 1,955,170 1,955,170 2,002,622 ∂58,555 ∂47,452 ∂47,452 National Institute of Child Health & Human Development ..................... 1,270,321 1,277,544 1,277,544 1,310,989 ∂40,668 ∂33,445 ∂33,445 National Eye Institute .............................................................................. 669,070 673,491 673,491 693,559 ∂24,489 ∂20,068 ∂20,068 National Institute of Environmental Health Sciences ............................. 644,505 647,608 647,608 667,372 ∂22,867 ∂19,764 ∂19,764 National Institute on Aging ..................................................................... 1,051,990 1,057,203 1,057,203 1,090,600 ∂38,610 ∂33,397 ∂33,397 National Institute of Arthritis and Musculoskeletal and Skin Diseases .................................................................................................... 511,157 513,063 513,063 525,758 ∂14,601 ∂12,695 ∂12,695 National Institute on Deafness and Other Communication Disorders ................................................................................................... 394,259 397,432 397,432 409,432 ∂15,173 ∂12,000 ∂12,000 National Institute of Nursing Research ................................................... 138,072 138,729 138,729 142,549 ∂4,477 ∂3,820 ∂3,820 National Institute on Alcohol Abuse and Alcoholism .............................. 438,277 440,333 440,333 452,271 ∂13,994 ∂11,938 ∂11,938 National Institute on Drug Abuse ............................................................ 1,006,419 1,010,130 1,010,130 1,035,167 ∂28,748 ∂25,037 ∂25,037 National Institute of Mental Health ......................................................... 1,411,933 1,417,692 1,417,692 1,460,393 ∂48,460 ∂42,701 ∂42,701 National Human Genome Research Institute .......................................... 488,608 490,959 490,959 502,804 ∂14,196 ∂11,845 ∂11,845 National Institute of Biomedical Imaging and Bioengineering ............... 298,209 299,808 299,808 309,091 ∂10,882 ∂9,283 ∂9,283 National Center for Research Resources ................................................. 1,115,090 1,100,203 1,100,203 1,188,079 ∂72,989 ∂87,876 ∂87,876 National Center for Complementary and Alternative Medicine ............... 122,105 122,692 122,692 126,978 ∂4,873 ∂4,286 ∂4,286 National Center on Minority Health and Health Disparities ................... 196,159 197,379 197,379 203,367 ∂7,208 ∂5,988 ∂5,988 John E. Fogarty International Center ....................................................... 66,632 67,048 67,048 68,745 ∂2,113 ∂1,697 ∂1,697 National Library of Medicine .................................................................... 315,146 318,091 318,091 327,222 ∂12,076 ∂9,131 ∂9,131 

Evaluation Tap Funding .................................................................. (8,200 ) (8,200 ) (8,200 ) (8,200 ) ............................ ............................ ............................

Subtotal, NLM ............................................................................. 323,346 326,291 326,291 335,422 ∂12,076 ∂9,131 ∂9,131 
327 

Office of the Director 3 ............................................................................. 358,047 385,195 482,216 487,434 ∂129,387 ∂102,239 ∂5,218 

Biodefense countermeasures .......................................................... ............................ ............................ (97,021 ) (97,021 ) (∂97,021 ) (∂97,021 ) ............................

Buildings and Facilities ........................................................................... 110,288 81,900 81,900 113,626 ∂3,338 ∂31,726 ∂31,726 

Total, National Institutes of Health (NIH) .................................. 28,364,515 28,509,784 28,506,805 29,414,515 ∂1,050,000 ∂904,731 ∂907,710 

Global HIV/AIDS Fund Transfer .......................................... ¥99,200 ¥100,000 ............................ ¥100,000 ¥800 ............................ ¥100,000 Evaluation Tap Funding .................................................... (8,200 ) (8,200 ) (8,200 ) (8,200 ) ............................ ............................ ............................

Total, NIH, Program Level ........................................................... (28,273,515 ) (28,417,984 ) (28,515,005 ) (29,322,715 ) (∂1,049,200 ) (∂904,731 ) (∂807,710 ) 

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION 

(SAMHSA) 

Mental Health: 

Programs of Regional and National Significance .......................... 274,297 210,213 253,257 274,297 ............................ ∂64,084 ∂21,040 Mental Health block grant .............................................................. 410,953 410,953 410,953 410,953 ............................ ............................ ............................

Evaluation Tap Funding ......................................................... (21,803 ) (21,803 ) (21,803 ) (21,803 ) ............................ ............................ ............................

Subtotal, Program level ..................................................... (432,756 ) (432,756 ) (432,756 ) (432,756 ) ............................ ............................ ............................

Children’s Mental Health ................................................................ 105,112 105,129 105,129 105,129 ∂17 ............................ ............................Grants to States for the Homeless (PATH) ..................................... 54,809 54,809 54,809 54,809 ............................ ............................ ............................Protection and Advocacy ................................................................. 34,343 34,343 34,343 34,343 ............................ ............................ ............................

Subtotal, Mental Health ............................................................. 879,514 815,447 858,491 879,531 ∂17 ∂64,084 ∂21,040 Subtotal, Program level .............................................................. (901,317 ) (837,250 ) (880,294 ) (901,334 ) (∂17 ) (∂64,084 ) (∂21,040 ) 

Substance Abuse Treatment: 

Programs of Regional and National Significance .......................... 418,066 442,752 405,131 407,791 ¥10,275 ¥34,961 ∂2,660 

Evaluation Tap Funding ......................................................... (4,300 ) (4,300 ) (4,300 ) (4,300 ) ............................ ............................ ............................

Subtotal, Program level ..................................................... (422,366 ) (447,052 ) (409,431 ) (412,091 ) (¥10,275 ) (¥34,961 ) (∂2,660 ) 

Substance Abuse block grant ......................................................... 1,696,355 1,696,355 1,696,355 1,696,355 ............................ ............................ ............................

Evaluation Tap Funding ......................................................... (79,200 ) (79,200 ) (79,200 ) (79,200 ) ............................ ............................ ............................

Subtotal, Program level ..................................................... (1,775,555 ) (1,775,555 ) (1,775,555 ) (1,775,555 ) ............................ ............................ ............................Subtotal, Substance Abuse Treatment .............................. 2,114,421 2,139,107 2,101,486 2,104,146 ¥10,275 ¥34,961 ∂2,660 Subtotal, Program level ..................................................... (2,197,921 ) (2,222,607 ) (2,184,986 ) (2,187,646 ) (¥10,275 ) (¥34,961 ) (∂2,660 ) 
328 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2005 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2006—Continued 

[In thousands of dollars] 

Item 2005 comparable Budget estimate House allowance Committee rec- ommendation Senate Committee recommendation compared with (∂ or ¥) 2005 comparable Budget estimate House allowance 

Substance Abuse Prevention: 

Programs of Regional and National Significance .......................... 198,725 184,349 194,950 202,289 ∂3,564 ∂17,940 ∂7,339 Program Management ..................................................................... 75,806 75,817 75,817 75,817 ∂11 ............................ ............................

Evaluation Tap funding (NA) ................................................. (18,000 ) (16,000 ) (16,000 ) (18,000 ) ............................ (∂2,000 ) (∂2,000 ) 

Subtotal, Program level ..................................................... 93,806 91,817 91,817 93,817 ∂11 ∂2,000 ∂2,000 Total, SAMHSA ................................................................... 3,268,466 3,214,720 3,230,744 3,261,783 ¥6,683 ∂47,063 ∂31,039 

Evaluation Tap funding ............................................ (123,303 ) (121,303 ) (121,303 ) (123,303 ) ............................ (∂2,000 ) (∂2,000 ) 

Total, SAMHSA program level ............................................ (3,391,769 ) (3,336,023 ) (3,352,047 ) (3,385,086 ) (¥6,683 ) (∂49,063 ) (∂33,039 ) 

AGENCY FOR HEALTHCARE RESEARCH AND QUALITY 

Research on Health Costs, Quality, and Outcomes: 

Federal Funds .................................................................................. ............................ ............................ 318,695 ............................ ............................ ............................ ¥318,695 Evaluation Tap funding (NA) .......................................................... (260,695 ) (260,695 ) ............................ (265,695 ) (∂5,000 ) (∂5,000 ) (∂265,695 ) 

Clinial effectiveness research (NA) ....................................... (15,000 ) (15,000 ) ............................ (20,000 ) (∂5,000 ) (∂5,000 ) (∂20,000 ) Reducing medical errors (NA) ................................................ (84,000 ) (84,000 ) ............................ (84,000 ) ............................ ............................ (∂84,000 ) 

Subtotal, Program level ..................................................... (260,695 ) (260,695 ) (318,695 ) (265,695 ) (∂5,000 ) (∂5,000 ) (¥53,000 ) 

Health Insurance and Expenditure Surveys: 

Evaluation Tap funding (NA) .......................................................... (55,300 ) (55,300 ) ............................ (55,300 ) ............................ ............................ (∂55,300 ) 

Program Support: 

Evaluation Tap funding (NA) .......................................................... (2,700 ) (2,700 ) ............................ (2,700 ) ............................ ............................ (∂2,700 ) 

Total, AHRQ ................................................................................. ............................ ............................ 318,695 ............................ ............................ ............................ ¥318,695 

Evaluation Tap funding (NA) ............................................. (318,695 ) (318,695 ) ............................ (323,695 ) (∂5,000 ) (∂5,000 ) (∂323,695 ) 

Total, AHRQ program level ......................................................... (318,695 ) (318,695 ) (318,695 ) (323,695 ) (∂5,000 ) (∂5,000 ) (∂5,000 ) Total, Public Health Service appropriation ................................ 43,019,098 41,808,243 44,522,972 46,141,247 ∂3,122,149 ∂4,333,004 ∂1,618,275 Total, Public Health Service program level ................................ (43,664,196 ) (42,450,541 ) (44,841,070 ) (46,790,545 ) (∂3,126,349 ) (∂4,340,004 ) (∂1,949,475 ) 
329 

CENTERS FOR MEDICARE AND MEDICAID SERVICES GRANTS TO STATES 

FOR MEDICAID 

Medicaid current law benefits ................................................................. 171,407,893 204,166,276 204,166,276 204,166,276 ∂32,758,383 ............................ ............................State and local administration ................................................................ 9,318,602 9,803,100 9,803,100 9,803,100 ∂484,498 ............................ ............................Vaccines for Children ............................................................................... 1,468,799 1,502,333 1,502,333 1,502,333 ∂33,534 ............................ ............................

Subtotal, Medicaid program level .............................................. 182,195,294 215,471,709 215,471,709 215,471,709 ∂33,276,415 ............................ ............................

Less funds advanced in prior year ................................... ¥58,416,275 ¥58,517,290 ¥58,517,290 ¥58,517,290 ¥101,015 ............................ ............................

Total, Grants to States for medicaid ......................................... 123,779,019 156,954,419 156,954,419 156,954,419 ∂33,175,400 ............................ ............................

New advance, 1st quarter ................................................. 58,517,290 62,783,825 62,783,825 62,783,825 ∂4,266,535 ............................ ............................

PAYMENTS TO HEALTH CARE TRUST FUNDS 

Supplemental medical insurance ............................................................ 114,002,000 128,015,000 128,015,000 128,015,000 ∂14,013,000 ............................ ............................Hospital insurance for the uninsured ...................................................... 87,000 202,000 202,000 202,000 ∂115,000 ............................ ............................Federal uninsured payment ..................................................................... 199,000 206,000 206,000 206,000 ∂7,000 ............................ ............................Program management .............................................................................. 215,000 164,000 164,000 164,000 ¥51,000 ............................ ............................General revenue for Part D benefit ......................................................... ............................ 53,596,000 53,596,000 53,596,000 ∂53,596,000 ............................ ............................General revenue for Part D administration (CMS) .................................. ............................ 357,000 357,000 357,000 ∂357,000 ............................ ............................General revenue for Part D administration (SSA) ................................... ............................ 320,000 320,000 320,000 ∂320,000 ............................ ............................HCFAC reimbursement ............................................................................. ............................ 80,000 ............................ 80,000 ∂80,000 ............................ ∂80,000 Prescription drug eligibility determinations ............................................ 105,900 99,100 99,100 99,100 ¥6,800 ............................ ............................

Subtotal, Payments to Trust Funds, current law ....................... 114,608,900 183,039,100 182,959,100 183,039,100 ∂68,430,200 ............................ ∂80,000 

Less funds advanced in prior year ................................... ............................ ¥5,216,900 ¥5,216,900 ¥5,216,900 ¥5,216,900 ............................ ............................New Advance Fiscal Year 2007 ......................................... 5,216,900 ............................ ............................ ............................ ¥5,216,900 ............................ ............................

Total, Payments to Trust Funds, current law ............................ 119,825,800 177,822,200 177,742,200 177,822,200 ∂57,996,400 ............................ ∂80,000 

PROGRAM MANAGEMENT 

Medicare reform funding 567 (NA) .......................................................... (250,000 ) (250,000 ) (250,000 ) (250,000 ) ............................ ............................ ............................Research, Demonstration, Evaluation ...................................................... 77,494 45,194 65,000 78,494 ∂1,000 ∂33,300 ∂13,494 Medicare Operations ................................................................................ 1,722,984 2,189,987 2,172,987 2,184,984 ∂462,000 ¥5,003 ∂11,997 

H.R. 3103 funding (NA) .................................................................. (720,000 ) (720,000 ) (720,000 ) (720,000 ) ............................ ............................ ............................

Subtotal, Medicare Operations program level ............................ (2,442,984 ) (2,909,987 ) (2,892,987 ) (2,904,984 ) (∂462,000 ) (¥5,003 ) (∂11,997 ) 

Revitalization plan ................................................................................... 24,205 24,205 24,205 24,205 ............................ ............................ ............................State Survey and Certification ................................................................. 258,735 260,735 260,735 260,735 ∂2,000 ............................ ............................
330 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2005 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2006—Continued 

[In thousands of dollars] 

Item 2005 comparable Budget estimate House allowance Committee rec- ommendation Senate Committee recommendation compared with (∂ or ¥) 2005 comparable Budget estimate House allowance 

Federal Administration ............................................................................. 581,493 657,357 657,357 655,000 ∂73,507 ¥2,357 ¥2,357 

Total, Program management, Limitation on new BA ................. 2,664,911 3,177,478 3,180,284 3,203,418 ∂538,507 ∂25,940 ∂23,134 Total, Program management, program level ............................. (3,384,911 ) (3,897,478 ) (3,900,284 ) (3,923,418 ) (∂538,507 ) (∂25,940 ) (∂23,134 ) 

Health Care Fraud and Abuse Control: 

Part D drug benefit/medicare advantage (MIP) ............................. ............................ 75,000 ............................ 75,000 ∂75,000 ............................ ∂75,000 Medicaid and SCHIP financial management .................................. ............................ 5,000 ............................ 5,000 ∂5,000 ............................ ∂5,000 

Total, Health Care Fraud and Abuse Control ............................. ............................ 80,000 ............................ 80,000 ∂80,000 ............................ ∂80,000 Total, Center for Medicare and Medicaid Services .................... 304,787,020 400,817,922 400,660,728 400,843,862 ∂96,056,842 ∂25,940 ∂183,134 

Federal funds ..................................................................... 302,122,109 397,560,444 397,480,444 397,560,444 ∂95,438,335 ............................ ∂80,000 

Current year .............................................................. (238,387,919 ) (334,776,619 ) (334,696,619 ) (334,776,619 ) (∂96,388,700 ) ............................ (∂80,000 ) New advance, fiscal year 2007 ................................ (63,734,190 ) (62,783,825 ) (62,783,825 ) (62,783,825 ) (¥950,365 ) ............................ ............................

Trust Funds ........................................................................ 2,664,911 3,257,478 3,180,284 3,283,418 ∂618,507 ∂25,940 ∂103,134 

ADMINISTRATION FOR CHILDREN AND FAMILIES 

FAMILY SUPPORT PAYMENTS TO STATES 

Payments to territories ............................................................................. 23,000 33,000 33,000 33,000 ∂10,000 ............................ ............................Repatriation .............................................................................................. 1,000 1,300 1,300 1,000 ............................ ¥300 ¥300 

Subtotal, Welfare payments ....................................................... 24,000 34,300 34,300 34,000 ∂10,000 ¥300 ¥300 

Child Support Enforcement: 

State and local administration ....................................................... 3,610,465 3,715,816 3,715,816 3,767,816 ∂157,351 ∂52,000 ∂52,000 Federal incentive payments ............................................................ 446,000 458,000 458,000 458,000 ∂12,000 ............................ ............................Access and visitation ...................................................................... 10,000 12,000 12,000 10,000 ............................ ¥2,000 ¥2,000 

Subtotal, Child Support Enforcement ......................................... 4,066,465 4,185,816 4,185,816 4,235,816 ∂169,351 ∂50,000 ∂50,000 Total, Family support payments program level ......................... 4,090,465 4,220,116 4,220,116 4,269,816 ∂179,351 ∂49,700 ∂49,700 
331 

Less funds advanced in previous years ........................... ¥1,200,000 ¥1,200,000 ¥1,200,000 ¥1,200,000 ............................ ............................ ............................

Total, Family support payments, current request ...................... 2,890,465 3,020,116 3,020,116 3,069,816 ∂179,351 ∂49,700 ∂49,700 

New advance, 1st quarter, fiscal year 2007 .................... 1,200,000 1,200,000 1,200,000 1,200,000 ............................ ............................ ............................

Total, Family support payments ................................................. 4,090,465 4,220,116 4,220,116 4,269,816 ∂179,351 ∂49,700 ∂49,700 

LOW INCOME HOME ENERGY ASSISTANCE PROGRAM 

Formula grants ......................................................................................... 1,884,799 1,800,000 2,006,799 1,883,000 ¥1,799 ∂83,000 ¥123,799 Emergency allocation: 

Contingent emergency allocation .................................................... ............................ 200,000 ............................ ............................ ............................ ¥200,000 ............................Emergency allocation ...................................................................... 297,600 ............................ ............................ 300,000 ∂2,400 ∂300,000 ∂300,000 

Total, Low income home energy assistance .............................. 2,182,399 2,000,000 2,006,799 2,183,000 ∂601 ∂183,000 ∂176,201 

REFUGEE AND ENTRANT ASSISTANCE 

Transitional and Medical Services ........................................................... 192,028 264,129 264,129 264,129 ∂72,101 ............................ ............................Victims of Trafficking .............................................................................. 9,915 9,915 9,915 9,915 ............................ ............................ ............................Social Services ......................................................................................... 164,888 151,121 160,000 151,121 ¥13,767 ............................ ¥8,879 Preventive Health ..................................................................................... 4,796 4,796 4,796 4,796 ............................ ............................ ............................Targeted Assistance ................................................................................. 49,081 49,081 49,081 49,081 ............................ ............................ ............................Unaccompanied minors ............................................................................ 53,771 63,083 63,083 63,083 ∂9,312 ............................ ............................

Emergency appropriations ............................................................... ............................ ............................ ............................ 19,100 ∂19,100 ∂19,100 ∂19,100 

Victims of Torture .................................................................................... 9,915 9,915 9,915 9,915 ............................ ............................ ............................

Total, Refugee and entrant assistance ...................................... 484,394 552,040 560,919 571,140 ∂86,746 ∂19,100 ∂10,221 

CHILD CARE AND DEVELOPMENT BLOCK GRANT ..................................... 2,082,921 2,082,910 2,082,910 2,082,910 ¥11 ............................ ............................SOCIAL SERVICES BLOCK GRANT (TITLE XX) ........................................... 1,700,000 1,700,000 1,700,000 1,700,000 ............................ ............................ ............................

CHILDREN AND FAMILIES SERVICES PROGRAMS 

Programs for Children, Youth and Families: 

Head Start, current funded ............................................................. 5,454,314 5,499,336 5,499,000 5,474,314 ∂20,000 ¥25,022 ¥24,686 

Advance from prior year ........................................................ (1,388,800 ) (1,400,000 ) (1,400,000 ) (1,400,000 ) (∂11,200 ) ............................ ............................Fiscal year 2007 .................................................................... 1,400,000 1,388,800 1,400,000 1,388,800 ¥11,200 ............................ ¥11,200 

Subtotal, Head Start, program level ................................. 6,843,114 6,899,336 6,899,000 6,874,314 ∂31,200 ¥25,022 ¥24,686 

Consolidated Runaway, Homeless Youth Program ......................... 88,724 88,728 88,728 88,724 ............................ ¥4 ¥4 Maternity Group Homes ................................................................... ............................ 10,000 ............................ ............................ ............................ ¥10,000 ............................Prevention grants to reduce abuse of runaway youth ................... 15,178 15,179 15,179 15,179 ∂1 ............................ ............................
332 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2005 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2006—Continued 

[In thousands of dollars] 

Item 2005 comparable Budget estimate House allowance Committee rec- ommendation Senate Committee recommendation compared with (∂ or ¥) 2005 comparable Budget estimate House allowance 

Child Abuse State Grants ............................................................... 27,280 27,280 27,280 27,280 ............................ ............................ ............................Child Abuse Discretionary Activities ............................................... 31,640 31,645 31,645 31,640 ............................ ¥5 ¥5 Community based child abuse prevention ..................................... 42,858 42,859 42,859 42,859 ∂1 ............................ ............................Abandoned Infants Assistance ....................................................... 11,955 11,955 11,955 11,955 ............................ ............................ ............................Child Welfare Services .................................................................... 289,650 289,650 289,650 289,650 ............................ ............................ ............................Child Welfare Training .................................................................... 7,409 7,409 7,409 7,409 ............................ ............................ ............................Adoption Opportunities .................................................................... 27,116 27,119 27,119 27,119 ∂3 ............................ ............................Adoption Incentive (no cap adjustment) ........................................ 31,846 31,846 31,846 22,846 ¥9,000 ¥9,000 ¥9,000 Adoption Awareness ........................................................................ 12,802 12,802 12,802 12,802 ............................ ............................ ............................Compassion Capital Fund ............................................................... 54,549 100,000 75,000 95,000 ∂40,451 ¥5,000 ∂20,000 

Social Services and Income Maintenance Research ............................... 26,012 ............................ 2,621 26,012 ............................ ∂26,012 ∂23,391 

Evaluation tap funding ................................................................... (6,000 ) (6,000 ) (8,000 ) (6,000 ) ............................ ............................ (¥2,000 ) 

Subtotal, Program level .............................................................. (32,012 ) (6,000 ) (10,621 ) (32,012 ) ............................ (∂26,012 ) (∂21,391 ) 

Developmental Disabilities Programs: 

State Councils ................................................................................. 72,496 72,496 72,496 72,496 ............................ ............................ ............................Protection and Advocacy ................................................................. 38,109 38,109 38,109 39,109 ∂1,000 ∂1,000 ∂1,000 Voting access for individuals with disabilities .............................. 14,879 14,879 14,879 14,879 ............................ ............................ ............................Developmental Disabilities Projects of National Significance ....... 11,542 11,529 11,529 11,529 ¥13 ............................ ............................University Centers for Excellence in Developmental Disabilities ... 31,549 31,548 33,548 33,548 ∂1,999 ∂2,000 ............................

Subtotal, Developmental disabilities programs ......................... 168,575 168,561 170,561 171,561 ∂2,986 ∂3,000 ∂1,000 

Native American Programs ...................................................................... 44,786 44,780 44,780 44,780 ¥6 ............................ ............................Community Services: 

Grants to States for Community Services ...................................... 636,793 ............................ 320,000 636,793 ............................ ∂636,793 ∂316,793 Community Initiative Program: 

Economic Development .......................................................... 32,731 ............................ 32,731 32,731 ............................ ∂32,731 ............................Individual Development Account Initiative ............................ 24,704 24,699 24,699 24,699 ¥5 ............................ ............................Rural Community Facilities .................................................... 7,242 ............................ 7,242 7,492 ∂250 ∂7,492 ∂250 
333 

Subtotal, Community Initiative Program ........................... 64,677 24,699 64,672 64,922 ∂245 ∂40,223 ∂250 

National Youth Sports .............................................................................. 17,856 ............................ ............................ ............................ ¥17,856 ............................ ............................Community Food and Nutrition ................................................................ 7,180 ............................ ............................ 7,180 ............................ ∂7,180 ∂7,180 

Subtotal, Community Services .................................................... 726,506 24,699 384,672 708,895 ¥17,611 ∂684,196 ∂324,223 

Domestic Violence Hotline ........................................................................ 3,224 3,000 3,000 3,000 ¥224 ............................ ............................Family Violence/Battered Women’s Shelters ............................................ 125,630 125,991 125,991 125,991 ∂361 ............................ ............................Early Learning Fund ................................................................................. 35,712 ............................ ............................ ............................ ¥35,712 ............................ ............................Mentoring Children of Prisoners .............................................................. 49,598 49,993 49,993 49,993 ∂395 ............................ ............................Independent Living Training Vouchers .................................................... 46,623 59,999 50,000 46,623 ............................ ¥13,376 ¥3,377 Abstinence Education ............................................................................... 99,198 138,045 110,000 101,000 ∂1,802 ¥37,045 ¥9,000 

Evaluation Tap Funding .................................................................. (4,500 ) (4,500 ) (4,500 ) (4,500 ) ............................ ............................ ............................

Subtotal, Program level .............................................................. (103,698 ) (142,545 ) (114,500 ) (105,500 ) (∂1,802 ) (¥37,045 ) (¥9,000 ) 

Faith-Based Center .................................................................................. 1,375 1,400 1,400 1,400 ∂25 ............................ ............................Program Direction .................................................................................... 185,210 185,217 185,217 186,000 ∂790 ∂783 ∂783 

Total, Children and Families Services Programs ....................... 9,007,770 8,386,293 8,688,707 9,000,832 ¥6,938 ∂614,539 ∂312,125 

Current Year ...................................................................... (7,607,770 ) (6,997,493 ) (7,288,707 ) (7,612,032 ) (∂4,262 ) (∂614,539 ) (∂323,325 ) Fiscal year 2007 ................................................................ (1,400,000 ) (1,388,800 ) (1,400,000 ) (1,388,800 ) (¥11,200 ) ............................ (¥11,200 ) Evaluation Tap funding ..................................................... (10,500 ) (10,500 ) (12,500 ) (10,500 ) ............................ ............................ (¥2,000 ) 

Total, Program level ................................................................... 9,018,270 8,396,793 8,701,207 9,011,332 ¥6,938 ∂614,539 ∂310,125 

PROMOTING SAFE AND STABLE FAMILIES ................................................ 305,000 305,000 305,000 305,000 ............................ ............................ ............................

Discretionary Funds ......................................................................... 98,586 105,000 99,000 90,000 ¥8,586 ¥15,000 ¥9,000 

PAYMENTS TO STATES FOR FOSTER CARE AND ADOPTION 

Foster Care ............................................................................................... 4,895,500 4,685,000 4,685,000 4,685,000 ¥210,500 ............................ ............................Adoption Assistance ................................................................................. 1,770,100 1,795,000 1,795,000 1,795,000 ∂24,900 ............................ ............................Independent living ................................................................................... 140,000 140,000 140,000 140,000 ............................ ............................ ............................

Total, Payments to States .......................................................... 6,805,600 6,620,000 6,620,000 6,620,000 ¥185,600 ............................ ............................

Less Advances from Prior Year ......................................... ¥1,767,700 ¥1,767,200 ¥1,767,200 ¥1,767,200 ∂500 ............................ ............................

Total, payments, current year .................................................... 5,037,900 4,852,800 4,852,800 4,852,800 ¥185,100 ............................ ............................

New Advance, 1st quarter ................................................. 1,767,200 1,730,000 1,730,000 1,730,000 ¥37,200 ............................ ............................

Total, Administration for Children & Families ........................... 26,756,635 25,934,159 26,246,251 26,785,498 ∂28,863 ∂851,339 ∂539,247 
334 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2005 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2006—Continued 

[In thousands of dollars] 

Item 2005 comparable Budget estimate House allowance Committee rec- ommendation Senate Committee recommendation compared with (∂ or ¥) 2005 comparable Budget estimate House allowance 

Current year ....................................................................... (22,389,435 ) (21,615,359 ) (21,916,251 ) (22,466,698 ) (∂77,263 ) (∂851,339 ) (∂550,447 ) Fiscal year 2007 ................................................................ (4,367,200 ) (4,318,800 ) (4,330,000 ) (4,318,800 ) (¥48,400 ) ............................ (¥11,200 ) Evaluation Tap funding ..................................................... (10,500 ) (10,500 ) (12,500 ) (10,500 ) ............................ ............................ (¥2,000 ) 

Total, Administration for Children & Families ........................... 26,767,135 25,944,659 26,258,751 26,795,998 ∂28,863 ∂851,339 ∂537,247 

ADMINISTRATION ON AGING 

Grants to States: 

Supportive Services and Centers .................................................... 354,136 354,136 354,136 354,136 ............................ ............................ ............................Preventive Health ............................................................................ 21,616 21,616 21,616 21,616 ............................ ............................ ............................Protection of vulnerable older americans-Title VII ......................... 19,288 19,360 19,360 20,360 ∂1,072 ∂1,000 ∂1,000 Family Caregivers ............................................................................ 155,744 155,744 155,744 160,744 ∂5,000 ∂5,000 ∂5,000 Native American Caregivers Support .............................................. 6,304 6,304 6,304 6,304 ............................ ............................ ............................

Subtotal, Caregivers ................................................................... 162,048 162,048 162,048 167,048 ∂5,000 ∂5,000 ∂5,000 

Nutrition: 

Congregate Meals .................................................................. 387,274 387,274 391,147 387,274 ............................ ............................ ¥3,873 Home Delivered Meals ............................................................ 182,827 182,826 184,656 182,827 ............................ ∂1 ¥1,829 Nutrition Services Incentive Program .................................... 148,596 148,596 150,082 148,596 ............................ ............................ ¥1,486 

Subtotal, Nutrition ............................................................. 718,697 718,696 725,885 718,697 ............................ ∂1 ¥7,188 Subtotal, Grants to States ................................................ 1,275,785 1,275,856 1,283,045 1,281,857 ∂6,072 ∂6,001 ¥1,188 

Grants for Native Americans ................................................................... 26,398 26,398 26,398 26,398 ............................ ............................ ............................Program Innovations ................................................................................ 43,286 23,843 23,843 40,513 ¥2,773 ∂16,670 ∂16,670 Aging Network Support Activities ............................................................ 13,266 13,266 13,266 13,266 ............................ ............................ ............................Alzheimer’s Disease Demonstrations ....................................................... 11,786 11,786 11,786 11,786 ............................ ............................ ............................White House Conference on Aging ........................................................... 4,520 ............................ ............................ ............................ ¥4,520 ............................ ............................Program Administration ........................................................................... 18,301 17,879 17,879 17,879 ¥422 ............................ ............................

Total, Administration on Aging .................................................. 1,393,342 1,369,028 1,376,217 1,391,699 ¥1,643 ∂22,671 ∂15,482 
335 

OFFICE OF THE SECRETARY 

GENERAL DEPARTMENTAL MANAGEMENT: 

Federal Funds .................................................................................. 179,837 172,643 172,643 182,810 ∂2,973 ∂10,167 ∂10,167 Trust Funds ..................................................................................... 5,804 5,851 5,851 5,851 ∂47 ............................ ............................

Subtotal ...................................................................................... 185,641 178,494 178,494 188,661 ∂3,020 ∂10,167 ∂10,167 

Adolescent Family Life (Title XX) .................................................... 30,900 30,742 30,742 30,742 ¥158 ............................ ............................Minority health ................................................................................ 50,518 47,236 47,236 50,980 ∂462 ∂3,744 ∂3,744 Office of Women’s Health ............................................................... 28,818 28,715 28,715 28,715 ¥103 ............................ ............................Minority HIV/AIDS ............................................................................ 52,415 52,415 52,415 52,415 ............................ ............................ ............................Afghanistan ..................................................................................... 5,952 5,952 5,952 5,952 ............................ ............................ ............................Embryo adoption awareness campaign .......................................... 992 992 992 2,000 ∂1,008 ∂1,008 ∂1,008 IT Security and Innovation Fund ..................................................... 14,695 14,630 ............................ ............................ ¥14,695 ¥14,630 ............................Evaluation tap funding (ASPE) (NA) ............................................... (39,552 ) (39,552 ) (39,552 ) (39,552 ) ............................ ............................ ............................

Total, General Departmental Management ................................ 369,931 359,176 344,546 359,465 ¥10,466 ∂289 ∂14,919 

Federal Funds .................................................................... 364,127 353,325 338,695 353,614 ¥10,513 ∂289 ∂14,919 Trust Funds ........................................................................ 5,804 5,851 5,851 5,851 ∂47 ............................ ............................Evaluation tap funding ..................................................... (39,552 ) (39,552 ) (39,552 ) (39,552 ) ............................ ............................ ............................

OFFICE OF MEDICARE HEARINGS AND APPEALS ...................................... 57,536 80,000 60,000 75,000 ∂17,464 ¥5,000 ∂15,000 OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION 

TECHNOLOGY 6 ..................................................................................... 4,318 75,000 46,100 32,800 ∂28,482 ¥42,200 ¥13,300 

Evaluation tap funding ................................................................... (19,693 ) (2,750 ) (28,900 ) (12,350 ) (¥7,343 ) (∂9,600 ) (¥16,550 ) 

Total, Health Information Tech. program level .......................... (24,011 ) (77,750 ) (75,000 ) (45,150 ) (∂21,139 ) (¥32,600 ) (¥29,850 ) 

OFFICE OF THE INSPECTOR GENERAL: 

Federal Funds .................................................................................. 39,930 39,813 39,813 39,813 ¥117 ............................ ............................

HIPAA funding (NA) ................................................................ (160,000 ) (160,000 ) (160,000 ) (160,000 ) ............................ ............................ ............................

Total, Inspector General program level ............................. (199,930 ) (199,813 ) (199,813 ) (199,813 ) (¥117 ) ............................ ............................

OFFICE FOR CIVIL RIGHTS: 

Federal Funds .................................................................................. 31,726 31,682 31,682 31,682 ¥44 ............................ ............................Trust Funds ..................................................................................... 3,287 3,314 3,314 3,314 ∂27 ............................ ............................

Total, Office for Civil Rights ...................................................... 35,013 34,996 34,996 34,996 ¥17 ............................ ............................

MEDICAL BENEFITS FOR COMMISSIONED OFFICERS: 

Retirement payments ...................................................................... 241,294 256,193 256,193 256,193 ∂14,899 ............................ ............................
336 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2005 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2006—Continued 

[In thousands of dollars] 

Item 2005 comparable Budget estimate House allowance Committee rec- ommendation Senate Committee recommendation compared with (∂ or ¥) 2005 comparable Budget estimate House allowance 

Survivors benefits ........................................................................... 14,750 15,600 15,600 15,600 ∂850 ............................ ............................Dependents’ medical care .............................................................. 74,592 56,759 56,759 56,759 ¥17,833 ............................ ............................

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

PUBLIC HEALTH AND SOCIAL SERVICE EMERGENCY FUND 

HRSA homeland security activities 3 ........................................................ 514,618 510,500 ............................ ............................ ¥514,618 ¥510,500 ............................CDC homeland security activities 3 ......................................................... 1,622,757 1,616,723 ............................ ............................ ¥1,622,757 ¥1,616,723 ............................NIH homeland security activities 3 ........................................................... 47,021 97,021 ............................ ............................ ¥47,021 ¥97,021 ............................Office of the Secretary homeland sercurity activities ............................. 63,821 83,589 63,589 63,589 ¥232 ¥20,000 ............................Other PHSSEF homeland security activities ............................................ 109,198 120,000 120,000 120,000 ∂10,802 ............................ ............................

Supplemental (Public Law 108–234) (emergency) ........................ 50,000 ............................ ............................ ............................ ¥50,000 ............................ ............................

Total, PHSSEF ............................................................................. 2,407,415 2,427,833 183,589 183,589 ¥2,223,826 ¥2,244,244 ............................Total, Office of the Secretary ..................................................... 3,244,779 3,345,370 1,037,596 1,054,215 ¥2,190,564 ¥2,291,155 ∂16,619 

Federal Funds .................................................................... 3,178,152 3,256,205 968,431 970,050 ¥2,208,102 ¥2,286,155 ∂1,619 Trust Funds ........................................................................ 66,627 89,165 69,165 84,165 ∂17,538 ¥5,000 ∂15,000 

Total, Title II, Dept of Health & Human Services ...................... 379,200,874 473,274,722 473,843,764 476,216,521 ∂97,015,647 ∂2,941,799 ∂2,372,757 

Federal Funds .................................................................... 376,469,336 469,928,079 470,594,315 472,848,938 ∂96,379,602 ∂2,920,859 ∂2,254,623 

Current year .............................................................. (308,367,946 ) (402,825,454 ) (403,480,490 ) (405,746,313 ) (∂97,378,367 ) (∂2,920,859 ) (∂2,265,823 ) Fiscal year 2007 ....................................................... (68,101,390 ) (67,102,625 ) (67,113,825 ) (67,102,625 ) (¥998,765 ) ............................ (¥11,200 ) 

Trust Funds ........................................................................ 2,731,538 3,346,643 3,249,449 3,367,583 ∂636,045 ∂20,940 ∂118,134 

TITLE III—DEPARTMENT OF EDUCATION 

EDUCATION FOR THE DISADVANTAGED 

Grants to Local Educational Agencies (LEAs): 

Basic Grants: 

Advance from prior year ........................................................ (1,883,584 ) (1,383,584 ) (1,383,584 ) (1,383,584 ) (¥500,000 ) ............................ ............................Forward funded ...................................................................... 5,547,798 5,955,508 5,452,798 5,452,798 ¥95,000 ¥502,710 ............................
337 

Current funded ....................................................................... 3,472 3,500 3,472 3,472 ............................ ¥28 ............................

Subtotal, Basic grants current year approp ..................... 5,551,270 5,959,008 5,456,270 5,456,270 ¥95,000 ¥502,738 ............................Subtotal, Basic grants total funds available ................... (7,434,854 ) (7,342,592 ) (6,839,854 ) (6,839,854 ) (¥595,000 ) (¥502,738 ) ............................

Basic Grants Fiscal Year 2007 Advance ........................................ 1,383,584 975,846 1,478,584 1,478,584 ∂95,000 ∂502,738 ............................

Subtotal, Basic grants, program level ....................................... 6,934,854 6,934,854 6,934,854 6,934,854 ............................ ............................ ............................

Concentration Grants: 

Advance from prior year ........................................................ (1,365,031 ) (1,365,031 ) (1,365,031 ) (1,365,031 ) ............................ ............................ ............................Fiscal Year 2007 Advance ..................................................... 1,365,031 1,365,031 1,365,031 1,365,031 ............................ ............................ ............................

Subtotal, Concentration Grants program level ................. 1,365,031 1,365,031 1,365,031 1,365,031 ............................ ............................ ............................

Targeted Grants: 

Advance from prior year ........................................................ (1,969,843 ) (2,219,843 ) (2,219,843 ) (2,219,843 ) (∂250,000 ) ............................ ............................Fiscal Year 2007 Advance ..................................................... 2,219,843 2,822,581 2,269,843 2,269,843 ∂50,000 ¥552,738 ............................

Subtotal, Targeted Grants program level .......................... 2,219,843 2,822,581 2,269,843 2,269,843 ∂50,000 ¥552,738 ............................

Education Finance Incentive Grants: 

Advance from prior year ........................................................ (1,969,843 ) (2,219,843 ) (2,219,843 ) (2,219,843 ) (∂250,000 ) ............................ ............................Fiscal Year 2007 Advance ..................................................... 2,219,843 2,219,843 2,269,843 2,269,843 ∂50,000 ∂50,000 ............................

Subtotal, Education Finance Incentive Grants .................. 2,219,843 2,219,843 2,269,843 2,269,843 ∂50,000 ∂50,000 ............................Subtotal, Grants to LEAs, program level .......................... 12,739,571 13,342,309 12,839,571 12,839,571 ∂100,000 ¥502,738 ............................

Even Start ................................................................................................ 225,095 ............................ 200,000 ............................ ¥225,095 ............................ ¥200,000 Reading First: 

State Grants (forward funded) ....................................................... 846,600 1,041,600 1,041,600 1,041,600 ∂195,000 ............................ ............................Advance from prior year ................................................................. (195,000 ) (195,000 ) (195,000 ) (195,000 ) ............................ ............................ ............................Fiscal Year 2007 Advance .............................................................. 195,000 ............................ ............................ ............................ ¥195,000 ............................ ............................

Subtotal, Reading First State Grants ......................................... 1,041,600 1,041,600 1,041,600 1,041,600 ............................ ............................ ............................

Early Reading First .................................................................................. 104,160 104,160 104,160 104,160 ............................ ............................ ............................Striving readers ........................................................................................ 24,800 200,000 30,000 35,000 ∂10,200 ¥165,000 ∂5,000 Literacy through School Libraries ............................................................ 19,683 19,683 19,683 19,683 ............................ ............................ ............................High School Intervention .......................................................................... ............................ 1,240,000 ............................ ............................ ............................ ¥1,240,000 ............................
338 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2005 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2006—Continued 

[In thousands of dollars] 

Item 2005 comparable Budget estimate House allowance Committee rec- ommendation Senate Committee recommendation compared with (∂ or ¥) 2005 comparable Budget estimate House allowance 

State Agency Programs: 

Migrant ............................................................................................ 390,428 390,428 390,428 390,428 ............................ ............................ ............................Neglected and Delinquent/High Risk Youth ................................... 49,600 49,600 49,600 51,000 ∂1,400 ∂1,400 ∂1,400 

Subtotal, State Agency programs ............................................... 440,028 440,028 440,028 441,428 ∂1,400 ∂1,400 ∂1,400 

Evaluation ................................................................................................ 9,424 9,424 9,424 9,424 ............................ ............................ ............................Comprehensive School Reform Demonstration ........................................ 205,344 ............................ 10,000 ............................ ¥205,344 ............................ ¥10,000 Migrant Education: 

High School Equivalency Program .................................................. 18,737 18,737 18,737 18,737 ............................ ............................ ............................College Assistance Migrant Program .............................................. 15,532 15,532 15,532 15,532 ............................ ............................ ............................

Subtotal, Migrant Education ...................................................... 34,269 34,269 34,269 34,269 ............................ ............................ ............................Total, Education for the disadvantaged .................................... 14,843,974 16,431,473 14,728,735 14,525,135 ¥318,839 ¥1,906,338 ¥203,600 

Current Year ...................................................................... (7,460,673 ) (9,048,172 ) (7,345,434 ) (7,141,834 ) (¥318,839 ) (¥1,906,338 ) (¥203,600 ) Fiscal Year 2007 ............................................................... (7,383,301 ) (7,383,301 ) (7,383,301 ) (7,383,301 ) ............................ ............................ ............................

Subtotal, forward funded ........................................................... (7,264,865 ) (8,677,136 ) (7,144,426 ) (6,935,826 ) (¥329,039 ) (¥1,741,310 ) (¥208,600 ) 

IMPACT AID 

Basic Support Payments .......................................................................... 1,075,018 1,075,018 1,102,896 1,102,896 ∂27,878 ∂27,878 ............................Payments for Children with Disabilities .................................................. 49,966 49,966 49,966 49,966 ............................ ............................ ............................Facilities Maintenance (Sec. 8008) ......................................................... 7,838 7,838 5,000 5,000 ¥2,838 ¥2,838 ............................Construction (Sec. 8007) ......................................................................... 48,544 45,544 18,000 18,000 ¥30,544 ¥27,544 ............................Payments for Federal Property (Sec. 8002) ............................................. 62,496 62,496 65,000 65,000 ∂2,504 ∂2,504 ............................

Total, Impact aid ........................................................................ 1,243,862 1,240,862 1,240,862 1,240,862 ¥3,000 ............................ ............................

SCHOOL IMPROVEMENT PROGRAMS 

State Grants for Improving Teacher Quality ............................................ 1,481,605 1,481,605 1,481,605 1,481,605 ............................ ............................ ............................

Advance from prior year ................................................................. (1,435,000 ) (1,435,000 ) (1,435,000 ) (1,435,000 ) ............................ ............................ ............................
339 

Fiscal Year 2007 ............................................................................. 1,435,000 1,435,000 1,435,000 1,435,000 ............................ ............................ ............................

Subtotal, State Grants for Improving Teacher Quality, program 

level ........................................................................................ (2,916,605 ) (2,916,605 ) (2,916,605 ) (2,916,605 ) ............................ ............................ ............................

Early Childhood Educator Professional Development .............................. 14,696 14,696 14,696 14,696 ............................ ............................ ............................Mathematics and Science Partnerships .................................................. 178,560 269,000 190,000 178,560 ............................ ¥90,440 ¥11,440 State Grants for Innovative Education (Education Block Grant) ............ 198,400 100,000 198,400 100,000 ¥98,400 ............................ ¥98,400 Educational Technology State Grants ...................................................... 496,000 ............................ 300,000 425,000 ¥71,000 ∂425,000 ∂125,000 Supplemental Education Grants .............................................................. 18,183 18,183 18,183 18,183 ............................ ............................ ............................21st Century Community Learning Centers ............................................. 991,077 991,077 991,077 991,077 ............................ ............................ ............................State Assessments/Enhanced Assessment Instruments ......................... 411,680 411,680 411,680 411,680 ............................ ............................ ............................High school assessments ........................................................................ ............................ 250,000 ............................ ............................ ............................ ¥250,000 ............................Javits gifted and talented education ...................................................... 11,022 ............................ ............................ 11,022 ............................ ∂11,022 ∂11,022 Foreign language assistance ................................................................... 17,856 ............................ ............................ 25,000 ∂7,144 ∂25,000 ∂25,000 Education for Homeless Children and Youth .......................................... 62,496 62,496 62,496 62,496 ............................ ............................ ............................Training and Advisory Services (Civil Rights) ......................................... 7,185 7,185 7,185 7,185 ............................ ............................ ............................Education for Native Hawaiians .............................................................. 34,224 32,624 24,770 34,500 ∂276 ∂1,876 ∂9,730 Alaska Native Education Equity ............................................................... 34,224 31,224 31,224 34,500 ∂276 ∂3,276 ∂3,276 Rural Education ....................................................................................... 170,624 170,624 170,624 170,624 ............................ ............................ ............................Comprehensive Centers ............................................................................ 56,825 56,825 56,825 56,825 ............................ ............................ ............................

Total, School improvement programs ......................................... 5,619,657 5,332,219 5,393,765 5,457,953 ¥161,704 ∂125,734 ∂64,188 

Current Year ...................................................................... (4,184,657 ) (3,897,219 ) (3,958,765 ) (4,022,953 ) (¥161,704 ) (∂125,734 ) (∂64,188 ) Fiscal Year 2007 ............................................................... (1,435,000 ) (1,435,000 ) (1,435,000 ) (1,435,000 ) ............................ ............................ ............................

Subtotal, forward funded ........................................................... (3,990,442 ) (3,736,482 ) (3,805,882 ) (3,821,042 ) (¥169,400 ) (∂84,560 ) (∂15,160 ) 

INDIAN EDUCATION 

Grants to Local Educational Agencies ..................................................... 95,165 96,294 96,294 96,294 ∂1,129 ............................ ............................Federal Programs: 

Special Programs for Indian Children ............................................ 19,595 19,595 19,595 19,595 ............................ ............................ ............................National Activities ........................................................................... 5,129 4,000 4,000 4,000 ¥1,129 ............................ ............................

Subtotal, Federal Programs ........................................................ 24,724 23,595 23,595 23,595 ¥1,129 ............................ ............................Total, Indian Education .............................................................. 119,889 119,889 119,889 119,889 ............................ ............................ ............................

INNOVATION AND IMPROVEMENT 

Troops-to-Teachers ................................................................................... 14,793 14,793 14,793 14,793 ............................ ............................ ............................Transition to Teaching ............................................................................. 44,933 44,933 44,933 44,933 ............................ ............................ ............................
340 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2005 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2006—Continued 

[In thousands of dollars] 

Item 2005 comparable Budget estimate House allowance Committee rec- ommendation Senate Committee recommendation compared with (∂ or ¥) 2005 comparable Budget estimate House allowance 

National Writing Project ........................................................................... 20,336 ............................ 20,336 23,000 ∂2,664 ∂23,000 ∂2,664 Teaching of Traditional American History ............................................... 119,040 119,040 50,000 121,000 ∂1,960 ∂1,960 ∂71,000 School Leadership .................................................................................... 14,880 ............................ 14,880 15,000 ∂120 ∂15,000 ∂120 Advanced Credentialing ........................................................................... 16,864 8,000 16,864 10,000 ¥6,864 ∂2,000 ¥6,864 Charter Schools Grants ............................................................................ 216,952 218,702 216,952 216,952 ............................ ¥1,750 ............................Credit Enhancement for Charter School Facilities .................................. 36,981 36,981 36,981 ............................ ¥36,981 ¥36,981 ¥36,981 Voluntary Public School Choice ............................................................... 26,543 26,543 26,543 26,543 ............................ ............................ ............................Magnet Schools Assistance ..................................................................... 107,771 107,771 107,771 107,771 ............................ ............................ ............................Choice Incentive fund .............................................................................. ............................ 50,000 ............................ ............................ ............................ ¥50,000 ............................Fund for the Improvement of Education (FIE) ......................................... 414,078 106,296 27,000 417,924 ∂3,846 ∂311,628 ∂390,924 Teacher Incentive Fund ............................................................................ ............................ 500,000 100,000 ............................ ............................ ¥500,000 ¥100,000 Ready to Learn television ........................................................................ 23,312 23,312 ............................ 25,000 ∂1,688 ∂1,688 ∂25,000 Dropout Prevention Programs .................................................................. 4,930 ............................ ............................ ............................ ¥4,930 ............................ ............................Close Up Fellowships ............................................................................... 1,469 ............................ 1,469 1,469 ............................ ∂1,469 ............................Advanced Placement ................................................................................ 29,760 51,500 30,000 33,000 ∂3,240 ¥18,500 ∂3,000 

Total, Innovation and Improvement ........................................... 1,092,642 1,307,871 708,522 1,057,385 ¥35,257 ¥250,486 ∂348,863 

SAFE SCHOOLS AND CITIZENSHIP EDUCATION 

Safe and Drug Free Schools and Communities: State Grants, forward 

funded .................................................................................................. 437,381 ............................ 400,000 300,000 ¥137,381 ∂300,000 ¥100,000 

National Programs ................................................................................... 152,537 267,967 152,537 150,000 ¥2,537 ¥117,967 ¥2,537 Alcohol Abuse Reduction .......................................................................... 32,736 ............................ ............................ 33,500 ∂764 ∂33,500 ∂33,500 Mentoring Programs ................................................................................. 49,307 49,307 49,307 49,307 ............................ ............................ ............................Character education ................................................................................. 24,493 24,493 24,493 24,493 ............................ ............................ ............................Elementary and Secondary School Counseling ........................................ 34,720 ............................ 34,720 36,000 ∂1,280 ∂36,000 ∂1,280 Carol M. White Physical Education Program ........................................... 73,408 55,000 73,408 74,000 ∂592 ∂19,000 ∂592 Civic Education ........................................................................................ 29,405 ............................ 29,405 30,000 ∂595 ∂30,000 ∂595 

Total, Safe Schools and Citizenship Education ......................... 833,987 396,767 763,870 697,300 ¥136,687 ∂300,533 ¥66,570 

Current Year ...................................................................... (833,987 ) (396,767 ) (763,870 ) (697,300 ) (¥136,687 ) (∂300,533 ) (¥66,570 ) 

Subtotal, forward funded ........................................................... (437,381 ) ............................ (400,000 ) (300,000 ) (¥137,381 ) (∂300,000 ) (¥100,000 ) 
341 

ENGLISH LANGUAGE ACQUISITION 

Current funded ......................................................................................... 84,816 43,925 ............................ 43,925 ¥40,891 ............................ ∂43,925 Forward funded ........................................................................................ 590,949 631,840 675,765 631,840 ∂40,891 ............................ ¥43,925 

Total, English Language Acquisition .......................................... 675,765 675,765 675,765 675,765 ............................ ............................ ............................

SPECIAL EDUCATION 

State Grants: 

Grants to States Part B current year ............................................. 5,176,746 4,893,746 5,326,746 5,265,546 ∂88,800 ∂371,800 ¥61,200 

Part B advance from prior year ............................................. (5,413,000 ) (5,413,000 ) (5,413,000 ) (5,413,000 ) ............................ ............................ ............................

Grants to States Part B (Fiscal Year 2007) ................................... 5,413,000 6,204,000 5,413,000 5,424,200 ∂11,200 ¥779,800 ∂11,200 

Subtotal, Grants to States, program level ................................. 10,589,746 11,097,746 10,739,746 10,689,746 ∂100,000 ¥408,000 ¥50,000 

Preschool Grants ............................................................................. 384,597 384,597 384,597 384,597 ............................ ............................ ............................Grants for Infants and Families ..................................................... 440,808 440,808 440,808 444,308 ∂3,500 ∂3,500 ∂3,500 

Subtotal, State grants, program level ....................................... 11,415,151 11,923,151 11,565,151 11,518,651 ∂103,500 ¥404,500 ¥46,500 

IDEA National Activities (current funded): 

State Personnel Development ......................................................... 50,653 ............................ 50,653 50,653 ............................ ∂50,653 ............................Special Education-Voc Rehab transition initiative ......................... ............................ 5,000 ............................ ............................ ............................ ¥5,000 ............................Technical Assistance and Dissemination ....................................... 52,396 49,397 49,397 49,397 ¥2,999 ............................ ............................Personnel Preparation ..................................................................... 90,626 90,626 90,626 90,626 ............................ ............................ ............................Parent Information Centers ............................................................. 25,964 25,964 25,964 25,964 ............................ ............................ ............................Technology and Media Services ...................................................... 38,816 31,992 31,992 38,816 ............................ ∂6,824 ∂6,824 

Subtotal, IDEA special programs ............................................... 258,455 202,979 248,632 255,456 ¥2,999 ∂52,477 ∂6,824 Total, Special education ............................................................. 11,673,606 12,126,130 11,813,783 11,774,107 ∂100,501 ¥352,023 ¥39,676 

Current Year ...................................................................... (6,260,606 ) (5,922,130 ) (6,400,783 ) (6,349,907 ) (∂89,301 ) (∂427,777 ) (¥50,876 ) Fiscal Year 2007 ............................................................... (5,413,000 ) (6,204,000 ) (5,413,000 ) (5,424,200 ) (∂11,200 ) (¥779,800 ) (∂11,200 ) 

Subtotal, Forward funded ........................................................... (6,052,804 ) (5,719,151 ) (6,202,804 ) (6,145,104 ) (∂92,300 ) (∂425,953 ) (¥57,700 ) 

REHABILITATION SERVICES AND DISABILITY RESEARCH 

Vocational Rehabilitation State Grants ................................................... 2,635,845 2,720,192 2,720,192 2,720,192 ∂84,347 ............................ ............................Client Assistance State grants ................................................................ 11,901 11,901 11,901 11,901 ............................ ............................ ............................Training .................................................................................................... 38,826 38,826 38,826 38,826 ............................ ............................ ............................Demonstration and training programs .................................................... 25,607 6,577 6,577 6,577 ¥19,030 ............................ ............................Migrant and seasonal farmworkers ......................................................... 2,302 ............................ 2,302 2,302 ............................ ∂2,302 ............................Recreational programs ............................................................................. 2,543 ............................ 2,543 2,543 ............................ ∂2,543 ............................
342 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2005 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2006—Continued 

[In thousands of dollars] 

Item 2005 comparable Budget estimate House allowance Committee rec- ommendation Senate Committee recommendation compared with (∂ or ¥) 2005 comparable Budget estimate House allowance 

Protection and advocacy of individual rights (PAIR) .............................. 16,656 16,656 16,656 16,656 ............................ ............................ ............................Projects with industry .............................................................................. 21,625 ............................ 19,735 19,735 ¥1,890 ∂19,735 ............................Supported employment State grants ....................................................... 37,379 ............................ 30,000 30,000 ¥7,379 ∂30,000 ............................Independent living: 

State grants .................................................................................... 22,816 22,816 22,816 22,816 ............................ ............................ ............................Centers ............................................................................................ 75,392 75,392 75,392 75,392 ............................ ............................ ............................Services for older blind individuals ................................................ 33,227 33,227 33,227 33,227 ............................ ............................ ............................

Subtotal, Independent living ...................................................... 131,435 131,435 131,435 131,435 ............................ ............................ ............................

Program Improvement .............................................................................. 843 843 843 843 ............................ ............................ ............................Evaluation ................................................................................................ 1,488 1,488 1,488 1,488 ............................ ............................ ............................Helen Keller National Center for Deaf/Blind Youth and Adults .............. 10,581 8,597 8,597 8,597 ¥1,984 ............................ ............................National Inst. Disability and Rehab. Research (NIDRR) ......................... 107,783 107,783 107,783 107,783 ............................ ............................ ............................Assistive Technology ................................................................................ 29,760 15,000 29,760 34,760 ∂5,000 ∂19,760 ∂5,000 

Subtotal, discretionary programs ............................................... 438,729 339,106 408,446 413,446 ¥25,283 ∂74,340 ∂5,000 Total, Rehabilitation services ..................................................... 3,074,574 3,059,298 3,128,638 3,133,638 ∂59,064 ∂74,340 ∂5,000 

SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES 

AMERICAN PRINTING HOUSE FOR THE BLIND .......................................... 16,864 16,864 17,000 18,500 ∂1,636 ∂1,636 ∂1,500 NATIONAL TECHNICAL INSTITUTE FOR THE DEAF (NTID): 

Operations ....................................................................................... 53,672 53,672 55,337 56,479 ∂2,807 ∂2,807 ∂1,142 Construction .................................................................................... 1,672 800 800 800 ¥872 ............................ ............................

Total, NTID .................................................................................. 55,344 54,472 56,137 57,279 ∂1,935 ∂2,807 ∂1,142 

GALLAUDET UNIVERSITY ........................................................................... 104,557 104,557 107,657 108,500 ∂3,943 ∂3,943 ∂843 

Total, Special Institutions for Persons with Disabilities ........... 176,765 175,893 180,794 184,279 ∂7,514 ∂8,386 ∂3,485 
343 

VOCATIONAL AND ADULT EDUCATION 

Vocational Education: 

Basic State Grants/Secondary & Technical Education: 

State Grants ........................................................................... 403,331 ............................ 403,331 403,331 ............................ ∂403,331 ............................Advance from prior year ........................................................ (791,000 ) (791,000 ) (791,000 ) (791,000 ) ............................ ............................ ............................Fiscal Year 2007 .................................................................... 791,000 ............................ 791,000 791,000 ............................ ∂791,000 ............................

Subtotal, Basic State Grants, program level .................... 1,194,331 ............................ 1,194,331 1,194,331 ............................ ∂1,194,331 ............................

Tech-Prep Education State Grants ................................................. 105,812 ............................ 105,812 105,812 ............................ ∂105,812 ............................National Programs .......................................................................... 11,757 ............................ 11,757 9,257 ¥2,500 ∂9,257 ¥2,500 Tech-Prep Education Demonstration ............................................... 4,900 ............................ ............................ ............................ ¥4,900 ............................ ............................Occupational and Employment Information Program ..................... 9,307 ............................ ............................ ............................ ¥9,307 ............................ ............................

Subtotal, Vocational Education .................................................. 1,326,107 ............................ 1,311,900 1,309,400 ¥16,707 ∂1,309,400 ¥2,500 

Adult Education: 

State Grants/Adult basic and literacy education: State Grants, 

current funded ............................................................................ 569,672 200,000 569,672 569,672 ............................ ∂369,672 ............................

National Programs: 

National Leadership Activities ............................................... 9,096 9,096 9,096 9,096 ............................ ............................ ............................National Institute for Literacy ................................................ 6,638 6,638 6,638 6,638 ............................ ............................ ............................

Subtotal, National programs ............................................. 15,734 15,734 15,734 15,734 ............................ ............................ ............................Subtotal, Adult education .................................................. 585,406 215,734 585,406 585,406 ............................ ∂369,672 ............................

Smaller Learning Communities, current funded ..................................... 4,724 ............................ 4,724 ............................ ¥4,724 ............................ ¥4,724 Smaller Learning Communities, forward funded ..................................... 89,752 ............................ 89,752 ............................ ¥89,752 ............................ ¥89,752 Community Technology Centers ............................................................... 4,960 ............................ ............................ 4,960 ............................ ∂4,960 ∂4,960 State Grants for Incarcerated Youth Offenders ....................................... 21,824 ............................ ............................ 24,000 ∂2,176 ∂24,000 ∂24,000 Literacy programs for prisoners ............................................................... 4,960 ............................ ............................ ............................ ¥4,960 ............................ ............................

Total, Vocational and adult education ....................................... 2,037,733 215,734 1,991,782 1,923,766 ¥113,967 ∂1,708,032 ¥68,016 

Current Year ...................................................................... (1,246,733 ) (215,734 ) (1,200,782 ) (1,132,766 ) (¥113,967 ) (∂917,032 ) (¥68,016 ) Fiscal Year 2007 ............................................................... (791,000 ) ............................ (791,000 ) (791,000 ) ............................ (∂791,000 ) ............................

Subtotal, forward funded ........................................................... (1,232,089 ) (215,734 ) (1,196,058 ) (1,127,806 ) (¥104,283 ) (∂912,072 ) (¥68,252 ) 

STUDENT FINANCIAL ASSISTANCE 

Pell Grants—maximum grant (NA) ......................................................... (4,050 ) (4,050 ) (4,100 ) (4,050 ) ............................ ............................ (¥50 ) 
344 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2005 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2006—Continued 

[In thousands of dollars] 

Item 2005 comparable Budget estimate House allowance Committee rec- ommendation Senate Committee recommendation compared with (∂ or ¥) 2005 comparable Budget estimate House allowance 

Pell Grants: 

Regular Program ............................................................................. 12,364,997 13,199,000 13,383,000 13,177,000 ∂812,003 ¥22,000 ¥206,000 Enhanced Pell grants for State scholars ....................................... ............................ 33,000 ............................ ............................ ............................ ¥33,000 ............................

Federal Supplemental Educational Opportunity Grants .......................... 778,720 778,720 778,720 804,763 ∂26,043 ∂26,043 ∂26,043 Federal Work Study .................................................................................. 990,257 990,257 990,257 990,257 ............................ ............................ ............................Federal Perkins Loans: Loan Cancellations ............................................. 66,132 ............................ 66,132 66,132 ............................ ∂66,132 ............................Presidential math and science scholars ................................................. ............................ 50,000 ............................ ............................ ............................ ¥50,000 ............................LEAP program ........................................................................................... 65,643 ............................ 65,643 65,643 ............................ ∂65,643 ............................

Subtotal, discretionary programs ............................................... 14,265,749 15,050,977 15,283,752 15,103,795 ∂838,046 ∂52,818 ¥179,957 Total, Student Financial Assistance ........................................... 14,265,749 15,050,977 15,283,752 15,103,795 ∂838,046 ∂52,818 ¥179,957 

STUDENT AID ADMINISTRATION 

Administrative Costs ................................................................................ 119,084 939,285 124,084 120,000 ∂916 ¥819,285 ¥4,084 Fed Direct Student Loan Reclassification (Leg prop) ............................. ............................ ¥625,000 ............................ ............................ ............................ ∂625,000 ............................LOANS FOR SHORT-TERM TRAINING ......................................................... ............................ 11,000 ............................ ............................ ............................ ¥11,000 ............................

HIGHER EDUCATION 

Aid for Institutional Development: 

Strengthening Institutions .............................................................. 80,338 80,338 80,338 80,338 ............................ ............................ ............................Hispanic Serving Institutions .......................................................... 95,106 95,873 95,873 95,873 ∂767 ............................ ............................Strengthening Historically Black Colleges (HBCUs) ....................... 238,576 240,500 240,500 240,500 ∂1,924 ............................ ............................Strengthening historically black graduate insts ............................ 58,032 58,500 58,500 58,500 ∂468 ............................ ............................Strengthening Alaska Native and Native Hawaiian-Serving Institutions ......................................................................................... 11,904 6,500 6,500 11,904 ............................ ∂5,404 ∂5,404 Strengthening Tribal Colleges ......................................................... 23,808 23,808 23,808 23,808 ............................ ............................ ............................

Subtotal, Aid for Institutional development ............................... 507,764 505,519 505,519 510,923 ∂3,159 ∂5,404 ∂5,404 

International Education and Foreign Language: 

Domestic Programs ......................................................................... 92,465 92,466 92,466 92,466 ∂1 ............................ ............................
345 

Overseas Programs ......................................................................... 12,737 12,737 12,737 12,737 ............................ ............................ ............................Institute for International Public Policy .......................................... 1,616 1,616 1,616 1,616 ............................ ............................ ............................

Subtotal, International Education & Foreign Lang .................... 106,818 106,819 106,819 106,819 ∂1 ............................ ............................

Fund for the Improvement of Postsec. Ed. (FIPSE) ................................. 162,108 22,211 49,211 162,211 ∂103 ∂140,000 ∂113,000 Minority Science and Engineering Improvement ..................................... 8,818 8,818 8,818 8,818 ............................ ............................ ............................Interest Subsidy Grants ........................................................................... 1,488 ............................ ............................ ............................ ¥1,488 ............................ ............................Tribally Controlled Postsec Voc/Tech Institutions .................................... 7,440 7,440 7,440 7,440 ............................ ............................ ............................Federal TRIO Programs ............................................................................ 836,543 369,390 836,543 836,543 ............................ ∂467,153 ............................GEAR UP ................................................................................................... 306,488 ............................ 306,488 306,488 ............................ ∂306,488 ............................Byrd Honors Scholarships ........................................................................ 40,672 ............................ ............................ 41,000 ∂328 ∂41,000 ∂41,000 Javits Fellowships .................................................................................... 9,797 9,797 9,797 9,797 ............................ ............................ ............................Graduate Assistance in Areas of National Need ..................................... 30,371 30,371 30,371 30,371 ............................ ............................ ............................Teacher Quality Enhancement Grants ..................................................... 68,337 ............................ 58,000 58,000 ¥10,337 ∂58,000 ............................Child Care Access Means Parents in School .......................................... 15,970 15,970 15,970 15,970 ............................ ............................ ............................Community college access ....................................................................... ............................ 125,000 ............................ ............................ ............................ ¥125,000 ............................Demonstration in Disabilities/Higher Education ...................................... 6,944 ............................ ............................ 6,944 ............................ ∂6,944 ∂6,944 Underground Railroad Program ............................................................... 2,204 ............................ ............................ 2,204 ............................ ∂2,204 ∂2,204 GPRA data/HEA program evaluation ........................................................ 980 980 980 980 ............................ ............................ ............................B.J. Stupak Olympic Scholarships ........................................................... 980 ............................ 980 ............................ ¥980 ............................ ¥980 Thurgood Marshall legal education opportunity program ....................... 2,976 ............................ ............................ ............................ ¥2,976 ............................ ............................

Total, Higher education .............................................................. 2,116,698 1,202,315 1,936,936 2,104,508 ¥12,190 ∂902,193 ∂167,572 

HOWARD UNIVERSITY 

Academic Program ................................................................................... 205,507 205,430 207,507 205,430 ¥77 ............................ ¥2,077 Endowment Program ................................................................................ 3,524 3,600 3,524 3,600 ∂76 ............................ ∂76 Howard University Hospital ...................................................................... 29,759 29,759 29,759 29,759 ............................ ............................ ............................

Total, Howard University ............................................................. 238,790 238,789 240,790 238,789 ¥1 ............................ ¥2,001 

COLLEGE HOUSING AND ACADEMIC FACILITIES LOANS PROGRAM: 

(CHAFL) ................................................................................................ 573 573 573 573 ............................ ............................ ............................

HBCU CAPITAL FINANCING PROGRAM—Federal Adm .............................. 210 210 210 210 ............................ ............................ ............................

INSTITUTE OF EDUCATION SCIENCES 

Research, development and dissemination ............................................. 164,194 164,194 164,194 164,194 ............................ ............................ ............................Statistics .................................................................................................. 90,931 90,931 90,931 90,931 ............................ ............................ ............................Regional Educational Laboratories .......................................................... 66,132 ............................ 66,132 66,131 ¥1 ∂66,131 ¥1 Research in special education ................................................................ 83,104 72,566 72,566 72,566 ¥10,538 ............................ ............................
346 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2005 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2006—Continued 

[In thousands of dollars] 

Item 2005 comparable Budget estimate House allowance Committee rec- ommendation Senate Committee recommendation compared with (∂ or ¥) 2005 comparable Budget estimate House allowance 

Special education studies and evaluations ............................................ ............................ 10,000 10,000 10,000 ∂10,000 ............................ ............................Statewide data systems ........................................................................... 24,800 24,800 24,800 24,800 ............................ ............................ ............................Assessment: 

National Assessment ....................................................................... 88,985 111,485 88,985 88,985 ............................ ¥22,500 ............................National Assessment Governing Board ........................................... 5,088 5,088 5,088 5,088 ............................ ............................ ............................

Subtotal, Assessment ................................................................. 94,073 116,573 94,073 94,073 ............................ ¥22,500 ............................Total, IES .................................................................................... 523,234 479,064 522,696 522,695 ¥539 ∂43,631 ¥1 

DEPARTMENTAL MANAGEMENT 

PROGRAM ADMINISTRATION ..................................................................... 419,280 418,992 410,612 418,992 ¥288 ............................ ∂8,380 OFFICE FOR CIVIL RIGHTS ........................................................................ 89,375 91,526 91,526 91,526 ∂2,151 ............................ ............................OFFICE OF THE INSPECTOR GENERAL ...................................................... 47,327 49,408 49,000 49,408 ∂2,081 ............................ ∂408 

Total, Departmental management .............................................. 555,982 559,926 551,138 559,926 ∂3,944 ............................ ∂8,788 Total: Elementary and Secondary Education Act programs ....... 24,529,212 25,504,846 23,725,884 23,779,249 ¥749,963 ¥1,725,597 ∂53,365 

TITLE III GENERAL PROVISIONS 

Pell grant shortfall payoff 9 ..................................................................... ............................ 4,300,000 4,300,000 4,300,000 ∂4,300,000 ............................ ............................

Total, Title III, Department of Education ................................... 59,212,774 63,239,040 63,706,584 63,740,575 ∂4,527,801 ∂501,535 ∂33,991 

Current Year ...................................................................... (44,190,473 ) (48,216,739 ) (48,684,283 ) (48,707,074 ) (∂4,516,601 ) (∂490,335 ) (∂22,791 ) Fiscal Year 2007 ............................................................... (15,022,301 ) (15,022,301 ) (15,022,301 ) (15,033,501 ) (∂11,200 ) (∂11,200 ) (∂11,200 ) 

TITLE IV—RELATED AGENCIES 

COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY DISABLED ................................................................................ 4,669 4,669 4,669 4,669 ............................ ............................ ............................
347 

CORPORATION FOR NATIONAL AND COMMUNITY SERVICE 

DOMESTIC VOLUNTEER SERVICE PROGRAMS 

Volunteers in Service to America (VISTA) ................................................ 94,240 96,428 96,428 96,428 ∂2,188 ............................ ............................Volunteers in Homeland Security ............................................................. 4,960 ............................ ............................ ............................ ¥4,960 ............................ ............................Teach for America .................................................................................... ............................ 4,000 2,000 ............................ ............................ ¥4,000 ¥2,000 National Senior Volunteer Corps: 

Foster Grandparents Program ......................................................... 111,424 112,058 112,058 112,058 ∂634 ............................ ............................Senior Companion Program ............................................................ 45,905 47,438 47,438 47,438 ∂1,533 ............................ ............................Retired Senior Volunteer Program ................................................... 58,528 60,288 60,288 60,288 ∂1,760 ............................ ............................

Subtotal, Senior Volunteers ........................................................ 215,857 219,784 219,784 219,784 ∂3,927 ............................ ............................

Program Administration ........................................................................... 38,688 39,750 39,750 ............................ ¥38,688 ¥39,750 ¥39,750 

Total, Domestic Volunteer Service Programs ............................. 353,745 359,962 357,962 316,212 ¥37,533 ¥43,750 ¥41,750 

National and Community Service Programs: 10

National service trust ..................................................................... 142,848 146,000 146,000 149,000 ∂6,152 ∂3,000 ∂3,000 AmeriCorps grants .......................................................................... 287,680 275,000 267,500 280,000 ¥7,680 ∂5,000 ∂12,500 Innovation, assistance, and other activities .................................. 13,227 9,945 9,945 15,945 ∂2,718 ∂6,000 ∂6,000 Evaluation ....................................................................................... 3,522 4,000 4,000 4,000 ∂478 ............................ ............................National Civilian Community Corps ................................................ 25,296 25,500 25,500 27,000 ∂1,704 ∂1,500 ∂1,500 Learn and Serve America: K–12 and Higher Ed ............................ 42,656 40,000 37,500 42,656 ............................ ∂2,656 ∂5,156 State Commission Administrative Grants ....................................... 11,904 12,642 12,642 12,642 ∂738 ............................ ............................Points of Light Foundation ............................................................. 9,920 10,000 10,000 10,000 ∂80 ............................ ............................America’s Promise ........................................................................... 4,464 5,000 5,000 5,000 ∂536 ............................ ............................

Subtotal, National and Community Service Programs ............... 541,517 528,087 518,087 546,243 ∂4,726 ∂18,156 ∂28,156 

National and Community Service, Salaries and expenses 10 .................. 25,792 27,000 27,000 66,750 ∂40,958 ∂39,750 ∂39,750 Office of Inspector General 10 .................................................................. 5,952 6,000 6,000 6,000 ∂48 ............................ ............................

Total, Corp. for National and Community Service ..................... 927,006 921,049 909,049 935,205 ∂8,199 ∂14,156 ∂26,156 

CORPORATION FOR PUBLIC BROADCASTING: 

Fiscal year 2008 (current) with fiscal year 2007 comparable ...... 400,000 ............................ 400,000 400,000 ............................ ∂400,000 ............................Fiscal year 2007 advance with fiscal year 2006 comparable 

(NA) ............................................................................................. (400,000 ) (400,000 ) (400,000 ) (400,000 ) ............................ ............................ ............................

Fiscal year 2006 advance with fiscal year 2005 comparable 

(NA) ............................................................................................. (386,880 ) (400,000 ) (400,000 ) (400,000 ) (∂13,120 ) ............................ ............................
348 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2005 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2006—Continued 

[In thousands of dollars] 

Item 2005 comparable Budget estimate House allowance Committee rec- ommendation Senate Committee recommendation compared with (∂ or ¥) 2005 comparable Budget estimate House allowance 

Rescission of fiscal year 2006 funds (NA) ........................... ............................ (¥10,000 ) ............................ ............................ ............................ (∂10,000 ) ............................

Subtotal, fiscal year 2006 program level ......................... 386,880 390,000 400,000 400,000 ∂13,120 ∂10,000 ............................

Digitalization program, current funded 11 ...................................... 39,387 ............................ ............................ 35,000 ¥4,387 ∂35,000 ∂35,000 

Previous appropriated funds (NA) 12 ...................................... ............................ (30,000 ) (30,000 ) ............................ ............................ (¥30,000 ) (¥30,000 ) 

Interconnection, current funded 11 .................................................. 39,680 ............................ ............................ 40,000 ∂320 ∂40,000 ∂40,000 

Previous appropriated funds (NA) 12 ...................................... (75,000 ) (52,000 ) (52,000 ) ............................ (¥75,000 ) (¥52,000 ) (¥52,000 ) 

Subtotal, fiscal year 2006 appropriation .......................... 79,067 ............................ ............................ 75,000 ¥4,067 ∂75,000 ∂75,000 Subtotal, fiscal year 2006 comparable ............................. (154,067 ) (82,000 ) (82,000 ) (75,000 ) (¥79,067 ) (¥7,000 ) (¥7,000 ) 

FEDERAL MEDIATION AND CONCILIATION SERVICE .................................. 44,439 42,331 42,331 43,439 ¥1,000 ∂1,108 ∂1,108 FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION .................... 7,809 7,809 7,809 7,809 ............................ ............................ ............................INSTITUTE OF MUSEUM AND LIBRARY SERVICES .................................... 280,564 262,240 249,640 290,129 ∂9,565 ∂27,889 ∂40,489 MEDICARE PAYMENT ADVISORY COMMISSION ......................................... 9,899 10,168 10,168 10,168 ∂269 ............................ ............................NATIONAL COMMISSION ON LIBRARIES AND INFO SCIENCE .................... 993 993 993 993 ............................ ............................ ............................NATIONAL COUNCIL ON DISABILITY .......................................................... 3,344 2,800 2,800 3,344 ............................ ∂544 ∂544 NATIONAL LABOR RELATIONS BOARD ....................................................... 249,860 252,268 252,268 252,268 ∂2,408 ............................ ............................NATIONAL MEDIATION BOARD ................................................................... 11,628 11,628 11,628 11,628 ............................ ............................ ............................OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION ................... 10,510 10,510 10,510 10,510 ............................ ............................ ............................

RAILROAD RETIREMENT BOARD 

Dual Benefits Payments Account ............................................................. 107,136 97,000 97,000 97,000 ¥10,136 ............................ ............................Less Income Tax Receipts on Dual Benefits ........................................... ¥7,936 ¥7,000 ¥7,000 ¥7,000 ∂936 ............................ ............................

Subtotal, Dual Benefits .............................................................. 99,200 90,000 90,000 90,000 ¥9,200 ............................ ............................

Federal Payment to the RR Retirement Account ..................................... 150 150 150 150 ............................ ............................ ............................Limitation on Administration ................................................................... 102,543 102,543 102,543 102,543 ............................ ............................ ............................

Inspector General ............................................................................ 7,196 7,196 7,196 7,196 ............................ ............................ ............................
349 

SOCIAL SECURITY ADMINISTRATION 

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

SUPPLEMENTAL SECURITY INCOME 

Federal benefit payments ........................................................................ 38,109,000 37,487,174 37,487,174 37,487,174 ¥621,826 ............................ ............................Beneficiary services ................................................................................. 45,929 52,000 52,000 52,000 ∂6,071 ............................ ............................Research and demonstration ................................................................... 35,000 27,000 27,000 27,000 ¥8,000 ............................ ............................Administration .......................................................................................... 2,986,900 2,733,000 2,897,000 2,710,400 ¥276,500 ¥22,600 ¥186,600 

Subtotal, SSI program level ....................................................... 41,176,829 40,299,174 40,463,174 40,276,574 ¥900,255 ¥22,600 ¥186,600 

Less funds advanced in prior year ................................... ¥12,590,000 ¥10,930,000 ¥10,930,000 ¥10,930,000 ∂1,660,000 ............................ ............................

Subtotal, regular SSI current year ............................................. 28,586,829 29,369,174 29,533,174 29,346,574 ∂759,745 ¥22,600 ¥186,600 Total, SSI, current request ......................................................... 28,586,829 29,369,174 29,533,174 29,346,574 ∂759,745 ¥22,600 ¥186,600 

New advance, 1st quarter, fiscal year 2007 .................... 10,930,000 11,110,000 11,110,000 11,110,000 ∂180,000 ............................ ............................

Total, SSI program ...................................................................... 39,516,829 40,479,174 40,643,174 40,456,574 ∂939,745 ¥22,600 ¥186,600 

LIMITATION ON ADMINISTRATIVE EXPENSES 

OASDI Trust Funds ................................................................................... 4,359,033 4,640,400 4,617,600 4,604,000 ∂244,967 ¥36,400 ¥13,600 HI/SMI Trust Funds .................................................................................. 1,256,968 1,704,000 1,643,100 1,704,000 ∂447,032 ............................ ∂60,900 Social Security Advisory Board ................................................................ 2,000 2,000 2,000 2,000 ............................ ............................ ............................SSI ............................................................................................................ 2,986,900 2,733,000 2,897,000 2,710,400 ¥276,500 ¥22,600 ¥186,600 

Subtotal, regular LAE ................................................................. 8,604,901 9,079,400 9,159,700 9,020,400 ∂415,499 ¥59,000 ¥139,300 

Additional CDR Funding: 

OASDI ............................................................................................... ............................ 25,000 ............................ 25,000 ∂25,000 ............................ ∂25,000 SSI ................................................................................................... ............................ 164,000 ............................ 164,000 ∂164,000 ............................ ∂164,000 

Subtotal, CDR Funding ............................................................... ............................ 189,000 ............................ 189,000 ∂189,000 ............................ ∂189,000 

SSI User Fee activities ............................................................................. 124,000 119,000 119,000 119,000 ¥5,000 ............................ ............................SSPA User Fee Activities .......................................................................... 1,000 1,000 1,000 1,000 ............................ ............................ ............................

Total, Limitation on Administrative Expenses ............................ 8,729,901 9,388,400 9,279,700 9,329,400 ∂599,499 ¥59,000 ∂49,700 

MEDICARE REFORM FUNDING 

Medicare reform funding 13 14 ................................................................. (446,054 ) ............................ ............................ ............................ (¥446,054 ) ............................ ............................
350 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2005 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2006—Continued 

[In thousands of dollars] 

Item 2005 comparable Budget estimate House allowance Committee rec- ommendation Senate Committee recommendation compared with (∂ or ¥) 2005 comparable Budget estimate House allowance 

OFFICE OF INSPECTOR GENERAL 

Federal Funds ........................................................................................... 25,542 26,000 26,000 26,000 ∂458 ............................ ............................Trust Funds .............................................................................................. 64,836 67,000 66,805 67,000 ∂2,164 ............................ ∂195 

Total, Office of Inspector General .............................................. 90,378 93,000 92,805 93,000 ∂2,622 ............................ ∂195 

Adjustment: Trust fund transfers from general revenues ....................... ¥2,986,900 ¥2,733,000 ¥2,897,000 ¥2,710,400 ∂276,500 ∂22,600 ∂186,600 

Total, Social Security Administration ......................................... 45,370,662 47,248,044 47,139,149 47,189,044 ∂1,818,382 ¥59,000 ∂49,895 

Federal funds ..................................................................... 39,687,825 40,834,644 40,809,644 40,812,044 ∂1,124,219 ¥22,600 ∂2,400 

Current year .............................................................. (28,757,825 ) (29,724,644 ) (29,699,644 ) (29,702,044 ) (∂944,219 ) (¥22,600 ) (∂2,400 ) New advances, 1st quarter ...................................... (10,930,000 ) (11,110,000 ) (11,110,000 ) (11,110,000 ) (∂180,000 ) ............................ ............................

Trust funds ........................................................................ 5,682,837 6,413,400 6,329,505 6,377,000 ∂694,163 ¥36,400 ∂47,495 

Total, Title IV, Related Agencies ................................................ 47,609,539 48,974,398 49,240,903 49,434,095 ∂1,824,556 ∂459,697 ∂193,192 

Federal Funds .................................................................... 41,807,064 42,441,091 42,791,491 42,937,188 ∂1,130,124 ∂496,097 ∂145,697 

Current Year ............................................................. (30,477,064 ) (31,331,091 ) (31,281,491 ) (31,427,188 ) (∂950,124 ) (∂96,097 ) (∂145,697 ) Fiscal Year 2007 Advance ........................................ (10,930,000 ) (11,110,000 ) (11,110,000 ) (11,110,000 ) (∂180,000 ) ............................ ............................Fiscal Year 2008 Advance ........................................ (400,000 ) ............................ (400,000 ) (400,000 ) ............................ (∂400,000 ) ............................

Trust Funds ........................................................................ 5,802,475 6,533,307 6,449,412 6,496,907 ∂694,432 ¥36,400 ∂47,495 

SUMMARY 

Federal Funds ........................................................................................... 488,978,652 586,624,660 588,183,697 590,841,346 ∂101,862,694 ∂4,216,686 ∂2,657,649 

Current year .................................................................................... (391,980,961 ) (490,877,734 ) (492,000,571 ) (494,658,220 ) (∂102,677,259 ) (∂3,780,486 ) (∂2,657,649 ) 2007 advance ................................................................................. (96,597,691 ) (95,746,926 ) (95,783,126 ) (95,783,126 ) (¥814,565 ) (∂36,200 ) ............................2008 advance ................................................................................. (400,000 ) ............................ (400,000 ) (400,000 ) ............................ (∂400,000 ) ............................

Trust Funds .............................................................................................. 12,366,339 13,587,965 13,408,876 13,594,967 ∂1,228,628 ∂7,002 ∂186,091 

Grand Total ................................................................................. 501,344,991 600,212,625 601,592,573 604,436,313 ∂103,091,322 ∂4,223,688 ∂2,843,740 

1 Funding from the Dislocated Worker National Reserve. 2 Two year availability. 3 Funds provided for biodefense activities are reflected within HRSA, CDC, and NIH respectively. 
351 

4 Includes Mine Safety and Health. 5 Funds provided in Public Law 108–173, the 2003 Medicare Prescription Drug, Improvement and Modernization Act. 6 $1 billion available for fiscal years 2004–2005. 7 $250 million available for fiscal years 2005–2008. 8 An additional $50 million for Health IT within AHRQ. 9 Part of the HEA reauthorization budget request. 10 Fiscal year 2006 House jurisdiction change account moved from former VA–HUD Appropriations. 11 Current funded. 12 Requested funds for these activities are from previously appropriated funds. 13 Funds provided in Public Law 108–173, the 2003 Medicare Prescription Drug, Improvement and Modernization Act and are available in fiscal year 2004 and 2005. 14 Funds required to continue implementing this Act are provided under the regular LAE account. 

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